The Mad and the Bad

As to the staff, both nurses and doctors were treating patients with a mixture of prejudice, ill-understood physical interventions such as shock therapy (in all its forms), and sedation. We all conducted our care within the provisions of the Mental Health Acts of 1959 and 1983, but the older nurses and doctors had been trained postwar. Doctors generally expected, and got, deference from patients. They got it from nurses too, though nurses could be a two-faced lot. Maybe it was the older nurses enduring influence that made psychiatric nurses enforce compliance from their patients. But from the 1960s, protest against the big forbidding madhouses became more frequent and vociferous. By the 1980s, there was a storm of coruscating reports and bitterly convincing accounts of mistreatment. So a new NHS mental health care policy was developed: Care in the Community. The old institutions would close down, and their inhabitants would be parented, so to speak, by the social security system and visits from community-based psychiatric nurses. This was not only cheaper (it got rid of those old asylums), but it also reflected liberal views of mental disorder as something that, with love and responsibility, could be lessened, while the mentally disadvantaged would have a better quality of life. Care in the Community got rid of some of the staff too, but many carried their old behavior into new jobs. This book relates my experiences between 1969 and 1989. I would like to think that psychiatric care is better now, but I dont. I think its just different.