Past tense

If mental health users/survivors are to take charge of our future, then we must also regain control of our past. That past, at both individual and collective levels, has largely been appropriated, denied, controlled and reinterpreted by other powerful interests-notably medical professionals, the state, politicians, charitable organizations and the media. This has been destructive to all our futures. In recent years, the survivors’ movement has begun to challenge this rewriting of our history. In this article i want to explore one particular way of giving this challenge further concrete expression: creating a survivor-controlled museum of madness and the psychiatric system.

Now is a crucial time in our history to reclaim our past. I am focusing here on two recent events that highlight the paramount importance of recording our side of the story before it becomes too late. the first is the announcement of the sudden death of community care. Since Frank Dobson’s reported reversal of policy (“Care in the community is scrapped,” Daily Telegraph, 19 January 1998), confusion and uncertainty have surrounded future policy. Best guesses point to a reinforcement of failed medical solutions, without adequate financing, as the likely way forward.

For service users, community care has been the most chequered and ambiguous of policies. The efforts of individual survivors, survivor organizations, allies and supportive practitioners have meant the winning of some genuine gains in policy and provision. Rights, involvement and empowerment have been forced onto the agenda. But, crucially for mental health users, community care has been a public relations disaster. Its inadequate implementation and under-resourcing have set back by a generation both public perceptions of madness and distress and how many service users may see themselves. The most appalling Victorian stereotypes of subhumanity, dangerousness and axe-wielding murder have been reinforced with all the power and subtlety of the modern media. It is probably difficult to overestimate the destructive effects that this has, both for current mental health service users and for anyone facing madness or mental distress for the first time.

The rather more specific event that highlights the need for a user-created history has been the “celebration” of the 750th anniversary of Bedlam. We might have expected that a history that from its earliest days reveals a familiar catalogue of inquiries, scandals, abuse and inhumanity would be approached with the same sadness and solemnity as any other past inhumanity or oppression. Instead it has become an opportunity, complete with commemorative mug, keyring, paperclip and teeshirt, for reinforcing professional pride and the brand identity of a medical product that, by its users’ accounts, has more to correct than to be proud of. Perhaps most disturbing of all has been its associated exhibition. This is presented in classic modernist terms of centuries of progress, culminating in modern psychiatry and the Maudsley Hospital.

It is made all the worse because it is given the respectability of being housed in the Museum of London, which generally shows a sensitivity to issues of difference and discrimination. The current psychiatric orthodoxy that “genes contribute to most mental illness” is presented as fact. The experience of thousands of inmates is reduced to a handful of indecipherable photographs posed in hospital wards and grounds, and select biographies of the famous and curious few. P> The commemoration and exhibition are disturbing snapshots of how powerful dominant versions of psychiatry remain, despite the emergence of survivors’ organizations and movements. they offer a warning, but it is one that survivors and mental health service users’ organizations are heeding. One of the good things that has come out of the commemoration has been the direct action by survivors, and the news coverage that it has sparked. This is just one expression of a much bigger survivors’ culture that has flowered in recent years, reflected in our own poetry, art, photography and creative writing, our own accounts and biographies, our own analyses, evaluations and training materials-and our own histories of ourselves and our movement. But the Bedlam revival, like the current shift in government policy, is a reminder of just how much more survivors still have to do, with less power, credibility and money than the psychiatric system.

There is also another cause for concern. When the psychiatric hospitals and asylums have gone and the last of the thousands who spent decades in them are dead, how will people know what life was really like for their inmates? How will the scale of suffering and physical, mental and sexual abuse within them be remembered? What sanitized accounts of the aims and regimes of these institutions will be offered? Many of them have already been demolished. Others are being recycled as industrial units and private housing. The biggest psychiatric hospital in the world was recently advertised in the Sunday Times as “a rare and unique opportunity to acquire luxury apartments in a period-listed building, set within 30 acres of woodland,” with no mention of its original function-its history deliberately hidden.

One of these institutions should be preserved as living testimony of the experience of the generations who lived and died within their walls. There have already been some attempts to create institutional museums, for example at the Stanley Royd Hospital, the old “West Yorkshire Pauper Lunatic Asylum” and at Calderstones Hospital. But what, crucially, should distinguish this initiative is that it is planned, established and run under the control of psychiatric system survivors and our organizations. Then the possibility of perpetuating professional accounts or becoming another peep show is minimized. It could also build on work that survivors have already done, putting together our accounts in exhibitions, books, news and broadcast media. Such a memorial could collect and house

  • the accounts and testimony of psychiatric system survivors over the years;
  • a developing archive of survivor material;
  • survivors’ mementoes; and
  • artifacts of psychiatry and its institutions.

It could reflect the different periods in the history of psychiatry, from the insane asylums of the last century, to the chemical-based warehouse psychiatric hospitals of the second half of the twentieth century. It could make a strong case for lottery funding-unusual in being strong on heritage and “user involvement”!

For some survivors, the idea of retaining the bricks and mortar of even one psychiatric hospital may be too painful and they want them all razed to the ground. This view demands respect, but will future generations be able to conceive of what these grim institutions were really like without any presence to remind them? Wouldn’t it have been easier to deny the holocaust if the remains of the extermination camps had been destroyed, as the Nazis intended?

Such institutions are the embodiment of both the failure and the cruelty of the medical model of madness. Reclaiming one as a home for our history gives us an opportunity to tell our truths-to show how badly psychiatry failed, and to ensure that there can be no going back.

Peter Beresford works with the Open Services Project and at Brunel University, and is a member of Survivors Speak Out. If you are interested in the museum proposal, or have any comments or ideas to offer about it, please write to Peter Beresford c/o OpenMind.

-With permission by Peter Beresford


Whose Stories?

As Peter Beresford (“Past tense” OM91) points out, many existing “historical accounts” of psychiatry and psychiatric institutions are problematic, based as much on assumptions and professional prejudices as on objective facts. On the other hand, there are some accounts by mental health professionals (such as David Clark’s work on Fulbourn) that offer valuable insights into how and why mental health services have developed in particular ways. Thus, Peter Beresford’s suggestion that the solution to this problem is for users to develop a competing historical narrative seems misguided. this would simply leave us with two opposing historical accounts with similar methodological flaws and biases.

what is required is collaborative historical research, bringing together service users, mental health professionals and “neutral” historians and social scientists. Then, the privileged knowledge of both mental health service users and professionals may be taken into consideration and the contribution that both groups can make to our historical understanding may be acknowledged.

John Hopton

School of Social Work, University of Manchester

Peter Beresford is right about “the need for a survivor-controlled museum of madness.” Yesterday a friend and I toured a development of hundreds of expensive houses and flats on the former site of Tooting Bec psychiatric hospital. When it closed in 1995, the hospital had been there almost 100 years. Many thousands of people had been patients there. We both used to work there, and wandering the site was a strange experience-not the slightest evidence of the hospital remained. The developer’s glossy brochure did mention that this was the site of “the famous Tooting Bec hospital.” It did not say what kind of hospital. At the very least, Lambeth Healthcare NHS Trust (former owners of the site) should have insisted on a memorial being placed there. The hospital was a grim place, but the people who lived, suffered and died there deserve to be remembered.

Peter Linnett

London SW17

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