A History of London County Lunatic Asylums & Mental Hospitals 9781399008730, 1399008730

Table of contents :
Cover
Booktitle
Copyright
Contents
Acknowledgements
Introduction
Chapter One Hanwell (1st Middlesex County Asylum / London County Asylum atHanwell / St Bernar d’s Hospital)
Chapter Two Colney Hatch (2nd Middlesex / London County Asylum / Friern Hospital)
Chapter Three Banstead (3rd Middlesex / London County Asylum)
Chapter Four Cane Hill (3rd Surrey County Asylum, later 4th London County Asylum)
Chapter Five Claybury (5th London County Asylum)
Chapter Six Bexley (7th London County Asylum aka Heath Asylum)
Chapter Seven The Epsom Cluster
Manor (6th London County Asylum of 1899)
Horton (8th London County Asylum of 1902)
St Ebba’s (9th London County Asylum and originally the EwellEpileptic Colony of 1903)
Long Grove (10th London County Asylum of 1907)
West Park (11th London County Asylum / Mental Hospital of 1924)
Glossary
Endnotes
Select Bibliography
Index
Back Cover

Citation preview

A HISTORY OF LONDON COUNTY

LUNATIC ASYLUMS &

MENTAL HOSPITALS

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A HISTORY OF LONDON COUNTY

LUNATIC ASYLUMS &

MENTAL HOSPITALS

ED BRANDON

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First published in Great Britain in 2022 by PEN AND SWORD HISTORY An imprint of Pen & Sword Books Ltd Yorkshire – Philadelphia Copyright © Ed Brandon, 2022 ISBN 978 1 39900 873 0 The right of Ed Brandon to be identified as the Author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. A CIP catalogue record for this book is available from the British Library. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without permission from the Publisher in writing. Typeset in Times New Roman 11.5/14 by SJmagic DESIGN SERVICES, India. Printed and bound in the UK by CPI Group (UK) Ltd. Pen & Sword Books Ltd. incorporates the Imprints of Pen & Sword Archaeology, Atlas, Aviation, Battleground, Discovery, Family History, History, Maritime, Military, Naval, Politics, Railways, Select, Transport, True Crime, Fiction, Frontline Books, Leo Cooper, Praetorian Press, Seaforth Publishing, Wharncliffe and White Owl. For a complete list of Pen & Sword titles please contact PEN & SWORD BOOKS LIMITED 47 Church Street, Barnsley, South Yorkshire, S70 2AS, England E-mail: [email protected] Website: www.pen-and-sword.co.uk or PEN AND SWORD BOOKS 1950 Lawrence Rd, Havertown, PA 19083, USA E-mail: [email protected] Website: www.penandswordbooks.com

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Contents

Acknowledgements������������������������������������������������������������������������������������ vi Introduction����������������������������������������������������������������������������������������������viii Chapter One Hanwell – 1st Middlesex (later London) County Asylum, aka St Bernard’s Hospital��������������������� 1 Chapter Two Colney Hatch – 2nd Middlesex (later London) County Asylum, aka Friern Hospital����������������������������� 31 Chapter Three Banstead – 3rd Middlesex (later London) County Asylum�������������������������������������������������������������������������� 54 Chapter Four Cane Hill – 3rd Surrey (later 4th London) County Asylum�������������������������������������������������������������������������� 69 Chapter Five Claybury – 5th London County Asylum����������������������� 97 Chapter Six Bexley – 7th London County Asylum, aka Heath Asylum������������������������������������������������������� 118 Chapter Seven The Epsom Cluster������������������������������������������������������ 141 Manor – 6th London County Asylum Horton – 8th London County Asylum St Ebba’s – Ewell Epileptic Colony & 9th London County Asylum Long Grove – 10th London County Asylum West Park – 11th London County Asylum/Mental Hospital Glossary�������������������������������������������������������������������������������������������������� 187 Endnotes�������������������������������������������������������������������������������������������������� 190 Select Bibliography��������������������������������������������������������������������������������� 192 Index������������������������������������������������������������������������������������������������������� 196

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Acknowledgements

Thank you to everyone reading this book. Also thank you to the following in particular whose direct help, encouragement, and/or interest in this project helped make it possible, as well as others who encouraged me by showing an interest in it, and others still who politely put up with me talking about it. Also thanks are made here to those who accompanied me on visits to asylums, helped out with information generally, or who facilitated access to certain buildings (or tried to). Special thanks to Lauren Patrick for the onerous task of her tireless initial proofreading and guidance. Also to David Brandon, Linda Brandon, Heather Birnie, Tony Lovell, Jay Gearing, Lee Mason, Tony Gibbon, Jane Brandon, Mark Game, Anne Beswick, Jo Harrison, Gina Soden, Mike Deere, Chris Swindells, Lucy Sparrow, Sally and Steve Birnie, Una Zarembo, Tom Ford, Nick Coombes, Pete Cracknell, Simon Cornwell, Marlon Bones, Cheyenne Graves, Mark and Lucy Wilsher-Grist, Neil Patrick, Linda Patrick, Chris Marshall, Emma Versen, Maciek Katsubowski, Dan Parkes, Rose Croft, Amanda Rigby, Kate Marsh, Paul Morris, Sophie Giardiniere, Alan Brooke, Prin Marshall, Michelle Cooper, Ida Sogaard-Jensen, Sarah Cady, Luke Payn, Ian Ilett, Mikey Hawes, Derek Young, Nigel Roberts, Ali Costelloe, Steve Weatherly, Mark Davis, Ted Sullivan, Dan and Kelly Crack, James Mitchell, Warren Allett, Bethen England, Matt Chapman, Chris Erskine, Nicola Latimer, Jayne Hutchinson, Lowri Jen Bate, Emma Wyn-Jones, Mike Fox at SAVE Britain’s Heritage, Eric Munro and Barbara Wood at WLTMHT, Paul Hunt at Mencap, Basra Jasvinder at NELFT, Aiden at HSE Ireland, Gill Winstanley at

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Acknowledgements

Aneurin Bevan Health Board, Cris Cristell at Norfolk & Suffolk NHS Trust, Sarah Chaney at Bethlem Museum of the Mind. Also thank you to Heather Williams, Lori Jones, and Karyn Burnham at Pen & Sword. And to those who supplied or helped with images used in this book: Marlon Bones, Nick Coombes, John R. Rifkin, Darren Robertson, Matt Spring, and the Wellcome Collection.

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Introduction

The history of organised mental health care in London has no definitive point of origin; certain charitable and religious hospitals, monasteries, and almshouses tended to adopt the role informally on a small scale, while the remainder of those suffering from mental health problems – if not accommodated and cared for by their families or immediate community – might find themselves begging on the streets if unable to work, sent to gaol or prison, or otherwise punished and persecuted if their symptoms transgressed social norms. It is not necessary to evoke specific images of the kind of persecution that would have been suffered by the ‘mad’ in medieval times, but for most it would have been brutal and unforgiving, and was usually felt to be justified on a religious basis: before the business of ‘mad-doctoring’ became a distinct profession in the eighteenth century, mental illness was almost invariably believed to be the result of failed morals, evil deeds, or possession by demonic forces, and so whatever punishment was meted out was felt to be perfectly justified. Since the county asylums discussed in this book were intended to operate in keeping with a common set of rules, regulations, and practices which changed and developed at all of them at roughly the same time – in tandem with the changes in the world around them – the author has attempted to avoid excessive repetition by covering some of the many topics in greater depth only within certain chapters. So, while each chapter acts as a separate ‘biography’ of each particular asylum, a greater understanding of the workings and history of any one of them (as well as the various differences between them) can be gained by reading all of the chapters. In regard to the historical terminology used around mental health care, the author has tried to simplify the presentation of these complicated and frequently changing terms as far as possible. Although the buildings viii

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in this book were variously referred to as ‘lunatic asylums’, ‘mental hospitals’, ‘colonies’, or simply ‘hospitals’ at various times in their service (not to mention the many informal, usually pejorative names also used), all were originally classed as county asylums. In order to avoid confusion, the author has noted when subsequent changes of name occurred but continues to refer to the buildings as either ‘asylums’ or ‘former asylums’ throughout, even when discussing an era in which that term would no longer have been formally used. Since their names changed so often, the author has also settled on the name given at the start of the chapter – ‘Colney Hatch’, for example – and continued to use the same one throughout, to provide consistency. Many of the medical terms used throughout the text are now not only outdated in a historical sense but have also gained negative or even offensive connotations over time; the history of mental health terminology is sadly littered with formal words which later entered the everyday language as terms of abuse. The author wishes to clarify strongly that no offence is intended, nor any casual attitude held toward the repetition of such terms, but has attempted to use the correct words in their once-appropriate contexts to maintain historical accuracy, rather than introducing any system of revision or sanitisation; explanations for what or whom these various terms were originally intended to describe are included within the glossary. Bethlehem Priory was founded in 1247 at London’s Bishopsgate as a resting and visiting stop for pilgrims and other Catholic figures and invariably acts as the starting point for any timeline of mental health care in Britain; over the following 150 years, it would evolve into ‘Bedlam’, and its reputation became so entrenched in the popular imagination during the following centuries that it not only became notorious itself, but also spawned its own noun in the English language. In 1377, King Richard II (1367–1400), then only 10 years old, had the ‘lunatic’ inmates of a small hospital in Charing Cross marched off to Bethlehem Priory in shackles because the noise they made was apparently disturbing the poor boy’s pet ravens, housed nearby. By 1403, ‘Bethlem’ or ‘Bedlam’ (as it came to be interchangeably known by popular truncation) was recorded to have ‘sex viri menti capti’ – six men who had lost their minds; this confirmed its adopted role had begun by then, and so either 1377 or 1403 tends to be referenced as the formal starting point of Bethlem’s evolution from a priory into a ‘lunatic hospital’. ix

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Bethlem was funded by charity, so its inmates were exempt from vagrancy laws and permitted to seek alms (to beg) in the streets under the watchful eye of their ‘keepers’ in order to help pay for their own and the institution’s upkeep. By 1509, King Henry VIII (1491–1547) sat on England’s throne and Bethlem – as a former Catholic establishment – was soon to be dissolved as part of the Reformation. The Lord Mayor of London, Sir Richard Gresham (1485–1589), convinced Henry to spare it from sale or demolition on the basis that it was no longer used for any purposes relating to the Catholic Church, giving a good indication that its role had developed and become somewhat formalised by that time. Henry bequeathed it to the Anglican Church on his deathbed, only on condition that it could never be sold, and it was henceforth run by the same committee who oversaw Bridewell Prison. Bethlem received the most meagre share of all available funds and would have been a truly miserable place of detention, with inmates shackled in stinking, fetid conditions (an open sewer ran down its centre), freezing cold in winter, and with no curative regime in place besides perhaps some occasional kindness from the keepers working there. However, the keepers appear to have been under little if any outside scrutiny, and over the decades, many came and went, with most being dismissed due to some scandal or other, including mistreatment of the inmates, stripping the hospital of whatever assets it had for a quick sale, or even selling the food and drink donated to the patients for personal profit. By 1610, the regime was somewhat more organised, and patients were brought to Bethlem by their families for ‘care’ or confinement, which was provided for a small weekly fee. It is unclear whether the majority of those committing their relatives were doing so in the genuine belief that some cure might be administered or simply to pass a ‘problem’ on to somebody else (and both scenarios likely occurred), but a thriving black market of quack tonics, potions, blessings, and tinctures developed around the building purporting to cure anything from baldness to scabies, so it must at least have gained some sort of reputation for dispensing effective cures and medical knowledge. By this time, visits for educational or ‘entertainment’ purposes were being organised too, as Bethlem lay within walking distance of London’s theatre district and other ‘attractions’: here begins its descent into the squalid circus it became during the sixteenth and seventeenth centuries before the concept of offering genuine ‘asylum’ for lunatics gained traction in the x

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medical sphere. Group tours were even organised, and paying visitors allowed to enter in order to ogle, irritate, and mock the inmates, or to study them for purposes of scientific, artistic, philosophical, or more general curiosity – all under the premise that this would at least cover the building’s running costs and feed those confined within. In 1666, the Great Fire of London destroyed Bridewell Prison (along with half the city) and so its committee had to use Bethlem’s shabby, stinking, squalid frame to conduct their meetings, which led to their overdue realisation that the old buildings were no longer fit for purpose; thus ‘New Bethlem’ was built at Moorfields in 1676. The old Bethlem was eventually demolished, and the only remaining sign of its existence now is the small blue plaque that can be seen on the side of the Great Eastern Hotel on Liverpool Street (formerly ‘Bethlem Street’), Bethlem having occupied the site where the railway station now stands. New Bethlem was the first purpose-built and permanent ‘lunatic hospital’ in the world and would form the general template for all such buildings for more than a century to come. It was considered one of the finest buildings in London by many and was then the third largest civic building in Britain, appearing in guidebooks and travelogues of the time as a ‘must see’. With its grotesque statues atop the entrance gates depicting the tortured figures of ‘raving madness’ and ‘melancholy madness’ functioning as an advert of sorts in much the same way as,

New Bethlem Asylum (Bedlam) at Moorfields, London. Engraving by unknown artist, c.1770. Collection of the author. (Public Domain)

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say, a carving of a lion might outside a zoo, it is in this second form that Bethlem truly came to be thought of as a place of entertainment and one of London’s premier ‘attractions’. Needless to say, the hordes of visitors leering, mocking and provoking the inmates seems unthinkably callous and damaging to those poor souls who instead required care and respite at the very least, but it did allow a few to become minor celebrities and earn decent coin by performing or acting as raconteurs for their ‘spectators’. To reflect on this in a positive way purely because certain inmates were forced to learn to make the best of it would be folly, but it is also true that, in most cases, New Bethlem would still have represented a considerably better fate than that to which they would be subjected on the brutal, unforgiving streets outside. While some patients pleaded to be released, others are recorded as having begged to stay in Bethlem even after formal discharge; however, this likely speaks more to the toughness of survival in London in general at that time than it does to any positive aspects of life in Bethlem.

‘Melancholy madness’ which sat atop the gates of New Bethlem from 1676 to 1810. Sculpture in Portland stone by Caius Gabriel Cibber (1630–1700). Housed at Bethlem Museum of the Mind. (Copyright Ed Brandon)

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After almost a century of fulfilling its awful role as little more than a human zoo, attitudes began to change. The superintendent of St Luke’s Hospital,1 Dr William Batty (1703–1776), introduced a regime at his institution as different to Bethlem as possible, and key to his agenda was ensuring that visitors with no ties to the patients or other legitimate business to conduct there would not be allowed inside. He also sat on the committee for New Bethlem and his efforts, along with those of other powerful men and women, particularly within the growing Quaker and Methodist movements, eventually pressured and embarrassed Bethlem into changing its ways so that it would, like St Luke’s, also come to rely only on donations and ‘subscriptions’ rather than continuing to function as little more than a sordid freak show. Toward the end of the eighteenth century, the madness of King George III (1738–1820) generated increased sympathy toward mental illness among the public as well as in some quarters of the press. Along with the ‘humane treatment’ regime adopted by Quakers at The Retreat in York (another charitable lunatic hospital), more progressive ideas began to ingrain themselves in the minds of a new generation of medical practitioners as well as among powerful reformist and philanthropist circles within society and government. While it would be incorrect to assume that the mood which led to the creation of the county asylums discussed in this book was one of pure altruism, free from any elements of class or social control, the 1808 County Asylums Act for England and Wales gave an indication of the change in thinking from its title alone; ‘asylum’ represented a new and progressive but also more curative and care-led attitude toward addressing lunacy. While Bethlem had been notoriously secretive about its regimes and practices, the County Asylums Act was the first significant attempt to amalgamate all the knowledge, thinking, and expertise developed at the handful of existing institutions across Britain and aimed to empower and guide counties to build their own. The Act attempted to comprehensively address all potential issues and perceived obstacles, advising on all manner of topics including where an asylum should ideally be located, how it should be constructed, who should be employed within it and in what capacity, how the finances might be run, the separation of the genders, treatment regimens, the classification of different types of patients, and so on. The act empowered Justices of the Peace (JPs) across Britain to use taxes to pay for the building of public county lunatic xiii

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asylums for paupers and it urged them to do so at haste. However, until the overhaul of the Act in 1845, this was merely a ‘recommendation’ and not mandatory by law, so with JPs elected by the very people whose rates would pay for any such building, the vast majority – perhaps unsurprisingly – found more reasons not to build one. After all, why should lunatics benefit from such exclusive additional expenditure when money had already been spent on gaols and workhouses into which they could be sent? This reluctance was anticipated, and the documentation suggested various measures to reduce the financial burden, including allowing smaller adjacent counties or those which had lower numbers of registered lunatics to go into partnership if appropriate, thereby sharing the cost. But despite such attempts to smooth and facilitate the process, highlight the potential benefits to law and order, and suggest where costs may be saved and the health and productivity of the population improved in the longer term, uptake was slow; Bedfordshire, for example, claimed to have surveyed all of its parishes and found that they had not one single lunatic anywhere in the county.2 Even twenty years later, only nine county asylums had been built: Nottinghamshire was the first to open its county asylum in 1812, and Bedfordshire followed it later that year. Norfolk’s opened in 1814, followed by Lancashire in 1816. The West Riding of Yorkshire and Staffordshire each opened their first county asylum in 1818, and others followed for Cornwall in 1820, Haverfordwest Borough in 1822, and Gloucestershire in 1823. Meetings between William Hone MP (1780–1842), the architect and reformist James Bevans (dates unknown), and the Quaker reformist Edward Wakefield (1774–1854) led the trio to investigate conditions at various public and private lunatic hospitals. At Bethlem in 1814, they discovered the tortured figure of James Norris, chained to a metal pipe, constricted in a straitjacket, and left in a cold, dingy cell in solitary confinement for almost a decade; and he only represented one of the worst of the myriad horrors they encountered. They presented their shocking findings to a Select Parliamentary Committee in 1815 which coincided with Norris’ excruciating death from the explosion of an impacted intestine caused by his constriction, leading to a public scandal and subsequent parliamentary inquiry which generated additional popular and political sympathy toward the idea of regulated, state-funded lunacy provision. xiv

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James Norris at New Bethlem. Coloured etching by G. Arnald, 1815. Courtesy of the Wellcome Collection. (Public Domain)

Earlier in 1814, the trio had also proposed a plan to Parliament for a ‘London Asylum’, which would have involved the purchase of forty acres of land on the outskirts of the city upon which a 400-bed asylum, built to designs by Hone and Bevans, would be constructed. Their design was a ‘radial’ plan (see Hanwell chapter) and envisioned to be run according to the ‘humane treatment’ principles practised xv

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at The Retreat – deliberately different to New Bethlem – with Hone to serve as its first superintendent. Despite the submission of their architectural plans and some funding and general interest being raised, Royal Bethlem – its third incarnation – opened at Southwark in August 1815 and was perceived as a convenient panacea to London’s need for provision and the reputation of the Bedlam of old, as well as removing any need for a county asylum proper. This drained the funding from the London Asylum project and, as Hone developed a severe illness which meant he was no longer able to contribute, the idea was abandoned. The revised County Asylums Act of 1845 made the construction of such buildings mandatory for each county and county borough, with each expected to build one large enough to house all of its registered pauper lunatics. Workhouses could also legally accommodate lunatics

The London Asylum, plans by Hone and Bevans, 1814. Collection of the author. (Public domain)

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but would eventually have to include dedicated wings or wards to house that particular category of inmate; they were also only supposed to accommodate ‘harmless’ and chronic cases, and not acute cases or those deemed to be potentially curable, suicidal, violent, or dangerous in any other way. Although this arrangement rarely worked quite as smoothly as hoped, it was generally adhered to in most counties. The first three county asylums built to serve the London area were all built by the Middlesex authorities, while the fourth was actually built by Surrey but inherited just a few years later by the new London County Council (LCC) which was formed in 1889 when London became its own county. All four were inherited by the LCC, who went on to complete Middlesex’s planned Claybury Asylum and build a further six themselves. This book covers those eleven buildings formally referred to as ‘London County Asylums’ between 1889 and 1930, and not the Metropolitan Asylums Board institutions, converted workhouses, or any of the other buildings in the London area which also performed roles in mental health provision. From the 1970s onward, areas of jurisdiction and the names of the various health authorities which oversaw the former asylums tended to change quite frequently. The author acknowledges that his coverage of this particular aspect of their late history is not exhaustive in relation to any given building, believing that such minor yet frequently occurring details – relating as they do more to opaque bureaucratic systems than the buildings themselves or what occurred within them – would likely be neither essential nor particularly interesting for the majority of readers. While many modern psychiatric units exist today on what was once a county asylum’s grounds or estate, among the 120-odd3 county asylums that once stood, there are now only a tiny handful at which a part of the original structures (if any remain at all) are still used for psychiatric in-patient services; there are two or three others that retain some small outpatient facilities, and a few others that retain some part of the old buildings for non-psychiatric medical use. Discussion regarding the closure of the former county asylums – and whether or not they should have been run down at all and how that process might have been better or differently handled if so – tends to be extremely divisive and represents a hugely complex topic that could not be addressed here in its due depth. It is a matter of fact that numerous medical procedures as well as many social or medical ideas and concepts now quite rightly considered xvii

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abhorrent were made manifest within the walls of the county asylums. From the everyday abuses and neglect which occurred unseen or simply ignored, to the tortures, indignities, and even mutilations once so confidently dispensed as convenient solutions (if not cures), including but not limited to leucotomies, focal infection therapy, aversion therapy, etc., hubristic and all-powerful doctors subjected thousands of patients to damaging and dehumanising practices which often appear to have placed the patients’ physical health – and indeed their very lives – secondary to those same men’s overwhelming desire to ‘win’ the battle with madness at any cost to the individual. Whether or not they truly believed they were doing the right things for the right reasons becomes immaterial given the price others ultimately paid for their misplaced confidence or curiosity. But the simple question of whether the county asylums were a good or bad thing overall is not quite so straightforward to answer without bias, because any answer would necessarily depend on who was being asked. By the standards of differing eras, any given asylum might, for example, have been relatively comfortable and well managed in 1890, then overcrowded and insanitary by 1930, and perhaps have offered a productive and therapeutic regime to willing, voluntary patients by 1980. In many real-life examples, the geriatric wards were dirty, neglected, and staffed by miserable, demoralised workers in, say, 1970, while acute patients at the same institution at the same time benefited from cheerful decor and the latest therapies administered by positive, optimistic, and inclusive staff in another ward-block only fifty yards away. Any review or summary of the value of the county asylums would therefore also be biased by what any given patient experienced, and how that related to what they believed they would have experienced had they not been there – how and why they felt their time in a county asylum had either benefited or blighted their lives as an individual. Unfortunately, for the first 150 years or so, such questions were rarely asked of the patients themselves (and usually not often enough even after that), at least not in any way which really allowed their voices to be heard, but examples do crop up throughout history. The narrative regarding the role of asylums in general has become an almost completely negative one over the years, largely because the horror stories tend to be the more marketable ones, and because the image of the Gothic Victorian lunatic asylum undeniably lends itself xviii

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to exaggerated or purely fictional horror stories a lot more naturally than it does to cheerful ones. But more hopeful examples do exist from all points in time, with positive evaluations to be found as far back as Bedlam and others, albeit admittedly scarcer, to be mined from any period one cares to examine. The author has spoken in person to former patients who spent time in one or another of the former county asylums during comparatively recent times, as well as listening to and reading the stories of others from further back, and while some certainly repeat the horrors one is more used to hearing, not all do. A hybrid summary of several first-hand stories told to the author directly would amount to a paraphrase something along the lines of: ‘I hated being put in there, and I hated the place itself, but it was what I needed at the time, and it worked for me: I don’t know if I would still be alive today otherwise.’ Others speak of the relief they felt at not having to think about or deal with anything else outside the asylum and its beautiful grounds, and of the sense of acceptance and lack of judgement which came from being part of a group of other people who were – to one degree or another – ‘in the same boat’, as opposed to the solitary and isolated journey many experience today. Such alternate perspectives and some occasional positive stories are included here not in order to present any overall argument one way or the other, nor to dismiss, reduce, or justify the very real negative experiences of any other patient at any point in history, but rather to introduce a sense of balance which appears to be almost always lacking from popular writing on this topic; if the author were to relate a history in which every patient’s experiences of a county asylum were wholly bad, he would not be relating the results of his research accurately. The author also wishes to acknowledge that in reference to these buildings – particularly from an architectural and aesthetic angle – he may appear to be indirectly praising or lamenting a system from which many feel no aspect at all should be savoured. But if there is lamentation of anything, it is in regard to what else besides neglect and eventual destruction could have been for so many of these fine, high quality buildings, and what they might have been able to offer the communities around them had a little more imagination and forward-thinking been applied. The buildings themselves were powerful and often beautiful statements of skill, craftsmanship, and a sense of investment in the future that seems so sorely lacking from either architecture or healthcare today. xix

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In that regard, it most certainly is a lamentation of the system that has replaced them – another topic too large to be covered here – but suffice to say that the author wishes he were able to conclude that even if we did not always give the buildings themselves due consideration, we had at least replaced the service they were intended to provide with something unarguably better. While the closure of the asylums undoubtedly led to immeasurably improved conditions and prospects for many patients, that was certainly not – and still is not – the case for many, many others. In the space of fifty years, Britain moved from a preposterous situation of institutionalisation and stagnant over-provision where, in the 1950s, almost one in every 350 people lived in a former county asylum or other psychiatric institution – a great many of whom should never have been there at all – to one where it is frequently unable to provide even a basic service for those who really need it. London had eleven county asylums with almost 25,000 beds between them at peak. On 27 October 2020, The Guardian reported on a teenage girl with mental health problems in Lancashire (which once had around 12,000 asylum beds of its own), who was violent as well as suicidal, and obviously in dire need of help. Instead, she had to be held in a police cell, with no proper care or treatment at that critical and possibly lifechanging time for her, because not one available psychiatric in-patient bed could be found anywhere in the whole of Britain.

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Chapter One

Hanwell (1st Middlesex County Asylum / London County Asylum at Hanwell / St Bernard’s Hospital) Uxbridge Road, Hanwell, London, UB1 3EU

Even after the passing of the 1808 County Asylums Act, those responsible for lunacy provision in London were satisfied that it was already adequately served by its two charitable public asylums: Bethlem and St Luke’s. By the mid-1820s, however, both were overcrowded and had ever-growing waiting lists. At the same time, prisons and workhouses were becoming increasingly difficult to run while accommodating the overspill of ‘lunatics’ requiring specialised treatment and management, as they had never been designed for such provision. Robert Gordon MP (1786–1859) arranged the 1827 Select Committee on Middlesex Pauper Lunatics, which in turn led to the planning of the county’s first pauper lunatic asylum, with a catchment area primarily covering London. With James Clitherow (1766–1841) as its chairman, another committee was then formed to scout for suitable locations and commission the design, staffing, and construction of the building. Seventy-four acres of land were purchased near the small village of Hanwell in what was then rural Middlesex to the southwest of London, with building work beginning in 1829. The site was within reach of London by carriage but deliberately positioned some distance from the main conurbation; at that time, around eight miles of mostly open countryside lay between them, with the nearest market town being Brentford. Perceived advantages to the chosen site included its position next to the Uxbridge Road atop a slight rise overlooking the surrounding land, and that its southern border sat adjacent to the Grand Junction Canal, which would be a considerable boon to the massive construction effort required, as well as useful for the ongoing delivery of goods and supplies. 1

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A Quaker architect named William Alderson (d. 1835), submitted the winning design, showing a surprising level of foresight and innovation in regard to this fledgling building type; he appears to have never designed anything remotely similar before and his only other known work was the modest Stoke Newington Quaker Meeting House of 1828 (demolished in 1959). The scant information regarding Alderson’s life and other works is perhaps accounted for by his early death so shortly after the completion of what would certainly have been his most prestigious project. By 1829, only four significant variations of asylum layout had emerged, with most adhering to the earliest ‘linear corridor’ plan, which saw ward blocks placed in a straight line on either side of a central administrative block, usually with some service buildings (kitchens, laundry, etc.) behind that, and while there had been some minor variations, all were based on the same general concept. Two examples of a second type known as the ‘radial plan’ had been built – one for the Glasgow City Asylum of 1814 and the other for St Lawrence’s (Cornwall County Asylum of 1820) – and there was one single example of a third: the crescent-shaped ‘spa plan’ used for Horton Road (Gloucestershire County Asylum of 1823). The ‘radial plan’ was quickly written off for use at asylums as it was largely based on the thinking around prison and workhouse design, where security and ease of management were prioritised above the inmates’ cure and comfort. Consisting of a central hub with the wings radiating out like the spokes of a wheel, it did allow for easy observation, security, and separation of the patients, but the closer any given patient was to the point at which the wings connected to the central hub, the narrower the gap between one wing and the next and therefore the less fresh air, sunlight, and breadth of view they would enjoy throughout the day; all aspects which had become key to asylum design. By the 1820s, it had become more widely accepted that lunatics should not be incarcerated as a form of punishment and this shift toward considering the welfare of the patients as well as ease of management is evident in Hanwell’s progressive layout. By the time Alderson would have been looking for inspiration, Watson & Pritchett’s design for Stanley Royd (West Riding County Asylum of 1818) was by far the most influential example; it was the fourth type of asylum layout to develop and the first ‘perpendicular corridor plan’ or ‘H’ plan, laid out in roughly the shape of a letter H if viewed from above. This rearrangement allowed 2

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architects to scale up the overall size of an asylum and incorporate additional ward space while curtailing the building’s need to sprawl over the kinds of distances they would need to if built in one long single line, as with the ‘linear corridor’ design. Alderson expanded on this idea both conceptually and literally, applying the same logic to the considerably larger building at Hanwell. He avoided some of the light restrictions the bisecting wings at West Riding caused by spreading them over a wider area, meaning a larger proportion of the galleries and day-rooms where the patients would spend their waking hours would catch the sun from the south. Its staggered perpendicular design also reduced the distance between the administrative centre and the furthest-flung wards; Hanwell would have been nearly a third of a mile end-to-end had it been laid out to a linear plan. It was also cleverly arranged to make future expansion as practical as possible, and while this reflected the grim expectation that the number of spaces required for lunatics would only continue to grow, it was another innovation on Alderson’s part that was far ahead of its time. Each of Hanwell’s octagonal towers (as seen in the aerial image) was three storeys high and 80ft in diameter and included a central spiral staircase by which an attendant could travel between floors and wards at speed (another idea Alderson borrowed from the West Riding Asylum). Each tower also had a ventilation shaft at the top, which could be opened and closed mechanically to allow fresh air to be moved through the building more freely. One tower punctuates the centre of the building, separating it into its female (west) and male (east) divisions while also serving as the administration block. This originally contained a meeting room for the committee, the superintendent’s and matron’s rooms, offices, the original chapel, and day rooms for the wards connected to it. The two other towers sat at symmetrical junctures on either division of the building, and the western one originally held communal areas for patients, an office and surgery for the surgeon, a sub-matron’s room, and two waiting rooms with connecting ‘receiving rooms’ for visitors. In the eastern tower on the male side, another surgery and an office were provided, while the basement contained working spaces for the joiners, coopers, painters, glaziers, and brush-makers. The whole site was originally surrounded by a tall brick wall and the main entrance from the Uxbridge Road to the north consisted of a 3

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Plan of Hanwell Asylum. From A Treatise on the Nature, Symptoms, Causes, and Treatment of Insanity by Sir William Charles Ellis (Samuel Holdsworth, 1838). Courtesy of the Wellcome Collection. (Public domain)

very solid and somewhat intimidating archway, closed to the outside world with heavy iron gates. Hanwell’s stout exterior acted as a physical and psychological dividing line between the world outside and the one within and was intended to be as much a message of reassurance to those beyond as it was a deterrent to any potential escapee. To either side of the arch were small single-storey lodges, one to receive male patients and the other to receive females. 4

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Entrance gates at Hanwell with lodges at either side. (Copyright Ed Brandon)

Visitors or patients would then travel up the 700ft driveway to the main building and see the staggering 1,000ft width of Hanwell loom into view, filling up the horizon before them. As they drew closer toward the main entrance, the protruding northern wings would enclose them on either side, eventually sealing off the view of anything but the asylum itself. It is not hard to imagine how intimidating Hanwell must have appeared to the widened eyes of a visitor in early Victorian times, let alone a patient; besides perhaps a cathedral, it would have likely been the largest building most had ever seen. Hanwell opened on 16 May 1831 to twenty-four male and eighteen female patients, and its population grew rapidly over the following decades. At that time, it was the largest building of its type in the world and the first of the truly immense asylums which would become such a domineering presence in the physical and psychological landscape of Britain for more than a century and a half to come. It was built in a muted neoclassical style from yellow London stock brick, with the towers being three storeys high and the wards originally two (later expanded to three) storeys. The central tower – aside from its unusual octagonal shape – was quite plain, featuring a simple arched doorway with a stone pediment, 5

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brick window arches, and banding of a lighter coloured brick among few decorative touches, although a clock enclosed in a wooden housing originally sat at its top. The wards were of similarly plain design, generally divided into individual cells and dormitories on the north side, with day-rooms facing south. Large, walled airing courts faced the canal to the south (which was blocked off to patients by the high boundary wall), and fields lay to the east and west where patients would assist with tending the land, grazing cattle, and growing crops for use at the asylum. The county asylums were designed to be as close to a self-sufficient ‘micro community’ as possible, and at the time, Hanwell took this concept further than any other, incorporating a brewery, bakery, apothecary, tailor, cobbler, upholsterer, forge, piggery, carpentry shop, plumber’s shop, tin shop, surgery, glazier, library, and cooper as well as printing rooms, stables, and kitchen gardens; areas for a dentist, photographer, and optician were introduced later. There were also farm buildings, including a cow house, hen house, and aviary, a fire

Hanwell Asylum as depicted in The Illustrated London News, c.1860. Collection of the author. (Public domain)

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station, and the asylum’s own gasworks. For outdoor recreation, there were bowling and croquet greens and pleasant shaded walks around the grounds. A mortuary (or ‘dead house’, as originally described) sat near the canal, along with a burial ground. Death rates during Hanwell’s early years would be most troubling by today’s standards: 1,324 patients left the asylum between 1831 and 1841, 585 of whom were discharged as ‘relieved’ or ‘cured’, while 739 had died. So, more patients left the asylum in a wooden box during its first decade of operation than were ‘cured’. However, this was not high in comparison to similar institutions of the time, and for the most part, reflected the high death rates among paupers across Britain, heightened by the types of injury, disease, and suicidal tendencies those committed to asylums tended to bring with them. The 1832 Anatomy Act had loosened the strict rules surrounding the dissection of corpses for medical study, and Hanwell would put this new legislation to immediate use, helping to cover the asylum’s running costs by selling the bodies of deceased patients for dissection by surgeons, scientists, medical colleges, and universities. The 1752 Murder Act stated that only convicted criminals who had been sentenced to death could be dissected legally. Perhaps contrary to popular belief, the number of state executions dropped consistently throughout the early nineteenth century, while demand for bodies to dissect in the name of science and medicine steadily increased. The simple laws of supply and demand dictated the market as ever, and a soaring cash value led to attractive sums of money being surreptitiously exchanged for fresh cadavers on a ‘no questions asked’ basis. The lure of these escalating prices predictably resulted in a black market which saw ‘body-snatchers’ or ‘resurrectionists’ (including Edinburgh’s notorious Burke and Hare) resorting to more ‘creative’ methods by which to acquire fresh corpses to sell. At first, this simply meant acquiring bodies wherever they could, regardless of legality or permission, which inevitably led to the conclusion that graveyards were pretty reliable places to find the dead. As the ghoulish practice of digging up the freshly buried was increasingly reported in the press, wars of attrition played out in graveyards up and down Britain, with families of the recently deceased forced to keep torch-lit vigils by their loved ones’ graves until the body had lain underground long enough to make its sale as a ‘fresh’ specimen impossible. 7

