The straight jacket and the padded cell offered ways to stop a patient hurting themselves - and were miles ahead of the previous chaining to a wall. It could be argued that today's medication is used as a drug based straight jacket, and not so far away from the past when times are desperate and someone needs to be kept safe.
All these reflections prompted me to pull out the information I got from local archive services in Surrey about the asylum my great grandfather worked for. He started in the epileptic colony in Epsom. I assume that without the meds now available that people had uncontrolled fits, and
increasing damage to the brain, but they were noted as different to the other patient groups. My great grandfather worked there before the First World War and returned to it after his war service. In time it became a space that accepted voluntary patients with hope of recovery (a novel idea previously) early users of talking therapies, then later became a home for those with learning disabilities.
Looking through that information again I noted a comment that 'From 1918 - Jan 1927 the institution served as a war hospital and treatment for neurasthenic ex-servicemen and administered by the Ministry of Pensions'. I don't remember looking it up before but was curious about what 'neurasthenic' meant. Google replied with -
Definition of neurasthenia
- : a condition that is characterized especially by physical and mental exhaustion usually with accompanying symptoms (such as headache and irritability), is of unknown cause but is often associated with depression or emotional stress, and is sometimes considered similar to or identical with chronic fatigue syndrome
I found that fascinating - that back then they had a name for something that looked like Chronic Fatigue Syndrome or ME, and ex soldiers were prone to it. ME was also linked to 'Gulf War Syndrome' as soldiers returning struggled with it. Labels of things that aren't understood are very woolly, and neurasthenic might include some expressions of what today we would consider Post Traumatic Stress Disorder (PTSD).
Whatever it described I am left pondering the possibility of my great grandfather working with those having CFS as I have experienced, and as the hospital went from epileptic colony to general mental health, maybe with those with bipolar (or manic depressive as it used to be known). Probably just imaginative thinking, but within possibility. He reached the rank of chief charge nurse.
Today mental health services are too often effectively 'flounder in the community' rather than the dream of 'care in the community' that was plugged when the big hospitals closed. The mass institution is outdated, and the wider population needs to know us not be protected from us, but the replacement is underfunded and leaves people being abandoned in crisis because the beds are not there when needed, and all the services designed to intervene before crisis are simply not there.
We may frown on the victorian ways of responding to poor mental health and the decades following, but in the asylums there was a massive investment in care, a vision to improve from the workhouses and chaining up, a vision of country air, and meaningful occupation.
We need vision and investment again. instead we get a few dregs...