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Over time, angry mobs accosting anyone seen loitering around graveyards, coupled with patrols by Sir Robert Peel’s then-new ‘police force’ made the acquisition of bodies from graveyards increasingly risky. Perhaps inevitably, this led a handful of the more unscrupulous criminals to conclude that it might be easier to simply create their own fresh corpses from scratch, and so clumsy ‘anatomy murders’ were committed to feed the demand. Hanwell’s nearest posse were known as the ‘London Burkers’: a gang of four men operating from the Bethnal Green area who would eventually confess to stealing or exhuming up to a thousand bodies between them over a twelve-year period to sell to surgeons at the most prestigious London hospitals and colleges. They were eventually arrested for the murder of a woman and her baby, along with the killing of two young boys; the victims’ bodies had all been sold to hospitals in London, save for the last boy whose corpse aroused the suspicion of a surgeon at King’s College School of Anatomy. While the surgeon would have been fully aware of the body’s questionable provenance, he notified the police when he realised the boy had obviously never been buried to begin with. The Burkers were convicted and sentenced to death, and thus to the eventual dissection of their own bodies in the name of medical science. The 1832 Anatomy Act sought to address the lack of legitimate corpses for dissection by allowing licensed physicians, surgeons, and medical students to perform autopsies and dissections on any corpse legally in their possession, regardless of whether that person had been executed as a criminal or not. It facilitated this by permitting the institutions to whom a pauper was financially indebted to use or sell their cadaver for dissection unless another party had claimed the body and – crucially – also paid a fee and any due debts incurred by the deceased within seventy-two hours of their death. Naturally, the persons to whom this applied would almost exclusively be pauper lunatics, prisoners, and those trapped in the workhouse system; people whose bodies would now automatically belong to the institution in question should no formal claim be made, or even if the family did want to claim the body but could not afford the fees. Not all of those in power supported the Act’s implicit suggestion that the poor were fit for dissection simply because no one could afford to pay their debts; the reformer William Cobbett (1763–1835) stated that ‘…if it be necessary for the purposes of science, let them have the 8

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bodies of the rich, for whose benefit science is cultivated.’ Of course, the research carried out on the thousands of bodies in question did much to advance the application of medical science from which all classes of person would eventually benefit, but the anger expressed by Cobbett and others stemmed from the sheer unfairness, arrogance, and classism of the obscene notion that poor people were fit to be chopped up, probed, and examined while the rich were above such indignity. It was an almost universal belief at that time that a soul could not enter heaven if it was incomplete; indeed, the gruesome punishment of ‘quartering’ a body and sending the four parts to the four corners of the kingdom was invented specifically to reflect that concept and thus considered to be the most severe punishment possible in law. In tandem with the existing Poor Law legislation, the Anatomy Act meant that even paupers who expressly did not want their family member dissected but could not afford the fees, debts, and burial were legally bound to accede to the whim of the institution into which their father, mother, husband, wife, sibling, or child had been placed. This gave the poor no choice but to consent to what the vast majority at that time wholeheartedly believed was a fate worse than anything that could be inflicted upon them in life, simply for the want of a ‘debt’ to an institution which, in many cases, they saw as having forced them to reside within against their own will in the first place. There were riots up and down the country in response to the Act, with one in Cambridge ending in the ransacking of an anatomy theatre. It is perhaps difficult for a modern mind – especially one not beholden to such religious ideas – to grasp just how important the concept of a rewarding, peaceful, pain-free afterlife would have been for those who had already eked out an existence as crushingly grim and blighted as that of the average nineteenth-century pauper. The absolute belief that even the hope of a final redemption was being denied to them or their loved ones must have been one last bitter kick in the teeth to thousands of families across Britain during this period. There were several routes via which one might find oneself in a county asylum like the ones described in this book, including Hanwell, but admissions came via three main avenues. A person could be arrested and brought to the asylum by the police and then declared a lunatic by the asylum’s physician or superintendent, although they would usually be held in a local gaol and certified as a lunatic by a doctor before being 9

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taken to court and then formally committed. They could also be certified by a local parish doctor; this was a diagnosis then given legal status by a local judge who would issue a warrant for their committal, forcibly or otherwise. The most common route to the asylum was by being referred from a workhouse after having already been diagnosed as a lunatic prior to admission there or by the workhouse’s own physician. As soon as the county asylums sprang up around the country, many workhouses saw it as a welcome opportunity to rid themselves of their most ‘difficult’ cases and dumped as many as they could at the doors of the asylums; others, perhaps counterintuitively, jealously held on to their lunatics. At Hanwell, new admissions would be brought to the gatehouse to have their committal documents checked by the porter who would escort them to either the male or female admission entrance; in later years at most asylums, this was a separate building or ward known as the ‘admission’ or ‘acute’ block. Those bringing the patient in, usually family, bailiffs, workhouse staff, or the police, would be quizzed regarding the patient’s history and constitution if known. A case file would then be created for the head attendant or matron, detailing their symptoms, potential treatments, and any perceived risk of violence,

View from gate lodges down driveway towards chapel. (Copyright Ed Brandon)

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suicide, or other self-harm. The new admission would then be stripped, forcibly if necessary, and thoroughly washed under the watchful eye of several attendants or nurses before their own clothes would be taken away, along with any possessions. The most common items recorded in patients’ possession upon admittance to asylums in the nineteenth century were a copy of the Bible or some pawnbroker’s receipts, and often both. The new patient’s hair would be shaved if they had lice; otherwise, if they were male, it would be cut moderately short and neat (along with a shave if necessary), or only trimmed and brushed neatly if female. They would then dress or be dressed in the asylum’s own generic attire, which in the early nineteenth century was usually made from a rough, hard-wearing hessian weave, but varied greatly in quality and comfort between different asylums as time went on. By the latter half of the nineteenth century, clothing for those who were not considered to be violent or destructive was considerably more aligned with what might be worn in a civilian setting. After dressing, the patient would be led off through the yawning, clattering, confusing corridors of the asylum, echoing with the noises of other patients and the bustle of activity, while unfamiliar sights, sounds, and a host of different smells assaulted their senses. The constant jangle of the nurse’s or attendant’s chain loaded with heavy iron keys would announce progression from one area to the next as doors were carefully, systematically and noisily unlocked in front of them and immediately locked again behind them, just like in a prison. In larger asylums such as Hanwell, this first bewildering march could take quite some time and cover a considerable distance, and it is not hard to imagine this process being a singularly frightening and disorientating experience for any new patient as they found themselves being led deeper and deeper into the bowels of this strange and overwhelming new environment, where everything must have felt so over-sized and labyrinthine. The patient would be shown to their ward, with its day-room full of strange new people, some of whom would have been acting in unusual and possibly disconcerting ways, and then handed over to the ward staff. By evening, they were herded with everyone else to the dormitory and shown to their new bed; in more overcrowded times (which were most times) beds would be arranged end to end, and a new patient might find themselves head-to-toe and almost cheek-by-jowl with fifty or more strangers. They would then be expected to sleep, or at least lie silently 11

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awake, doubtless staring nervously at the darkened outlines of all the sleeping figures in that large, crowded, high-ceilinged room, while listening to whatever unique noises each of them might make during the night. After a few days’ observation, a treatment regime would be devised, although in practice this would usually be only a generic one based on the category of madness with which the patient had been labelled. If the patient was not considered violent or suicidal and was physically fit and cooperative, they would soon be encouraged to participate in some form of work, which was sometimes vaguely matched to their existing skills or interests if possible, but more often would only be whatever was available. They were then expected to settle into life within this strange, new, and very rigid system, run to the unerring rhythms of the asylum’s ever-watchful clock tower, without further question. Hanwell’s committee was composed of fifteen voluntary magistrates, whose job it was to discuss every detail regarding the running of the building and its finances; this is perhaps not the most engrossing material to reproduce at length, but an essential role nonetheless. The committee also made frequent personal visits, which were often deliberately conducted without giving advance notice. Hanwell’s first superintendent, Dr William Charles Ellis (1780–1839) said of this process in his book A Treatise on the Nature, Causes, Symptoms and Treatment of Insanity (Samuel Holdsworth, 1838): These visits are of much more importance to the wellbeing of the establishment than those which take place [regularly]; they ought never to be relaxed, even if good order and propriety be found in every department. They will always afford gratification to those who do their duty [and] the subordinate officers and servants, knowing members of the committee are in the habit of going round the asylum, will be kept alert, and attention and diligence on their parts will be the result. This practice pre-empted that of the Commissioners in Lunacy (CiL), who from 1845 would be responsible for carrying out similar inspections of all county asylums in England and Wales without prior notice each year for the same purpose: to see how the asylum was being run when visitors were not expected. 12

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From its opening in 1831, Dr Ellis would run Hanwell alongside his wife Mildred, who was also the first matron. A former apothecary, Ellis had begun his career in ‘mad-doctoring’ (as it was formally known at that time) in 1814 at Sculcoates Refuge near Hull: a small charitable asylum modelled on The Retreat at York. After that, the couple held the same roles of superintendent and matron at Hanwell’s conceptual antecedent – the West Riding Asylum at Wakefield – from its opening in 1818, where the Ellises’ regime set the standard for other early county asylums to live up to. Dr Ellis’ book was the most important work of its time on the emerging subject of asylum governance, going into minute detail regarding the construction of future asylums, and it saw him become one of the key contributors to the development of and thinking behind how asylums were built and managed around the world for much of the mid-nineteenth century. Dr Ellis’ ‘moral treatment’ regime was based on that introduced to Britain by Samuel Tuke at The Retreat in York during the 1790s, which was in turn based on the earlier ideas and writings of Phillipe Pinel (1745–1826), who has been dubbed ‘the father of modern psychiatry’. Pinel worked with the patients confined to the wards for the mentally ill at the Bicêtre and later the Salpêtrière hospitals of Paris, and unlike others who – in the tradition of London’s own New Bethlem asylum – had largely treated them with cruelty, neglect, and disdain, Pinel had the novel idea of simply talking to the patients each day, engaging with them, and treating them as kindly as possible. He did away with much of the quackery and unproven ‘treatments’ of his time, such as bleeding, purging, and blistering, and sought to remove shackles, bindings, and other mostly unnecessary methods of constraint. Dr Ellis referred to the patients at Hanwell as his ‘family’, and believed his work with the insane was the result of divine inspiration. However, he usually explained it in less grandiose, more humanist terms and in his book, he stated: ‘the most essential ingredient [to moral treatment] is constant, never-tiring, watchful kindness; there are but few, even among the insane who, if a particle of mind be left, are not to be won by affectionate attention.’ Dr Ellis’ unshakable belief that there was no reason such humane ideals should not be applied to all patients, regardless of affliction or social class or of the scale of the institution in question, was an important one in relation to the evolution of the county asylums, especially when being seen practised at what was then the world’s largest and most prestigious building of its type. 13

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As far as medicines and physical treatments were concerned, Dr Ellis often took the same erroneous path as that of his contemporaries; he administered nonsense cures, such as bleeding and purging in cases where insanity had been caused by a cranial injury, and doses of calomel (mercury) and potash were given for ‘copious evacuations’. Cooling the head with an ice pack while keeping the extremities warm with hot water were among the more fantastical therapies, while daubing the patient in lashings of ‘warming’ mustard compound was another. Digitalis, extracted from the common foxglove plant, was used to lower the heart rate, to which Dr Ellis wisely advised ‘great caution’, since a high enough dose can stop the heart altogether; a fact that had to be learned through some poor unfortunate’s direct and completely unnecessary experience. Thus was the freedom given to men in his position to hold the lives of pauper lunatics in their hands, and seemingly give little more than a shrug of the shoulders when some erroneous (if not outright preposterous) avenue of research or supposed cure went catastrophically wrong. In his book, Dr Ellis used a vivid example of a patient who thought the devil stalked him through the streets to back up his beliefs; the patient eventually cut his own throat from ear to ear and although he bled profusely, he did not injure himself fatally, and had apparently also overcome his delusions when he recovered. This was taken as straightforward proof of the efficacy of ‘bleeding’ patients, while in fact it was of course a painful and pointless process at best, but also potentially a harmful one, especially for those already in a weak physical state. It is all too common to see such fantastical summaries made in psychiatric medicine, and terrifying to consider the employment of such techniques by men who, while often well-intentioned, were in positions of such great and often unchallenged power over so many. In Hanwell’s first decade of operation, recognised ‘physical causes’ of madness numbered only four: intemperance (excessive consumption of alcohol), epilepsy, head injury, and paralysis. The recognised categories for the ‘moral causes’ were broader and included poverty, disappointed affections, domestic unhappiness, religious enthusiasm, fright, grief, and anxiety. These moral causes were fixed in the minds of most medical men of that era as being definite and specific triggers for insanity, and otherwise healthy young people were thought to have been rendered insane or even to have dropped down dead on the spot, from nothing more than some singular instance of shock, disappointment or rejection. 14

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Dr Ellis felt that by far the most dangerous and commonplace of the ‘moral causes’ for insanity was that of sexual self-pleasure, and an entire page dedicated to the woeful practice of masturbation was tucked away at the end of his book, so that any casual reader of a less stout constitution might not happen upon it by chance. In this, he stated: A pale face, general lassitude, drowsiness, cold extremities, trembling hands, and a voracious appetite are the indications of its existence… . We must not, however, omit to mention that the practice is often the consequence, as well as the cause of [madness]. Where the circulation is only accelerated through certain portions of the body, the mass of blood not being increased, the other parts are then robbed of their due share, and their functions are consequently weakened and disturbed. And thus, readers both past and present should consider themselves duly warned. Christian morality, or the lack thereof, was a huge factor in eighteenth- and nineteenth-century society in general and with so little in the way of genuine scientific medical knowledge, ‘immoral behaviour’, including sex outside marriage, masturbation, excessive drug or alcohol consumption, gambling, lustful thoughts and other such ‘vices’, were perceived as causes of physical illness, madness and general disadvantage in medical circles just as they were elsewhere in society, informed and reinforced by religious principles grounded in concepts of guilt, subordination and sin. Such conclusions were usually presented along with ‘real-life’ examples to offer the appearance of some sound basis in science, when in reality there was barely a kernel of truth to most of it. We do now know that drug or alcohol abuse and sexually transmitted diseases can indeed lead to mental health problems in certain circumstances, particularly in relation to venereal diseases such as syphilis, which was then untreatable and could severely affect the brain; however, at the time, such conclusions were almost exclusively based on a biblical morality – cause and effect perceived but not proven. At the same time, it was perhaps not totally unreasonable to conclude, based on what little real science they had, that when patients who were 15

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mad were repeatedly turning out also to be infected with syphilis, that it was indeed some form of judgement being meted out for a lack of conformity to Christian ideals. While religious observance was seen as essential to a patient’s cure, thanks to the rather uncharitable request of local parishioners, patients were banned from attending the church in Hanwell village, as their alleged ‘strangeness’ supposedly scared the existing congregation. Unable to convince the church to allow even those patients deemed convalescent or harmless, Dr Ellis himself conducted Sunday services for patients and staff until a full-time chaplain was eventually appointed. A similar story was seen regarding a carriage Mrs Ellis had arranged to take convalescent patients on regular trips to Brentford to reacclimatise them to the world outside the asylum as, again, prejudiced locals objected. What appears to be little more than pure conjecture was often bent to fit the desired conclusion. Dr Ellis also described the horrific story of a young girl supposedly subject to the moral cause of ‘terror’, providing a good example of how the thinking of his time was applied; he discusses the ‘sudden effect of terror’, as he called it, and tells the story of a woman who went on an evening visit, leaving her young daughter in the care of servants, who then took the opportunity to have a party in the house. In order to keep the child quiet, the nurse-maid chose to frighten her into staying in bed: For this purpose, she dressed up a figure, and placed it at the foot of the bed, and told the child that if she moved or cried it would get her. In the course of the evening the mother’s mind became so forcibly impressed that something was wrong at home, that she could not remain without going to ascertain if anything extraordinary had occurred. She found all the servants dancing and in great glee and on inquiring for her child, was told that she was in bed. She ran upstairs and found the figure at the foot of the bed, where it was placed by the servant, and her child with its eyes intently fixed upon it, but, to her inexpressible horror, quite dead. This sad case study is held forth as a concrete example of ‘terror’, but once the genuine tragedy and horror of the story has receded, one is of course left to wonder what was already wrong with the child, or what else the 16

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nurse-maid had really done to keep the unfortunate child quiet, knowing that Dr Ellis’ diagnosis – so conclusively offered as the sole cause of death in an otherwise healthy child – cannot possibly have been correct. Tellingly, the first of many extensions was already underway by November 1831, just six months after Hanwell opened. Overseen by the Middlesex County Surveyor William Moseley (c.1799–1880), the soil on the east side of the building was dug away so that the basements could be converted into wards for another 115 patients, with additional ward blocks added on to the existing ones. More expansion took place in 1837 and this proved too much for Dr Ellis, who had already made it clear he did not believe a true moral treatment regime could be conducted in any asylum which housed more than around 300 patients. He would finally resign in protest at the committee’s wishes to expand the asylum again in 1838. Dr Ellis founded his own private madhouse, Southall Park, in September 1838, and it grew to accommodate around twenty patients. But he would not be there for long, dying of dropsy in October 1839, while the building itself burned down in 1883. At Hanwell, expansions continued apace, with the patient population rising to over 800 by 1840. Dr John Conolly (1794–1866) was born at Market Rasen in Lincolnshire, and, after taking up a brief military career, he eventually joined the University of Edinburgh, presenting a dissertation on the then unpopular subject of insanity. Practising general medicine, he was appointed as visiting physician to several private asylums, gaining an insight into the wretchedness of the madhouse system. He became coeditor of the highly influential British and Foreign Medical Review and would later be a co-founder of what would evolve into the British Medical Association, now the registered trade union and professional association for all British doctors. By 1838, Dr Conolly’s expertise made him a prize catch for Hanwell’s committee to replace Dr Ellis, and his interest in madness meant he was also keen to get to work in the largest asylum in Europe. By far the most significant change would be his introduction of a ‘non-restraint’ policy; this was a step forward even from the moral treatment regime and quite controversial at the time. He sought to introduce a regime whereby all forms of mechanical restraint (bindings, straitjackets, chains, etc.) might be abolished completely. This bold choice was a manifestation of the fact that, although glacially slow, general opinion regarding the treatment of the insane was changing. 17

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Dr Conolly often noted that his main influence had been his observations at The Lawn, a charitable public asylum in the heart of Lincoln city which opened in 1820 to house fifty lunatics, with Dr Edward Parker Charlesworth (1783–1853) as its first visiting physician. Although they were put into use some of the time, under the purview of its subsequent superintendent, Dr Robert Gardiner Hill (1811–1878), The Lawn had been run for significant periods without resorting to mechanical restraints at all. When Dr Conolly arrived at Hanwell, he found that an average of forty patients were subject to some form of mechanical restraint every single day. He immediately required that daily reports be kept on the use of any such restraint and would henceforth scrutinise the reason for its use in each case, offering guidance or discipline to any staff member who employed it without good cause. Its overall use was gradually reduced, and by September 1839, it had been abolished altogether, save for medical cases where the patient might tear at a wound or bandages, for example. Dr Conolly deserves note for his devotion to this idea in the face of significant criticism and even outright mockery from many of his peers, as well as for the significant influence he personally had on its subsequent adoption at other asylums. In his book On the Construction and Government of Lunatic Asylums (John Churchill, 1847), Dr Conolly described the scenes he witnessed when first visiting Hanwell: It was in the female infirmary at Hanwell [that] I found, among other examples of the forgetfulness of what was due either to the sick or insane, a young woman lying in a crib, bound to the middle of it by a strap round the waist, to the sides of it by the hands, to the foot of it by the ankles, and to the head of it by the neck; she also had her hands [in] canvass [sic] sleeves; she could not turn, nor lie on her side, nor lift her hand to her face, and her appearance was miserable beyond the power of words to describe. How long she had been in this state it is not material to record. That she was almost always wet and dirty, it is scarcely necessary to say. But the principal point I wish to illustrate by mentioning this case is that it was a feeble and sick woman who was thus treated. At that very time, 18

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Restraints used at Hanwell before Dr Conolly’s employment. Courtesy of the Wellcome Collection. (CC BY 4.0)

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her whole skin was covered with neglected scabies, and she was suffering all the torture of a large and deep-seated abscess… . The excuse alleged for this mode of treatment was that she would eat the poultices employed, which contained lead, and that she was very mischievous; that was all. However, she was liberated, no bad consequences ensued, and in a few weeks I saw the poor creature at the chapel, and even heard her play the organ, which she had been accustomed to do in the church of a village in Middlesex before her admission. This patient died very recently, having from the time of her liberation from restraints scarcely ever given any trouble to the attendants. Dr Conolly’s next book The Treatment of the Insane Without Mechanical Restraint (Smith and Elder, 1856) covered the specific subject in far greater depth and became the ‘textbook’ for the emerging practice. He described how alternative methods might be employed at an asylum of any size throughout the world, just as they had at Hanwell, including short periods of seclusion – ideally in padded cells – which was the preferred alternative during his tenure at Hanwell. The JPs’ formal report on Hanwell of 1841 looked back at the preceding two years, seeking some concrete facts and figures to justify the use of the policy and address the criticisms of its employment from certain medical circles. In Dr Conolly’s section of the document, he notes how the frequency, methods, and reasons for using mechanical restraint had simply gone undocumented in the past and how it was thus almost unavoidably liable to abuse, being little more than a licence for the attendants to make their own lives easier at the expense of the patients’ wellbeing. Dr Conolly explained that the mere availability of such manacles and bindings tended to ‘harden the feelings of the attendants and blunt their humanity, of which, under other circumstances, they are by no means destitute’, and grimly recalls ‘having more than once discovered that dying patients were not released from restraints. Even in the restlessness of death their feet were strapped or chained to the bedstead, and an order to liberate them seemed to occasion surprise.’ The report noted that in the handful of other asylums where nonrestraint had also been introduced, it had similarly been found to work 20

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well and helped them gain a more positive reputation, whereas at asylums whose committees claimed restraint was indispensable, the introduction of such a regime had not even been attempted. The report concluded that cure rates at Hanwell had risen from 16.2 per cent during the three years prior to the introduction of the non-restraint regime to 22.7 per cent during the most recent two, and it was felt that this was all the proof that was needed. Dr Conolly’s first book offers a summary of the thinking behind the construction, arrangement, management, and curative regimes implemented within asylums at the time, as well as a range of ideas around what could be changed in the future. He discusses the bigger concepts – such as the most efficacious layouts of the ward blocks and the categorisation of the patients – as well as exploring the more granular minutiae of an asylum’s day-to-day running, including details as seemingly small as the correct positioning of water closets and what sort of locks and flushing systems they should have, the best sorts of heating and ventilation, the layout and landscaping of the airing courts, the best types of door to use in different areas of the building, the internal decoration, and even which types of paint are best. The list provides what was essentially a manifesto for planning and micro-managing an immense, self-sufficient community populated by people with highly specific and often quite differing needs. Dr Conolly’s opinions were among the most influential in relation to the subject of the book’s title, and he was also one of a small group of senior voices within the psychiatric community who argued against some of the recommendations of the Lunacy Commission, while at the same time being among its most important contributors. He argued that those with first-hand experience who actually worked with the insane, rather than architects, politicians, lawmakers, or commissioners, should be consulted not just in the bricks-and-mortar design of new asylums, but in every decision to be made about or implemented within one, as they alone understood the real impact of such changes in ways those outside his profession could not. His opinions would form the backbone of the 1845 County Asylums Act, but it is interesting to note that there was still not the slightest thought given to any form of organised consultation with the present or former patients themselves regarding what they felt might be required for their own care, cure, or recuperation, despite their obvious first-hand experience. 21

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By 1840, there were around 800 patients at Hanwell, watched over by seventy-five attendants (on the male side) and nurses (on the female side). They worked gruelling fourteen-hour shifts, six days a week. Dr Conolly acknowledged how tough this job was and noted in his first book: The duties of an attendant in an asylum begin early in the morning, are incessant during the day, and end late. The visitors who [see them] neatly dressed and apparently at leisure to answer every curious or idle question can by no means appreciate the labour necessary to produce the cleanliness, or the continued watchfulness required to maintain the order, which [is] so much the object of admiration in the wards of such institutions. During most of the nineteenth century, the diet of patients changed little from that provided during the 1840s, which was allocated according to the gender, classification, and what work the patient did within the asylum. Breakfast consisted of a pint of milky porridge with bread, while dinner would be 5oz of steamed meat (except on Sundays when it was baked) and yeast dumplings with vegetables, all served with gravy. This was varied with soup and bread, Irish stew and bread, meat and potato pie, or a currant dumpling on certain days. During summer, fruit pies were substituted for meat, with bacon and beans being another variation. Hanwell was so large that hot meals had to be distributed from the kitchens by horse and cart in order to still be warm by the time they reached the most distant wards. Each patient was also given half a pint of beer with dinner until 1888, when the on-site brewery was closed; its provision was considered inappropriate when Hanwell began to accommodate ‘inebriate’ patients. Female patients were provided with tea, while, for reasons that are unclear, male patients could only have the same if it had been donated to them personally by friends or relatives. Male patients did, however, get a supper of cheese, bread, and half a pint of beer, with extra daily beer for those who worked on the land, which females did not receive unless they worked at the laundries. Females of an ‘elderly and feeble’ constitution were given meat every day, while Catholics were allowed fish instead of meat on Fridays. Physically ill patients of either gender 22

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had to eat whatever their diagnosis dictated, but they alone could also request tea, coffee, beef tea, sago, or an arrowroot-based drink, with a shot of brandy if permitted. In 1857, an entire new floor was added to all the main ward blocks, differentiated by the flat tops of its windows as opposed to the arched windows of the two original floors; this work expanded the available ward space by almost a third. Dr Conolly urged that the labour of patients within any asylum should never be perceived as a means of production or punishment, as it was at the workhouse and in prison, but rather a means to occupy unhappy minds and a way of distracting them from ‘morbid’ thoughts. The concept of forcing paupers to work for their own upkeep was quite entrenched in the minds of many among the Victorian middle and upper classes, and it took much effort from influential people like Dr Conolly to begin to reverse that pervasive idea in relation to patients in asylums. To further move

Original 1831 reinforced windows utilised throughout the first two floors. The thick iron frame prevented escape, while the circular section could be rotated to allow ventilation. (Copyright Ed Brandon)

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away from a punitive or captive atmosphere, books, newspapers, and magazines were distributed throughout the asylum and the patients were encouraged to read to themselves or each other, especially on Sundays, which Conolly described as ‘the most difficult day in the week to manage them’, since work and most of the other activities in which they could usually engage were not seen as suitable activities for the ‘day of rest’. Dr Conolly resigned as superintendent in 1844, acting only Portrait of Dr John Conolly, c.1835. as visiting physician until 1852 Courtesy of the Wellcome Collection. while also running his own private (CC BY 4.0) asylums: Lawn House (note the tribute) and Hayes Park. He continued to keep his name in the news, being frequently called upon to give court evidence in criminal cases where the defendant’s sanity was deemed relevant to the trial. His final report to Hanwell’s committee stated: ‘The great and only real substitute for restraint is invariable kindness. This feeling must animate every person employed in every duty to be performed.’ As a result of his work, it is common to find blocks, departments, or wards of other Victorian as well as modern psychiatric institutions named ‘Conolly’. Reverend Charles Maurice Davies offered a vivid contemporary account of a visit to Hanwell as part of his book Mystic London: Or, Phases of Occult Life in the Metropolis (Tinsley Brothers, 1875), now in the public domain and abridged here for brevity: It rained dismally and the wind nearly blew the porter out of his lodge as he obeyed our summons at the Danteesque portal of the institution, in passing behind which so many had literally abandoned hope. The wards, especially on the women’s side, were gaily decorated with paper flowers, and all looked as cheerful and happy as though no shadow ever fell across the threshold, 24

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but alas, there were every now and then padded rooms opening out of the passage and as this was not a refractory ward, I was told they were for epileptic patients. [The ballroom] was gaily decorated and filled with some three or four hundred patients with the ladies on one side and the gentlemen on the other. The frequent warders in their dark blue uniforms lent quite a military air to the scene and on the ladies’ side the costumes were more picturesque; some little latitude was given to feminine taste and the result was that a large portion of the patients were gorgeous in pink gowns [but] the belles of the ball-room were decidedly to be found among the female attendants who were bright, fresh-looking young women in a neat, black uniform, with perky little caps and bunches of keys hanging at their side. One gentleman, reversing the order assigned to him by nature, walked gravely in on the palms of his hands, with his legs elevated in the air. He had been a clown at a theatre, and still retained some of the proclivities of the boards. Then I passed up and down the long rows with a courteous official, who gave me little snatches of the history of some of the patients. Here was an actor of some note in his day; there a barrister; here again a clergyman; here a tradesman recently gone. God Save the Queen was played in one key by the orchestra, and sung in a great many different ones by the guests… The most painful sight of all was one little girl there, a child of eleven or twelve years: a child in a lunatic asylum! Think of that, parents, when you listen to the engaging nonsense of your little ones; think of the child in Hanwell’s wards! Instead of being chained and treated as wild beasts, the lunatics are treated as unfortunate men and women, and every effort is made to ameliorate, both physically and morally, their sad condition. This was what I saw by [entering] Hanwell Asylum, and as I ran to catch the last train, which I did as the saying is, by the skin of my teeth, I felt that I was a wiser, though maybe a sadder man, for my evening’s experiences at the Lunatic Ball. 25

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Hanwell’s chapel of 1881, with eastern tower in the background. From print c.1880, artist unknown. Collection of the author. (Public domain)

As Hanwell’s patient population increased, the original internal chapel proved too small, so over the course of 1880–81, a new recreation hall and a handsome new chapel were constructed; the hall was built on to the northern end of the admin block (which could still be accessed from the side), with the adjoining former chapel knocked through and converted to form both its stage and backstage areas. Dances would then be held inside every week from around October to April, while social gatherings would happen outdoors with similar frequency when possible, during summer. That same year, the CiL noted that Hanwell was forced to turn patients away and that increasing numbers were then being boarded out in ‘licensed houses’ (as the former private madhouses had by then become known); they also noted that while new provision was certainly needed, they did not think Hanwell should be expanded any further. In 1889, all of the three existing Middlesex County Asylums, Hanwell (which by then housed 1,891 patients), Colney Hatch and Banstead were handed over to the new London County Council (LCC); however, under this regime, in which patient numbers increased while the number of staff did not, mechanical restraint was reintroduced in 1890, regressing from Dr Conolly’s brighter ideals. Some patients actually enjoyed 26

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greater freedoms than before, with picnics being particularly popular, at least until the beer supplied at such excursions was removed. Ornate cast-iron fire escapes were added around the asylum in 1893, and during the same year, the older workshops at the base of the male tower were converted into a billiards room, pathology lab, museum of the asylum’s history, and photographic studio. In 1918, the building’s formal title was changed to the ‘London County Mental Hospital, Hanwell’, in a progressive move that pre-empted the 1930 Mental Treatment Act, which would forbid the use of the term ‘asylum’ in official parlance. In 1929, the stationery makers were again kept busy with a change to the shorter ‘Hanwell Mental Hospital’. In 1937, it was changed for the last time to ‘St Bernard’s Hospital’, which again pre-empted a move later implemented nationwide as the ‘mental’ prefix was dropped universally in favour of the non-specific ‘hospital’ suffix upon the foundation of the NHS in 1948. During the Second World War, one of Hanwell’s wards was commandeered by the Emergency Medical Services, who set up a casualty ward there. Hanwell was close to the AEC factory on Windmill Lane and to the Wharncliffe viaduct – the latter being an important rail

Hanwell from the air, in a postcard image c.1920. The entrance gates can be seen to the far right, with driveway leading to the chapel spire, then the recreation hall with central tower/ admin behind that. The canal is to the bottom left, with archway into the asylum’s dock. William Clifford-Smith’s 1910s additions can be seen in the distance toward the centre-top. Collection of the author. (Public domain)

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link; this saw several German bombs land in the area, causing minor damage to the grounds and buildings, including one of the gatehouses. In 1944, the original laundry was completely destroyed by a stray V-1 ‘doodlebug’ flying bomb, killing several workers and patients as well as injuring numerous others. Patient numbers peaked in 1910 at 2,583, and although there were still 2,200 by 1961, began to decline more significantly from the late 1960s onward. By 1971, wards were gradually being unlocked as regimes at all the former county asylums became more relaxed for most; only 189 of Hanwell’s then 2,039 beds remained on locked wards. In 1979, the concrete monstrosity that is Ealing General Hospital opened on part of Hanwell’s land, adjacent to the original Victorian buildings. Although the blunt thoughtlessness of its placement was quite typical of its era, and Hanwell was far from the most attractive county asylum, the contrast from an architectural perspective could not have been starker. In 1985, by which time the resident population had reduced to around 950, the Three Bridges Regional Secure Unit opened on land at the rear of the asylum and this unit has a ward named after the poet and mental health campaigner Benjamin Zephaniah (b. 1958). In July 1992, the John Conolly Wing (JCW) was opened to incorporate the adult acute, rehabilitation, and elderly mentally ill wards. As the old asylums eventually closed across Britain and long-term in-patient beds became a rarity, Hanwell was among the last to remain in use and its catchment area broadened massively, eventually taking patients from as far north as Bedfordshire. The Edwardian additions to the west of the site by William Clifford-Smith (who also designed Manor, St Ebba’s and West Park asylums for the LCC) were demolished, and the wards on the western side of the main building were stripped and sold for housing in the late 1990s. Much of the exterior brickwork was acid-cleaned in 1998, taking away over 160 years of London grime to turn the blackish-grey look back to the more yellow-grey hue it had originally sported. The managing health authority changed numerous times over the years as boundaries shifted; at the time of writing, St Bernard’s Hospital is managed by West London & Thames Mental Health Trust, which is also responsible for Broadmoor Hospital. August 2007 saw the opening of The Orchard Centre at the rear of the site and with sixty beds it is 28

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the largest female-only medium secure unit in the UK. One of the old Victorian shelters from the asylum’s airing courts was refurbished and placed in its grounds as a bicycle shelter. Hanwell was used as a location for numerous media over the years, including films such as Tim Burton’s Batman (1989), television shows such as The Professionals and Porridge (both 1970s), and the videogames including Welcome to Hanwell and Sherlock Holmes Vs. Jack the Ripper. It is also mentioned in many novels and plays, including George Bernard Shaw’s Pygmalion of 1914. In the late 1990s, the Corsellis Collection – thought to be the largest bank of brain samples in the world – was moved from Runwell Mental Hospital in Essex to Hanwell, but has since been divided up and is now stored in various other locations. Hanwell’s museum, which opened in 1893, once housed a significant collection of artefacts, equipment, documents, and various patient possessions from throughout its own history, including an entire padded cell. It also displayed a letter written by former patient Arthur O’Connor, who was committed to Hanwell on 6 May 1875 for wielding an unloaded pistol at Queen Victoria. He wrote to her requesting a pardon, which was granted to him in November the following year, and he was never again committed to an asylum or indeed arrested again for any other reason. The museum collection was also broken up in 2004 and its items are now held at the Bethlem Museum of the Mind, Gunnersbury Park Museum, and the Wellcome Collection, with all the documents now deposited in the London Metropolitan Archives. At the time of writing, the area around Hanwell is still very much an active site for mental health services, albeit now conducted mostly from purpose-built modern structures. The entrance arch still makes quite an impression from the street, and besides a red Royal Mail post-box (itself added almost three quarters of a century ago), the view from there has changed very little, with ivy still creeping across the top and the clock tower still peering down from the far end of the driveway. However, once moving through the gates, the view is totally obscured by newer medical buildings and ugly, bland modern housing in a mess of differing scales and styles, obscuring any panoramic view. The 1831 buildings along with the chapel and lodges are Grade II listed, and quite correctly, the health trust responsible sold the disused parts of the building for conversion, while other areas remained open. 29

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In contrast, most such sites saw their disused areas left in neglected stasis awaiting the building’s full closure, by which time they were waterlogged, vandalised, burnt-out and stripped of lead and slate, thus encouraging demolition by even a sympathetic developer. Thankfully, Hanwell did not suffer the same fate and, besides demolition of some later Victorian buildings to the rear of the site and all of the Edwardian additions to the west, the original building remains mostly intact, albeit with assorted unnecessary ‘embellishments’ that modern developers seem to feel compelled to add. A two-bedroom flat within one of Hanwell’s former wards at the time of writing costs around £430,000, and they are advertised without any reference to almost 200 years of the building’s rich history, besides being described simply as a ‘former hospital’.

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Chapter Two

Colney Hatch (2nd Middlesex / London County Asylum / Friern Hospital) Royal Drive, Friern Barnet, London, N11 3BG

By 1846, only fifteen years after it opened, Hanwell was already full and housed over a thousand patients, but its own physician, along with much of the local populace were fiercely against proposals to double its already enormous size. As a result, the Middlesex authorities conceded to build their second asylum on a new site serving the north of the county. The area known as Colney Hatch (the first word is usually pronounced to rhyme with ‘pony’) sat within the small village of Friern Barnet in sleepy rural Middlesex, around eight miles north of central London. Its name derived from the Latin ‘colonia’ – a Roman settlement in a conquered land – while ‘hatch’ refers to a gateway or entrance of some sort. Despite having been rejected as a potential site for Middlesex’s first asylum (Hanwell was selected instead), it looked more appealing twenty years later when it lay just next to the route of the proposed Great Northern Railway (GNR) service running from London’s Maiden Lane to Peterborough which, from 1850 onward, would see eight trains running in each direction daily. GNR agreed to build a ‘Colney Hatch’ station specifically for staff, visitors, and supplies bound for the planned asylum, on condition that the Middlesex authorities agreed to connect the station buildings to the asylum’s own gas and water supply. The arrival of the asylum and its railway connection would see Friern Barnet’s population rise dramatically from a scant 944 in 1851 to 3,344 by 1861. The original intention was that Colney Hatch would take all or most of the quiet, chronic, and incurable patients who were expected to take longer to recover, or in many cases, to not recover at all, thus freeing up Hanwell’s wards for the recent, acute, and more ‘hopeful’ ones. This need for classification of patients within asylums was well-established 31

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and many also felt that acute patients suffered when locked up alongside the long-term cases. Bluntly put – the plan was that Hanwell would offer somewhat more bespoke care to the promising patients while Colney Hatch would simply meet Middlesex’s obligation for provision, allowing cheaper accommodation en masse by not wasting money on patients who were unlikely to get any better. The plan met with opposition, with one of the loudest dissenting voices coming from Hanwell’s own superintendent Dr John Conolly, who also sat on Colney Hatch’s new committee. He argued that while classification of patients was indeed essential, the presence of convalescent and new patients could often have a positive effect on the morale of the longerterm ones. He also pointed out that those presumed ‘incurable’ were still deserving of the same standard of care as any other lunatic, in both a legal and a moral sense, regardless of their prognosis. The argument was won in favour of each asylum serving all classifications, with beds allocated only by which parish the patient belonged to; Hanwell would henceforth generally receive patients from the south and west of Middlesex and London, with Colney Hatch drawing mainly from the north and east of the area. A competition was announced to design the new building and Samuel Daukes (1811–1880) submitted the winning plans to claim the £300 prize and £3,000 fee. Daukes enjoyed a prolific and varied career designing stately homes, churches, warehouses, shops, railway stations, a smallpox hospital, and even a zoo. Many survive to this day, although his most notable work after Colney Hatch would likely be the remodelling of Witley Court, a stunning Italianate mansion in Gloucestershire which is now a spectacular ruin after being gutted by a fire in 1937. In 1850, Daukes also designed a handsome manor house in Kent, which in 1936 was sold and converted into the admin block for what became Leybourne Grange Mental Hospital. Daukes was a proponent of the then highly-fashionable Italianate style and Colney Hatch very much adhered to that vision. Around ten million bricks were used in the construction of this vast building and were fired from local clay which came mostly from the digging-out of the initial foundations, to which iron and magnesium were added to produce a warm honey-yellow tone. It featured Italianate groins, door and window dressings in stone, and roofing of Welsh slate and the central block featured picturesque arches and cornices, with a fine 32

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copper dome, ornate ventilation towers, and other decorative touches that lent it a grand, classical aspect; it was certainly the most externally flamboyant and grandiose of all the county asylums built for either Middlesex or London. At 1,881ft in length, incorporating 987 different rooms and several miles of corridors, it was the largest asylum in the world when built, with a façade roughly twice the length of the Palace of Westminster. The main corridor that ran along the length of its front allowed foot traffic to travel almost its entire span without having to pass through the wards and was said to be the longest single corridor in any building in Europe at that time. By total patient population, it would become the fifth largest asylum in Britain. To the north, twin porters’ lodges sat at either side of a straight driveway which led through iron gates to a turning circle in front of the arched main entrance at the centre of the building. The main doors led straight into the admin block which had a chapel at its centre, and there were also offices, attendants’ rooms, a dispensary, and a waiting room

Colney Hatch: bird’s eye view and floor plan. Wood engraving by Laing after Daukes, c.1851. Courtesy of the Wellcome Collection. (CC BY 4.0)

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along with a committee room decorated with ornate Venetian stucco. The recreation hall sat behind the chapel, with the kitchens, stores, and laundry arranged along the centre towards the rear on the south side. The wings were connected to either side of the centre with eighteen wards on the western division assigned to female patients and fourteen allocated to males on the east; these were spread over two floors on both sides with some three-storey blocks at the rear. Each ward had thirty or forty single rooms as well as dormitories with five beds in each. The floors in all wards originally consisted of either simple cold flagstones or ‘metallic lava’ (now somewhat less evocatively known as asphalt); the flagstones tended to guarantee injury in falls, fits, faints, or scuffles while the ‘lava’ – utilised for its supposed resistance to water and damp – was said to have in fact been more effective at soaking up the smell of urine and other bodily fluids and causing the whole building to reek of it, so all the original flooring was replaced by wooden boards in the 1890s. Corridors, stairs, and some other areas featured distinctive terracotta ‘honeycomb’ ceilings said to impede the spread of fire; common to a number of 1850s hospitals and asylums including St John’s (Lincolnshire County Asylum of 1852) and Warley (Essex County Asylum of 1853), this design feature seems to have fallen out of favour even by that decade’s end. Landscaped airing courts were laid out at the rear of the building for patients to exercise in, and there were ornamental gardens at the front designed by William Broderick Thomas (1811–1898) who would go on to create gardens at the royal residences of Sandringham and Buckingham Palace. As with all the county asylums, Colney Hatch was designed to function like a small township in its own right, with its own seventy-five-acre farm beyond the airing courts to the south, along with most of the other facilities common to large asylums as detailed in the Hanwell chapter. In addition, Colney Hatch also had its own gasworks, an aviary for breeding canaries, Turkish baths (added in 1865), and a stable block for the horses of committee members and other important visitors. Rather than bringing in supplies via canal as at Hanwell, a siding led off the mainline railway track nearby and into the asylum’s grounds. More than one commentator has spoken of a ‘secret’ tunnel running between the railway station and the asylum, to be used in case a highprofile patient such as a politician or member of the Royal Family was taken ill and needed to be brought in away from public view. If such 34

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a tunnel ever existed, it was likely used for bringing in coal and other supplies, or some similarly mundane purpose, but the idea of its use for VIP clients is pure fantasy: such well-known (not to mention wellheeled) persons would have sought discreet private treatment and would absolutely not have been brought into a public asylum for paupers. Colney Hatch officially opened on 17 July 1851 with eleven male and five female patients arriving that day. Responsible for its management was a ‘committee of visitors’ who met regularly and toured the building at least once a year, talking to all patients and visiting every area, themselves answerable in turn to the Commissioners in Lunacy (CiL) who applied the existing legislation to the running of all public and private asylums. The superintendent of the male side was initially Dr William Charles Hood (1824–1870) with Dr J.G. Davey (1813–1895), formerly of Hanwell Asylum, in charge of the female side. They were answerable to the committee, although neither lasted more than a year, replaced by Dr D.F. Tyerman and Dr W.G. Marshall on the male and female sides, respectively. As the asylum’s population spiralled upwards, four new wards as well as other significant enlargements were made in 1859. These were designed by Lewis Cubitt (also the architect of King’s Cross railway station) and brought the number of total available beds up to 1,925. Able-bodied male patients would work on the farmland or at the gasworks, workshops, or brewery, while female patients were confined to domestic work in the laundry or to cleaning and kitchen duties supervised by staff. Around 12,000 dirty items would pass through the laundry each week, although the first automated washing machine was introduced as early as 1860, lightening that burden just a little. Gender bias was omnipresent but did not always fall in favour of the men; by the 1880s, female staff had a comfortable room to retire to during their breaks, warmed by a fire in winter and furnished with books and periodicals, whereas the superintendent was apparently satisfied that the male attendants could simply go and stand around outside the building if they wanted an off-ward break, whatever the weather. Occupations held by patients before committal to the asylum were recorded upon admission with ‘labourer’ being the most common among the records of 1852, followed by servant, boot and shoe maker, painter, glazier, and tailor. Victorian staples such as coach-maker, chimney sweep, and coal porter were also common, with more unusual professions including horse jockey, parliamentary agent, looking-glass 35

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silverer, and mother-of-pearl worker. To bust a persistent Victorian myth, there was not a single ‘hatter’ among them. The phrase ‘mad as a hatter’ is recorded in print as early as 1829 but the concept was popularised by Lewis Carroll’s character in his 1865 novel Alice in Wonderland. It is believed the term derives from the prolonged exposure to small amounts of mercury, which was used in the making of hats, and which could indeed cause twitching or shaking, but not ‘madness’. In the 1881 census there were 22,689 people in England and Wales listing ‘hatter’ as their profession (which may seem rather a lot now, but this was when almost everyone wore one, regardless of class or weather), yet in the 1882 CiL survey of all admissions to asylums that year, only fourteen of the 21,778 total stated ‘hatter’ as their trade, working out at just over 0.06 per cent of the total – and this percentage differed little from any other year. The various reasons for committal to Colney Hatch in its opening year of 1851–52 and during much of the Victorian era were divided into ‘moral’ and ‘physical’ causes, as discussed in the Hanwell chapter. At Colney Hatch, ‘moral’ causes recorded in the casebooks included ‘sudden shocks and frights’, ‘loss of wife or children’, ‘unhappiness at home’, and ‘suicide of a brother’. Alongside these sadly telling but understandable causes were such seemingly fantastical causes for insanity as ‘unfaithfulness’, ‘disappointed affection’, ‘erroneous views on religion’, the ‘sudden loss of several cows’, and even ‘over-excitement at the Great Exhibition’. Interestingly, reasons for depression or insanity which might today be considered related in some way to poverty were divided up and spread over various categories such as ‘reversal of fortune’, ‘unemployment’, and ‘failure in business’, meaning that sheer poverty itself did not have to be seriously considered even as a contributory cause where some other, more imaginative reason could be evoked instead. The recorded ‘physical’ causes of madness were overwhelmingly led (at almost 25 per cent, with the next highest at only 7 per cent) by ‘intemperance and debauchery’, with other unlikely explanations including ‘over-study’, ‘bad company’, and ‘masturbation’, juxtaposed with far more credible causes such as ‘injury to head’, ‘epilepsy’, ‘old age’, and ‘disease of the brain’. Patients transferred from workhouses were usually in a sorry state of both mental and physical health, having become used to being locked up for most if not all of their days, under-fed 36

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Colney Hatch A patient with amputated legs, at Colney Hatch, c.1870. Courtesy of the Wellcome Collection. (CC BY 4.0)

and in receipt of little if any care and attention. While conditions were squalid at Colney Hatch by any modern standards, many Victorian-era patients expressed their appreciation of the comparative generosity of space, comfort, and caring they found there, especially if having previously been in a workhouse. The CiL even went so far as to admonish the committee for what they called an ‘excess of luxuries and appliances’ provided to pauper patients at Colney Hatch, stating in the Annual Report of 1852 that such indulgences ‘tend to aggravate the distress of those discharged as recovered, who on their return to their homes [would] have to forego [sic] those comforts which by long use had become almost necessary’. This attitude was tied to the prevailing thinking around workhouse provision, in which it was believed that pauper accommodation should never be made too comfortable, lest it encourage the poor to try to enter or remain within the workhouse or asylum simply to benefit from the free food, accommodation, or other perceived luxuries. Meanwhile, certain other practices were criticised for being too harsh; in the report of 1872, the CiL noted that a male epileptic patient at Colney Hatch had been restrained with leather gloves for nine months continuously for violence, with ten other patients also kept in gloves for a total of 252 hours; far more than at any other county asylum that year. When deemed to be ‘cured’ or ‘recovered’, patients were certified by the committee based on evidence from the physician and usually released on a month’s trial, after which they were visited to check on their progress or brought back for assessment and then formally certified as ‘cured’ or ‘retained’ for longer if not. 37

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For over thirty years, up to six patients would be bathed in the same water in succession, as the asylum could not generate enough hot water for each without the process taking up half the day; each patient finally received their own hot bath with fresh water from 1883 onwards. Turkish baths introduced in 1865 saw reports of many patients finding a breakthrough after sessions in this most relaxing and cleansing of environments, the manifold health benefits of which many extol to this day. It should be noted, however, that several positive reports on its efficacy were written by Dr Edward Sheppard, the superintendent of the male side from 1862 to 1881 who was a great believer in hydrotherapy and whose idea it had been to introduce them at no small expense in the first place. While Dr Sheppard was unlikely to have persuaded the committee to install them only to subsequently conclude that they did not in fact have any useful effect, it is one of the few treatments available at that time which even a modern observer might concede may have been calming, cleansing, and relaxing for the patients, even if nothing more. In the same year, a significant donation of books was made to the asylum’s own library by a Mr W.H. Smith (1825–1891) whose family business expanded rapidly after he had opened a stall selling travel books at London’s Euston station in 1848. The asylum recorded its first death just eleven days after opening, with one Catherine Doudan dying following an epileptic fit; a total of forty-five patients died within six months of the asylum’s opening. Space for a cemetery had been made within the grounds, but was full by 1873, reaching its capacity of 2,696 bodies, most of whom were buried upright to conserve space; to keep costs down, no markers or headstones were provided either. From 1873, the asylum’s unclaimed dead were buried at the Great Northern Cemetery on Brunswick Park Road. A proper stone marker was placed at the asylum’s own cemetery many years later but subsequently removed and replaced by a single small stone. Almost offensively dismissive in its tiny stature and lack of specificity, the stone states only that it is ‘consecrated ground’; the thousands of souls once considered ‘pauper lunatics’ beneath it seemingly unworthy of stalling the living for even the briefest pause of acknowledgment, let alone to state their individual identities or the reason they are interred there. 38

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Although there were variations for certain festivities or due to changes in supply, for the first seventy years, meals for patients were drawn up to the same exacting specifications: Breakfast – 60 ounces of bread, 1 pint of cocoa, and half a pint of beer. Dinner – 7 ounces of uncooked meat, 4 ounces of dumplings, and 12 ounces of vegetables. 1 pint of soup on Mondays, 14 ounces of stew on Thursdays, and 10 ounces of pie on Saturdays. Supper – 6 ounces of bread, 2 ounces of cheese, and half a pint of beer. Knives and forks were finally provided in 1921, as meat had been cut up prior to serving and then eaten with a spoon up to that point; drinking glasses were also introduced to replace the grim tin cups in use since the asylum first opened. By 1905, one third of all patients at Colney Hatch specified their religion as Jewish, so kosher food was provided by external contractors. A Hebrew-speaking attendant had been tasked with also acting as interpreter since as far back as 1854, but a full-time interpreter was employed in 1893. Two patients with whom this Hebrew translator would likely have come into direct contact were David Cohen and Aaron Kosminski. Both were significant suspects in the case of the world’s most notorious serial killer – the man known as ‘Jack the Ripper’. The series of murders of women in the Whitechapel area between August and November 1888 shocked, terrified, and utterly fascinated London – but famously, no one was ever convicted. Over the years, theories have ranged from a rogue butcher, surgeon, vet, or physician, to occultists or even members of the Royal Family. Various members of London’s Jewish community were accused, due more to a general atmosphere of anti-Semitism than to any meaningful evidence. In notes made decades later, Aaron Kosminski was named as a significant suspect by Donald S. Swanson (1848–1924), the former Metropolitan Police superintendent who was a key investigator during 1888 when the ‘Ripper’ was still active. His notes (as well as those of Sir Melville McNaughton (1853–1921), another key investigator) stated that Kosminski had been identified by the only witness who ever 39

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actually saw Jack the Ripper’s face in person. However, this witness was aware of the potential repercussions if the killer were revealed as Jewish, and also unwilling to have the culprit’s inevitable execution on his conscience, and so would not agree to testify in court. The Aaron Kosminski who appears in Colney Hatch’s own case notes was described as an anti-social ‘imbecile’ who refused food or to be bathed by anyone else, and who would only eat when he picked up food himself from the floor. He was not considered to be dangerous or violent and was also not taken into the asylum until 1891 – three years

‘A Suspicious Character’ depicted in The Illustrated London News, 13 October 1888. Collection of the author. (Public domain)

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after the murders attributed to Jack the Ripper had stopped. Kosminski would remain at Colney Hatch before transfer to Leavesden Asylum where he would remain until his death there in March 1919, without ever being involved in any incidence of violence besides once momentarily brandishing a chair at an attendant. ‘David Cohen’ was a generic name often given to someone of Jewish descent who came into contact with police or other authorities when their real name could not be ascertained or understood, not unlike the modern ‘placeholder’ name ‘John Doe’. Brought into Leman Street police station in December 1888 after being found wandering ‘incoherent’ around Whitechapel, one particular ‘David Cohen’ remained uncommunicative and so was transferred to Stepney Green workhouse infirmary where he still refused to identify himself. Since nobody recognised him and no next of kin could be found, it is here that he likely acquired the ‘David Cohen’ pseudonym, simply in order that his paperwork could be filled out. This ‘David Cohen’ soon became too violent and aggressive for the workhouse, so he was sent under restraint to Colney Hatch, where he continued to attack attendants and other patients and had to be kept in isolation. He remained in restraints and under constant observation for the duration of his time there, before finally being confined to his bed where he died in October 1889. A man named Nathan Kaminsky lived at Black Lion Yard (now demolished) in 1888, at the epicentre of the area where the ‘Ripper’ killings occurred; this is known because he had been diagnosed with syphilis at the Whitechapel workhouse infirmary in March that year and discharged from there that May, after which he disappears from the historical record for good. This puts Kaminsky in exactly the right place at the right time as well as (considerably more speculatively) the syphilis infection also perhaps identifying him as an unmarried man who may have utilised the services of prostitutes. He would therefore eventually have also been very likely to have suffered from the severe effects that syphilis can have on the brain. As noted, there are all manner of theories about Jack the Ripper’s real identity, but one avenue proposes that between the inquiries of Swanson and McNaughton, the name given by the witness identification, the workhouse’s records, and the asylum’s own records, Aaron Kosminski was somehow mixed up with the quite similar-sounding Nathan Kaminsky and that the violent, aggressive man dubbed ‘David Cohen’ admitted to 41

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Colney Hatch in December 1888 was in fact Nathan Kaminsky. This theory would explain why Aaron Kosminski did not remotely fit the description of a violent, aggressive, woman-hater attributed to him by Swanson and McNaughton, or the profile of someone capable of murdering five women as well as so adeptly evading public notice and the attention of the police. As noted, Kosminski was also not admitted to the asylum until three years after the murders ended. Nathan Kaminsky, on the other hand – if indeed he and ‘David Cohen’ were one and the same – was apprehended and thus taken off the streets less than a month after the final killing, whereupon he attacked anyone he could at the workhouse and continued to do so at the asylum. Kaminsky would then also fit all of the attributes Swanson and McNaughton were looking for in the profile of the killer: Jewish, violent, mentally unsound, a known visitor to prostitutes, a hater of women, and a resident in exactly the right area during exactly the right window of time. This theory proposes that the killing spree of Jack the Ripper (aka Nathan Kaminsky – perhaps) ended because he had been locked up in Colney Hatch Asylum, where he was later ruled out of the detectives’ investigation when they visited him because the attendants there mistakenly showed them Aaron Kosminski instead. The author must reiterate that ‘David Cohen’ definitely having been a pseudonym (there have been people genuinely named ‘John Doe’, after all), and the mixing up of the names of the two men are key elements to this theory which require some significant supposition which is not – and is now unlikely ever to be – proven. However, it is certainly among the more interesting theories to emerge over the years, at least as credible as many of the others, and a fascinating potential explanation of both the origin and demise of the world’s most notorious serial killer. The CiL report of 1872 noted that Colney Hatch was becoming ‘unmanageable’ as its population swelled to 2,076 and its problems were exacerbated after all patients classed as ‘quiet’ were removed to the recently opened Metropolitan Asylums Board (MAB) asylum at Leavesden, only to be replaced by the most ‘troublesome’ cases from the workhouses. The CiL painted a reasonable picture of the asylum in many regards but criticised the state of the ‘dirty and noisy’ refractory wards, which they said were poorly managed with very little input from staff; patients were apparently sleeping on little more than sacking and there were no amusements or even decent chairs provided for the 42

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Colney Hatch A patient at Colney Hatch. Photographer unknown, c.1900. Courtesy of the Wellcome Collection. (Public domain)

wards, which stank of the faeces and urine which was allowed to soak down constantly into the flooring. In 1889, Colney Hatch passed into the hands of the newly formed London County Council (LCC) and became the ‘London County Asylum at Colney Hatch’. Due to the intense overcrowding, a set of single-storey buildings named the ‘X wards’ were built in 1896; intended only to be a temporary measure until the LCC’s new asylum at Bexleyheath opened in 1898, they were constructed from wood with a corrugated iron shell and housed 300 female patients. The CiL warned repeatedly that these structures did not meet regulations and that evacuation would be extremely difficult in the event of a fire. Seven years later, even after the LCC’s Bexley, Manor, and Horton asylums had opened, adding over 4,700 beds between them, the wooden structures remained in use. At around 5.30am on 27 January 1903, local residents were woken by the asylum’s siren and drew their curtains to see an ominous orange glow emanating from the grounds of Colney Hatch and lighting up the cold early morning sky; a fire had started in a clothes cupboard near the boiler house of the X wards. Despite being noticed quickly and the alarm being raised almost immediately by a nurse named Ada Woolford, the valiant attempts of the asylum’s staff and its own ten-strong fire brigade, along with numerous locals who climbed over the walls to help, were woefully inadequate to fight such an inferno. Flames rushed through the wooden interiors of ward X4 and its connecting corridor at shocking speed, fanned by gale-force winds, with the iron walls and roof said to have been white hot within minutes and the interior ablaze. The Hornsey fire brigade were the first of twenty-five horse-drawn engines and around 43

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200 men to arrive, but by the time they had dammed a nearby brook to obtain deep enough water for the pumps, almost an hour had passed and the fire had spread to the other X wards. The weekly Illustrated Police News covered the evacuation effort in its 7 February 1903 edition: One official declared that the terror of some of the patients was heart-rending, while others seemed utterly unable to appreciate the gravity of their peril. Many rushed aimlessly to and fro, unconsciously hindering the work of their would-be rescuers; others completely lost what little selfcontrol they ordinarily possessed and fought, he said, like fiends with each other, and some, apparently overcome by abject terror, and yet afraid that the rescuers intended to harm them, ran deliberately away from safety, and crouched beneath their beds, or in other places of imaginary shelter. ‘In fact’ said one official, ‘had every inmate been perfectly sane, escape would have been difficult in some cases and impossible in others, but being what they were, the marvel is that so many were got out alive.’ By around 9am, all the X wards were razed to the ground and when the flames were finally quashed, little was visible besides smouldering concrete foundations covered in hundreds of mangled and half-melted bed frames; the death toll gradually increased as charred bodies were discovered lying on floors or cowering in corners across the area, sometimes in piles of up to ten bodies all fused together. Fifty-one female patients aged between 19 and 77 perished that morning, with many others injured (as were numerous staff members including Nurse Woolford) and the next day Colney Hatch railway station was besieged by hundreds of anxious relatives seeking word of their loved ones as the news hit the papers. The LCC was held responsible in the subsequent enquiry, but in horrible parallel to more recent and similarly-avoidable tragedies in London, it does not appear that anyone with any personal responsibility for making the key decisions (or ignoring the advice) which led to the tragedy was held accountable in any meaningful way. It is still the thirteenth deadliest peacetime fire in British history and, as the observer quoted above notes, it was indeed a miracle more lives were not lost. 44

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The LCC’s architect William Clifford-Smith was set to work designing bricks-and-mortar replacements for the X wards and seven new villas were completed by 1913; one was to house young epileptic boys, one would operate as a tuberculosis isolation hospital, and the rest were allocated to the survivors of the fire. According to the CiL, Colney Hatch reached its all-time peak of 2,835 patients in 1915, although the asylum’s own records show a peak of only 2,654 much later, in 1937. A possible explanation for this discrepancy may be that the CiL counted the temporary patients transferred from internment at Alexandra Palace, while the asylum itself did not. These patients were citizens of German, Austrian, and Hungarian descent who had been rounded-up as a perceived national security risk in the months leading up to the First World War in 1914.4 Many of the detainees would have been married and settled with homes, businesses, and families just a few months earlier and suddenly found themselves locked up with around 3,000 others and sleeping on the floor of a huge, draughty old building, separated from their wives and children whom many would never see again; some were simply deported to Germany at the end of the war while others died at the palace or in similar places of detention. The mental health of many unsurprisingly deteriorated as a result of these sudden and utterly lifechanging experiences, with several hundred such cases being sent on to Colney Hatch. As with all asylums and hospitals, staffing was problematic during the war as patient numbers increased while staff numbers diminished, particularly on the male side. Many members of Colney Hatch’s staff enlisted and seven of them died ‘in service’ between 1914 and 1918. Dorothy Lawrence (1896–1964) attained some success in journalism with work published in The Times, and upon the outbreak of the First World War, she wrote to several newspapers requesting commission as a war correspondent. Meeting with no interest, unofficial sponsorship came from a sympathetic editor at The Times and so she travelled to France, volunteering as an aid worker and then as a freelance war reporter, although she was intercepted two miles short of the front line and ordered by French soldiers to leave. Sleeping in a haystack that night, the next day she headed to Paris and befriended some British soldiers stationed there. Persuading them to smuggle a uniform to her piece by piece, she also had her hair cut short 45

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and set about hiding her figure with corsets and bulking out her shoulders with padding. She would graze her cheeks to give the appearance of a shaving rash and darkened her skin with cosmetics, then got her new army friends to show her the basics of marching and drilling. Lawrence obtained a set of forged papers and became Private Denis Smith (sic) of the Leicestershire Regiment, setting off on bicycle for the front line at the Somme. On the way, she met a British sapper named Tom Dunn who told her of an abandoned cottage in a nearby forest; she would return there every night after helping Dunn with tunnelling work and living off whatever rations could be scraped together by Dunn and others sympathetic to her cause. While the cottage in the forest may sound idyllic, in reality it was cold and perpetually damp; the dangerous environment, malnutrition, and sleeping on a cold, wet mattress every night eventually took its toll and after ten days she was ill with chills, rheumatism and fainting fits. Knowing that letting herself get seriously ill might result in those who had helped her having to admit their knowledge of her actions in order to save her, she handed herself over to the area’s commanding sergeant and was promptly arrested. While initially interrogated as a spy, they soon concluded that she was some sort of prostitute, or ‘camp follower’. Lawrence had no idea what that term meant, and so hours of interrogation were conducted at confusing cross-purposes as she continued to appear evasive simply due to being ignorant of precisely what her interrogators were trying to get at. Even as they came to believe her story, they could not comprehend that any woman would willingly place herself in such danger, and when her true motivation was finally accepted, they were embarrassed that she had been able to fool anyone and fearful that her story might encourage others to attempt something similar. She was forced to sign a declaration that she would not publicise her story, on pain of imprisonment, and sent back to England. By pure coincidence she ended up on the same ferry as Emmeline Pankhurst (1858–1928), founder of the suffragette movement and a huge influence toward the independent spirit which had led Lawrence to France and back. Pankhurst was fascinated by her story and invited her to speak at one of their meetings. Attempting to get her story out upon return to London, the 1914 Defence of the Realm Act was invoked to thwart publication of Lawrence’s articles, so she instead wrote a book entitled Sapper Dorothy Lawrence: The Only English Woman Soldier (Bodley 46

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Head, 1919), but it was significantly censored by the War Office. Possibly as a result of the censorship and perhaps also due to its general spirit of challenging the patriarchal status quo, the book received largely dismissive reviews and did not sell well, leaving Lawrence with little money. She became increasingly ill, having contracted a form of debilitating septic poisoning during her time spent near the front line. As an unmarried woman with no family support (she was the only child of a single mother), increasing poverty saw her physical health decline significantly by the mid-1920s when she confided in her doctor that, as a teenager, she had been raped by her church guardian. While some commentators have speculated that making this accusation against such a ‘respected’ member of society may have been the sole trigger for her committal to an asylum, we do not know what other symptoms she may have displayed and cannot know this for certain, although – horribly – it is far from impossible. She was committed to Hanwell Asylum in March 1925 and moved to Colney Hatch in 1926, where she would remain until she died in 1964, on her 68th birthday. In the forty-odd years she spent at the asylum, Dorothy Lawrence did not receive a single personal visitor. In 1923, the railway station’s name was changed to ‘New Southgate’ (as it remains to this day) due to pressure from locals to disassociate their neighbourhood from the asylum, which by that time had become notorious, and in 1930 the official name of the asylum was changed to ‘Colney Hatch Mental Hospital’ in keeping with the Mental Treatment Act passed that year. Electric lighting was introduced in 1933, and the whole building was connected to the grid in 1935, with the gasworks then being demolished. The building was renamed yet again as ‘Friern Mental Hospital’ in 1937, largely to avoid the stigma that the name Colney Hatch had accrued over the preceding three quarters of a century. By the Second World War, Britain was better prepared with contingency measures in place as early as 1938 when conflict loomed again. At Colney Hatch, 770 beds were allocated to war use by departments of St Bartholomew’s Hospital, with 350 displaced female patients sent to Bexley Asylum. Up to 5,000 war casualties were treated at Colney Hatch each year between 1939 and 1945, including French soldiers and German POWs. Although the nearby Standard Telephones & Cables plant was the main target, the asylum and its grounds were also hit during German bombing raids and several attacks were fatal, the 47

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most severe instance occurring on 16 November 1940, when a parachute bomb destroyed three villas, killing thirty-six patients and four nurses. The emergency hospital closed on 30 September 1945 and life at Colney Hatch gradually returned to normal, its patient population now including many casualties of war. Around 1,800 windows had been smashed and with few resources to fix them, most were simply covered in black cardboard and not replaced until 1947. In 1948, Colney Hatch joined the rest of Britain’s former county asylums under the newly formed NHS but, oddly, it was a good decade or so after most other such buildings had already dropped the ‘mental hospital’ suffix that its name was changed for the last time to ‘Friern Hospital’ in 1959. Throughout the 1960s, work conducted by patients on the farm was gradually wound down and replaced by occupational, recreational, music, art, industrial, and social therapy. This happened across Britain as the asylum farms were closed (with Colney Hatch’s shutting down in 1965) and either sold or demolished, with food then being bought rather than grown or raised on-site. This was a positive step for some patients and of significant detriment to others and while never mandatory, it was strongly encouraged for those who were able. For some, such rural work was nothing but a chore, seen as barely above slavery, while for others it was a lifeline and a meaningful focus of energy that helped them contribute to something constructive, distracted them from negative

Colney Hatch from the air, c.1950. (Unmarked postcard, photographer unknown)

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thoughts and feelings, and allowed them to still feel useful. Frustratingly, under the guise of being purely beneficial to the patients, one regime which removed their autonomy and choice was simply replaced by another; each patient still did not get to choose for themselves whether to partake in such activities or not, as the farms were now gone. The impact this had on the finances of the asylums was also huge, as it meant they had suddenly lost their in-situ workforce, which had been an essential part of their ability to self-sustain since the earliest years. While the change was sold to the public as being purely of benefit to the patients, with hindsight many came to feel it had been rather more strategic and designed to create a self-fulfilling prophecy which was reframed at a later stage to argue for permanent closure of all the asylums on the basis they were not financially viable. By the 1950s at Colney Hatch alone, 74,300 meals had to be provided and 30,000 items of clothing and linen needed to be washed each week; this was in addition to the endless cleaning, maintenance, repairs, and decoration, much of which had been done by patients but was now performed by salaried or contracted staff. With successive post-war governments increasingly reluctant to spend taxpayers’ money on the actual taxpayers themselves, this would become an extremely handy point of persuasion when it was time to convince the public that the asylums were no longer ‘value for money’ – irrespective of any arguments about whether they still had any viable role in mental health provision. The industrial therapy unit did generate a little revenue as patients were paid a nominal wage for making toys, garden furniture, baskets, picture frames and the like, which were then sold at moderate profit. With the world outside the asylum having changed almost beyond recognition after more than a century, it is understandable that by the 1950s, light manufacturing and crafting skills were far more likely to be beneficial for employment upon return to the metropolis which the asylum now served than knowing how to grow vegetables or rear cattle. Indeed, even when the asylum first opened – given its catchment area – many of its patients found the idea of picking up a spade and working in muddy fields annoyingly quaint and arcane. In 1958, the Halliwick Hospital was built on the western side of the grounds and this large new building which was able to house 152 beds was given a distinct name to help distinguish it from the old asylum. Its purpose was to provide care purely for voluntary in-patients and visiting 49

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outpatients, and there was an evening clinic so that patients could attend without disrupting their work or having to inform their employer. Despite such progressive steps in certain regards, the institution was criticised – along with others – in the book Sans Everything: A Case to Answer (Nelson, 1967), compiled by Barbara Robb. Most of the allegations related to neglect, particularly in the cases of elderly patients, but there were also instances of direct abuse documented. There is a demoralising case where one woman documents the difficulties she experienced in trying to get straight answers or even unsupervised access to her father once he had been admitted, and her horror at the misery, fear, and hopelessness she could see overtaking him. She makes the point that if she, as a strong and proactive woman with a history of working in mental health organisations, had struggled to get her voice heard or to affect change, what hope could a patient locked up in that institution or a hundred similar ones around the country without such an ally or advocate possibly have of making a complaint or effecting their release? Such cases highlight one of the persistent problems with guaranteeing a voice for those housed in such institutions; in Victorian times, the CiL would visit and make a point of speaking to every single patient, and they appear to have been genuinely sensitive to the need for patients to be able to see them alone upon request. But one must wonder how many were ever completely honest, or simply remained silent given their knowledge that any serious accusation against staff or the regime would require their complicity be exposed to persons with such total physical control over them, and within an environment from which they could not remove themselves by choice. A common occurrence during the CiL’s visits was of patients asking them what they needed to do to be released from the asylum; the CiL’s representatives would tell them – quite correctly – that responsibility for this ultimately lay with that particular asylum’s own committee. The patients would then, in the rare instances when they could get anywhere near a committee member, be told that they should wait for the CiL inspectors to come around again and ask them. This Kafkaesque scenario is reminiscent of attempting to get a response to a very important query only to end up stuck in a loop between a website that refers you to a helpline which then refers you back to the same website ad infinitum. Obviously, such misery is trifling compared to the horror and frustration which must have been felt by those who were essentially being told they should wait months, 50

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or perhaps even another entire year of their lives locked in the asylum before their complaint or request might even be heard. In Colney Hatch’s case, the Sans Everything accusations led to an inquiry which did little to address such systemic problems but did expose a litany of more general issues, many of which were concluded to be down to the poor financing the asylum received and its knock-on effects of understaffing, inadequate facilities, and a lack of recreational activities. In 1965 for example, the health board responsible asked for £127,000 for essential repairs and yet was granted only £13,000. In 1970, as a sign of the changing times, the strict separation of genders was abolished as mixed-gender wards were created. With a donation of £500 from the nearby Minchenden School, the ‘Radio Friern 350’ station began broadcasting in 1971 – 350 being the extension patients could call to request songs – and Pete Abbott, who would go on to host talkSPORT and Talk Radio, was among its several presenters. In 1981, the 8ft walls around the perimeter, originally erected both to deter escape as well as to block prying eyes, were lowered to around half that height. In the same year, the former bakery was converted into The Bakehouse Boutique, where quality clothing was sourced cheaply and sold at cost, so that long-term in-patients could shop for clothes they actually wanted to wear, rather than having to wear those from the asylum’s communal supply. It was opened by then Prime Minister Margaret Thatcher (1925– 2013), who would hammer the final nail into the coffin of the former asylums (for better and for worse) just two years later with the 1983 Care in the Community Act. By then, Colney Hatch was run by North Camden District Health Authority and cost around £13 million per year to run: a quite significant figure, but one which provided for 950 in-patient beds, 4,000 outpatient attendances, and 20,000 day-hospital visits per annum. Thatcher had determined to close the asylums in order to recoup this money and provide care and treatment services from within the ‘community’ – although she was never specific about whether or not this ‘community’ was one and the same as the ‘society’ that she herself would famously claim in a 1987 interview did not even exist.5 Either way, the writing was on the proverbial wall and by 1990 only 419 patients remained. In 1991, an amateur artist named Andolie Luck visited a friend and was shocked by the stark, yawning grimness of the main corridor; she was given permission to paint images along most of its length, taking ‘requests’ from patients and staff alike, perhaps 51

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the most unusual of which came from a pest controller who asked for images of a cockroach and a rat, which were duly added. The last ever summer fayre – a fixture much enjoyed by patients and the surrounding community alike for more than a century – took place in 1992 and a farewell party was held in the recreation hall on 19 February 1993. The main building at Colney Hatch finally closed after 142 years on 31 March that year. Each item in the building was catalogued, with Hampstead NHS Trust getting first pick of any items they felt might still be useful, while the rest were put up for auction; around 400 beds and mattresses were bought by the Sudanese government and shipped there. As the layers of the building’s many years of modification were stripped back, asbestos was found, and this alone cost over £500,000 to remove, with another £500,000 spent on clearing the south side of the grounds which had been used as a rubbish tip for more than a century. Just under £1 million more was spent on decommissioning the remainder of the site. Colney Hatch had been used as a location for the satirical British film Britannia Hospital (1982), directed by Lindsay Anderson and starring Mark Hamill, Leonard Rossiter, and Malcolm McDowell. Shooting was permitted as the film satirised a general hospital rather than a psychiatric one. After closure, it also served as the location for Beyond Bedlam (1994) starring Craig Fairbrass and Liz Hurley. Some of the wards added to the rear of the building in 1859 had already been empty for many years and were demolished as early as 1993; but the rest of the site sat unused until 1997, when building work started on the Friern Bridge retail park (against local protests) and Halliwick Park Estate. Both would open in 1998, with housing covering much of the rest of the south and west of the site over the following years. As far back as 1986, a certain development company had been slavering at the lips to acquire the site and had put in an application to demolish all of the original buildings; fortunately that bid was rejected due to the acquisition of a Grade II listing four years earlier. Despite an initial valuation of around £14 million, the site was eventually sold to the Brookstream Corporation for what was described in the local press as ‘a nominal sum’. Work began in 1996 to turn the main building into ‘Princess Park Manor’ in phases, with the first finished in 2000 and the last apartments occupied as late as 2009. The conversion was designed by the architect Peter Smith, who sadly chose to demolish more of the building, including some listed areas, as well as dividing up the famous main 52

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corridor by incorporating it into the new apartments. New sections were added to the east wing, even though planning permission had not been properly obtained; however, these are at least very much in keeping with the original buildings. Thankfully, the external appearance was almost completely retained and acid cleaning saw it returned to its original colour, with the whole building now looking similar to when it was new, albeit with its spectacular span somewhat diminished and scores of cars now parked in front. The chapel was gutted and replaced with a gym, which incorporates a swimming pool and a bar. As a condition of any proposed conversion plan, part of the grounds had to be allocated for use as a public park and this opened as ‘Friern Park’ to the northwest of the site in 2002, to the distaste of many of the building’s new residents. Indeed, groups such as One Direction, JLS, Busted, 5ive, and Girls Aloud, who once drew legions of adoring followers, all had members living at Princess Park Manor at one time or another, along with millionaire footballers such as Ashley Cole and Jermaine Pennant. For a while, this drew fans, stalkers, and undiscerning autograph hunters to the site as London’s second pauper lunatic asylum became one of the most desirable and expensive addresses in London.

Colney Hatch as ‘Princess Park Manor’. (Copyright Ed Brandon)

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Chapter Three

Banstead (3rd Middlesex / London County Asylum) High Down Road, Sutton, Surrey, SM2 5PD

Banstead represented a third attempt to curtail overcrowding at the two earlier Middlesex county asylums as the nineteenth century wore on and London expanded exponentially. In 1873, suitable land for building was acquired at Hundred Acre Farm, on the Banstead Downs in Surrey, near to the village of the same name. It was around 12.5 miles south of London on a slight elevation, offering views across the surrounding ‘downs’: a common feature of that part of the country consisting of chalk hills covered in grass. It was an inexpensive area at that time, with the land costing Middlesex just £10,000. Frederick Hyde Pownall (1831–1907) was Middlesex’s county surveyor, a post he held for around forty-five years and which involved overseeing the county’s official architectural and building work. His projects included making alterations to the county’s Sessions House and extensions to Coldbath Fields Prison (both at Clerkenwell) as well as designing the Middlesex Guildhall at Parliament Square in Westminster. Independently, he specialised almost exclusively in Catholic churches and other religious architecture, having converted to Catholicism himself in the 1880s. Within London, he designed the churches of St Philip & St James at Twickenham, St Peter’s at Wapping, Sacred Heart at Holloway, Corpus Christi at Covent Garden, and the Most Holy Trinity Monastery at Notting Hill. Despite having no previous experience designing asylums, it was not uncommon for the county surveyor to be called upon in this regard when needed, and although he had studied under Samuel Daukes – the architect of Colney Hatch – Pownall took his influence for Banstead directly from the two Metropolitan Asylums Board (MAB) ‘idiot and imbecile’ asylums which had recently been built at Leavesden in Hertfordshire and Caterham in Surrey to serve the north and south of the metropolitan area respectively. 54

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Caterham and Leavesden were essentially identical; both were designed by John Giles and Edward Biven and had opened in 1870 within just ten days of each other. While Banstead sported aesthetic differences and some very minor changes to its layout, Pownall copied their design almost to a tee and so Banstead was arranged according to what has become known as the ‘dual pavilion’ or ‘parallel pavilion’ plan. The ‘pavilion’ plan (singular) had become a common layout used for various types of hospital and saw each of the ward blocks attached to a single main corridor in the form of separate ‘pavilions’,6 whereas the ‘dual pavilion’ layout essentially doubled the number of blocks by having two main corridors, one on either side of the various admin and service buildings aligned along the centre, with the pavilions attached at right-angles to both corridors and standing one behind the other (or next to each other, depending on the angle of view). The main benefit of this design was that it made very economical use of the available space: the two parallel sets of pavilions could each have their own corridor rather than utilising a single exceedingly long one which, in a building intended to hold as many beds as Banstead, would have left the furthest-flung wards at impractical distance from the central services and admin areas. This was doubly convenient at an asylum, where a symmetrical division between the male and female sides of the building was felt to be required anyway; each block could also face its own adjacent airing court created in the space between that one and the next. The main drawbacks of the plan were that its ultra-economical arrangement sacrificed many of the ideals of space, light, and openness which had long been considered essential to asylum design; each ward blocked the light available to the ones adjacent to or behind it, as well as obscuring the pleasant views of nature that were considered such an essential part of the curative regime. Banstead’s airing courts were also somewhat smaller than those of many county asylums in relation to the number of patients housed on each ward. These factors speak volumes about the county’s attitude toward the patients who were expected to occupy Banstead, at least at the time when it was being planned; a scheme to allocate patients with ‘brighter’ prospects to one asylum while ‘warehousing’ those not expected to recover in another one had been blocked by Dr John Conolly and others when Middlesex was planning Colney Hatch back in the late 1840s. However, twenty-five years later that was the role Banstead was 55

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primarily intended to fill, housing only chronic and ‘imbecile’ patients. Its layout reflected that intention and at only £18,500, it was also the cheapest asylum built by Middlesex or London County Council (besides Manor at Epsom, which was intended to be temporary). The idea was blocked by the Commissioners in Lunacy (CiL) however, who forced the LCC to use Banstead for all classifications of patient. For the reasons outlined above, the dual pavilion layout soon fell out of favour. As noted, it was seen at Caterham and Leavesden and was used again at St Augustine’s (2nd Kent County Asylum of 1875) which was also co-designed by John Giles, but Banstead was the last contemporary example. The MAB’s Tooting Bec Asylum of 1903 was built to a similar principle but was excused its focus on economy since it was only intended to house immobile senile and short-term patients, while a final ‘proper’ dual pavilion cropped up one last time many miles away in Lancashire at Calderstones, planned as that county’s sixth asylum in 1906 but not opening fully until 1920 as a ‘Certified Institution for the Mentally Defective’; built at a time when economy was paramount, that building was built as cheaply as possible, but the pavilions were set out with greater space between them in order to overcome some of the design’s inherent flaws. Banstead opened on 23 March 1877 with beds for 625 male and 1,075 female patients allowing for 1,700 in total. Arrival via High Down

Banstead from the north-west. The admin block is in the centre with its spire. The chapel’s bell-cage can be seen to the left, with the water tower behind it. Unmarked postcard, c.1910. Collection of the author. (Public domain)

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Road led the visitor past a gate lodge and into the asylum’s grounds where the driveway led south toward the laundries and workshops at the rear of the complex or west along the northern edge of the building to the admin block and main entrance located at the very westernmost point. Banstead’s admin block was the most notable deviation Pownall made from the aforementioned MAB asylums and was among the most handsome examples of its kind. Grandiose and generously proportioned, it incorporated wings and bays with grouped pairs and trios of arched windows, and a central portico stood over the entrance topped by additional sets of arched windows leading up to a stone pediment featuring the coat of arms of Middlesex. Above that was an imposing clock tower with a four-faced mechanism, surmounted by a copper dome with its own small bell cage and spire on top. A corridor led from behind admin and into the main north-south corridor at the front of the building, which at either end turned east at a ninety-degree right-angle to form the two main east-west corridors skirting the edges of the central services. Each of these was 730ft long, with smaller spur corridors leading off to their respective sets of pavilions. At Banstead, there were originally ten such pavilions, six on the female side to the north and four on the male side to the south, with one more added to each side in 1881. While Pownall made the size of the day-rooms a little more generous than at the similar MAB asylums and each set of blocks differed slightly based on the category of patient being accommodated, the main differences to those earlier buildings were really only aesthetic. Additional spurs designed by George T. Hine were added to two of the blocks in 1893. Behind admin sat workshops, delivery areas, and storerooms, followed by the kitchens, with the recreation hall located behind those. The latter was of a good proportion and featured a stage and backstage area, with tall, elevated windows and an open-beam ceiling; however, it was among the most plain and functional example seen at any of Britain’s county asylums. The fact that such unusually fine decoration had been lavished on the admin block but so little on the hall – the latter usually being the one area where the purse strings were loosened a little purely for the benefit of the patients – again says much about the county’s attitude toward those originally expected to be using it; they were an obligation to be met in as cost-effective a way possible. The water tower and boiler-house chimney were combined into one structure 57

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and sat adjacent to the hall, and the tower was of the more functional type and again quite plain, with a pyramidal wooden top. The laundry and drying grounds sat behind the tower to the very rear of the building. The chapel was attached to the main corridor at the front of the building next to the admin block and attendance was expected of all who could. The site also included assorted farm buildings and houses for senior medical staff. Housing for less senior staff was initially within the asylum itself but developed elsewhere in the area over time, mostly in the village and in the nearby Belmont area, although there was a string of semi-detached houses for married staff within the southern boundaries of the site. A small fire station with a portable engine was incorporated into the original plans too, since the nearest fire brigade was based around 3.5 miles away in Purley, and would at that time of course have only been horse-drawn. There was also a burial ground adjacent to what is now Fairlawn Road. Padded cells were also installed at Banstead; consisting of straw or other soft material covered in painted leather panels, they had been introduced in the late 1830s in order to replace the bindings and mechanical restraints used before them, which often led to injuries and greater indignities as attendants struggled to wrestle combative or self-destructive patients into them. Despite the horror they tend to evoke now, at the time, padded cells were seen as a far more humane solution to an obvious problem: they stopped patients from hurting themselves and reduced the chances of them being injured, including epileptic patients during a fit. The revulsion they evoke has been significantly stoked by their grim portrayal in various forms of media over the years, but there is of course an innate fear of the isolation and sheer helplessness they represent. They did also readily lend themselves to abuse or misuse, and the fact that they blocked sound from both inside and outside meant that placing a problematic patient within one was an inevitably tempting option for an overburdened or lazy staff member, and an obvious means of threat or punishment available for use by a cruel one. In the interest of offering varied perspectives however, some former patients speak of actually enjoying these soft, quiet, isolated rooms occasionally, while staff recall patients who would ask to be allowed to use them when they knew they needed some ‘alone time’. Padded rooms are also still made and used today, although they are now usually called ‘quiet rooms’, ‘cool-down rooms’, or something similar. 58

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A Pocock Brothers padded cell, identical to those used at Banstead, as seen from inside. (Copyright Darren Robertson)

In March 1889, London became its own county with Banstead formally becoming the 3rd London County Asylum. Among other changes, the LCC withdrew beer from the diet at all their asylums in 1890 against the wishes of the CiL, who felt it was physically beneficial as well as good for general morale. In 1894, the CiL stated, unusually forcefully, that it was unfair to inflict the beliefs of ‘an intemperate [sic] minority’ on those who would be free to choose whether to drink or abstain from 59

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alcohol if they were not within an asylum. They also stated that ‘an asylum is not a reformatory’ and that ‘total abstinence is not, in fact, the same as temperance anyway’. As the temperance movement spread across Britain, many other asylums saw the withdrawal of beer from the menu, although as seen at Hanwell, it was eventually removed from all of them as the treatment of mental problems relating to alcoholism became more common. In 1895, Banstead attempted to address its inevitable overcrowding problem by building temporary wood and corrugated iron ward blocks within the grounds to house 300 male patients. Similar buildings had been constructed at Colney Hatch around the same time, but the horrific fire which tore through the ones at that asylum in January 1903 led to their replacement at both sites, with five new brick-built blocks added to the south of Banstead in 1904 by William Clifford-Smith, the LCC’s architectural engineer. In 1912, the LCC purchased the adjoining Fairlawn farm, which added eighty-three acres to the asylum’s land, giving it 200 acres in total, 130 of which were then used for farming. In 1918, in a progressive move pre-empting the 1930 Mental Treatment Act that would see the world ‘asylum’ shorn from the official terminology across Britain, the building became formally known as Banstead Mental Hospital. It was ahead of the curve again in 1937 when the ‘mental’ prefix was also dropped a decade before the foundation of the NHS in 1948 would make that practice standard, and it became formally known as Banstead Hospital. A nurses’ home was built in 1931, freeing up the on-ward sleeping quarters previously occupied by nurses which were then converted into space for forty-one female patients. In 1932, a large admissions, or ‘acute’ block was built to the northeast of the site away from the main buildings to admit patients for screening and assessment before they were moved into the main building; it was similarly divided into male and female divisions, each able to accommodate up to fifty patients. Banstead was not taken into military use during the First World War and was instead among the asylums which received patients from others requisitioned by the War Office. However, five wards were cleared for use as an emergency hospital in 1939 and that same year Banstead reached its peak population of 2,687 patients. Just one year later its role was given a re-think and the same wards were instead used to accommodate 400 service personnel suffering from various mental health problems, 60

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and some of the grounds were also used by the War Office as a military camp and later as a POW camp. Although numerous bombs fell near to the asylum, only one actually hit it, destroying a detached fourteenbed male villa but thankfully causing no human casualties. Banstead joined the NHS in 1948 and the five wards were handed back with all associated military activity coming to an end by the close of 1950. Four wards initially remained empty as it was felt they required repair and modernisation before being brought back into mental health use and the whole building received a significant update and refurbishment over the following few years. A patients’ club room, hairdressers, library with a reading room, and canteen were all added; the X-ray equipment was also updated, and a new internal telephone system was introduced. However, while many areas and facilities were upgraded, with televisions also placed on the wards, others were becoming increasingly outdated by the standards of the time: some of the washrooms still only had cold water available. The interior of the admin block and other office areas were, in the opinion of the health authority at least, ‘spruced-up, modernised, and made to look better’. From a purely aesthetic angle, concepts such as ‘modernised’ and ‘made to look better’ often seem to have been mutually exclusive at most asylums in the 1950s, just as they were at that time in most of the towns they served, which – to modern eyes at least – often looked far more pleasing, welcoming and ‘human’ before the designers and planners of the 1950s had finished letting their imaginations run riot on them. As with all of the asylums in this book, Banstead administered electro-convulsive therapy (ECT) and trans-orbital leucotomies; two of the most notorious and reviled ‘treatments’ ever associated with asylums – in the popular imagination at least. ECT was first used in 1938 by the Italian psychiatrist Ugo Cerletti (1877–1963) and initially involved placing electrode pads on either side of the patient’s head and administering a brief electric shock of between 70–120 volts. Initially, this was done without anaesthetic, resulting in the patient thrashing around and often breaking bones; anaesthetic and muscle relaxants were soon introduced, but the patient still had to be physically held down by several nurses, making it a singularly terrifying and traumatic experience, even for those who went in willingly. Its main purpose was to treat depression and, for a significant number of patients, 61

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it did actually work. While it was certainly used with over-enthusiasm at asylums, often amounting to unnecessary, if not deliberate, torture for patients who didn’t want or need it, it is still commonly used today – mainly for those with major depressive disorders and bipolar disorders where drugs have not proved effective. It can now only be given with consent, although there is still some debate in psychiatric circles about whether it should be used as an early intervention or only ever as an absolute last resort. The Portuguese neurologist and surgeon Antonio Moniz (1874– 1955) experimented on chimpanzees by removing areas of their frontal lobes and found that one of them appeared to experience reduced stress when failing at a subsequent memory test. Despite the fact that the other chimp appeared to be more agitated, he began to experiment on human patients in 1935, drilling holes through the bone behind their eye sockets and introducing ethyl alcohol to specific areas to burn away the brain tissue. He then developed more dedicated tools to accomplish the same task, which he called a ‘prefrontal leucotomy’.

Typical ECT machine from the 1950s. Now housed at Glenside Hospital Museum, Bristol. (Copyright Ed Brandon)

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The American physician Walter Freeman (1895–1972) was of the firm belief that mental disorder was an organic problem, and not one that could be solved through discussion, occupational or art therapy, psychoanalysis, etc., so after he learned of Moniz’s work, he modified the procedure and first performed it on a patient at his private clinic in 1936, calling his technique a ‘lobotomy’. By 1945, he had simplified his procedure to involve nothing more than what was essentially an ice-pick, forced under the eyelid and through the thin bone at the back of the eye socket, then manipulated by hand (not with the aid of an X-ray or other imaging tool, but only by a combination of good anatomical knowledge, a little guesswork, and a terrifying degree of luck), and moved back and forth to sever the neuronal tracts at the front of the brain. This procedure became known as the trans-orbital leucotomy/lobotomy. While many in the medical community were highly sceptical of Freeman’s methods, the American press enthusiastically promoted his work, and others (including desperate patients) were keen to try out his potentially life-changing cure. While it did succeed in reducing stress and anxiety in many, it also had a range of side effects including apathy, poor concentration, and passivity – the latter of which is key to its sinister reputation as a procedure used to forcibly turn ‘problematic’ patients into quiet, complicit ones. Freeman toured the USA, developing and playing up to his new-found semi-celebrity status, performing his technique to audiences (in as seemingly inappropriate locations as hotel rooms) and even manufacturing his own line of ‘Freeman’ branded ‘orbitoclast’ sets – essentially little more than a modified ice-pick, complete with complimentary hammer for knocking it into place. Freeman’s manipulation of the media meant that scientific and medical criticism of the technique was not what was hitting the headlines, and it was used at most asylums to varying extents from the late 1940s to as late as the mid-1960s, with the new anti-psychotic drugs of the mid-1950s seeing its gradual phasing-out. Freeman himself was able to perform the whole procedure in as little as ten minutes, so for many it did appear to be an ugly but potentially valuable option. However, he personally conducted or supervised around 3,500 lobotomies between 1936 and 1967, and 490 of those patients died as a result, giving him a 14 per cent fatality rate. Around 5 per cent of the tens of thousands of patients who had the procedure performed in hospitals and asylums also died as a direct result, and that figure would be higher if ‘indirect’ results were also taken into account. 63

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In 1951, one ward at Banstead became the Regional TB (tuberculosis) Unit with thirty-eight beds (later expanded to 100) allocated to male patients with TB who also had mental health problems; they would receive the same surgical or chemotherapy treatments as other TB patients, but it was felt that this particular patient group could or should not be treated in general hospitals. The TB unit continued operating into the 1960s, as Banstead’s in-patient numbers began to decrease in line with all the former county asylums. In 1967 it had 2,005 beds in total and just a year later, that figure had fallen to 1,599. The book Sans Everything: A Case to Answer (Nelson, 1967), compiled by Barbara Robb, detailed cases of abuse, neglect, mistreatment, and mismanagement at various British asylums during the early 1960s (also discussed in the Colney Hatch chapter). Most contributors remained anonymous, making it difficult to substantiate certain claims or even to pin down exactly which asylums were being referred to. Robb clarified that the reason for this was partly to protect her whistle-blowers, but also because the book was intended as an attack upon the systems which allowed such abuses to occur at all, rather than being intended only to highlight specific cases, which she felt would only allow the more systemic problems to continue or re-emerge over time. In 1967, the health board organised a committee to investigate allegations in the book believed to have occurred at Banstead regarding the rough treatment of elderly patients, general neglect, and a lack of stimulation for the patients. The anonymous author of that chapter noted: To be a doctor in that hospital often seemed no more than a form of play-acting. You put on a white coat, stuffed a stethoscope in your pocket, and hurried down the long corridors looking at your watch, in a kind of white-rabbit act. But you would seldom go into the wards. Perhaps it was too disturbing to look the real facts in the face. Staff were also accused of charging patients five pence each for supplying them with tea and bread on the wards, as well as taking similar ‘perks’; quite a lucrative little business to conduct daily on a ward with eighty patients who had no opportunity to shop elsewhere and little else to do with their money. At that time, five pence would buy a whole loaf of 64

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bread, a pint of beer only cost eight pence, and twenty cigarettes were around twenty-five pence. The committee asked staff to whistle-blow, assuring them they could do so anonymously if they wished. They also decided not to contact any former patients who had been resident at Banstead during the period specified under the oddly presumptuous premise that it would not be worthwhile because many may have died or changed their address in the intervening years, while others might not wish to have a letter relating to their time in a mental hospital suddenly drop on their doorsteps. The latter point was a considerate one, but it also rather conveniently eliminated all of the most lucid witnesses, leaving only the longer-term patients who were still not well enough to have been discharged and who were also still under the control of those they may have wished to make complaints about. Twenty-five replies were received from staff, and all claimed to have no knowledge of any ill-treatment, wilful neglect, or informal moneymaking schemes. According to the report, many instead mentioned all the improvements made to the quality of life for patients and noted good relationships between staff and patients in general, with the only significant criticisms being around staff shortages and the difficulties caused by the employment of foreign staff ‘who could scarcely speak English’. One doctor mentioned a general despondency and apathy throughout the institution, noting that the knowledge among staff of the asylum’s planned closure in a decade or so (it would end up taking longer than that, but their suspicions were essentially correct) was inevitably detrimental to the interests and welfare of staff and patients alike, and this amounted to the most significant criticism the committee found or chose to include. Twelve replies were received from persons involved with external bodies and other organisations (health authorities, visitor groups, patient advocacy groups, etc.) along with responses from each of the five chaplains working at Banstead. All made similar statements to the effect that they had not witnessed any abuse and, with one exception relating to one single case, had also not received any complaints from any of the patients they visited or worked with. The single incident noted was attributed to a patient described as ‘confused’, and the worker who reported it stated he had encountered no other problems or complaints despite having regularly visited forty different patients at Banstead over 65

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the preceding fifteen years, all of whom he stated had been ‘very nicely looked after’. Unhelpfully, the committee noted precisely how many responses it had received from each of the various categories of current and former patients and staff in some cases but not in others, leading to a sense of obfuscation around some of their conclusions. For example, where it notes that only two of the in-patient respondents offered what it called ‘minor criticisms’, it fails to explain either what these were or even what proportion of the total responses that figure represents; there obviously being a significant difference in the conclusions an observer might draw if those patients were, say, two respondents out of a total of forty, or two out of a total of four. The committee concluded that there was no good evidence to support any of the allegations made in the book, stating: We have examined the situation in the wards today and found that they are being managed and the patients are being treated as well as the conditions set by Banstead’s heritage will allow. The medical and nursing staff alike have departed [from] the old Victorian approach of keeping mental patients in custody and deliberately isolated from the outside world to the modern appreciation that all patients, whatever their age, are admitted primarily for treatment with a view to cure and discharge at the earliest opportunity. The removal of bars and the unlocking of doors are signs of the change which has seen the development of, for instance, the large industrial training organisation, the mother and baby unit, the social club, the development of outside contacts, and the introduction of many new medical policies and treatments. Reorganisation in 1974 saw Banstead’s catchment area focus on Victoria, Kensington, Chelsea, and Westminster. As regional health authorities were constantly rearranged during the 1970s and 1980s, links were formed between Banstead and Horton Asylum as they both came to serve the same general catchment area around the West End of London. Banstead’s patient population was wound down rapidly by the early 1980s, with most of its long-term residents who could not be re-housed 66

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Banstead, late 1970s. The admissions block can be seen to the top right of the image, while William Clifford-Smith’s 1910s extensions are visible to the centre-bottom. (Photographer unknown)

in hostels or local general hospitals moved to either Horton or Cane Hill. It became the very first of Britain’s county asylums to fully close its doors for good, and as such, served as something of a prototype (some might say ‘guinea pig’) for the scores of others which were by then scheduled for the same fate. Banstead was not considered to be a successful model in this regard for a number of reasons, but particularly because the practice of simply moving patients into other asylums which were themselves only scheduled to remain open for perhaps another decade or so was confusing and distressing for patients and staff alike; it also merely stalled the inevitable closure of those institutions which received the patients, meaning many of those transferred would eventually have to go through the same traumatic upheaval all over again. In October 1986, Banstead became the first former county asylum in England and Wales to fully close, as well as the first to be demolished. New construction began in 1989 with the Category B prisons of HMP High Down and HMP Downview both opening on Banstead’s former 67

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site in 1992. Only the gate lodge, a few senior staff buildings, and some farm buildings remain of the original asylum, while the later admission block and nurses’ home were retained and incorporated into HMP Downview. The asylum’s burial ground has been left undisturbed and is currently kept in a neat condition. Adjacent to HMP Highdown’s entrance, the white stone pediment of Banstead’s once-spectacular admin block sits on a pedestal as a reminder of what once was. It stretches credulity to think that at least this beautiful, high-quality part of the building could not have been retained, re-purposed, or otherwise incorporated into the new structures in some way, given just a little will and imagination, but the whole of Banstead was long gone before any new building work had even begun.

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Chapter Four

Cane Hill (3rd Surrey County Asylum, later 4th London County Asylum) Lime Tree Avenue, Coulsdon, Surrey, CR5 3GB

Surrey initially built three county asylums: Springfield at Tooting (now part of London) was the first to open, in 1841, followed in 1867 by Brookwood near Knaphill, Surrey. Both were expanded numerous times, and by the late 1870s, each had more than double its initial capacity, with Springfield even having to lay out beds for patients in its basement corridors. As a result, pressure mounted on the Surrey authorities to provide a new county asylum and thus Cane Hill was designed as their third. An advert was placed seeking a piece of land of between 100 and 150 acres, with good road access but no public footpaths running through it. In response, land was offered at the price of £70,700 by one Edmund Byron (1846–1921), a Surrey magistrate and the Lord of the Manor of Coulsdon. This land had been a part of the Portnalls estate, consisting of around 131 acres including timber and farm buildings. As the county surveyor for Surrey and consulting architect to the Commissioners in Lunacy (CiL), as well as designer of the county’s earlier Brookwood Asylum, Charles Henry Howell (1824–1905) persuaded the Surrey authorities not to expand the earlier asylums and instead accept the offer of the Portnalls land to build a new one. Howell duly provided his designs and the clerk of works, foreman, and labourers (many with their families in tow) moved onto the site in June 1880. There must have been some concerns over their welfare, perhaps due to local opposition, as the Surrey authorities requested that the Metropolitan Police strengthen their presence in the area while the building work took place. Besides Brookwood, Howell had also designed Fair Mile (1870) and Broadgate (1871), which were the county asylums for Berkshire, 69

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and the East Riding of Yorkshire respectively, and he would go on to design St Luke’s in 1898, which served Middlesbrough and Cleveland. The first two were variations on the standard ‘corridor plan’, but Cane Hill was to be something else entirely. The ‘radial pavilion’ was a variant of which some argue Cane Hill was the only true example. While Cane Hill’s layout was certainly unique, its origins and influences were very much evident in the transitional design made by Robert Griffiths for Parkside (South Cheshire County Asylum of 1871), which then influenced Henry Littler’s design for Whittingham (4th Lancashire County Asylum of 1873) and the latter was arguably the first of four radial pavilion asylums built in Britain.7 In this layout, a horseshoe-shaped main corridor saw the pavilions (ward blocks) positioned around its outer edges at right-angles to the corridor’s curve, creating an overall layout which appeared almost semi-circular if viewed from above. Central services sat along the middle of this ‘up-turned horseshoe’ shape and were linked to it and each other by additional corridors criss-crossing the centre of the building.

Ground floor plan of Cane Hill (including later additions) by Charles Howell. Lithograph accompanying annual report by the Commissioners in Lunacy, 1892. Collection of the author. (Public domain)

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At Cane Hill, Howell tightened up Whittingham’s more spread-out design so that he could not only add twice as many pavilions, but so that it could also be easily expanded in future by simply extending the main corridor and adding more. This would indeed be the case, but only to the extent that Howell’s initial design allowed; Cane Hill was an incredibly complex and ‘dense’ building which packed a host of different structures and spaces into its tight footprint of around twelve acres, so there would be little room for further expansion beyond what he had allowed for with his initial design. The ‘radial pavilion’ would come to be viewed as an important but failed experiment that acted as a transition between the earlier corridor plan and the later ‘echelon’ or ‘compact arrow’ plan, largely because it prioritised economy of space over patient comfort. Since the blocks were so densely packed together, with many also positioned at unusual angles, it packed a lot of ward space into a relatively compact area, but this led to a curtailing of panoramic views and sunlight for many of its wards, as well as a more stifling sense of enclosure, much as had been the case with the prison-like ‘radial’ plan last used for an asylum over sixty years earlier. There was a ‘north lodge’ on Portnalls Road and a ‘south lodge’ on what is now Lime Tree Avenue: a driveway eventually curtailed by the A23, which cut through the southernmost grounds alongside the railway line. From either entrance, driveways ran around the building and eventually led to the admin block at the far south of the complex; the southern one was eventually flanked by a long line of beautiful trees leading up the hill to the main entrance, and since the asylum sat at the peak of the hill 450ft above sea level, visitors arriving on foot would have to make this climb which, although gradual, was still a tiring 180ft above their starting point. Cane Hill was generally symmetrical, albeit with many small differences to each side. The female division lay to the west and the male division to the east, and the whole complex was angled to face southeast rather than directly south. After a visitor had struggled up the southern driveway and made a sharp right turn, the asylum – thus far only glimpsed through gaps in the trees – would suddenly swing into full view, forming one of the most impressive and intimidating first impressions of any asylum, as the visitor was confronted by the looming grandeur of the admin block, flanked by hulking ward blocks, with the 71

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chimney and water tower glowering down from behind it. Former nurse Stephen Burrow evocatively describes his first experience of this in the early 1970s in his book Buddleia Dance on the Asylum (Melrose, 2010): The scale and physically imposing architecture of the first building – the hybrid resemblance to the public school, private mansion, or country retreat – all hinted at impervious authority. A view from overhead would have described a methodical estate structure that had been lain out across the land like a vast beetle, the projecting limbs of the residential wards articulating with the central body of administrative organs. But the builders could never have conceived the mystical aura that their creation evoked, or the competing impressions that this was either an elaborate complex of state oppression or an eccentric, benevolent guardianship. Among the more handsome and distinctive of its type, the admin block was designed in a lively Queen Anne revival style and proportioned much like a modest manor house. It featured a striking symmetrical array of windows in differing flat, rounded, arched, and gabled styles on

Cane Hill’s admin block. Postcard image by G&E Leisten, c.1900. Collection of the author. (Public domain)

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each of its floors, two of which projected from the centre, progressing into three-storey bays at either end. In the centre, a pair of arched double doors formed the main entrance, while the level above consisted of a pair of arched windows with a balcony, topped by a pediment with an engraving of ‘1882’ in a cartouche. The roof was crowned by a fourfaced clock tower topped with a white wooden cupola, upon which this excess of grandeur finally ended with a fine copper weathercock. Inside were offices for the superintendent, an office each for the porter, clerk, steward, and offices for their assistants, an office for the dispenser (of medicines), a committee room, a waiting room, and a sitting room. Cane Hill was connected to the telephone system and its number was originally given out as ‘Purley 7’. The chapel was not only integrated into the main building complex but also unusually positioned right behind the admin block, with only a small space between them. Otherwise, it appeared much like any English church of its time both inside and out, with a standard cruciform layout with seating for up to 800 patients and a bell-gable at the northern end. The arched polygonal apse lay at the southern end and featured a lavishly detailed stone altar and beautiful polychrome floor tiling. At its northern end, the chapel connected to the asylum’s corridor network, thus allowing male and female patients to trail in through separate doors without having to go outside. Epileptic patients were seated closest to these doors so that they could be assisted and removed quickly in the event of a seizure. Sweeping arched aisles with pillars ran along each side, and it also featured a fine open-beamed roof. The recreation hall lay behind the chapel and was 94ft long by 50ft wide and able to accommodate up to 500. At one end there was a stage with a proscenium arch, with dressing rooms and prop rooms for plays and other performances housed in the basement below, while at the other end, a balcony offered seating for another 130. Tall stainedglass windows ran along its length, as did a series of chandeliers to provide lighting during evening and winter events. A counter on one side connected straight to the scullery in order that meals and drinks could be served directly into the hall. Behind the scullery were various food stores, followed by the kitchens, which initially could cater for up to 2,000 patients (the asylum’s anticipated peak) and up to 250 staff every day. Cooking apparatus was powered by steam and gas, with ovens able to cook around a hundred 73

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joints of meat at the same time; only the most modern appliances of the day were installed throughout. The steward’s stores were located behind the kitchens, and behind those – to the rear of the central line of the building – were the laundries and their drying grounds on the female side. The male side hosted the bakery, engine room, boiler room, and water tower, along with workshops for carpenters, painters, engineers, shoemakers, tailors, upholsterers, a hair-pickers’ shed, and a smithy. A photographer’s room was added in 1885 to document each patient admitted, with the resulting photo then attached to their case file. Cane Hill’s water tower was 107ft tall and among the plainer examples of its type, with three pairs of slat lancet windows on each of its four sides being the only notable breaks in the brickwork before the peak, which itself featured only simple rows of narrow arched lancet windows with mantles and red brick detailing around the top. The windows allowed inspection and maintenance of the immense 34,000-gallon tank within, which was fed from a deep well near Lion Green. A mortuary with a post-mortem room including twin porcelain dissection slabs sat at the very rear of the workshop area to the far north of the main building; there had been four deaths within just one month of the asylum’s opening, which prompted the rector of Coulsdon to hastily request that patients not be buried at the parish churchyard, as this would inconvenience his congregation and fill up the available space too quickly. A burial ground was created after adding an additional two acres to the asylum’s own land. Cottages and ‘half-cottages’ (the latter for child-free staff) were built for attendants within the grounds and could be rented for 4s or 3s per week, respectively. Male staff could use the grounds as they wished, but their wives and children were not allowed to stray beyond the area around the cottages. The central services were linked to the rest of the building by the sprawling network of corridors which became such a defining feature of the larger asylums, and Cane Hill had around three miles of these in total. They were gently sloped where needed in order to avoid including any steps (although later additions did), even though there was as much as 26ft difference between the various elevations the asylum covered. Each of the (originally) fourteen main pavilion blocks could be accessed directly from the corridors and due to Howell’s unusual design, some cleverly straddled the corridor, allowing the dormitories and sleeping 74

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areas where sunlight was less important to be tucked further back; others were placed at odd angles deeper within the asylum’s footprint, where they would have received relatively little light at any time of day. All the original blocks were built in London stock brick with slate roofing and decorated with Portland stone, with banding and window surrounds of red brick. Their large bays featured smaller arched sash windows with stone modillions running along the eaves. Each pavilion was enclosed by a landscaped airing court with a wooden shelter in the centre, and the ground sloped away toward the surrounding fence allowing the patients to see over and beyond it, while also making escape more difficult. To create a greater sense of openness, the boundary of the asylum’s grounds was marked only by hedgerows and light fences, leading to frequent problems with ingress from members of the public; unspecified mischief was supposedly caused by ‘gypsies’ (as the superintendent’s report described them) camped at nearby Farthing Downs, while a local fox hunt had to be dissuaded from trampling over the estate with their horses on several occasions. At other times, fruit, plants, and vegetables, as well as tools, ladders, and anything else not nailed down were pinched from around the grounds regularly. The farmland and gardens covering the asylum’s estate were worked by patients under the supervision of staff, and by 1893 there were

Cane Hill as seen from Farthing Downs. Unmarked postcard image, c.1910 Collection of the author. (Public domain)

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established fields producing root vegetables, hay and potatoes, as well as a kitchen garden and livestock including 37 cows and a bull, 25 sheep, 113 chickens, and 140 pigs; however, most food was still bought from outside traders at that time. Dr James Moody (1852–1915) was appointed as the first superintendent in October 1882, having previously worked as assistant medical officer at Surrey’s earlier Brookwood Asylum. He received £700 per annum as well as a large purpose-built house to the south of the estate, free coal, gas, and laundry, and regular produce from the asylum’s farm. Cane Hill was to initially admit patients from Dorking, Epsom, Godstone, Reigate and Croydon, along with a portion of the patients from the parishes of St Olave’s and St Saviour’s (the remainder being sent to Springfield). The asylum opened on 20 December 1883 with twenty patients transferred from Brookwood; by July 1884, there were 992 in total. Male patients’ clothing allocation at that time consisted of corduroy trousers and a blue striped shirt, twill (warm and hard-wearing wool textile) jacket, drab jean jacket, handkerchief, braces, and grey knit stockings. Female patients were given a twill cotton print dress, chemise, striped cotton nightgown, muslin cap, apron, gingham sun bonnet, handkerchief, shawl and scarf, coarse calico dress, and brown hosiery. Boots and shoes for all were initially purchased cheaply from prisons where they were made by the inmates, but Cane Hill would be able to make and repair its own by 1892, when twelve male patients could churn out around 220 boots every quarter; eventually they were also able to provide boots to be used at other asylums. Male attendants’ uniforms were based on the Army Hospital Corps’ outfits, which gave them the rather stern military look not uncommon to their role at that time; a bow was removed from the nurses’ outfit to provide a similarly stern effect. A brass band was considered essential for any asylum at this time and many contemporary recruitment adverts state that an aptitude for a musical instrument (as well as being a good cricketer or football player) would be seen as a considerable boon to any job application. A band was formed as early as February 1884 and an attendant would receive an additional 6d for each practice attended. The Coulsdon & Cane Hill railway station opened in 1889 and had been planned by the London, Brighton & South Coast Railway (LB&SCR) as early as 1880, while the asylum was still being built. By then, it was understood that placing a station near to an asylum was 76

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a great investment for any railway company since there would be a constant flow of patients, visitors, and staff and that the asylum and station in tandem would invariably see new housing and businesses crop up around them, so a steadily increasing profit was almost guaranteed at any area within reach of London. This led to the stations situated to both the north and south of the asylum incorporating ‘Cane Hill’ into their names. A branch line leading much closer to the asylum was planned but proved far too costly, given the distance it would need to cover further down the line to begin its climb up the hill; supplies were instead brought by cart from Stoats Nest & Cane Hill station to the north, which opened in 1899 (it was renamed Coulsdon North in 1923, but demolished by 1984). Although admission books and some other documents survive, all or most of Cane Hill’s patient case files and hoards of other documentation were either left inside the building at closure or destroyed. While some information can be gleaned from parish records as well as those of other Surrey and London asylums into which certain patients may have also been admitted, much of the information about these people as individuals is now mostly lost. On average, 38 per cent of patients were discharged as ‘recovered’ in the years between 1883 and 1892, although certain cases do suggest this may not have been as promising as it might sound. For example, one Alfred Ferrer, a labourer, was admitted to Springfield Asylum aged 27 in 1871; discharged as ‘recovered’, he was readmitted in 1875 and then discharged again six weeks later. By February 1877, Alfred was back at Springfield for five weeks, and then back again that September for another five weeks. In May 1881, he was admitted yet again for another five weeks and then found himself at Cane Hill in October 1887, remaining there for five weeks. That November, he was back again and discharged as ‘recovered’ once more in March 1888. Finally, he was admitted to Brookwood Asylum just two months after that, where he died in 1895 aged 51, after spending seven years there. Of course it was wholly correct for an asylum to not retain a patient unnecessarily when thought to be ‘recovered’ and able to leave, but it is also easy to see how official ‘recovery’ (not to mention admission) rates could end up being skewed quite significantly just by examining this single case. By 1886, Cane Hill was already overcrowded, and a contract was drawn up with Starcross (Western Counties Idiot Asylum of 1864) in 77

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far-away Devon for them to receive some of Cane Hill’s ‘idiot and imbecile’ patients, while others were boarded out to asylums as far from home as Gloucester and even Lancaster, and efforts were made to send ‘quiet and harmless’ cases back to the workhouses. While Cane Hill had been built with expansion in mind, it was not anticipated to be required quite so soon; but in July 1887, the decision was made to move forward with the second stage of building. However, early the following year the Local Government Act of 1888 was passed by Parliament, and Surrey was informed that it would lose Cane Hill to the new London County Council (LCC) – as well as losing Springfield to Middlesex – as areas of jurisdiction were re-drawn. The Surrey authorities protested to no avail, and so halted their planned expansion of Cane Hill. As part of the national changes, Croydon became its own county borough in 1889, thus able to manage itself independently from the parent county of Surrey. An agreement was made that for an initial period of five years, Croydon would board 200 of its lunatic patients at Cane Hill at a cost of 14s per week, and this arrangement remained until 1899 when Croydon began building its own asylum, later known as Warlingham Park, which opened in 1903. By 1893, the LCC had completed the enlargements abandoned by Surrey, adding six new pavilions; the main corridor network was extended to join up with them, as per Charles Howell’s original vision. Several of the new blocks were huge three-storey affairs in a similar aesthetic to the rest of the building, but with a different internal layout incorporating twin or split day-rooms with large bay windows, giving Cane Hill a total of forty-nine wards and adding another 900 beds, almost doubling its peak capacity to 2,000. This also allowed the return of many patients previously boarded out to other asylums, including 190 sent back on a private train from Lancaster. As far as the main building was concerned, there was no more room for outward expansion, as the northernmost parts of the building now sat almost adjacent to the Portnalls Road boundary. This was a matter of concern considering that by 1894, Cane Hill’s population had already soared past its capacity to 2,222, and many of the already put-upon nurses saw their sleeping areas moved down into the dingy basements so that patients could be crammed into their former quarters. Unsurprisingly, overcrowding tended to lead to more frequent problems with behaviour among the patients as well as being a far greater strain on the staff, whose numbers were not increased in tandem. During 78

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this decade, twenty-eight incidents of ‘ill treatment’ of patients by staff were recorded. Complaints submitted by patients with no witnesses tended to be ignored (at Cane Hill as at most asylums) unless there was any inarguable sign of physical injury. Two staff were dismissed and another three asked to resign as a result of these cases, with others demoted or having their wages docked instead. Asylum committees tended to prefer dealing with punishments or dismissals internally rather than involving the law or prosecuting staff in court, even after more serious incidents, perhaps in the knowledge that it would reflect badly on their asylum in the press. However, the CiL would sometimes step in and prosecute staff themselves in more serious cases, regardless of the wishes of the committee. Of course, staff members in any role were also at risk themselves and were sometimes injured and occasionally even killed by patients at asylums. At Cane Hill, a patient named George Guy was transferred from Colney Hatch in 1895, where he had been known to put stones in a handkerchief and attack staff and patients, and as a result was not allowed beyond the airing courts. During outside exercise one afternoon, he climbed up a drainpipe onto the roof and began dislodging slate tiles and throwing them at those below. The asylum’s fire brigade convened with ladders and climbed up after him while still being showered with sharp, heavy slates; a 30-year-old attendant named Edward Finch managed to get near to him, at which point Guy struck him on the head with a piece of wood he had also pulled from the roof, knocking Finch’s fire helmet off in the process. He then continued to batter him with it before eventually being restrained by the others. Finch died two days later, and Guy was sent to Broadmoor for the remainder of his life. While visiting some of Cane Hill’s patients boarded out to Fisherton House Asylum8 at Salisbury, Dr Moody was attacked and severely injured by a patient wielding a knife. His injuries were serious enough to see him off work for six months, and upon returning to work, he was attacked again at Cane Hill by a patient named Henry Watson, who broke his jaw. In a speech made while advising Croydon Borough on the building of Warlingham Park, he told of another incident during which he only just managed to talk his way out of being boiled alive in a copper vat by a mob of angry female patients at the asylum’s laundry. A total of 2,008 yards of ‘un-climbable’ fencing was eventually erected around the site both to keep patients in and members of the public 79

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out – the latter increasingly blamed for ongoing thefts and damage. Dr Moody requested an additional police presence in the area in 1897 due to ‘the very rough element attracted to the vicinity’, and ‘the number of gypsies and vagrants who haunt the neighbouring downs and roads’. In 1894, the LB&SCR gained permission from Parliament to build a new railway line between the Surrey towns of Purley and Earlswood, which would cut through three acres at the south of Cane Hill’s land. After various protestations, including quite valid arguments around patient safety with trains running through the site, it was agreed that the cutting required would be completely covered over and enclosed from above; it would then be laid with turf so that it would be all but invisible, as well as preventing patients from being able to get onto the line. By 1900, around 1,300 of Cane Hill’s patients took regular walks around the grounds, with some permitted to walk at leisure alone or as they wished, although the majority were escorted in groups around set routes by at least two members of staff at a time. Another 300 or so only went as far as the airing courts, either because they did not want to go further, were not allowed to, or else were not physically able to do so. In the same year, verandas were added to the infirmary wards to allow immobile patients to sit outside, with similar additions to other wards following over time. By 1912, the proportion of patients permitted beyond the airing courts had reduced to 28 per cent, perhaps due to Dr Moody having been apparently most perturbed by an incident in which a female patient on a walking group had attempted to jump in front of a motor car. This was still a higher proportion than any of the other LCC asylums permitted at the time, and perhaps reflects the categories and types of patients being catered for as the numbers of elderly and immobile patients at all asylums began to increase. It may also have been a result of continued overcrowding and understaffing, since it was inevitably easier to manage the patients within tighter restrictions than to undertake the amount of assessment, categorisation, documentation, and monitoring required to be more permissive. Hannah Hill (1865–1928) was born in Walworth in London and began a career in showbusiness at the age of 16, adopting the stage name Lily Harley. Aged 18, she fell for a man who took her to South Africa, where he was said to have involved her in prostitution; she eventually returned to London, pregnant with his child. She resumed an earlier relationship with a fellow actor named Charles Chaplin, 80

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and after her first son was born in March 1885, the couple married at St John’s Church in Walworth that June. Hannah (now Chaplin) and Charles resumed their stage careers with reasonable success and a son, also named Charles, was born to them in April 1889. Their marriage deteriorated as Charles’ career took him away on long tours across Britain and North America, and Hannah eventually became involved with another stage actor named Leo Dryden, with whom she had a third son, Wheeler Dryden, in August 1892. Hannah and Leo’s relationship had also ended by 1893, with Leo taking Wheeler with him and Hannah moving in with her sister – another stage performer. Hannah’s health began to deteriorate and she suffered from headaches and eventually periods of ‘mania’, but managed to continue performing for several years. In 1894, her voice failed her on stage at Aldershot, and her son Charles got up and sang in her place. As her health deteriorated further, she was admitted to Lambeth Infirmary in 1895, with her two eldest sons sent to the Cuckoo Schools at Hanwell; this was essentially a workhouse for destitute children with an added educational component – better than a standard workhouse, but not by much. Hannah was admitted to Cane Hill in September 1898 and was said to act in ‘a very strange manner’, her mood swinging from abusive and violent to calm and polite in an instant; as a result, she was often confined within one of the padded cells. After two brief periods of discharge, she was readmitted in 1903 and again in 1905 and would then remain at Cane Hill for over seven years. In the meantime, her sons had gradually built up their own showbusiness careers, with Charles in particular finding great success, eventually becoming arguably the most famous person in the world at that time, and far better known as Charlie Chaplin (1889–1977). Showbusiness was clearly in the blood, as Wheeler Dryden (1892– 1957) also became an actor and director, working with Stan Laurel on Mud and Sand (1922) as well as with Charlie on The Great Dictator (1940), among other credits. Her sons paid for Hannah to be moved to Peckham House – a private asylum where she would be more comfortable – and then, after his rise to mega-stardom with his first leading role in The Kid (1921), Charlie was able to bring her to Los Angeles and pay for her to stay in a private nursing home, where she lived and had frequent contact with her two eldest sons until her death in 1928. The recurring showbusiness connection was later proven again 81

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as Hannah was portrayed by her own granddaughter Geraldine Chaplin (b. 1944) in Richard Attenborough’s biopic Chaplin (1992), in which Charlie himself was played by Robert Downey Jr. Entertainment was also considered important at Cane Hill itself, with gramophones and records donated for use on the wards in 1905, but Dr Moody’s request for cinema projection equipment in 1907 was denied by the LCC. In 1913, a petition requesting the same was signed by 258 patients, and the following year, the LCC compromised by arranging for the Pathé Brothers to visit each of their asylums twice during the winter, bringing along projectors and an 11ft by 9ft screen to show a two-hour performance at each. In certain instances, patients’ rehabilitation after discharge was assisted directly by the asylum under Dr Moody’s regime: in 1902, a friend of his offered one patient a job which needed filling urgently, provided that the discharge paperwork was present and correct, so Dr Moody sought out two members of the committee himself in order to obtain their signatures immediately, rather than waiting for the next committee meeting to convene and seeing the patient lose their opportunity. In 1904, a female patient was admitted who had purchased a sewing machine that was being paid for in instalments; considering the patient to be making good progress and that her sewing would be therapeutic for her, Dr Moody arranged for the machine and a box of clothes to be delivered to the asylum on her behalf and made assurances to the lender that payments would resume after her release, rather than seeing the machine repossessed and the woman left without income upon returning home. The First World War would see Cane Hill continue in medical use and face the usual problems of overcrowding and understaffing. Patients were transferred from other LCC asylums which had been designated for war use, with 249 sent from Horton, 46 from St Ebba’s, and 72 from Manor. Thirteen attendants, two labourers, and an assistant matron had already left Cane Hill and signed up for the war effort during August 1914 and a total of eighty-six would eventually enlist or be called up. Their families would continue to receive half their usual pay from the LCC for as long as they served, although many would of course never return, and many of those who did were injured or otherwise unable to resume their former work. Staff who had retired were called back to 82

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the asylum where practical, to replace some of those lost, and the rule regarding nurses having to leave the asylum’s employ when married was rescinded as they were hastily called back with sudden offers of re-employment. Nurses would now also have to work on the male wards (which was not previously allowed) as there were no longer enough male attendants available. Despite how much British society would come to rely on women during wartime to fill jobs formerly considered ‘inappropriate’, or simply beyond their wit or competence, when Dr Moody attempted to employ a female dispenser (of medicine), he was directly overruled by the Home Secretary Reginald McKenna (1863–1943), who insisted the role must only be filled by a ‘qualified man’. When Dr Moody informed McKenna that no such person was available and the need really was quite urgent, he relented as far as allowing the employment of ‘a highly recommended unqualified man’ instead. Death rates at most asylums shot up during the war due to the overcrowding, understaffing, and reduction in available food and other supplies; only five of the 169 patients transferred from Horton ever returned there, the rest having all died during wartime. Dr Moody, who had worked at Cane Hill since it opened in 1883 when he was aged just 30, was knighted in 1909 for his work there as well as for his teaching and lecturing at universities, hospitals, and other asylums. After a week’s illness, he died in September 1915; his funeral was held in the asylum’s own chapel and he was buried in its cemetery along with his patients, as he had wished. After several temporary replacements during the war, Dr Samuel Elgee (later OBE), who had formerly worked at various other LCC asylums including Colney Hatch, took up the superintendent role fulltime at Cane Hill in 1919. As the war ended, many of the staff who had survived returned to work and, as at most asylums, they were followed by an influx of men with mental health problems caused by the trauma of what they had seen and experienced in wartime. Military patients left over from the war were classed as ‘service patients’ rather than paupers, and so were subject to the same improved conditions offered to private patients. There were 110 such service patients at Cane Hill in 1922, by which time the Ministry of Pensions was making a concerted effort to downgrade as many as possible across Britain’s asylums back to the status of ‘pauper’. In cases where it could not be conclusively proved 83

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that their mental problems had been caused by living in a muddy trench for months while being shot at, incessantly bombarded by explosions, and seeing their friends blown apart in front of them – rather than perhaps having arisen from some other, unrelated cause – they would be duly downgraded, and their family would no longer receive a war pension in recognition of their sacrifices. The actor, writer, and comedian David Walliams (b. 1971) featured in the October 2020 episode of the BBC’s Who Do You Think You Are? TV programme and discovered that his great-grandfather had been taken to Napsbury9 (Middlesex County Asylum of 1905) suffering from ‘shellshock’, after which he was sent to Cane Hill, where he would stay for the remainder of his life. This final section of the episode was shot within Cane Hill’s derelict chapel, where Walliams is visibly moved to learn about and consider his great-grandfather’s fate. Dr Elgee was responsible for modernisation at Cane Hill, and under his regime electricity and X-ray equipment was introduced, while ultraviolet radiation therapy followed in 1928; then thought to have produced ‘striking’ results. Cane Hill was also used as a test location for malaria therapy, although this was later administered via Horton Asylum, as detailed in the chapter on the Epsom cluster. Elgee introduced male and female ‘acute’ wards in the mid-1920s, in order that patients could be assessed before being moved on to other parts of the asylum. It took until the mid-1920s under Dr Elgee’s regime for the committee to acknowledge they were relying an awful lot on the nurses’ goodwill to make many of them work all day on the wards and then sleep on them too, where they would not only be subject to the general noise of the ward at night, but inevitably also end up disturbed by or involved in any incident or disruption which took place during the night; it must have been incredibly difficult for all but the heaviest sleeper to get anything approaching good rest. A nurses’ home with eighty rooms was connected to the furthest northern point of the corridor network on the western side; this also released fifty-four rooms on the wards which, with a little modification, could then be used by patients, and a second nurses’ home was constructed to the east of the admin block in 1935. The building’s title was formally changed to Cane Hill Mental Hospital in 1930, and Dr Elgee retired in 1931 to be replaced by Dr George Lilly (1888–1970). In 1934, Cane Hill employed its first non-white staff member, Dr Sudhindranath Banerji, as well as its first female doctor, 84

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Cane Hill chapel, after closure. (Copyright Ed Brandon)

Dr Pauline Sterling. Dr Lilly had to struggle through the belt-tightening years of the 1930s as Cane Hill was still mostly lit by gas lamps and the wards were said to be clean and tidy but looking increasingly shabby, as there had been no significant renovations or redecoration since the early 1920s. The Board of Control (BoC) commented that many of the wards were now ‘dark and dilapidated with a lack of flowers and very few plants’, although there were more positive comments about the status and physical health of the patients and the quality of the food. Occupational therapy was introduced to Cane Hill in 1929 and 85

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developed over the following decade before being reduced again at the outbreak of the Second World War. Although Cane Hill was not taken out of psychiatric use, four wards on the male side were cleared out to become a 268-bed emergency hospital during the war, for which Dr Lilly was responsible in addition to his usual duties; this alone added around 8,000 additional items of washing to the laundry’s workload each week. Overcrowding inevitably arose as patients were sent from other LCC asylums which had again been cleared out for use as war hospitals, including 344 sent from Horton and forty from an asylum on the British Territory of Gibraltar. Collectively, this brought the patient population up to 2,405, exceeding its supposed capacity by 449. Cane Hill briefly employed a professional chef to teach the catering staff how to make the most nutritious and appealing meals possible out of what little they had to work with. Rabbit meat was imported from Ireland, and the Commonwealth was relied upon to help with food supplies after the war, with consignments arriving from Australia, New Zealand, and Canada. By 1943, seventy-seven of Cane Hill’s patients were voluntary and ECT and trans-orbital leucotomy had been introduced, although the latter was initially deemed unsuccessful there. The asylum’s population hit its peak of 2,423 in late 1944. As well as hosting a small camp for Canadian soldiers within its grounds, Cane Hill also lay within two miles of key military targets, including RAF Kenley and Croydon Airport, and so was subject to stringent blackout controls: varnished hessian was placed on all the windows to stop light escaping, and to make them shatterproof, and there was no hot water at night because the boiler fires had to be put out. An extensive air raid shelter was dug in the grounds in 1941; after the war, ‘Coulsdon Deep Shelter’ was bought by a company who manufactured precision lenses and found the stable temperatures underground perfect for their work. However, the environment was also dark and damp, and the damp corroded their machinery, not to mention making the staff thoroughly miserable, so it was abandoned in the early 1970s. Cane Hill joined the NHS in 1948 and its name was formally changed for the final time to Cane Hill Hospital. It struggled somewhat through the 1940s and 1950s with staffing shortages, shabby interiors, and a lack of occupational therapy and jobs for patients to do. Only 50 per cent of the male and 30 per cent of the female patients worked – a much lower figure than at most asylums at that time – and Cane Hill in particular was 86

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Aerial view of Cane Hill. Unmarked postcard image, c.1940 Collection of the author. (Public domain)

said to be populated by large numbers of patients simply sitting inactive or wandering aimlessly in the corridors, airing courts, and grounds; its first qualified occupational therapist was employed in January 1948 in an attempt to address this. Redecoration and modernisation began in the early 1950s, with lockers and new armchairs for the female wards and prints obtained from the National Gallery appearing on the walls, but the process of improvement was slow and completed in a piecemeal fashion. Most bathrooms still had no hot water and, to save money, electric lighting was not allowed on the wards in the daytime even on gloomy days, which must have lent Cane Hill a bleak and depressing air during those years. Each ward only had ten armchairs, and so those not quick enough to grab them first had to sit on hard wooden benches around the edges of the day-rooms. By 1950, although rationing continued, the shop was still able to sell cigarettes, sweets, crisps, cakes, tobacco, cosmetics, haberdashery items, and eventually more, with working patients able to earn a little money to spend there. Dr Lilly retired in 1949 to be replaced by Dr Alexander Walk (1901– 1982), who was the last man to hold the position of superintendent at Cane Hill. He was assistant editor for the Journal of Mental Science at 87

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the age of 27 (and continued to write for it until he was 81), was president of the Royal Medical Psychological Association (RMPA) for two years, acting as advisor to Parliament on the 1959 Mental Health Act, and was president of the General Nursing Council and the Association of Psychiatric Workers at different times. He also wrote several books on asylums and mental health work and was responsible for renaming Cane Hill’s wards after notable writers and other historical figures, moving away from the old and impersonal alpha-numeric system. Television sets were introduced from 1950 onward (still quite the luxury at that time), on which patients could watch the news about the developing Cold War, during which Cane Hill became a ‘cushion hospital’, designated to receive casualties in the event of a nuclear or chemical attack. Patients from St James’ (Portsmouth Borough Asylum of 1879) and St Mary’s Hospital (also at Portsmouth) would be transferred to Cane Hill if such an attack occurred, in order to free up beds in that important naval and military location. Ten staff at Cane Hill became Civil Defence Corps volunteers and all the staff were trained in preparation for attack. Ingress from the public onto the site continued to be the more immediate problem as locals adopted the grounds for dog walking, young children made their way in to play, and errant teenagers damaged the buildings and found fun by provoking and taunting the patients. As fences were repaired, they would be cut or broken again almost immediately and, at one point, horses were even found being grazed in the airing courts. Ironically, at the same time, there were complaints from the public about the patients going outside the asylum’s grounds; as the numbers allowed parole beyond the boundary grew, so did complaints from locals who felt the patients were a potential threat to themselves or their children, despite no significant incidents occurring. In general however, the asylum was becoming more, rather than less, integrated with the surrounding community who – from the early 1950s – could attend sporting events in the grounds and dances in the recreation hall. Female members of the social club came together to create The Cane Hill Chronicle, the asylum’s monthly magazine which launched in 1950 and, aside from certain articles, this was written by and for the patients, and the very first edition discussed the new freedoms the majority of patients were then enjoying. In 1957, the walls to the airing courts of Guy, Faraday, and Ellis wards were all lowered as fewer 88

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patients were now locked in: over 1,000 patients were free to roam within the grounds, almost 600 of whom were also allowed to leave the site during the day. A hair salon was opened (for female patients only) in 1959, and in the same year patients were finally allowed to have their own sets of underwear returned to them after washing, rather than having to wear whatever the asylum provided. Cane Hill had the largest catchment area of any former LCC asylum after Bromley Borough was incorporated in 1957. The BoC made their final visit in March 1960 when Cane Hill had around 2,230 patients and produced a glowing report somewhat at odds to the perspective of the asylum in its own notes and committee reports; in the latter, one gains a sense of an understaffed and overcrowded institution with some very outdated accommodation and facilities, struggling to keep its head above water, while the BoC described ‘bright, cheerful, and very suitably comfortable’ wards, great improvements to the buildings and gardens, and ‘a cheerful and harmonious atmosphere’. Dr Alexander Walk retired in December 1961 along with the chaplain Reverend D.V. Davies, both of whom had been avid supporters of the asylum magazine and encouraged the patients to run it themselves. The chaplain who replaced Davies apparently saw it as more of a platform for himself and an opportunity to write lengthy sermons, and his ‘uplifting essays’ eventually killed it off completely, with publication ceasing in 1965. Cane Hill’s closure was discussed as early as 1962, when the Ministry of Health described it as ‘most efficiently run’ but ‘old, with large wards’ and lacking several key facilities. It was planned that it would amalgamate with Springfield, with closure envisioned as early as 1975, although upon review of its significant catchment area, this date was pushed back to 1977 as the earliest possible date to even begin closing it down. By 1967, the farm was closed, and the land later leased out and then eventually sold. As discussed in the Colney Hatch chapter, this was common to all the former county asylums and saw food bought in from outside: a thousand tons of turkey were bought for Christmas dinners at Cane Hill alone. Unable to recruit enough staff within the UK for the pay and conditions on offer (affordable accommodation in the area was also increasingly scant), recruitment drives focused on Commonwealth countries, and so English language lessons were taught at the asylum 89

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twice a week. Volunteers were increasingly leaned on to escort the patients on excursions and run or assist with the social and occupational therapies and activities. On three wards, the padded cells were locked for six months as part of an experiment to see how and if staff would cope without being able to resort to their use, although sadly records do not remain regarding the results of that experiment. From 1977, wards with patient numbers which dropped below thirty were closed and the remaining patients amalgamated into other wards on the former female side to the west, since the male side was considered to be the more run down of the two; in this sense, the projected date of closure beginning in 1977 was actually adhered to, albeit in a considerably ‘softer’ form than had been hoped. The asylum’s cemetery had been vandalised over the years, with most of the headstones broken or damaged as early as 1965, when they were dug up and removed for storage. The health authority sold the land to a housing developer in 1981, and the bodies of a handful of former staff, eighteen casualties of war, and almost 6,000 bodies of pauper patients were exhumed and removed to Mitcham Road Cemetery in Bromley, where they were cremated and either re-buried or scattered at that site. Local newspapers expressed their dismay at reports of piles of bones being bundled into black plastic bags and thrown on the back of trucks. A small memorial was placed in the grounds of Cane Hill, which included the gravestone of Dr Moody, along with a plaque. In 1982, almost exactly a century since it had been installed, the clock on the top of the admin block stopped working and the £1,300 required to repair it was not considered justifiable in the face of so many cuts and deficiencies elsewhere in the building. This unavoidably stands as a metaphor reflecting the position of Cane Hill itself within the wider strategy for mental health provision at that time, as the mechanisms to which the whole asylum once ran were either failing or being neglected; the former county asylums were being de-prioritised and the approach to mental health care was shifting toward vastly cheaper communitybased services for the majority of patients, some of whom would benefit greatly from these changes, while others would not. Official visitors in the early 1980s describing Vanbrugh ward stated that the ‘lavatories were deplorable, there was no privacy in the washroom, [and] the dormitory carpet was heavily impregnated while its airing court was full of litter’. They noticed damp in Webb ward and 90

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water penetration in Dickens ward and described the staff canteen as ‘a health hazard’. There were potholes in several of the corridors and Blake – an admission ward – was described as ‘deplorable’; unforgivable considering it would be the first part of the building frightened new patients had to experience. Several wards were being locked up again at this point, due only to shortages of staff. The health authority still saw some use for the grounds, with a separate new SASS (Special Assessment and Supervision Service) secure unit opening in 1984. A report in 1985 stated that £3.4 million was needed just to keep Cane Hill going at an ‘operationally acceptable standard’ for another five years, even though fifteen of its forty-one wards had already closed by then and patient numbers had reduced to around a quarter of its peak to only 636 in total. Resettlement teams were put together to find new accommodation for the remaining patients, with Bromley’s contingent being the last to leave. Its Positive Futures Team was responsible for either assisting patients to live on their own outside the asylum or resettling them at a family home, in hostels, nursing homes, beds in general hospital units, or within a number of five-bedroom houses which were purchased by Bromley Health Authority for that specific purpose. Some of Cane Hill’s staff would continue to work with these patients in their new housing. The last patients housed within the main buildings at Cane Hill left at the end of March 1992, just over 109 years after the first ones had arrived. Unlike many asylums, Cane Hill’s fascinating stories did not come to an end with its closure. Its reputation and the speculation surrounding it only seemed to grow the longer it remained empty and disused; besides Bedlam, no British asylum has acquired quite such a folkloric status as Cane Hill did during its sixteen-year ‘afterlife’. With its water tower poking tantalisingly over the treetops, visible for miles around, it lured the morbid, the nefarious, and the simply curious toward it like a beacon. Those who made their way through the trees and up the driveway to get a closer look were often captivated by its hulking mass of towering blocks, its darkened glowering windows with tattered orange curtains billowing in the wind, and its overbearing and unusual structures. Many then found themselves compelled to discover more about its seemingly arcane purpose, and exactly why such huge, atmospheric, and idiosyncratic buildings now lay abandoned. The keys to Cane Hill were handed over to a security firm straight away, but for its first decade of abandonment, thieves, vandals, arsonists, 91

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Cane Hill’s clock tower after closure. (Photograph copyright Marlon Bones)

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and curious explorers still found ways in with relative ease. Even by the late 1990s, many internal doors were still locked, and there were areas of the building that still had not been seen at all since its closure. Cane Hill was an astonishingly complex and labyrinthine building when it opened in 1883, and after well over a century of additions, moderations, and repurposing efforts both large and small, the reasons for many of these changes could only be guessed at decades later. Doubtless many visitors came throughout the 1990s as the site deteriorated and never told of what they found there, nor what they took away from the site; there were rumours of entire rooms full of old staff uniforms, straitjackets, the whistles once carried by attendants, etc., all of course stolen long ago. More thorough documentation by those visiting the site began in the early 2000s, as the improvements in digital photography saw a greater number of images begin to emerge online, and the most ardent online documentarian of Cane Hill – both in terms of its history as well as its afterlife – is undoubtedly Simon Cornwell, who through his eponymous website has gradually built up a wonderful record of its history as well as his own frequent visits, complete with a wealth of his photographs. His images and summaries of his trips were a significant factor in the development of the UK ‘urban exploration’ scene and attracted many more visitors to Cane Hill, and his concept of ‘the cult of Cane Hill’ nicely sums up the fascination and mythology which developed in regard to the site. Cornwell picks the buildings apart in minute detail, noting numerous easily missed differences between one ward or area and the next, making Cane Hill one of the most carefully studied and well-documented of all the county asylums to enter a similar period of abandonment – a valuable task no formal body had been bothered to conduct. Ali Costelloe’s later canehill.org website also hosts an exhaustive wealth of information including some fascinating memories shared by former staff and patients, adding an additional ‘human’ angle. In 1994, the band Big Audio Dynamite (featuring Mick Jones, formerly of The Clash, as well as the DJ, musician, and film director Don Letts) shot two of their music videos – Looking For a Song and Psycho Wing – at the empty asylum; both can be found online and feature some interesting images of the buildings both inside and out. As time went on, additional associations were dug up; for example, the actor Michael Caine’s half-brother was a long-term resident at Cane 93

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Hill. His mother kept her illegitimate child a secret from the rest of the family (despite her visiting him there every single week for over fifty years), and Caine himself did not find out about his existence until around 2001 after a journalist happened upon the story after interviewing several patients, one of whom happened to be his half-brother’s girlfriend. The musician David Bowie had occasionally talked about his halfbrother Terry Burns’ mental illness in relation to his own life and work, but the connections to Cane Hill – where Terry was admitted several times and where he spent the last four years of his life – were not so apparent or scrutinised until Cane Hill acquired notoriety decades later. Terry was a huge influence on Bowie’s formative years as well as his taste in music, and was somewhat idolised by him until Terry’s schizophrenia made their relationship more complicated. Bowie’s songs All the Madmen and The Prisoner were about Terry and Cane Hill, and the original 1970 US version of his seminal album The Man Who Sold the World even featured Cane Hill’s admin block on the cover. Although the image (already partially censored) was changed completely for the UK release, it was fully restored for the UK edition of The Metrobolist album in 2020: a re-ordered remix of nine of the original album’s songs. Terry had already attempted suicide several times, and after escaping from Cane Hill, he was successful in doing so on the tracks at Coulsdon South station in January 1985. Many speculated that a large mural of a train coming down the tracks toward the viewer – painted on one of the walls inside Cane Hill – was some sort of perverse memorial to this, but in fact it had been painted by some children from a local school during an art project. English Partnerships (EP) were responsible for the Cane Hill site and from an early stage appeared to only be interested in demolishing it and replacing it with housing. Various attempts were made to gain listed status for all or part of the site, but these only found success for the admin block and chapel and, even then, only on a local listing basis that did not offer any real legal protection. The fairly recent preservation of Claybury Asylum allowed EP to claim that other, better examples of ‘echelon plan’ asylums had already been retained, and this was used to diminish Cane Hill’s perceived historic value; of course, it was not an echelon asylum and was in fact unique, but it became clear that any arguments offered were going to do nothing to derail the chosen plan. 94

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There were a series of significant arson attacks made on the abandoned building in the late 1990s and early 2000s, the most severe of which came in 2002, when the recreation hall was torched, resulting in over a hundred firefighters and fifteen fire engines having to attend and battle the flames for over four hours, leaving the hall nothing more than a shell. After this, a huge palisade fence was erected around the entire main complex, and 24hr security patrols by zealous staff with guard dogs helped to make the empty building considerably more difficult to access. In 2008, the bulldozers and diggers moved in and began tearing down the buildings until eventually all that remained was the water tower, chapel, and the now-iconic admin block. While many were upset that the rest of the building had been demolished, others were glad to see the back of these hulking, dangerous ruins about which so many negative news stories had by then been written. Most were pleased that the handsome admin block at least had been retained, but in November 2010, this too burned down in a mysterious fire which started in the damp basements; the police somewhat inexplicably stated they did not suspect foul play. Many local residents turned up to

Cane Hill being demolished in 2008. (Photograph copyright Marlon Bones)

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see the blaze and some cried as they watched the wooden clocktower finally collapse and disappear down into the raging flames. There had been a significant explosion in the admin block in March of the same year, and some assumed this had been a final attempt by someone to blow open the large iron safe contained within which, despite many earlier attempts, had remained resolutely locked shut since closure. However, it turned out – far more bizarrely – that the SAS had been allowed to test explosives in the building, and the damage they had done meant that it would probably have had to be demolished anyway. Even though more than two thirds of it was destroyed, the outpouring of anger which accompanied its destruction saw promises made to repair it in some manner. This offered some hope but, rather like a zombie returning from the grave as a disfigured shell of its former self, the resulting plans were so ugly, insensitive, and inappropriate, one might have wished this particular ‘loved one’ had stayed dead. While Cane Hill’s fame and notoriety appears to have lasted (and even spread) well beyond its physical form (there is even a successful metal band from Louisiana, USA who named themselves after it) the site itself is now almost unrecognisable, with the water tower and chapel the only parts remaining within the surrounding housing estate.

The admin block fire being put out in November 2010. (Photograph copyright Marlon Bones)

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Chapter Five

Claybury (5th London County Asylum) Manor Road, Woodford Green, IG8 8BX

While all the county asylums were immense civic building projects, Claybury marked a significant step forward even in relation to other large, complex, and ambitious contemporary examples such as Cane Hill and High Royds (3rd West Riding County Asylum of 1888). When it was built, many felt that Claybury represented the pinnacle of the county asylum as a distinct building type and similar arguments were made a century later when considerations were being made regarding which of the county asylums should be preserved after closure. Claybury was the first British asylum designed to provide over 2,000 beds upon opening and the total footprint of the main building range was the largest in the British Isles. It included over twenty acres of floor space and while the average number of bricks used to construct a house in Britain is 8,000, Claybury’s construction utilised around 27,000,000, weighing approximately 150,000 tonnes. To provide a level base for building, 300,000 cubic feet of soil were removed and the new asylum would utilise 2,600 doors, 4,600 windows, and 33 miles of pipework. When the boundary fence enclosing the site was completed, it was just over 2.5 miles long. Claybury was originally commissioned in 1887 by the Middlesex authorities, who found a plot of land at Woodford; geographically situated in the county of Essex although now a London Borough, located around 9.5 miles to the northeast of Central London. However, just two years later, the area it was intended to serve had moved under the auspices of the new London County Council (LCC), and so building commenced under their purview instead. In the Middle Ages, the land had been owned by the De La Clay family, although there seems to be some dispute over whether the land was named after them during the 97

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eleventh century or whether the family had taken their name from the land. Records of formal occupation date back to around 1270 when the locale was known as ‘Clayberry’ and owned by Barking Abbey. Several large houses existed on the site over the centuries and former residents included one Oliver Cromwell (uncle to his more famous nephew); John Fowke (1596–1662), a former Mayor and Sheriff of London; and Sir Thomas White (1492–1567), also a former Mayor of London and founder of St John’s College in Oxford. The eighteenth-century house which remains to the west of the site was built for a wealthy malt distiller named James Hatch (1750–1806) in around 1785; although English Heritage states that no official record exists, the architect is believed to have been Jesse Gibson (1748–1828), whose only other surviving work is the Queen Elizabeth College Almshouses of 1818 on Greenwich High Road. Claybury Hall featured lavish grounds laid out by renowned landscape designer Humphrey Repton (1752–1818) in 1789, and the whole estate formed part of the land purchased by Middlesex, which amounted to 269 acres at a cost of £39,415. Levelling-out work commenced on 1 October 1887, with the twin gate lodges to the north on Manor Road built first; these were complete by March 1888, and it is testament to the perceived complexity and importance of the operation that the clerk of works, a Mr Wise, took up residence in one lodge while the architect himself, George T. Hine, moved into the other one to personally oversee his most ambitious and prestigious project as it came to fruition. George Thomas Hine (1842–1916) was the son of renowned Nottingham architect Thomas Chambers Hine (1813–1889) and had acted as his father’s apprentice from 1858, going into partnership with him from 1867. Thomas Hine’s numerous works included many churches, Nottingham’s Corn Exchange and its Castle Museum of Fine Art, HM Prison Foston Hall, and the Great Northern Railway station buildings for Nottingham, Radcliffe, and Bingham, among others. In comparison to most British cities in the Georgian era, Nottingham had been progressive in terms of its public health provision, opening its general public hospital as early as 1781 and building the very first county asylum in England and Wales, which opened in February 1812 at Sneinton. It became grossly overcrowded as Nottingham grew into a large industrial city, so the authorities decided to move all their fee-paying patients out of Sneinton and into a nicer, newer building which Thomas 98

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Aerial image of Claybury as planned. Engraving insert from unknown publication, c.1887. (Public domain)

Hine was commissioned to design; The Coppice was a handsome asylum of modest proportions which opened in 1859 to that end. However, by 1874, continued overcrowding at Sneinton meant separate county asylums were needed for Nottinghamshire and Nottingham Borough, which gave his son, George T. Hine, an opportunity to pitch his first solo design, winning the contract in competition against seven more experienced architects. While it seems likely that his local status as well as his father’s renown boosted his chances somewhat, George’s design for what became Mapperley – the Nottingham Borough Asylum of 1880 – was a confident and competent example of contemporary asylum architecture (although the Commissioners in Lunacy (CiL) did have to revise the design to incorporate a few more bathrooms and other facilities), if not a particularly innovative one. It is often noted that his father’s ‘watchful eye’ was doubtless present during George’s first tentative steps toward the creation of such a distinct building type, and some argue that Thomas’ influence pervades at Mapperley; however, while some of his father’s style and motifs are visible, anyone familiar with George T. Hine’s later work will notice that many of his own little aesthetic idiosyncrasies do in fact already appear even at this early stage, and anyone familiar with Claybury Asylum will see similarities too. Mapperley was a symmetrical 99

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corridor-plan asylum and typical of most built at that time; it gave little indication that George T. Hine would become by far Britain’s most noted, prolific, inventive, and influential asylum architect. He would design fifteen asylums in total and complete significant additions or extensions to five more. George T. Hine’s asylums: 1880 Mapperley

Nottingham Borough Asylum at Mapperley, Nottingham 1893 Claybury 5th London County Asylum at Woodford, Essex 1895 Cherry Knowle Sunderland Borough Asylum at Ryehope, Co. Durham 1898 Bexley 7th London County Asylum at Bexleyheath, Kent 1899 Hill End Hertfordshire County Asylum at Hill End, Hertfordshire 1900 Purdysburn Belfast City Asylum at Belfast, Northern Ireland 1902 Horton 8th London County Asylum at Epsom, Surrey Rauceby Kesteven County Asylum at Rauceby, Lincolnshire 1903 Hellingly East Sussex County Asylum at Hellingly, East Sussex 1907 Long Grove 10th London County Asylum at Epsom, Surrey Barnsley Hall 2nd Worcestershire County Asylum at Bromsgrove, Worcestershire 1909 Netherne 2nd (replacement) Surrey County Asylum at Netherne-on-the-Hill, Surrey 1914 St Mary’s Gateshead Borough Asylum at North Saltwick, Northumberland 1917 Park Prewett 2nd Hampshire County Asylum at Basingstoke, Hampshire (opened 1921) 1932 Cefn Coed Swansea Borough Mental Hospital at Swansea, Glamorgan, Wales 100

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He also made additions or extensions to The Towers (Leicester Borough Asylum), Fair Mile (Berkshire County Asylum), Tone Vale (Somerset County Asylum), Herrison (Dorset County Asylum), and Banstead (3rd London County Asylum). Between completing Mapperley and submitting his designs for Claybury, George T. Hine would invest in a building society project which failed so badly it almost bankrupted him. He later became embroiled in a fraud case which might have seen him imprisoned had he been convicted, and would have ended his architectural career – at least as far as building asylums with county authorities was concerned. Perhaps fortunately for Hine, the plaintiff became ill before he was called to court and the case subsequently fell apart. Hine also spent the decade or so between his first two asylums scrutinising earlier designs as well as the many others planned or already being built, determined to expand upon the best and eliminate the worst of the existing ideas. He paid particular attention to the works of Charles Howell, who had designed Cane Hill among others, and to those of Robert Griffiths (d.1888), who was then the County Surveyor for Staffordshire. While Griffiths tends not to be celebrated among asylum architects in the same way as either Hine or Howell, his designs were always innovative and experimental. In particular, his plans for St Mary’s (Herefordshire County Asylum of 1871), Parkside (South Cheshire County Asylum of 1871), and St Crispin (Northamptonshire County Asylum of 1876), were all vastly different to one another and would all lead to new layouts and ideas being adopted and repeated by later architects, including Hine and Howell. While Hine certainly took influences from Cane Hill, he also incorporated key elements of two of Robert Griffiths’ designs in his submission: Parkside was the prototype for the ‘radial-pavilion’ layout, while St Mary’s was the first British asylum to make proper use of the ‘echelon’ plan. The latter was partly inspired by the American ‘Kirkbride plan’,10 which saw each parallel row of ward blocks on either side projecting further outward from the centre than the one in front in a staggered progression en echelon (from the French and denoting a parallel alignment of features within a built structure) thus creating a V-shaped, or arrow-shaped, layout and a trapezium form to the whole building if viewed from above. The primary benefit of the echelon layout was that each ward block could face fully to the south to gain maximum sunlight 101

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with minimal obstruction from the wards in front as well as retaining wide, open views from each block. It also reduced the asylum’s overall sprawl by keeping each ward close to the next as well as remaining as near as possible to the central core of admin and service buildings. The ‘radial pavilion’ plan at Cane Hill went some way toward resolving the same issues but was more of a compromise between the comfort of the patients and the convenience of management. As noted, Robert Griffiths had utilised the echelon concept for the first time at St Mary’s, but being relatively small, that asylum only incorporated two levels of ‘echelon’. Much larger ‘wide arrow’ echelon plans closer to the American style followed, at Parc Gwyllt (2nd Glamorganshire County Asylum of 1886) and High Royds, but these designs also sprawled across great distances, forcing Hine’s clever rethink. What he did differently was essentially to combine the radial pavilion and wide-arrow concepts into a new form which took the best ideas of both and resulted in his new ‘compact arrow’ plan for Claybury, the first of its type in Britain. Hine also shrewdly rearranged numerous less obvious elements within the overall design to make more economical use of the available space while

Ground floor plans for Claybury. From Hospitals and asylums of the world by Henry C. Burdett (J&A Churchill, 1893). Courtesy of the Wellcome Collection. (Public domain)

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putting greater thought into what was needed for the different categories of patient to be housed in each block. His innovative new form won him the contract against several architects with far more experience than he had at that time. When Thomas Hine retired in 1890, George moved the practice to London and ran it under his own name; he was followed there by Hallam Carter-Pegg (1862–1929), who had joined the Hine family business as an understudy in 1880. The two would continue to work together, with Carter-Pegg credited as co-architect on most of Hine’s asylums from 1899 onward and the company name was changed to Hine & Pegg in 1910. Hine had a severe stammer from childhood which lasted throughout his adult life; while this might have been addressed differently today, in his day there was no alternative for those who did not simply grow out of it, and his being sent off to a sheep farm in Australia in his early twenties seems to have been one component of some strange plan to address this. He delivered a speech to the Royal Institute of British Architects (RIBA) in 1901 on the topic of asylum design and although his stammer meant he had to appoint someone else to read it aloud for him, this speech also highlighted his position as the most significant asylum architect in Britain (arguably in the world, given the somewhat niche nature of his speciality) and certainly the most prolific, since he designed only asylums for the entirety of his career. In 1897, he succeeded Charles Howell as Consultant Architect to the CiL and was made an honorary member of the Medico-Psychological Association of Great Britain and Ireland in 1898 in recognition of his thoughtful

George T. Hine (1842–1916) in around 1895. Collection of the author. (Public domain)

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and functional designs, which were felt to have significantly improved conditions both for patients living in asylums and the staff working in them. George T. Hine died in 1916, a year before his and Carter-Pegg’s penultimate asylum – Park Prewett – was finished, and sixteen years before their final design for Cefn Coed would finally open in 1932. The laying of the foundations at Claybury commenced in June 1888 and a branch line was built near Woodford station with an 0-6-0 saddletank engine named ‘Fleetwood’ running between the main line and the asylum’s grounds, supplies then being fed onto a tramway that ran from the gate lodges to the main site. It was decided to renovate Claybury Hall as an annexe for private patients, whose stay would be paid for by themselves or their families at a rate of thirty shillings per week. While the hall was intended to offer upgraded accommodation for the better-off, it would still be hard to accuse the LCC of having skimped in relation to its pauper patients; not only was Claybury considered absolutely cutting edge in terms of its layout and facilities, it was also by far the most lavish of any London-serving county asylum. Claybury was built of red brick and featured high quality stone dressings, lintels, and window surrounds with slate roofing across the ranges, regularly punctuated by the pleasing pyramid-turreted bay windows Hine tended to include whenever the budget allowed. Beyond the aforementioned lodges, the driveway ran south for around a quarter of a mile before splitting in two. One fork led to the rear (north) of the building, giving access to the laundries and goods yard, while the other path skirted for another quarter of a mile around the whole western side and down past the male airing courts to finally arrive at the front (south) of the asylum. Claybury was unusual in having three distinct buildings form the foremost tip of the complex with its admin block/main entrance to the left, the superintendent’s residence to the right, and the chapel placed between them. The admin block was a handsome building of three floors in a domestic Tudor style with a stone entranceway featuring gothic arches inlaid with stained glass. It was surprisingly modest in scale considering the asylum it was designed to oversee, but given enough of a sense of stature by a central gabled bay flanked by twin pyramidal turrets seated above two symmetrical sets of triple bay windows. Inside was the Italian mosaic flooring so typical of its era, along with Hine’s usual glazed brickwork up to dado level and an open-well staircase with 104

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Claybury from the southwest. Male infirmary ward to the left, water tower in the centre, and admin block to the right. Unmarked postcard image, c.1910 Collection of the author. (Public domain)

decorative wrought iron balustrade, which led to the upper floors past glittering stained-glass stair lights depicting the different boroughs of London the asylum would serve. It had become unusual to place the superintendent’s residence within or attached to the main complex by this time, but such was the case at Claybury. While perhaps not everyone would wish to retire from work of an evening to a family home sandwiched between a chapel and a female ‘sick and infirm’ ward, the house was of a similarly handsome style to the admin block – albeit of a slightly smaller, more domestic proportion – and was a grand enough proposition for the man who would be sought to occupy it along with his prestigious role. The first medical superintendent appointed was Dr Robert Armstrong-Jones (1857–1943), who had previously worked at both the Earlswood Idiot Asylum at Redhill in Surrey (1855) as well as at Colney Hatch. The chapel added another spire, octagonal in this case, to the building’s already varied skyline and internally was quite reminiscent of Charles Howell’s handsome design for Cane Hill, with large gothic nave arches in red brick, leading the eye toward a polygonal sanctuary. It could seat 800 persons and there were sections at the back on each 105

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side for epileptic patients to sit separately from the others; these were set nearest to the corridor, in order that the patients might be assisted and removed at haste in the event of a seizure. In another feature borrowed from Cane Hill, the chapel was only accessed by patients via the internal corridor, so that they could file in from the male (west) and female (east) sides through their segregated doorways and back out again after services without ever having to cross paths. All three of these buildings at the front of the asylum connected directly to the extensive corridor network behind them, which itself then disappeared off in long, straight stretches, with the north-south corridors skirting alongside the catering and service buildings in the centre and those vanishing off toward the east and west leading to the thirteen ward blocks arranged around the outermost edges of the complex. Most of the wards were three storeys high and some straddled both sides of the corridor network, with the male and female divisions given the same allocations; each had two infirmary blocks, an epileptic block, one for ‘recent cases’, one for ‘chronic cases’, and one for ‘acute cases’, and the female side had an additional block for patients who worked at the laundry, to which it stood adjacent. The two infirmary blocks at the very front of the asylum featured a few more decorative features than the remainder, likely in order to further impress guests alighting at the main entrance. Set behind the chapel was a visiting room, with the recreation hall behind that. While the halls at county asylums tended to be the one area where a degree of extravagance was employed purely for the benefit of the patients, Claybury’s hall was among the most spectacular examples of its type: 120ft long and 60ft wide, it could hold 1,200 people. Decorated in a lavish Elizabethan style, it sported fine oak panelling topped with a Renaissance-style frieze running along each wall and storey-high stained-glass windows in buttressed, arched bays towering overhead. The ribbed segmental arched ceiling was a riot of colour, detail, and shape, and coupled with a spectacular proscenium arch standing over the stage at one end – with its bust of Shakespeare set atop an ornate pediment flanked by obelisks surmounting Corinthian columns – it would have instilled a sense of awe akin to the finest theatres and dance halls of its time. At evening events, the hall was lit by eight electric chandeliers (or ‘electroliers’ as it was then felt novel enough to warrant more correctly describing them) with twelve lamps set in each, while the 106

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Claybury’s recreation Hall. Photograph by London & County Photographic Co., 1890s. Courtesy of the Wellcome Collection. (Public domain)

stage was wired with 200 lamps which, when seen together, would have been a truly astonishing spectacle for the pauper patients and indeed many of the staff at that time. In addition to their usual duties, around twenty staff were also proficient in playing musical instruments and would form an orchestra for individual recitals or to accompany the various balls, dances, pantomimes, and plays throughout the year. A gallery sat at the west end of the hall overlooking the throngs that would gather, and this would later be backed by a cinema projection room built on to the back of the hall. Behind the main hall stood Claybury’s iconic water tower, which was again among the most impressive examples of its type. Although the 170ft tower was of plain red brick and only punctuated by slat windows until its uppermost segment, it then flowered into an ornately detailed Venetian Gothic design decorated with stone and terracotta and sporting four triangular windows with stone tracing forming a circle motif with a star at its centre. Surmounted by corner pinnacles and a pyramidal roof, the overall design was very much modelled after Alfred Waterhouse’s spectacular tower of 1864, which once stood over the Manchester 107

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Assize Courts. Two smaller octagonal water towers with pyramidal roofs also sat at the northern junctions of the northeast and northwestfacing corridors, ready to distribute water more rapidly to the nearby blocks and other areas in the event of fire, both adding to the asylum’s already imposing skyline. Behind the main water tower lay the kitchens, bakery, and other catering areas, along with a host of associated sculleries and food preparation and storage rooms, followed by the various laundry, washing, and drying rooms, and finally, at the northernmost point, a huge courtyard for hanging and drying the tens of thousands of clothes and linen items which passed through the laundry each week. To the west of this area was the boiler house with its attendant chimney and the workshops yard; this was only accessible from the male side of the asylum and housed various rooms for carpenters, upholsterers, printers, plumbers, smiths, and engineers as well as a ladder store, coal shed, and a room for the clerk of works. A mortuary, operating theatre, and fire station were also included in the design, while to the north of the main complex stood a detached isolation hospital (later named Willow House), with beds for up to twenty patients suffering from infectious diseases. The CiL visited the new asylum in March 1893, just before it opened, and again that October (five months after opening) and made largely positive comments in both instances. They noted the difficulties involved in recruiting hundreds of capable staff to be ready for such an unprecedented and rapid influx of patients; at the time of their first visit, all the workshops were still full of excess bedding materials waiting to be transferred to the wards. The reorganisation of boundaries between what had formerly been Middlesex and what became London County in 1889 meant that Claybury opened as the 5th London County Asylum on 16 May 1893, with the first patients admitted that day. Claybury was designed to accommodate 800 male and 1,200 female patients and was the first asylum in Britain to have space for that many upon opening. It was also the first to be fully wired with electric lighting and was heated by a hot steam system; cutting-edge luxuries which none of its patients at that time would have had access to at home. Indeed, many of its patients from poorer parts of London would still not have had indoor toilets or central heating at home even as late as the 1950s. In its first year, 2,180 patients were 108

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admitted to Claybury, with 1,091 of those having been transferred from other asylums. Although some would have died or been discharged, Claybury’s population had reached its peak capacity of 2,000 patients and around 500 members of staff within eight months of opening. Just three years later, as its population hit 2,500, the CiL described it as ‘overcrowded and insanitary’, but its relentless growth was finally curtailed by the opening of Bexley Asylum in 1898 and those built at Epsom from 1899 onwards. By the 1910s, Claybury employed nearly 1,000 staff, with the kitchens serving around 10,200 individual meals, 2,500lbs of bread, and 900lb of cake every single day. During the First World War, Claybury was one of the LCC asylums which remained in psychiatric use and so, as it picked up patients from other asylums commandeered for war use, its population rose to its peak of 2,739 in 1915. As with all county asylums, each ward block was served by its own airing courts and each of these in turn had its own shelter (or ‘kiosk’ as they seem to have been more often referred to at Claybury) in the centre. These consisted of the classic octagonal wood and iron type with

Kitchens at Claybury. Photograph by London & County Photographic Co., 1890s. Courtesy of the Wellcome Collection. (Public domain)

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seating inside, covered at the top but otherwise open to the elements and designed to evoke the feel of similar structures then often found at beachfronts and in public parks across the country. For the first fifty years or so all patients, besides those bedridden or kept inside for safety or security reasons, were taken out into the airing courts for two hours at a time between 10am and 12pm and again between 2pm and 4pm, weather permitting. Beyond the airing court fences, extensive walks were laid out across the grounds and the circular route around the site totalled almost 2.5 miles; much of this route contained ancient woodlands as well as Repton’s pre-existing landscaped areas, with more land set aside for farming and cattle grazing, which was worked by patients who were physically able. Three of the leading professionals present during Claybury’s early years would be key to securing its place among the most influential asylums in Britain and in developing concepts and practices instrumental to moving away from the use of the county asylums at all, albeit a century or more later. As the first superintendent, Dr Armstrong-Jones held progressive views on community-based care, which set the tone at Claybury for much of its active lifespan. From as early as 1906, he was among the most vocal advocates of the embryonic idea that general hospitals should have outpatient departments where patients could seek help in a more informal context, without necessarily having to enter an asylum at all; he believed that many patients’ problems might be addressed at an earlier and perhaps more hopeful stage as a result. Dr Armstrong-Jones also fought to establish a proper research laboratory, which opened at Claybury in 1895 and was among the very first of its kind in a county asylum. Dr Frederick Mott (1853–1926) was appointed as the laboratory’s director and under his purview it became one of the most influential such departments in the world, displaying an inspiring willingness to innovate and adopt pioneering research and ideas; this was another recurring theme in Claybury’s long history at the forefront of British psychiatric care. Much of Dr Mott and his team’s research centred on the links between physical and mental symptoms and their correlation to mental health problems. For example, his work significantly contributed to the discovery that ‘general paralysis of the insane’ – then by far the most common cause of death recorded for patients in asylums – was 110

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actually the final stage of syphilis infection, which crucially revealed that it might therefore be possible to cure it. This was indeed the case; his conclusions were published in a paper in 1899, and the unusual solution administered at Claybury and later pioneered at Horton Asylum is discussed in more detail in the chapter on the Epsom cluster. Dr Mott was also a key founder of The Maudsley, Britain’s first fully voluntary mental hospital, which opened in 1923 at London’s Denmark Hill and represented a huge step forward in terms of changing the way mental health was treated as well as the attitudes surrounding it. However, like Dr Henry Maudsley (1835–1918), for whom that hospital was named, Mott was also a part of the eugenics movement, who believed most aspects of insanity, imbecility, and idiocy to be hereditary and that selective breeding and the curtailing of certain bloodlines might hold the answers to madness and other mental health problems, as well as broader social problems in the longer term. Although it was a topic that led to much heated debate and many in the medical professional strongly opposed any ideas of forced segregation or sterilisation, eugenics and the implementation of social and reproductive manipulation gained significant popularity across Britain, Europe, and North America. Such ideals were upheld by many in high positions in both the medical and political sphere, including the likes of Winston Churchill (1874–1965), who wrote a letter to former Prime Minister Herbert Asquith (1852– 1928) in 1911, stating that the ‘unnatural and increasingly rapid growth of the feeble-minded and insane classes, coupled as it is with a steady restriction among all the thrifty, energetic, and superior stocks, constitutes a national and race danger which it is impossible to exaggerate’. The popularity of the movement continued into the 1930s, until the events of the Second World War saw Germany carry out a national plan of mass extermination in the name of eugenics, with up to 300,000 psychiatric patients in Germany, Austria, and occupied European countries slaughtered between 1941 and 1945 which in Germany itself, was conducted with the collusion of the Catholic Church. While not the only factor, this did allow the world to see quite clearly where such thinking could lead and how it might look in practice, and led to a fairly abrupt end to the movement; at least in any open, public sphere. While the events of the war certainly saw eugenics forever associated with Hitler’s National Socialist Party, history books to this day – at least those taught more generally in schools across Europe and North America – 111

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still tend to collude in implying it was a mode of thinking only ever popular in Nazi Germany. However, Dr Mott did not advocate euthanasia or sterilisation and his own research at Claybury concluded, perhaps to the disappointment of many, that there were no greater number of admissions to asylums resulting from those who were committed, discharged, and then had children than any other demographic within the wider community, disproving the firm hereditary links many were certain would be found. Another paper he published in 1900 from his work at Claybury disproved the theory that colitis – an intestinal disease which killed many in asylums at the time – was a symptom of insanity, showing rather that it was simply due to poor hygiene; this and the syphilis discovery between them undoubtedly saved the lives of tens, if not hundreds, of thousands. Dr Armstrong-Jones was knighted in 1917 for his work at Claybury and his general service to psychiatry, and Dr Mott was also knighted in 1919. Dr Helen Boyle (1869–1957) was appointed as assistant medical officer to the female division in 1895 and was one of the very first women employed as a doctor in any British asylum. She was a pioneer of early intervention and treatment for the insane, especially for pauper women, who her research had concluded found it even harder than men to get any sort of recognition of their condition before the point at which it might require long-term admission to an asylum. Dr Boyle founded the Lady Chichester Hospital in Brighton in 1920; this was a large townhouse converted into the first hospital of its type, working exclusively with female pauper neurosis cases. In 1939, she became the first female president of the Royal Medico-Psychological Association (now the Royal College of Psychiatrists). Forest House was opened at Claybury as an admission villa for fifty female acute patients and, in 1930, a new nurses’ home was built to provide accommodation for seventy-three nurses. In the same year, the asylum’s name was formally changed to Claybury Mental Hospital to comply with the Mental Treatment Act of that year. The painter Thomas Hennell (1903–1945) was resident at Claybury around this time; born in Kent, he became a successful full-time painter, but following a breakdown supposedly triggered by a rejected marriage proposal in 1932, he was detained at St John’s (Buckinghamshire County Asylum of 1853) near Aylesbury before being moved to The Maudsley and finally ending up at Claybury until his discharge in 1935. 112

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Hennell painted and drew many images of life at the asylums he stayed in, including Portrait Study: Three Figures (1935), which was captioned ‘We were debtors to the sane’, and depicted an attendant at Claybury rifling through the pockets of an inmate and stealing their possessions. Despite this observation, his reflections on his time there were mostly positive, and he later stated that he felt he had been ‘treated well’. Before he left, Claybury’s then-superintendent Dr Barham asked that he might ‘leave behind some proof of his talent’ and so Hennell agreed to paint an enormous mural across a wall of the asylum’s canteen. A biographer in 2015 unearthed a photograph from 1939 which shows the mural in the background of an image displaying said canteen; however, it is framed to depict the patients rather than the mural and sadly no clearer, more comprehensive image has yet been found. This important work has now been lost for good, likely either during some later refurbishment while Claybury was still open, or else bulldozed afterwards in ignorance of its significance. Returning to life outside the institution, Hennell continued to work as a painter as well as taking up writing, and in his most important book, The Witnesses (Peter Davies, 1938), described his experience of schizophrenia and subsequent incarceration in lucid and unsensational detail, with an honesty that had rarely been put into print before. In 1943, he became an official war artist for the Ministry of War and was sent all around the world, finally arriving at Java, Indonesia, where he was captured by native nationalist fighters and is presumed to have been killed by them at some point on or around 5 November 1945. Hennell’s work was exhibited at the National Gallery as early as 1944 and can now be seen in the Tate Modern, the Imperial War Museum London, the National Maritime Museum, the Royal Air Force Museum, and the V&A, among others. His work can also be seen at Bethlem Royal Hospital’s Museum of the Mind, along with many other superb works by well known, lesser known, and unknown artists resident in asylums and mental hospitals at one point or another, including several of those discussed in this book. In 1939, Dr John Harris (1900–1986) was appointed as the new superintendent at Claybury, having previously worked as a deputy to the same role at The Maudsley and also at the LCC’s West Park Asylum. He became renowned for his ‘unflappable’ temperament, which would come in useful as, within a year of appointment, he would find himself 113

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running London’s largest asylum during wartime. He was informed that Claybury would be expected to find space for 450 emergency war hospital beds as well as room for a new, larger operating theatre, all of which would be staffed by doctors from the London Hospital at Tower Hamlets. While some patients were discharged to relatives to make room for this, there was little choice but to overcrowd the other areas of the asylum and cram more patients into the wards that remained. Claybury was bombed several times during the Second World War, but, by sheer luck, all missed. In one instance, a German bomber being attacked by a British fighter plane dumped its entire payload above the asylum but amazingly, the nearest hit was just thirty yards from the nurses’ home. A huge crater was left behind and all the windows and roofing were blown off, but there was no irreparable structural damage, and no one was injured. In another incident, two V2 rockets hit the grounds near to the female division and blew out almost all of its windows, causing numerous minor injuries, but again no deaths or serious injuries. Claybury was incorporated into the NHS in 1948 and had 2,332 patients by 1950. The 1960s would see huge changes to the way mental health was addressed across Britain, with Claybury at the forefront. In 1959, the institution was renamed Claybury Hospital in keeping with the Mental Health Act of the same year, and in 1961, Dr Harris left after twenty-three years to become the official ‘medical visitor’ to the Lord Chancellor. He oversaw the appointment of his successor – a Dr Denis Martin – who, along with Dr John Pippard, built up the embryonic ‘therapeutic community’ concept at Claybury, which had been tentatively introduced in the mid-1950s. The idea of group therapy through discussion had been seeded in the sessions that took place among returning soldiers after the First World War. The idea of sharing experiences and perspectives with those in a similar situation in order to build a sense of belonging and trust as well as to address mental health problems was considered to have been quite effective for some patients, and this idea was coupled with a regime which allowed the patients much more freedom to decide what they wanted to talk about and how. While it met with great resistance in some circles, the ‘therapeutic community’ concept was popularised by Maxwell Jones (1907–1990), who had worked at The Maudsley before developing such methods at other institutions. It centred around the idea 114

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of creating an environment in which the patients could help each other as well as themselves to feel empowered and to have their voices heard, while also learning to be more attuned to the feelings and thoughts of others. The patients were given more responsibility for how the asylum (or at least their area of it) was run, as well as greater control over the regime, timetable, and topics discussed; attempts were also made to break down the barriers (both physical and psychological) between those within the asylum and the wider community. Those directing the therapy attempted to start by looking inward at the family as the starting point of an individual’s concept of ‘self’, then to look outward to consider others in the asylum and then the community beyond it, and from there to finally establish a link and a place of acceptance within both the group and the wider community outside. In the book A Hospital Looks at Itself: Essays From Claybury (Cassirer, 1972), edited by Dr Elisabeth Shoenberg (1916–2005), a host of different staff members summarise their experiences and opinions on Claybury’s therapeutic community, both historically and at that time. In the spirit of the general concept, the book also includes testimonies from several patients who experienced it first-hand. The latter are fascinating, warm, and lucid accounts and also show an interesting range of responses which are mostly positive, although one patient states: ‘I don’t want other people; I want to be left alone’, and the text notes that at his request, he was transferred back to another asylum where he was allowed ‘to just sit’, as he wished. On the 24 November 1966, The Ilford Recorder ran a headline implying that Claybury had become a victim of its own advocacy of the 1959 Mental Health Act as it was now apparently having to retain patients who should have been discharged, simply because there was nowhere else for them to go. Claybury only had twenty-five places allocated at the time at a hostel at Enfield, with Dr Martin commenting that ‘mental patients are much better off living away from a big institution so long as facilities which they can use outside are good’, and that ‘the attitude of society towards them is changing for the better but little has been done by local authorities in the way of providing hostels’, and expressing his exasperation at the lack of viable places to move patients on to. This was a similar situation to that faced by most of the former county asylums across the country at the time, and by 1970 Claybury had 1,537 patients with over half of all admissions being returning ones, 115

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as patients were discharged, and then found their way back through the system and reappeared again because the support required outside simply wasn’t there for them. The nationwide plans to wind down and eventually close all such sites were in full swing by the 1980s and Claybury would be no exception, regardless of whether or not suitable accommodation elsewhere could be provided. Wards at the northern end of the building were closed first, with remaining patients concentrated toward the southern ones nearest to the admin block. By 1990, only 429 patients remained, but the massive building and its immense grounds still had to be maintained to minimum standards: by 1991 it still employed five gardening staff. Claybury finally closed in 1997, with former staff volunteering to stay and patrol its empty corridors at night to deter would-be thieves and vandals. Its ward blocks, water tower, admin, superintendent’s house, and chapel had all been listed as Grade II in 1990, but the NHS still proposed to have as much of the site demolished as possible in order to gain the maximum sale value of the land, which would likely have seen the removal of almost everything besides the pre-existing Claybury Manor. While gaining maximum value for money was understandable, full demolition would have robbed the country of one of its finest examples of a Victorian asylum and the finest example of a compactarrow asylum bar none: an unforgivable waste of heritage and history, not to mention of such high-quality buildings. Fortunately, English Heritage and the local planning authority (under the auspices of the London Borough of Redbridge Council) had different ideas and wanted the exact opposite – to retain as much as reasonably possible. A public inquiry was held in 1997 and the Council and English Heritage’s position was upheld as Historic England identified Claybury as ‘the most important asylum built in England after 1875’ (although which other one they were referring to is unclear). The developer Crest Nicholson, working closely with English Heritage and the London Wildlife Trust, eventually obtained permission to demolish the corridor network, several ward blocks, and all service buildings, and convert all the remaining wards, admin block, superintendent’s house, chapel, recreation hall, and water tower. The service buildings were replaced by an avenue of trees running along the centre of a new housing estate and the central airing courts were hollowed out and then replaced (including the original shelters) in 116

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order to provide hidden underground parking spaces. While it is shame in some ways that this manicured estate sees Claybury entirely lose its sense of ‘place’, and it is certainly a shame the buildings were not betterdocumented before such changes, it was among the most sensitive conversions carried out on a former county asylum, externally at least. The author has often heard it said in regard to one asylum or another that they ‘cannot be saved’, or that it would be ‘impossible to convert’, and Claybury stands in defiant rebuke of such laziness, while also acting as a sad reminder of what could have been done with so many others besides demolition. While all the wards were converted into apartments, the water tower was converted to a single dwelling over eight floors (which at time of writing can be hired for one or more nights, but only if one can stomach both the height and the choice of internal décor) offering truly spectacular views from the top. The recreation hall and chapel were converted into a gym and swimming pool respectively. The site is now known as Repton Park and is a gated community; this former lunatic asylum was once surrounded by fences and walls designed to keep its paupers patients in, while those same fences now keep the general public away from the well-heeled residents within.

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Chapter Six

Bexley (7th London County Asylum aka Heath Asylum) Old Bexley Lane, Dartford, Kent, DA2 7WD

Even though the London County Council (LCC) had opened the immense Claybury Asylum in 1893, it was full within just eight months and thus the hunt for new land to build upon began as early as June 1894. A site of around 750 acres known as Baldwyn’s Park was found in the neighbouring county of Kent, near to the village of Bexley and adjacent to Dartford Heath. It cost the LCC £34,000 in total and included the handsome sixteenth-century Baldwyn’s Mansion and its adjoining landscaped grounds, large tracts of meadowland, and woodlands. While Dartford had become an important crossing point over the Thames river even by Roman times, Bexley itself had just forty-one occupants listed in the Domesday Book in 1086 with just one church and three mills between them. During the reign of King John (1166–1216), Baldwyn’s Park had been owned by Lesnes Abbey, but during the Reformation King Henry VIII’s Lord Chancellor Cardinal Wolsley (1473–1530) engineered the transfer of the abbey’s assets to The Crown, which in turn passed rent from the land to Cardinal’s College, Oxford. In 1532 it was traded with Eton College for some land near Windsor, and they in turn leased it to a Mr George Tucket in 1630. In 1780, 8,000 soldiers camped on the area in readiness for an anticipated ground invasion by France and Spain, although in the end such an event did not take place. When Bexley was connected to the railway system with its own station in 1866, it went from being a village with a population of less than 5,000 to a small town of around 13,000 over the following thirtyodd years, typical of many ‘commuter belt’ locations around the capital. Among those attracted to its now more accessible location was Hiram Maxim (1840–1916), an American entrepreneur and inventor who moved to Britain in 1881 and among a number of patents (including curling 118

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tongs, steam pumps, an inhaler for sufferers of bronchitis, and even a type of mousetrap) became famous for his invention of the first automatic machine gun, marketed as the ‘Maxim Gun’. Manufactured in England by Vickers, it was a weapon that would herald the dawn of modern warfare and thus change the wider world forever. In 1887, Maxim moved into Baldwyn’s Mansion and embarked on a plan to create a flying machine, with much of the testing and development as well as its first ‘flight’ taking place there. A 1,800ft track was built on the site and his engine, capable of generating 362hp, was the first of its kind – although some dispute whether it really constitutes the first ‘true flight’ since it was only able to lift the fuselage off the ground while still attached to its wheels. While Maxim’s record of ‘flying’ at 2ft for eight seconds may not sound so impressive now, it stood until the Wright Brothers beat it with their inarguably ‘true’ flight six years later. The concept of the wooden propeller (found to cause less friction than metal) and the use of a wind tunnel for the testing stages were both ideas first utilised by Maxim at Baldwyn Park and later employed by the Wright Brothers and were innovations for which Maxim now receives unduly scant credit. Baldwyn’s Park passed through various owners with the last family to claim it being the Minets, descended from the Huguenot line of Isaac Minet (1660–1745), a former Sheriff of Kent; they sold the land to a syndicate from which it was eventually purchased by the LCC to build Bexley Asylum. Apparently due to preparations and machinations in the lead-up to The Boer War (1899–1902), as well as the various other conflicts or conquests Britain was then engaged in, suitable labour was scarce, so the LCC shrewdly gathered patients from its existing asylums who had backgrounds in construction or were thought capable of working toward the building of the new asylum. George T. Hine, who had so recently impressed the LCC with his design for Claybury Asylum, was called upon again, but rather than replicating the splendour of that building, the LCC instead requested he deliver plans for an asylum that could contain around the same number of patients but at a significantly lower cost. While Claybury had been revolutionary in its design and is widely regarded as the pinnacle of the form, Hine’s plan for Bexley, which he submitted in January 1896, arguably improved upon it in several ways, from a functional if not an aesthetic perspective. It adhered to the same 119

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‘compact arrow’ plan, but made even more intelligent use of the available space by seeing almost every outer ward block connected to the next with little compromise to the overall ‘echelon’ concept (see Claybury chapter), thus significantly maximising the building’s immense 1,225ft span and reducing the distances which needed to be travelled in order to move around the building. There were nine blocks for females and eight for males with eighteen wards in total initially designed to hold 2,180 patients, including thirty-five in each of the two detached villas for ‘quiet cases’. Bexley was constructed from yellow stock brick with red brick banding and along with its near-identical ‘sister’ asylum Horton (of 1902), was among the most plain and economical per available bed of all the county asylums in Britain. Concrete lintels, multi-paned sash windows, and Welsh slate roofing were used, but there were none of the towers, terracotta detailing, carved stonework, or ornate flourishes seen at most of Hine’s other asylums. Twin gate lodges sat at the north

Plans for Bexley Asylum by George T. Hine. Supplement to CiL report of 1896. Collection of the author. (Public domain)

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entrance to the site and a driveway led east toward a turning circle at the front of the admin block at the centre of the north side of the complex. The admin block comprised two floors with a large arched doorway fronted by a brick portico covering the entrance, topped with a large arched stair window. Above that was a Dutch gable with a circular white clock set in the centre. Six smart red brick pilasters separated four sets of sash windows on either side, and each end on both floors finished in wide bay windows; handsome enough but again, all still extremely plain compared to most of Hine’s other works. Admin contained the usual rooms for the superintendent, a committee room, officers’ rooms, and a reception room. A corridor led south past a waiting room, clerks’ offices, and a library, then connected to the sprawling corridor network, part of which also included a series of visiting rooms on either division; visitors could not see the patients on their wards. Visiting was kept to strict times on specific days unless a patient was so ill that they might not survive much longer, in which case their family would be notified and could visit whenever they were able. Only two visitors were permitted at a time; children and infants were discouraged but not banned, although infants ‘in arms’ were not allowed at all. Laid out along the centre of the building to be accessible from both male and female divisions were the steward’s stores, followed by the kitchens and associated food storage and preparation rooms (including one labelled ‘women’s potato peeling room’), dining areas, and then the main recreation hall, with its attendant stage area to the east. A small surgery sat behind the hall, followed by strictly separate rooms for the female nurses and male attendants, with the nurses getting two sitting rooms and the attendants having one sitting room and a billiards room. Each division also had a whole residential block for nurses on one side and attendants on the other. Finally, the AMO’s (assistant medical officer’s) block sat at the far south end of the building, along a corridor which allowed him immediate access to the rest of the building, particularly the infirmary wards. Each division had a range of ward blocks skirting the outer edges of the building, each with their own airing court and on both sides the infirmary wards sat at the far south, followed by the acute wards and then the epileptic wards as one moved north through the complex. On the female side, the latter had a hoarding added at the boundary to obscure the airing courts from view of the nearby road. There was 121

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a block on each side consisting of two wards which housed working patients: females who worked at the laundry were housed on the west side, with male patients who worked at the boiler house and in the various workshops to the east. The latter area included a room each assigned for upholsterers, hair picking (for mattresses), printers, tailors, cobblers, bricklayers, a coal shed, painters, carpenters, plumbers, and a smithy. The water tower, which incorporated the boiler house chimney, also sat in this area next to the steward’s yard and, as with the rest of the asylum, was perhaps the single most plain example of its type, featuring only a light battlement type decoration around the top and appearing most subdued in comparison to the extravagance Hine was allowed at Claybury. The chapel stood just to the northeast of the asylum, laid out to a rectangular plan and capable of seating 850 patients at a time, with separate entrances for males and females. It was designed in an unusual mix of modern and neo-Georgian styles and thus strikingly different to any of Hine’s other, more typically Gothic-revival chapels. A burial ground for pauper patients not claimed by their families was laid out to the southwest of the site, away from the main buildings. A detached acute block was among the original buildings and by 1904 a second was added, allowing one to accommodate only female and the other only male patients. Electric lighting was installed while the asylum was being built as well as an early telephone system. The Heath Asylum (as it was first known) opened on 19 September 1898 with only four male wards occupied, mostly by those helping with the construction; three of the female wards were also occupied by early 1899. Dr T.E.K. Stansfield (1862–1939) was the first medical superintendent, on a salary of £1,000 per annum. His wife (named only as ‘Mrs Stansfield’ in the relevant documents) organised a Christmas party to be thrown in the recreation hall at the asylum’s expense for the attendants and their wives and children each year. Female staff were not allowed to be married and therefore would, ‘of course’, also not have children, so could not attend. By 1904 the asylum had almost 2,000 patients and Baldwyn’s Mansion was converted into additional accommodation space. The same year there was a furore with local council members complaining in the press about the LCC’s proposal to change the building’s name to ‘Bexley Asylum’. They had been relatively happy with the vaguer 122

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‘Heath’ prefix, as it did not really identify their locale, but there was much concern about the effect on the area’s reputation and in particular to local property prices if such a change was made. The entire council put their names to a document which described this as a ‘grave injustice’ and beseeched the LCC to rename it ‘Dartford Heath Asylum’. This was ignored and it was renamed Bexley Asylum in 1905, with a new superintendent, Dr G. Clarke taking up the lead role in 1907. On 29 May 1908, Bexley was in the press again regarding one Thomas Bradley, a former soldier described as ‘dangerous at times’ who had been a patient there for five years and escaped once already, albeit briefly. Apparently, he had cut around half the way through the hinges on his bedroom door before giving up and cutting a hole in one of the door panels instead. This feat would have taken quite some time and effort, even with a knife or small saw, but Thomas had apparently managed to accomplish it using only an iron clamp (of the type used to reinforce the corners of a heavy trunk) he had somehow obtained in the asylum. Since his escape must have taken several nights to achieve, the panel had to be cut perfectly enough that it would fit back into place without falling out or even being noticed before his work was complete. Assuming the night attendant’s testimony that he had fully carried out his hourly patrols through all parts of the ward block were true, Thomas would also have had to listen out for any approaching footsteps, stopped working upon hearing them and got back into bed (in case the attendant looked in through the spy-hole in the door, as he should have done for each cell if following regulations) and only once he was absolutely sure the attendant had moved out of earshot would he then have been able to resume his surreptitious work. Thomas would then have had to crawl through the hole he had made and out into the corridor, somehow obtain his daytime clothing, then arrange his bedclothes under his sheets in the classic ‘sleeping body’ outline before making his way into the day room (which should also have been locked). There, he would have had to use his shoddy makeshift tool yet again to unscrew at least four screws from the wooden blocks which restricted the runners of every sash window frame.11 Again, this would need to have been completed within a very tight timescale before the night attendant returned. Upon finally completing this admittedly impressive task, he made the 16ft drop to the ground from the sabotaged upper-floor window, made his way across the asylum’s farm, scaled the perimeter fence, and then 123

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headed off down the main road and away into the night. Thanks to the fake ‘body’ in his bed, his disappearance was not discovered until the morning rounds at 5.30 am, whereupon eight attendants were sent out on bicycles in different directions to try and track him down. Since no trace of him was found besides the evidence of his ingenious scheme, and he was not suspected to have been involved in any subsequent crimes, he was deemed to have ‘survived’ without incident for more than fourteen days, so his original committal was legally declared void and he was a free man. Another patient named William Lett, who escaped in December 1924, actually snuck back into the asylum. While the cold was probably also a factor, he stated that he had escaped to look for work in London but, being unable to find any, was ‘pleased to get back here’. As with all asylums, transmissible diseases were a constant threat, and Bexley had its own isolation hospital to provide accommodation away from the main buildings for those who might infect others. Tuberculosis, smallpox, diphtheria, scarlet fever, and typhoid were all major causes of death in the late nineteenth and early twentieth centuries, and the overcrowding at asylums meant any patients showing symptoms needed isolating quickly. In 1910, when there were 2,232 patients in total, some were becoming ill on ward G1 and had to be transferred to the isolation blocks. Upon testing, it turned out that a nurse named Jenny Watson who had worked with these patients had herself suffered with typhoid in 1901; since one in twenty who have an untreated typhoid infection but survive can still retain the disease while asymptomatic themselves, they become prime ‘carriers’ as had been the case with the notorious Mary Mallon.12 Nurse Watson was soon dismissed. While similar small outbreaks were common and larger ones occasional, asylums often avoided the worst effects of the various flu pandemics and other diseases which swept across Britain from time to time as they were able to seal themselves off from the surrounding community with relative ease. During the First World War, Bexley was among the county asylums not requisitioned as a war hospital, and so suffered the usual overcrowding and understaffing which came as a result of taking patients in from the ones that were. In 1918, it was renamed ‘Bexley Mental Hospital’ which, as with most of the LCC asylums, pre-empted the 1930 Mental Treatment Act that would make the term ‘asylum’ legally redundant. 124

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The 1920s were a period of change for the world in general and Bexley was no exception; occupational therapy was introduced during this time, with rug-making and box-making among the activities available. The fences around some of the airing courts were also taken down and more of the wards unlocked during the day as patients’ freedoms slowly grew. A small ‘allowance’ was given to each patient so they could buy goods from the canteen and the asylum’s own shop to be stored in their new bedside lockers, and patients could even earn a little extra money by assisting with cleaning, washing, farm work, and gardening jobs. Visiting times were relaxed a little and approved patients were allowed to stay with friends or relatives overnight on ‘parole’. Patients’ clothing was adjusted to fit them properly, and instead of having to wear whatever they were given, they could keep their own set of clothes which would be returned to them after washing. Attempts were made to create a system whereby new patients would enter the acute hospital or one of the villas, and then ideally be transferred to a convalescent villa before leaving, with the intention that the more ‘hopeful’ cases might never have to enter the main asylum at all. Male attendants became ‘male nurses’ from 1923.

Ward in admission villa. From the Royal College of Psychiatrists. Courtesy of the Wellcome Collection. (CC BY 4.0)

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By the 1930s, conditions were further relaxed, and the old visiting rooms were repurposed, with visitation now allowed in both the grounds and on the wards. Dr L. Cook took up the role of superintendent in 1939 and in his first speech to the committee and staff he summarised the recent past at Bexley as he saw it, stating: Even in 1938, 186 patients were secluded for the huge total of 10,580 hours, and no less than 1,430 pounds of paraldehyde and 273 pounds of chloral hydrate were used during the year. In the more refractory wards, there was a sustained atmosphere of tension; struggles and minor casualties were numerous and there was even an element of personal danger to visitors passing through the wards, especially at mealtimes. At the time of his appointment, the plan to house the ‘hopeful’ patients in the external buildings (to which an additional three villas were added in 1939) was felt to be working for the most part; however, of the eighteen wards of the main building, only two were ‘open’ with the remainder still locked down. Five were nursing wards for the sick, elderly, or infirm while another two housed those suffering from chronic depression, most of whom had already been there for between two and twenty years. The remainder housed those who were felt, at the time, to be violent or destructive in their behaviour. Dr Cook hoped to move toward implementing some of the more permissive and progressive elements of the 1930 Mental Treatment Act, but the Second World War would begin during the first year of his tenure, with air raid shelters dug out in the grounds and an anti-aircraft battery installed on neighbouring Dartford Heath. The maintenance tunnel network beneath the asylum was also used as shelter as the asylum took three direct hits from German bombs. One hit Baldwyn’s Mansion, almost completely gutting it in the subsequent fire, and in 1944 another hit M block, killing a male nurse and twelve patients. Two hundred and ninety patients were moved to Bexley from other asylums (including Colney Hatch) during the war and with 380 beds set aside for emergency hospital use and another 500 allocated for casualties, its psychiatric patients unsurprisingly suffered under severe overcrowding during that time. Surprisingly, it was felt that the diet of patients actually 126

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improved as activities for physically able patients were focused on producing meat and vegetables from the asylum’s farmland, leading to subsequent reductions in their intake of sugary and fatty foods as both sugar and butter became scarce due to rationing. After the war, Bexley’s catchment area was concentrated around Greenwich, Lewisham, Woolwich, and Deptford and along with all the other county asylums it was incorporated into the NHS in 1948. That same year, as damage caused during the war was repaired and the whole asylum was modernised and refurbished, a garden party was held in the grounds for staff to celebrate Bexley’s 50th anniversary, with the patients enjoying a similar event a week later. There were 162 male and 213 female nurses to work with 2,141 patients at that time and around a third of the latter were over the age of 65, with a quarter of all new admissions being elderly patients with dementia. Four rooms at Baldwyn’s Mansion had continued to be used despite much of the rest of it having been damaged by a bomb, with the staircase boarded off to prevent access to the upper floors. It was finally repaired and refurbished in 1956 (although the original domed roof was replaced by a simple flat one) and became the occupational therapy department. During the same year, Olive Fraser (1909–1977) was admitted to Bexley. Raised in Aberdeen, Scotland, Olive had been born to a young couple who had married in secret; her parents had then emigrated to Australia, leaving Olive to be brought up by her great-aunt in Nairn. Although her parents did return to Britain separately, neither would acknowledge her upon their return, as she lamented in her 1971 poem The Unwanted Child. Olive was successful at school and while studying English at Aberdeen University, where she won the Calder Verse prize for her sad, often poignant poetry. In 1935, she won the Chancellor’s Medal for English Verse – the first woman to do so. She was given compassionate release from the Women’s Royal Naval Service during the Second World War due to ‘mental instability’ (perhaps exacerbated by one of her first postings during a particularly severe bombing of Liverpool) and later moved to London, commuting to work at the Bodleian Library. It was at this time that she was diagnosed as schizophrenic and admitted to Bexley several times over a five-year period from 1956. She wrote several of her poems while at Bexley and was attempting to gather enough for a book but, like many artists suffering from mental 127

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health problems, was frustrated that her health concerns held her back and her work received little further recognition at the time. She moved back to Scotland and spent time in Aberdeen’s Royal Cornhill Asylum from 1968, where she was eventually re-diagnosed with hyperthyroidism rather than schizophrenia and prescribed new medication which saw her outlook and prospects transformed. She found a new lease of life and experienced greatly improved mental and physical health such as she had not known in decades. Sadly, a different health concern was soon to scupper her progress again, as she was diagnosed with cancer in 1976 and died in Aberdeen the following year. A stash of her works was discovered in 1983 and her friend Helena Shire compiled the book The Wrong Kind of Music (Canongate, 1989), bringing Olive Fraser wider and more lasting recognition. The asylum’s own magazine, entitled Bric-a-Brac, was written and published by the patients and printed on site from the 1950s, and a social club known as The Heather Club was opened in 1959, where patients could go to have an experience rather more akin to life outside the asylum; they could also arrange to meet friends or relatives there. While many asylums are considered to have been at their worst during the 1950s when overcrowding often reached its peak, the staff appear to have felt that life at Bexley was at its most convivial during this time, both for themselves as well as for the patients. Naturally, this is to be taken with a significant pinch of salt as such a perspective is both highly subjective and given by those who could leave the building whenever they wished, were paid to be there, and were not unwell, although by then around 90 per cent of Bexley’s patients were resident on a voluntary basis. The reasons given for this sunnier outlook from the staff’s perspective were that the asylum’s sporting and recreational activities were at their most inclusive during this time, with many fond memories of the weekly football and cricket matches (which the patients also attended and participated in) and that real efforts were being made towards providing high quality performances and activities within the main hall, which most patients were also said to thoroughly enjoy. There was also said to be a greater sense of community and real involvement and inclusion of the patients in directing their own recreational time, with many volunteers coming in and helping forge more meaningful and long-term connections between the patients, the wider community, and the world outside the asylum. 128

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In 1960, the Industrial Therapy Unit opened and was subsequently moved to a purpose-built site within the grounds in 1967. Here patients could try out, and go on to learn, a variety of different industrial skills and techniques and, with the help of the Re-Instate organisation, could opt to get a minibus to nearby Erith to enrol in paid work for longer hours if they wished; they could even be contracted out to various factories and warehouses for some real paid work which led to full-time jobs for many, eventually allowing them to support themselves outside the asylum. Tobacco was the main currency paid to patients for their work on various tasks within Bexley itself and a mini ‘black market’ developed around its trade and distribution. Toward the end of the 1950s, uniforms for staff were abolished with the doctors’ white coats and the nurses’ starched, striped uniforms abandoned in favour of more casual clothing. As at other asylums, most patients reported enjoying this change and feeling that it broke down the barriers of hierarchy, mistrust, and distance which had existed before, while there was always a minority (mostly among new patients who had not known the staff before the change) who were absolutely terrified at the prospect of not being able to immediately tell a patient from a member of staff during their introduction to the wards. The 1959 Mental Health Act repealed the previous acts and among its many changes abolished the Board of Control as the overseer of all mental health provision. It also legally excluded any of the former ‘moral’ considerations from the criteria for committal: promiscuity, sexual orientation, sexual identity, pregnancy, infidelity, etc. were no longer seen as valid justifications for entry into an asylum. Bexley’s farm was still in use during the 1950s and work there was generally seen as a healthy and enjoyable activity by the patients. Even by then, its main source of power was still two shire horses, who at that time were named ‘Punch and Judy’. They helped pull ploughs, drew the asylum’s hearse when needed, were shown off at fetes and festivals, and gave rides to the children from the local primary school who often passed through the asylum’s grounds. Staff recall the farm area being a real little haven at that time, where it felt as if almost nothing at all had changed since the asylum itself was built more than half a century earlier; even then it was said to make one pine for a simpler, slower pace of life and was somewhere one could go to feel free from the trappings of the modern world outside. 129

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Aerial view of Bexley from the southeast. Unmarked postcard image. (Collection of the author)

In 1961 an outbreak of foot-and-mouth disease hit the farm and within two days, its entire population – 103 cattle and 390 pigs – was destroyed to curb the disease. The event made the BBC evening news and livestock movement was curtailed within a ten-mile radius. The carcasses were burnt on site and one patient recalled ‘there was a smell of roast meat around for days’. This led to the full closure of the farm later that year, although as with all the other county asylum farms, it was scheduled to be closed during the next decade or so regardless, supposedly for the patients’ own benefit. Bexley was back in the newspapers several times during the 1970s as a spate of fires hit various parts of the building, some accidental, some deliberately set. In 1973 the basement stores somehow caught fire, with the only casualty being ‘Minnie’, a cat who had taken up residence down there. Many windows were broken and irreplaceable archives from the asylum’s history lost for good; it took thirty firefighters with breathing apparatus heading down into the subterranean network of tunnels to put it out. In 1974, the nurses’ home went up in flames when a television set blew up. Fortunately, one nurse who could not sleep that night heard a crackling noise and raised the alarm in time. In the same year, there was another fire in the basement of Elmdene ward, the cause of which was 130

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unknown. In 1976 a fire destroyed the prefabricated buildings which housed the student library and adjacent reading room, with eight fire engines sent out to quell the flames. Also in 1976, Dartford Police were brought in after beds in several of the wards were set on fire over a period of a few months; all were thankfully discovered quite quickly but could have been much more serious. Early in 1977, the culprit was found and this 43-year-old patient – who had been at Bexley since 1956 – pleaded guilty to starting a fire which had caused £48,000 of damage, explaining he had done so because he could not sleep at night and felt depressed about the sense of routine at the asylum. He was sent to secure accommodation elsewhere. Bexley was also in the news in 1974 after a man came into the waiting room and then refused to leave when the registrar explained he could not simply be admitted to the asylum there and then without going through the usual processes. Turning violent, he smashed up furniture and windows in the room, and when the Kent Police arrived, negotiations dissolved into something more akin to a siege situation. Growing impatient, the police took the highly unusual decision of throwing a canister of CS gas (tear gas) into the room to force him out. CS gas was usually kept in small reserves for use in riots or other serious, high-level situations and at that time was already a hot topic in the news due to its controversial deployment in Northern Ireland. The decision by police to use it at Bexley was questioned in the press, since although legally defined as ‘non-lethal’, it can cause permanent injury to those with existing chest or lung problems. By 1977, Bexley had reduced its population to just under 1,000 patients and was facing the same issues as most of the other former county asylums: an increasingly ageing population who had little or no support waiting for them outside the institution. Where rehousing was available, it was usually something of a stretch to expect these elderly, long-stay patients, who many argued were victims of state-inflicted institutionalisation, to suddenly be able to survive on their own. In 1976, an elderly male patient was rehoused in a hostel in Margate, Kent. After twenty years at Bexley, he found himself alone and unsupported in an unfamiliar town with no friends or family around, so he eventually walked all the way back to the asylum and simply returned to his old ward. While he was clearly quite physically capable (it is just over sixty miles from Margate to Bexley), no meaningful social or psychological 131

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coping strategies had been built up before his resettlement (or implemented afterwards), and so he unsurprisingly hated the experience of suddenly being totally isolated and without his ‘pals’, as he put it. This story would doubtless have been similar in a great many instances, although not all would have had the confidence or ability to do what he had done and would have simply had to suffer wherever they were put. Bexley continued to be considered one of the more forward-looking and inclusive asylums during the 1970s and 1980s, with general reports of good relationships between staff and patients, a more progressive and permissive regime than some, and a more welcoming atmosphere than most. Again, this must be taken with a pinch of salt as it is the perspective only of the staff, but this notion is lent some additional credence by Bexley’s apparent willingness to engage with the community and the press. In 1979 Community Care magazine approached four London-area asylums with a view to being allowed to visit over a set period to gain an idea of what life was really like in a long-stay psychiatric institution at that time; only Bexley agreed to allow them in. It is painful to note that Bexley was perhaps at its most therapeutic and beneficial to many patients at exactly the time that activity there was beginning to wind down and patients and staff were being moved out. While suitable accommodation was found for some, the 1983 Care in the Community Act often meant taking patients out of their existing community within the asylums and placing them in tower blocks on grim council estates where they did not know anyone, often suffered with acute loneliness, and were frequently subjected to ridicule, stigmatism, and even outright abuse, exploitation, or violence. By the mid-1970s, the disused former visiting rooms which sat along the curved parts of the main corridor network in both divisions were converted and then redeveloped over the course of the 1980s. Although the building had already become much more integrated in terms of the mixing of genders, the original allocations remained to some extent and on the western ‘female’ side, these rooms were converted into The Crescent – the psycho-geriatric unit of the occupational therapy department. This catered for short- and medium-term elderly patients and used music and art therapy with other forms of ‘mental stimulation’ to evoke memories and teach or re-teach independent living skills and self-care. The same area on the ‘male’ side was renamed The Cedars, and under the stewardship of Mr Dudley North was gradually transformed into a 132

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sort of ‘gentleman’s club’ for the elderly male patients. The series of rooms were fitted out with soft furnishings, warm lighting, wood panels, and old signs, as well as paintings and other quirky décor, with tea and cakes baked in one of the rooms. The elderly patients who visited came to see the place as something of a home within their wider home and in the summer it would open out into an enclosed airing court planted with flowers and filled with interesting statues, structures, and themed corners to make it feel like a vastly different, much more intimate retreat from the coldness of the rest of the building. The art therapy department at Bexley became unusually vibrant and well utilised during this period too. A genuine little haven was created within the building by the hard work of some exceptionally enthusiastic staff led by Britta Von Zweigbergk, who would later co-write and publish the asylum’s biography The Village on the Heath (Von Zweigbergk & Armstrong, Doppler, 2004). The rooms it utilised had been the former bath house which, with its high ceilings and glass roof, lent itself to the bright, spacious environment required. The walls were constantly covered in the patients’ graffiti and pieces of artwork in all manner of media, with tables covered in sculptures and other three-dimensional creations, as Pink Floyd’s The Dark Side of the Moon album played on near-constant rotation in the background (during the 1970s at least). ‘Open’ sessions were held regularly, and an almost open-door policy was eventually implemented, creating a ‘drop-in’ feel rather than the more organised and regimented approach which often existed elsewhere. Students and volunteers would prowl the wards encouraging the more withdrawn patients to come and have a look and as a result, some of the more reluctant felt able to join in, often becoming regular attendees to the point where they would have to be cajoled into leaving at the end of the day. Art therapy has been an often-overlooked but always essential part of any asylum’s regime over the years, and there are a wealth of examples of wonderful creations by those who have spent time within them, plus doubtless a great many more lost to history – the author can think of numerous instances where, after a particular asylum closed, everything that existed in the art department’s storerooms was either burned, thrown into a skip, or simply left to rot. At various asylums at various times, access to art materials brought out previously unknown skills and creativity in those who may never have even tried to turn their hand 133

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to anything creative before. In other cases, asylums acted as a unique environment where even established artists produced some of their most important works due to having been free of the need to create work ‘to order’ for commercial purposes and having an expanse of time on their hands; this often led to fascinating new directions once the constraints of the fashions and artistic styles of their day could be abandoned in favour of focusing on whatever they really wanted to create. One example would be Cynthia Pell (1933–1977) who grew up in Finchley, winning a national art competition in her final year of school and considered the most gifted student of her year when she attended Camberwell School of Art. She was diagnosed as schizophrenic aged 16. She married a fellow art student, Ron Weldon (who later married the author and playwright Fay Weldon), and they spent the summer of 1955 painting in France. In the first of what was to become a repeating pattern, she destroyed many of her works from that time and after her first solo exhibition, she also burned all the unsold works on a bonfire. Eventually divorcing Ron and returning to using her birth name, Cynthia continued to paint and while some of her works from the 1950s and 1960s remained in circulation, her mental health problems gradually came to the fore, seeing her admitted to Hanwell Asylum at various times from 1961. After several suicide attempts, she was admitted to Bexley in 1973 where, although she generally chose to stay away from the art department and be on her own around the building, especially at night, she sketched and drew constantly and established a cautious friendship with Britta Von Zweigbergk. Von Zweigbergk compared Pell’s work to that of a war correspondent: she would scurry along the asylum’s corridors to sit on the periphery of wards, kitchens, workshops, and day rooms with scraps of paper, crayons, and a biro in hand, sketching and painting melancholy moments of life at the asylum. Her impromptu sketches and drawings were rough and almost abstract in style but captured a curious veracity and muted emotion often lacking from more ‘classical’ works. A favourite place for her to sit was in the warmth of the boiler house, where she would feed and sketch the cats who were also drawn to the heat and seclusion of that subterranean area. Cynthia would remain at Bexley for four years. She waited until the two staff members she felt closest to, Von Zweigbergk and a charge nurse named Brian O’Connor, were on leave before committing suicide there in July 1977, aged 43. 134

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In 1999, Von Zweigbergk was on leave from work and listening to the Woman’s Hour programme on BBC Radio 4, on which two female artists were discussing another female artist friend whom they had known back in the 1960s and who had vanished inexplicably from their lives. They were currently organising an exhibition of this mysterious woman’s known work and expressing their disappointment at being unable to locate any of her other works, or even discover what had become of her. When the name Cynthia was mentioned and she mulled over the timeline being discussed, it dawned on Von Zweigbergk that they were talking about Cynthia Pell, the patient whose artwork she had thoughtfully collected and squirreled away more than twenty years earlier. She got on the phone and called the BBC, who put her in touch with the artists in question and they agreed to meet at Bexley, which by then was partly demolished and mostly empty but still officially open. There, Von Zweigbergk revealed the 122 pieces of artwork she had held on to, to the amazement of her visitors. All of the works were included in the planned exhibition and the book Cynthia Pell: The Bexley Hospital Drawings was published in a limited edition in 1999 and, along with several subsequent exhibitions, brought far wider recognition of Pell’s work. The early 1980s saw a spate of violent incidents at or connected to Bexley which sent shockwaves through the wider community, staff, and patients alike. Of course, this reflected negatively upon the building, regardless of whether it was established that the situation had arisen from its own failings or those of the wider system in which it operated. In 1981, Robert Potter, who had been released from Bexley just eight months earlier, murdered a young woman and was jailed for life. Peter Jenner, another ex-patient, also murdered a woman, this time only a month after discharge in November 1982. He was sent to Broadmoor. In July 1984, social worker Isobel Schwarz, described by Von Zweigbergk as a gentle, kind, and conscientious worker, was murdered in her office at Bexley. With the benefit of hindsight, it was realised that the office was unwisely placed for use by someone who often dealt with potentially difficult or violent patients, located as it was in a somewhat isolated area of the building. When Isobel did not arrive home, her boyfriend returned to Bexley and found her. Initially, the murder was a mystery; Isobel’s office door had been locked and the only information to go on was that a woman had been seen with a knife in that area earlier in the day by a porter, but he had not intervened and did not even call the 135

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police. There were still 900 patients in residence at the time and police interviewed many of them. The mental state of the patients, combined with their feelings of sadness, regret, and even guilt-by-association, led to around fifty patients actually confessing to the murder. It was a tragic marker of the impact this event had at Bexley, as well as how the patients saw themselves, that most of these erroneous confessors said they could not actually recall having committed the act, yet genuinely believed it was quite possible that they might have done it. After around twelve months, all staff and management at Bexley were cleared of any wrongdoing or negligence, although new electronic and other security measures were henceforth implemented. A former patient named Sharon Campbell, aged 21, was arrested for Isobel’s murder in 1985 and detained at Broadmoor, later standing trial in 1987 and pleading guilty to manslaughter on the grounds of diminished responsibility. She had developed a hatred and resentment toward all social workers, which grew into an obsession that eventually fixated upon Isobel Schwarz. After it emerged that Campbell had already physically attacked Isobel once before and made a series of death threats, a series of campaigns by Isobel’s father, Dr Victor Schwarz, led to a new public inquiry. A 3,000-page report was published in 1988, although the conclusions were largely in line with what might have been expected: a need for additional security, additional checks, etc. Much of it related to the kind of care Campbell should have received after leaving Bexley, rather than what was done or not done with her while there, although it was noted that she had requested certain treatments which she was not given and that, for some reason, her formal discharge note was not even completed until five weeks after she had left. Unfortunately, this scenario echoes a great many others, most of which never get so widely told, where patients and those around them suffer greatly in one way another from the shameful lack of available in-patient beds or outpatient follow-up support, care, and suitable accommodation. The reason the three patients described above and others like them are remembered is because, in those particular instances, their illnesses manifested in ways that made for big news stories by temporarily embarrassing those charged with providing their care and treatment (if not those in a position to make a legislative difference to it); but in so many other instances where that destruction might perhaps focus inward, this demographic tends to remain largely ignored. 136

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In September 1985, the Bracton Centre, a medium-secure unit initially built to house up to fifteen patients who had committed crimes or were thought to be violent and a potential risk to the public, opened just to the east of the main building. There was (as is almost always the case) some local opposition to this, especially in light of the cases mentioned above, but at that time it did at least serve patients from the local area, with a catchment of Bexley as well as the more distant London boroughs of Greenwich, Southwark, and Lewisham. One of the defining features of life at Bexley was its huge population of feral cats. This ever-growing menagerie was unofficially encouraged by many patients and staff, and each ward and department tended to have its own two or three (at least) for which they were informally ‘responsible’. While they gave pleasure and company to many and were best friends to some, they inevitably brought problems too, including fleas, allergies, uncontrolled breeding, and obvious hygiene issues as they fouled the maintenance tunnels and other areas they called home. Bexley’s cats were apparently so well known that people would occasionally dump unwanted cats and kittens around the building and pest controllers were brought in to address the over-abundance from time to time, resulting in a scramble by sympathetic patients and staff to hide their favourites from the prowling nets and traps, despite official warnings against doing so. The message from management was that staff could take one home and rehouse it if they wished, but there would be disciplinary action against anyone found to be protecting or encouraging them. ‘Bexcats’ was formed in 1980 by patients and staff to advocate for the cats and find the best middle ground between caring for them and staying safe. Arguments were made for their retention, including that a significant population of cats was preferable to a greater number of mice and rats which would doubtless exist otherwise. Papworth Hospital in Cambridgeshire had seen a serious problem with rodent infestation occur not long after a big drive to rid itself of its cat population; this role is, after all, precisely why the symbiotic relationship between cats and humans developed in the first place, although many might argue that within domestic settings at least, the cats triumphed in that particular battle of wills quite some time ago. Through fundraising, Bexcats was able to have all the animals neutered or re-homed and this at least avoided any further extermination or trapping until Bexley’s eventual destruction, from which time the fate of any remaining cats is unknown. 137

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In March 1988, it was announced that plans for Bexley’s closure were in place, but with no timescale drawn up, around £6,000,000 would need to be spent to keep it in a suitable condition for ongoing use. Greenwich Borough announced it would be removing or rehousing all patients under its responsibility within the next few years, with Lewisham and Southwark soon announcing the same. While the neighbouring Bracton Centre was enlarged in 1989, the original wards continued to be emptied and left disused one by one, with the building containing only around 450 usable beds by 1990. Despite its designation as a green belt site, various proposals contrary to that definition were floated as the vultures circled the declining, aged building and its valuable land. A site for a new prison was among the first ideas proposed, while others included a railway station linked to the Channel Tunnel. By the early 1990s, most of Bexley was disused and roofing across the asylum leaked, with buckets and pails distributed throughout the corridor network to catch the worst of the water ingress. The recreation hall caught fire in December 1991, and with an estimated repair bill of up to £200,000, it was scheduled for early demolition instead. One day in June 1992, Britta Von Zweigbergk had started her morning as usual, in the art department at The Cedars among the patients’ halffinished artwork, awaiting their arrival later that morning. Patients duly began to arrive and Von Zweigbergk popped out to deliver art materials to the Bracton Centre. The art department was visited by the fire brigade’s safety inspectors and Von Zweigbergk returned to find it, along with the rest of The Cedars area, closed and locked up with all the patients having been sent back to their wards. This oncevibrant part of the building now sat empty of human life, with yet more buckets strategically left under the worst leaks and ivy growing in under the doors. Although art therapy would continue to be available in different parts of the building, the real heart had stopped beating and many felt this truly signalled the end of an era and the beginning of the end for Bexley. By this time, whole wards were sealed up and left empty or cluttered with discarded furniture and equipment, subject to vandalism and break-ins and now home only to the inevitable roosting pigeons making their way in through broken tiles and smashed windows. Although the grounds, which by this time had long been open to the public, provided 138

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locals with pleasant dog walks and places for children to play, others took advantage of the openness and decline in security; fly-tipping took place as well as the theft of roofing slates, iron drainpipes, lead and other metals, all of which helped to accelerate the building’s decline. At Baldwyn’s Mansion, by then also disused, the fine marble fire surrounds and even an entire wooden staircase were stolen by more ambitious thieves. Expensive new fencing was erected around the site but again, as ever, a hole was cut through it within twenty-four hours of its completion. By 1992, there were less than 400 patients left and the central services had all closed. Almost all of Bexley, apart from the eastern range of ward blocks, the Bracton Centre, the chapel, and some of the outlying villas was by then abandoned and boarded up. With the main kitchens closed, hot meals were distributed around the wards in foil boxes, and staff and patients alike complained about its quality. The chapel was still in use but in quite a sorry state: there were leaks in the roof, the toilets and half the plug sockets did not work, some subsidence was occurring at one end, and there had been questions raised about the suitability of the fire exits. Demolition of the western range of ward blocks and central services began towards the end of 1995, and an eerie sense of uncompleted transition pervaded on the remaining side. The long corridors which once allowed for seemingly endless wandering, now ran for a certain length before a juncture which used to lead somewhere familiar would now abruptly end in a wall of new breeze blocks. Patients and staff alike could look out of their windows and watch the areas which had been so familiar for so long to so many now fenced off and being torn down in front of them. As the outer walls came down, the innards of wards, cells, bathrooms, and offices were exposed to the elements and might then have vanished completely the next time one looked, until eventually the water tower was all that remained, standing resolute over the rubble and raw, churned soil. While the Bracton Centre was further enlarged and continues to operate to this day, Bexley Asylum finally closed whatever doors still remained for good in 2001. The nurses’ home, gate lodges, and chapel survived (the latter now a gym) and the sports pavilions and fields are still in use by local clubs. Baldwyn’s Mansion was refurbished and is now split into fourteen units of private housing. The long-neglected 139

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burial ground was tidied up in the 1960s and is now occupied by a modern church. All the other buildings were demolished. The 120ft water tower was dynamited in a public ceremony on 27 November 2002, and typically presented as an event to be enjoyed and celebrated – the plunger being pushed by former nurse Linda Noyes. While some may have felt this act was akin to witnessing the demise of a noble old watchful protector, others doubtless viewed it as more comparable to the toppling of an outdated, oppressive dictator who should have been ousted decades earlier. The author notes that such ‘events’ typically feel less like a celebration and more like some grotesque public execution. A loud bang follows a split second of voyeuristic stasis as time dilates and the moment of anticipation seems to stretch on far longer than it should, before the thing which held its own weight just a moment earlier slumps and clatters to the ground, obliterated from the world for good to the cheers of the easily pleased, who then head home to seek fresh entertainment.

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Chapter Seven

The Epsom Cluster Manor (6th London County Asylum of 1899) Horton (8th London County Asylum of 1902) St Ebba’s (9th London County Asylum and originally the Ewell Epileptic Colony of 1903) Long Grove (10th London County Asylum of 1907) West Park (11th London County Asylum / Mental Hospital of 1924)

Even while the London County Council (LCC) was building Bexley – its huge new asylum scheduled to open in 1898 – they understood that the pattern of the last sixty years would inevitably repeat and that just like the earlier asylums, it would be full almost immediately. This time a new approach was to be taken, and so rather than the piecemeal method of hastily securing sites as a compromise between cost, availability, and overall suitability, they instead sought a single tract of land big enough to allow the ongoing development of a ‘cluster’ of asylums operating as separate institutions but which, by close proximity to one another, could maximise the economies of scale which helped such institutions run cost-effectively. In 1896, the LCC bought the Horton estate in Surrey with precisely that idea in mind; consisting of just over 1.6 square miles of land located to the southwest of the market town of Epsom, itself around 13.5 miles southwest of central London and known for its horse racing and the ‘Epsom salts’ (magnesium sulphate) originating from its former status as a spa town, the plan was to build six new county asylums there over the following twenty or so years: an ambitious plan expected to save a good deal of money in the longer term. ‘The Epsom cluster’ would develop into the largest mental health complex in Europe, with five distinct asylums comprising nearly 100 individual structures with 2.5 million square feet of available floor space spread over 537 acres and home to over 9,000 patients at its peak. The Horton estate was named after its twelfth-century occupant Sampson de Horton, whose name in turn meant ‘muddy town’, although 141

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the indentations of the moat that once surrounded his medieval castle are all that still remain of his tenure today. A ‘Horton Manor’ had existed in some form since the fourteenth century and was rebuilt several times; the one that existed in 1896 (and still remains today) dates from 1712 and had already passed through many hands. In 1821, it was bought by a Reverend John Browning, whose son and heir Charles was to end up in London’s Fleet Prison for debt, while his own wife Elizabeth could not manage the estate alone due to being ‘of unsound mind’; one wonders if she ended up in an asylum herself. Their son and obvious heir apparently died in Brazil in 1842, leaving it up for sale again, and after passing through several more owners, it was finally bought by the LCC from Sir Thomas Buxton (1837–1915), who left Britain to become the thirteenth Governor of Australia; Horton estate – by then somewhat dilapidated – was snapped up for the bargain price of just £35,900. With constant pressure for new beds in asylums, the Home Secretary ignored the advice of his Commissioners in Lunacy (CiL) and gave permission for the LCC to start building temporary accommodation to be used, in theory, only until the first proper bricks-and-mortar asylum at Epsom was ready. To this end, their chief architectural engineer William Clifford-Smith (1855–1931) was called upon to draw up plans to convert the existing Horton Manor into a makeshift administrative block and nurses’ accommodation, while temporary single-storey wood and corrugated-iron ward blocks were arranged along a central corridor around it. The CiL were wary of allowing such buildings to be used for accommodation, and their caution was sadly vindicated just a few years later in 1903, with the huge fire in the similar temporary buildings at Colney Hatch Asylum; fortunately, nothing similar ever occurred at Epsom. Opening in 1899, the Manor Asylum saw 700 female patients classified as ‘quiet and harmless’ initially moved in, followed by 110 physically healthy male patients who would complete the building work, develop the grounds, and see to any maintenance tasks. It had been expected to open earlier than Bexley, hence Manor being the 6th LCC asylum and Bexley the 7th, despite opening earlier. The original plan had been that, when ready, Manor’s patients would be moved into the first ‘proper’ asylum to be built on the estate, while a new permanent one would be built in Manor’s place, while in fact, it remained in constant psychiatric use until just three years shy of a century later. A chapel was built in one 142

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of the temporary structures and ten new brick buildings had been added by 1909; the old, prefabricated blocks were eventually replaced one by one until, eventually, all of the main areas were built from brick. Due to the perceived urgency to build as quickly as possible and relieve pressure on their existing asylums, plans by George T. Hine, who had already designed Claybury and Bexley for the LCC, were hastily approved. Hine delivered an asylum for 2,000 patients that was almost exactly the same as his design for Bexley, even featuring the same admin block, chapel, and water tower. Hine certainly earned this lucrative contract easily, but his copy-and-paste approach also sat well with the LCC since it meant the new building could commence at haste precisely because it was a design the CiL had already approved. Horton was built in ‘white’ London stock brick (actually of a more yellowed appearance) with red brick banding, and as with its ‘sister’ asylum Bexley, is strikingly plain and functional for a county asylum. Per available bed, it was the cheapest such building in Britain, about which the LCC were also doubtless extremely happy. For a more detailed description of its layout, including the chapel, see the Bexley chapter; the two are so architecturally similar there is nothing of note to add, except that they did not even bother to add the clock to the front of the admin

Aerial view of Manor from the west, showing its ad-hoc design. Unmarked postcard image. (Collection of the author)

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block (which did appear at Bexley), leaving just an empty flat circle. Even the handsome brick portico which softened the stark appearance of the entrance was removed at some point at Horton, apparently purely because a committee member took a dislike to it. The superintendent originally lived in a large pre-existing house nearby, but a more modest house in a similar style to the main building was later constructed for him just opposite the main asylum. Horton also had a fourteen-bed isolation hospital separate to the other buildings, used to house infectious patients. As per the initial plan, water, gas, electricity, sewerage, a cemetery, a sports centre, and the light railway system were all centralised with a view to serving Manor, Horton, and the other Epsom asylums to follow. Horton’s water tower loomed over its vast expanse of seventeen twostorey ward blocks, its huge recreation hall, and its numerous service buildings unmistakably signalling the coming of the asylums to Epsom. While the tower of any asylum tended to inspire a mix of curiosity and trepidation, Horton’s cold monolithic edifice – featureless besides its tiny windows and battlement-like peak – combined with the fact that it was the first to have been essentially copy-pasted from an earlier one, seemed to speak to the public concept of the ‘loony bin’ more explicitly than most. Horton exemplified the building of mass asylum

Horton Asylum’s admin block, c.1916. Unmarked postcard image. Collection of the author. (Public domain)

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accommodation at its most austere, stark, and functional; it was a product of a post-Victorian society making remarkable progress in so many scientific, medical, and technological areas, but demonstrably failing to stem what it perceived as an unending surge of madness caused, for the most part, by the physical and moral inadequacies of its poorest people. They blamed madness on their subjects’ inability to cope with society’s rapid changes, their inability to control their own urges and vices, and, above all else, on their inherent hereditary fallibility, which was also largely connected to their position among the pauper class. While the construction, legislation, and management of asylums was never without elements of genuine altruism, kindness and social responsibility, this era showed the Victorian and Edwardian establishment still responding by throwing public money at a system based upon containment and separation of such persons, both from each other in terms of gender as well as from the rest of society in terms of their incarceration in these isolated locations. Money was spent on studies into the role of eugenics, alcoholism, class, and immorality in relation to madness at the time, but there was no concept of a welfare state; extraordinarily little was spent on alleviating the physical and economic circumstances outside the asylum which led to, or exacerbated, so many of the patients’ initial problems, or which might have prevented them from coping without having to enter such an institution. Despite having long understood that, in many cases, by the time a patient reached the asylum it was often too late to effect meaningful change or improvement, there were barely any formal preventative approaches developed before the turn of the nineteenth century. Add to this the fact that as individual asylums grew ever larger, it usually cost local authorities less to keep their paupers in an asylum than in the smaller, less cost-efficient workhouses (particularly as the population of the asylums grew older and institutionalised and were not ever going to return to work), and that doctors would receive a payment for each person they certified … and suddenly this era of mass confinement in asylums, that can seem so perplexing to modern eyes, appears somewhat self-fulfilling and almost inevitable in hindsight. Reasons for admission at this time had moved on somewhat from the scant categories used in the nineteenth century discussed in the Colney Hatch chapter and were now separated into the headings of hereditary, mental instability, deprivation of special sense (no sight, taste, smell, 145

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etc.), critical periods (puberty, senility, etc.), child rearing, mental stress, physiological defects or errors, toxic, traumatic, diseases of the nervous system, and finally ‘other bodily afflictions’. After Horton opened in 1902, the knowledge that there were still another five such asylums planned irked the local population and ill feeling would remain for many years to come. The local populace had not been consulted in any meaningful way about the grand building plan which was set to have such a significant effect on their town and resentment only increased as the asylums’ physical presence and reputation grew. Negative feelings were exacerbated as certain notable figures in the local horse-racing industry relocated to Newmarket in Suffolk, taking their money and prestige with them. Lord Rosebery (1847–1929) made it a particular crusade of his and chaired a local meeting in 1908 attempting to block the building of the fifth asylum at Epsom. ‘I represent the constituency of the sane’ he declared, citing lurid and exaggerated stories in the newspapers about escaped lunatics parading around the town.

Aerial view of Horton from the south, c.1940s. Long Grove can be seen just to the top-left of the image. (Collection of the author)

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Of course, not every resident of Epsom would have been so resentful, as the huge new asylums began to provide jobs for hundreds of local people, directly and indirectly. By the 1960s, 10 per cent of the borough’s entire population were either patients or staff at one of the Epsom asylums, and as well as the hundreds of people that each asylum employed or purchased from directly, the country fairs, annual fetes, hotly contested inter-asylum football and cricket matches, dances, parties, plays, orchestral recitals and pantomimes hosted by the asylums involved and benefited many in the local community over the years. The first superintendent at Horton (Dr Bryan) was asked to resign in 1905 after just three years’ service; a scandal involving eleven staff members caught stealing supplies drew the committee’s scrutiny toward other failings, including his request to buy clothing for his patients from other asylums (meaning Horton was not making or repairing enough of its own) and he was asked to resign. He was superseded by Dr John Lord (d. 1931), who set about vigorously implementing a new regime; within two years, Horton was producing 1,006 aprons, 1,878 shirts, 1,801 dresses, and 2,854 towels per annum. Horton also managed to produce 1,074 curtains for use in the subsequent Epsom asylums. Opening on 1 July 1903, St Ebba’s became the third psychiatric institution at Epsom; situated at the far eastern end of the estate, it originally opened as the Ewell Epileptic Colony, so was in fact never formally titled as an ‘asylum’, despite essentially fulfilling the same role later in time and being counted as the LCC’s 9th numerically. Its construction represented an attempt, albeit only briefly realised, to move away from housing epileptic patients alongside ‘lunatics’ and a greater understanding of the difference between lunacy and epilepsy, with the latter eventually classed as a ‘neurological problem’ and not a form of mental illness. The first ‘epileptic colony’ in Britain was a charitable institution known as Chalfont (at Chalfont St Peter in Buckinghamshire), which was founded by the National Society for the Employment of Epileptics and utilised temporary buildings to house its ‘colonists’ in 1894. Their mission was to address the obstacles epileptics faced in gaining employment, as most employers were unwilling to offer a position, or sufferers would often lose their job upon having a seizure. This saw many epileptics end up in the workhouse or at an asylum despite being perfectly willing and capable of work, albeit with some consideration of their 147

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condition. Chalfont offered subsidised accommodation in significantly preferable conditions to the workhouse, with supervised and supported outdoor employment to enable the patients to earn their keep. St Ebba’s followed a similar model and was one of only two such institutions built by local authorities, the other being Langho in Lancashire, which opened in 1906. The regime at St Ebba’s was to be similarly managed, facilitating its colonists to live in an environment where their condition was understood, and their safety could be prioritised while surrounded by staff and other residents who knew how to respond and how to look out for each other. The only medicinal treatment administered in its early days specifically to treat epilepsy was potassium bromide, which was effective in reducing the frequency and severity of seizures in around two thirds of all patients, although it could have unpleasant side effects for some and was also highly toxic, requiring careful administration. The LCC again employed William Clifford-Smith to provide the plans for St Ebba’s, and he delivered a design adhering to the ‘colony’ (or ‘villa’) plan; an idea first utilised in Germany in the 1870s before becoming popular in the USA. Rather than consisting of one immense interconnected building, this design featured many smaller buildings scattered over the available space, creating a feel more akin to a village than a monolithic institution. Clifford-Smith had recently visited Europe

St Ebba’s admin block. Unmarked postcard image, c.1910. Collection of the author. (Public domain)

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and the USA to see some of their examples but was also influenced by the buildings at Chalfont, which had evolved into a similarly scattered layout as it grew in size. Originally intended to be temporary iron and wood buildings, the Colney Hatch fire which took place earlier in 1903 and destroyed several similar buildings to disastrous result saw the CiL shut that plan down immediately, so St Ebba’s was built of red brick with red slate roofing enhanced by recurring gables, arched entrance coverings, exposed beams, and stone decorations. There was a handsome turreted admin block in the centre and a nearby boiler house with a chimney and small water tower, along with laundries, kitchens, and a recreation/dining hall. Rather than interconnected ward blocks, eight L-shaped ‘villas’ of two storeys were dotted around the site and named after different trees (initially Holly, Lime, Pine, Elm, Chestnut, Hawthorn, Walnut, and Beech). Each was designed to house thirty-eight patients supervised by a married couple who were also resident in each, offering an initial capacity for 320 residents. There was also a separate infirmary block to be occupied as needed. All the buildings at St Ebba’s were built to a high quality, with handsome brickwork and fine examples of woodwork and joinery adorning their roofs, entrances, and gables, but had a modest, unimposing feel in comparison with similar institutions, looking more reminiscent of a collection of farm buildings and chalets than an ‘asylum’. In 1909, two more villas in the same style were added, taking the potential patient population over 400. Saint Ebba was a ninth-century governess (or abbess) of a monastery in the shire of Berwick on the English/Scottish border. When Danish pirates attacked in around AD 870, the fear of her and her subordinate nuns losing their chastity was seen as the worst fate possible by Ebba, so she mutilated herself by cutting off her nose and top lip with a razor, then urged the others to do the same, hoping all would appear less appealing to the lustful invaders. The duly disappointed Danes then burnt the monastery down in anger, killing everyone inside and martyring poor Ebba in the process; but with her chastity thus intact, she was canonised and became known as St Ebba thereafter. While it makes for a shocking, saddening, and gruesome story, one might struggle to see how this little-known Scottish saint relates to an epileptic colony in Epsom; she is the patron saint only to that far-off part of the British Isles. The author offers the most plausible suggestion, which is that it was due 149

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to a simple misunderstanding: Epsom was once known as ‘Ebbesham’ and ‘Ebba’s Ham’, and although these names relate to a local Saxon landlord and have nothing at all to do with Ebba the saint, it seems quite likely they are the source of some later confusion and subsequent assumption leading to the otherwise baffling choice of name. On 20 April 1905, the Long Grove light railway opened, running for two and a quarter miles and ostensibly presented an answer to locals’ complaints about the huge increase in horse traffic and of houses being shaken or even partially collapsing as steam-powered traction engines rumbled by both day and night. While the railway indeed saw traffic moved around by somewhat quieter means, most local residents did not yet know that its main purpose was to transport building supplies for another huge asylum soon to be added to the outskirts of their town. Locals were upset again even by the class of person working on this new asylum: 1,100 men were engaged on the building site, 900 of whom were brought in as part of an LCC scheme to find work for unemployed builders and labourers. These labourers arrived at Epsom on a specially commissioned train each day, but in order to appease the townsfolk who did not want them hanging around Epsom’s hostelries of an evening and ‘lowering the tone’, they were only paid if they left on a specific scheduled train at the allotted time when their working day ended. Long Grove Asylum was situated almost directly across the road from Horton and was again built according to designs provided by George T. Hine. It was also almost identical to Bexley (and Horton), albeit with the admin block set at the opposite end of the building to face Horton Lane to the south. Unlike Horton, Long Grove’s bricks were dug and fired on site, with the local clay giving a warm orangey-red hue. Otherwise, the ward ranges, services, and almost all other parts of the main building were essentially identical. The chapel was larger and arguably more attractive, while the water tower was indisputably more handsome than the austere monoliths watching over Bexley and Horton, it being more ornate, detailed and Gothic in style, with pretty sandstone and terracotta dressings. The admin block was unique and of a much more handsome design too, with three storeys, generous bay windows, three Jacobean gables with seashell motifs, stone dressings, and a four-sided clock housed in a small white wooden tower on top. Inside, there was an Italian mosaic floor along with Hine’s typical polychrome glazed brick and tile work, and a dado with an Art Nouveau frieze adorned the walls. 150

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Long Grove’s admin block, c.1910. Unmarked postcard. Collection of the author. (Public domain)

The CiL were not keen to allow the LCC to build yet another asylum to the hurried Bexley template and along with Dr (later Sir) Hubert Bond (1870–1945), who would be the asylum’s first superintendent, called for Long Grove to incorporate some of the new ‘colony’ ideas that had been introduced at St Ebba’s. While this plea was largely ignored, there were a few significant nods to the concept; nine detached two-storey villas were included to the north of the main building near the laundries and workshops to provide accommodation for 400 working patients between them, around a fifth of Long Grove’s original capacity of 2,020. Each villa would be surrounded by trees and shrubbery rather than a fence or wall, with most patients housed within being free to come and go within the grounds as they wished during daylight hours – quite the novel idea at that time. Each would also be managed by a live-in married couple, as at St Ebba’s, with the husband acting as charge nurse and the wife as cook and ‘house mother’. In another nod to the colony plan, the semi-circular corridor running around the centre of the building was originally left open on one or both sides to the landscaped internal airing courts to create a sense of openness and connection to fresh air and nature; this perhaps optimistic 151

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Long Grove under construction, c.1905. Photographer unknown. Collection of the author. (Public domain)

feature was later bricked in on all sides in certain places due to the reality of the British weather. The grounds were laid with twenty-one different types of tree and beautifully maintained over the years; it was claimed that while most were not rare or uncommon types, one would need to go to either Kew Gardens in London or Nymans Gardens in Sussex to see the same variety together in such close proximity. Long Grove was named after the woodland area covering the northern part of the site and became the 10th London County Asylum, opening on 15 June 1907. It received its first 200 patients three days later and had 1,482 patients by that November, with seventeen having left ‘recovered’, one escaped, and twenty-six died. When Long Grove was complete, the light railway line was extended with a branch running southwest to Four Acre Wood where it split again, with one branch leading to the central pumping station and the other to the far west of the Horton estate where an area then known as ‘West Farm’ was to be the setting for the final major stage of building at Epsom. The designs for what became West Park were commissioned as early as 1906 and William Clifford-Smith was yet again engaged as architect. He delivered a building largely adhering to the then-typical 152

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Long Grove’s corridor network under construction, c.1905. Photographer unknown. Collection of the author. (Public domain)

‘compact arrow’ plan (see Claybury chapter) while incorporating some elements of the ‘colony’ plan. West Park was designed as the largest of the Epsom asylums with an initial capacity for 2,096 patients. Since the building site was somewhat concave, construction began at the northern end; as the tunnel network and foundations were dug, the resulting earth, along with the spoil from the digging of the London Underground’s Northern Line (then being extended to Morden) and chalk and rubble from Cane Hill Asylum’s estate, was transported to the centre of the West Park site and packed down to level it out. Set in 83.5 acres of land with the completed buildings covering nine of them, West Park measured 1,790ft (over a third of a mile) between the outer edges of the furthest-flung wards. Built from local red brick hardened to engineering grade, all the buildings were topped with grey Welsh slate roofing, giving the complex a neat, modern appearance. Tuscan columns and cornices adorned the outer doorways and verandas to the ward blocks, but there was nothing as Gothic or ornate as that seen at most asylums. None of the structures besides the water tower were of more than two floors in height, and each ward block had generous open 153

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West Park Asylum general plan, from Hospitals Gazette, 1926. Collection of the author. (Public domain)

space around it rather than the contiguous ranges of bricks and windows at Horton and Long Grove. These elements, combined with a somewhat ‘suburban’ feel lent by the half pebble-dashing of many of the structures, meant West Park was missing much of the oppressive, imposing nature of many asylums despite its immense size. Patients were housed in forty-five wards spread between twenty main accommodation blocks with females to the west and males to the east. Fourteen blocks were connected to the main corridor network, while detached buildings included a large acute reception block, an isolation hospital, a chronic epileptic block, and several ‘villas’, including one each for the male and female patients who worked on the farm. A driveway skirted the south of the grounds and passed by the lodges and the 850-capacity chapel, which obscured the view of the pathology labs and mortuary nestled just behind it, continuing to a turning circle in front of the admin block at the south of the complex. This was a handsome building with modest neo-Georgian styling, which retained 154

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West Park admin block, from Hospitals Gazette, 1926. Collection of the author. (Public domain)

a pleasing sense of proportion despite generous bay windows, a large doorway with stone surround, and four ionic pilasters leading up to a large pediment detailed with regular modillions above. The rear of the admin block connected to the corridor network which sprawled off to the north, east, and west, and, instead of the more usual brick, some corridor sections consisted of simple wooden panels with small multi-paned windows along the top halves, while in other areas they were simple steel frames with a roof, open to the elements; most of the latter would later be filled in with wood half-panelling and glass windows to allow some protection from the weather. Basement corridors ran underneath the building, mirroring the ones above ground; these carried pipes and cables for hot and cold water, gas, electricity, and steam for the heating system, and would later also host the cabling for the telephone system. Behind admin sat a dispensary area with a small yard, and the recreation hall was situated behind that. The hall could accommodate 1,200 people and was typical of its time with large, high windows, an ornate stage, a balcony, and a cinema projection room. A large visiting room and cafeteria sat behind the hall, with the main kitchens, scullery, and bakery behind that, followed by the workman’s yard and water tower which stood above the boiler house to the northeast. The tower was surrounded by various workshops and craftsmen’s rooms on the eastern, male side, while a needle-room, laundry, and various workshops 155

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occupied the same areas on the western, female side. West Park’s water tower was among the more handsome of its type and incorporated the boiler-house chimney into its structure. It comprised 18ft of thick black engineering brick at its base and brown brick with red brick dressings for the remainder of its six storeys, three of which contained the huge water tanks needed to maintain pressure across the site and to allow water from any connected hoses to reach the highest roofs. At the

West Park water tower, from Hospitals Gazette, 1926. Collection of the author. (Public domain)

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tower’s top, a set of corbelled balconies on three sides sat below small round-arched windows with the rear (northern) side having a doorway to a small balcony. An oversailing ‘swept’ roof was covered in Welsh slate and lent it a somewhat Germanic look to top off its 120ft height. Originally, there were four blocks used for staff accommodation, all of which were within the main complex; only one of these was for male staff, as they were expected to have rooms in the main ward blocks, whereas nurses were not allowed to sleep on the wards for perceived safety reasons. A detached nurses’ block was built in 1938 and male staff would not get one of their own until 1959. Despite plans being submitted in 1906, building work did not begin until 1913, although this continued even after the outbreak of the First World War and on until 1916, which was when West Park had originally been scheduled to open. It was almost ready for its intended use when it was requisitioned as a Canadian war hospital for Commonwealth troops fighting in mainland Europe. As a measure of wartime economy, the ward blocks were constructed with the upper floors made of reinforced concrete while the lower floors were hurriedly laid with soft wood (rather than the usual hardwood), and this would be a shortcut that would cause problems and ongoing costs for the duration of the building’s life, since they were never to be replaced as intended. Just three months after the First World War began in June 1914, eighteen staff at Horton had already left for military service. While it was expected that Long Grove’s railway line meant it would be the one most likely taken into war use, the Ministry of War instead chose Horton, and on 9 February 1915, it became Horton War Hospital. Dr Lord surely could not have been pleased at having to dismantle the systems he had so recently put such energy into rearranging at Horton nor, one would hope, to see his 2,143 patients either discharged or decanted into other asylums; nonetheless, he threw himself into his new role with gusto. However, as Ruth Valentine points out in her book Asylum, Hospital, Haven: A History of Horton Hospital (Riverside Mental Health Trust, 1996), this would also have been the first time he truly felt supported by local residents; after fifteen years of resentment, Epsom now felt rather proud of its asylums and their new wartime role. A visit from King George V and Queen Mary in July 1916 to confirm Horton’s importance to the war effort would not have hurt in that regard either. As criticism arose from some corners of Parliament suggesting that former lunatic 157

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asylums were no suitable place for ‘our boys’ to be housed and healed, the Epsom newspapers now leapt to the defence of their local ones. Decisions about who went where in terms of patient relocation when the asylums were emptied for military use were generally based on proximity to a patient’s local parish as well as distance from their relatives. However, since the system was unable to provide all patients with nearby provision even in peacetime, it is unlikely this move worked out well for all; patients were sent off with only their medical papers and, where possible, a single change of clothing to their name. This mass evacuation took place at both Horton and Manor, which was also converted to war use over the space of just two months, with all Horton’s patients discharged or placed in other asylums by April 1915; some of those discharged would doubtless then have enlisted to fight. Since the asylums were already at bursting point, this sudden need to find accommodation for around 3,000 displaced patients in the other LCC asylums only heightened pressure on the receiving ones, while resources and provisions which were already tight had to stretch yet further. Suitable male staff became almost impossible to recruit, as most of those capable of such physically demanding work had either already enlisted or were sent to war-related work elsewhere. Deaths of patients in county asylums across England and Wales saw a massive 31.9 per cent increase during 1917 (compared to only 1.9 per cent the previous year, and not including those asylums which were also treating war casualties) and the Board of Control (BoC) surmised that this was a direct result of patients receiving less food, causing a loss in weight which then led to a lowered immune system, exacerbated by a vastly reduced staff-to-patient ratio. Of course, it was the BoC’s patriotic duty to merely point this out in their report as a statement of fact and not to make a fuss about it. Naturally, the war also affected Long Grove, which remained in psychiatric use despite losing fifty-three staff who had enlisted, while it simultaneously received a huge increase in its patient population. St Ebba’s role as a pioneering ‘epileptic colony’ was cut short as it was also taken into war use, and from 1918 treated servicemen diagnosed as ‘neurasthenic’ – a now-redundant definition typified by mental and physical fatigue, dizziness, and sleeplessness. St Ebba’s remained in such use until 1927 when it was transferred back to the LCC, enlarged, and used to house all categories of mental patient; further extensions were added in 1936 and 1938, seeing its population peak at 933 during the latter year. 158

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Manor was taken over for war use in August 1916 and also emptied of its pre-existing patients, providing 1,200 beds for dysentery and malaria patients, and later providing general medical treatment and various types of surgery. Over the course of the First World War, Manor would treat 12,545 patients and a proliferation of picture postcards emerged from most of the British ‘war asylums’, including Manor and Horton, during this period. Despite being over a century old now, examples of these can still be easily found on the second-hand collectors’ market, along with their corresponding and sometimes touching messages on the reverse. Such cards were created to meet the huge demand for soldiers wanting to write to their loved ones, with many featuring images of convalescing soldiers as well as the buildings and their grounds. Such cards generally depict beautiful and serene environments, with scenes of the men playing cricket or in sunny recuperation on lawns beneath shady trees; all doubtless good for the nation’s morale and reassuring to those waiting for them back home. However, given the kind of physical and psychological damage so many would have been suffering and the horrors they had experienced, life at Manor and Horton during wartime would obviously not have been quite such a peaceful and pleasant experience for all.

Horton during wartime, c.1916. Postcard by G. Stackman. Collection of the author. (Public domain)

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Horton was adapted to provide space for up to 2,532 military patients at any given time, with emergency space available for another 182. The first casualties arrived in May 1915, with seventy-two ‘sitting-up cases’ transferred from Woolwich to be greeted by a crowd of locals welcoming them to Epsom station with homemade drinks and refreshments. By the end of August, there were around 2,000 casualties at Horton at any given time and a hostel was opened in the town for soldiers’ wives to board at when visiting. A pub in Epsom was fined £10 for selling alcohol to soldiers who, while undergoing treatment at Horton, were still very much classed as being ‘in service’ and therefore not allowed to frequent the local hostelries. Although bestowed with the honorary rank of Lieutenant Colonel, Dr Lord attempted to create an environment as free from military hierarchy and formality as was reasonably possible, but he was given that senior military rank and title largely in order that other military men might be more willing to obey his authority. Despite the misery which many soldiers must have brought back with them, spirits were doubtless enlivened by the sudden availability of clean water, proper toilets and good bathing facilities, as well as comparatively generous portions of food – not to mention no longer being shot at. Besides Dr Lord and a few of the elderly porters and clerks, Horton’s staff had become entirely female, and the attention of the dozens of young female nurses would also likely have been very welcome for most of the casualties after months in the freezing, filthy trenches, surrounded only by other freezing, filthy men. Regular concerts in the recreation hall and sporting events within the grounds were also attended with zeal by all who could. Epsom Council provided a new burial ground at this time, with space so limited that multiple soldiers were buried in the same plot, although Dr Lord chose to look on the brighter side of this, stating rather sweetly in his book The Story of the Horton War Hospital, Epsom (William Heinemann, 1920): ‘it was also necessary to bury several soldiers in one grave, but considering the comradeship which existed among soldiers during life, this did not appear to me to be objectionable’. By 1919, 351 men were buried there, but in terms of overall deaths, this would have only represented those whose bodies were not transferred back to relatives for a local burial and was far fewer than the total deaths at Horton during its wartime use. The flu epidemic of 1918 arrived just at the end of the war and killed five of Horton’s staff as well as knocking 160

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Horton’s recreation hall during wartime, c.1916. Postcard by G. Stackman. Collection of the author. (Public domain)

Dr Lord out of active service, so he missed the big armistice celebration in the recreation hall on 11 November that year, instead having to be treated in his own hospital. By the time Horton’s war service came to an end, it had treated 44,593 servicemen. In February 1920, it reverted to use as an asylum, although it was so difficult to find staff at that time that five of the female wards remained closed until 1922. In 1918, Long Grove was renamed Long Grove Mental Hospital in a progressive move pre-empting the national change to that formal terminology which would be introduced in 1930. In 1921, all institutions catering for psychiatric patients not classed as ‘lunatics’ were renamed with the suffix ‘Certified Institution’; this was the case at both St Ebba’s and Manor, with the latter becoming a ‘certified institution for mental defectives’, as it had by then begun accommodating patients with what we might now call either learning disabilities or differences, and/ or Downs syndrome. By 1930, the Mental Treatment Act withdrew this terminology too, and it simply became known as ‘The Manor’. Industrial therapy was a particular focus at the time, with brushmaking, upholstery, tailoring, tin-smithing, boot-making, printing, and 161

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the production of hessian matting among the many different types of manual work and training undertaken by the patients over the years, all in aid of offering them confidence and skills which could then be used outside the institution. Horton Lodge was a Georgian manor house at the junction of Christ Church Road and Horton Lane; it seems to have been annexed from the Horton estate when it was first sold to the LCC, but in 1926 they were able to buy it and allocate it to Manor as accommodation for a number of its older female patients who were considered to be more independent. The early history of this handsome building – including its exact date of construction – appears to have been lost, although a house, likely with the very same name, had stood on that spot since at least 1768. It was renamed ‘Hollywood Lodge’ to avoid confusion with Horton Asylum. West Park was returned to the LCC from the Canadian military in 1920, and work soon began on converting the existing buildings back to psychiatric use, and to finish constructing the areas originally planned but never completed. Its first medical superintendent was Major Norcliffe Roberts (later OBE, MD, BS, and DPM, dates unknown), who in addition to setting out the new regime for the asylum also took personal responsibility for the landscaping of the extensive grounds and airing courts, which would mature beautifully over the following century. Although ‘West Park Asylum’ is written on the original architectural plans and various legal documents, Dr Roberts started as he meant to go on – with a progressive and forward-looking regime – so despite still being legally classed as an ‘asylum’, West Park never actually operated under that suffix. With the music for its opening ceremony provided by Long Grove’s staff orchestra, the eleventh and last purpose-built county asylum for London was opened by the Rt Hon. John Wheatley MP (1869–1930), then the Minister of Health, on 20 June 1924 as ‘West Park Mental Hospital’, with its first patients arriving the same day. Even though several outlying buildings (including the chapel) would not be completed until 1926, 1,270 patients had been admitted within a year of opening, 1,117 of whom were transfers from other LCC asylums. Dr Roberts operated West Park true to its progressive principles and began to utilise the so-called ‘open door’ policy as early as 1925. Over 400 of its patients lived in unlocked wards and villas and were allowed free use of the grounds unattended, with another 125 able to go beyond the boundary walls as they wished within just four years of opening; 162

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West Park recreation hall, from Hospitals Gazette, 1926. Collection of the author. (Public domain)

this was quite controversial at the time, and many medical professionals felt it would inevitably lead to a lack of order and control as well as increased risk to the public. In the 1920s, most patients coming to an Epsom asylum would be brought in by train, while horse-drawn ambulances came from London to deliver any ‘problematic’ or infirm patients. Body lice were a common problem, and many patients had to visit a receiving station which housed hot baths in order to rid themselves of such infections before being allowed to pass on into the main buildings. While shifts for nurses and attendants had previously been an exhausting twelve hours long, timings were amended in 1923 and spread across six or seven-hour day or night shifts, although the week was still forty-eight hours long in total as their new rota included weekends. A staff member’s uniform remained the property of the asylum until it was worn out and a replacement was issued, whereupon they could dispose of the used one as they saw fit. However, any shawls, hoods, and overcoats issued by the asylum, as well as the embossed brass buttons 163

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Male patients being washed by hospital attendants at Long Grove, c.1925. Courtesy of the Wellcome Collection. (CC BY 4.0)

which featured on the men’s uniforms, all had to be handed back when worn out or if the staff member left, and these would be recycled or repurposed. At this time, staff were still as strictly separated by gender as the patients, with the weekly dances in each of the asylums’ recreation halls being the only opportunities for patients or staff of different genders to mix. Off-duty staff could attend as long as they still came in uniform, but even then, they were only allowed to dance with patients and not with any other staff member. Quite what catastrophe was imagined befalling the workings of the asylum if two staff members maintained a relationship is unclear, although the morals and social etiquette of the era guide us somewhat and were upheld to the extent that while any male staff member could marry, he could only do so with the express written permission of the superintendent; any nurse wishing to do the same was also permitted, but only upon the forfeiture of her employment. 164

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‘Malaria therapy’ was among the range of eyebrow-raising and winceinducing treatments devised for mental patients during the first half of the twentieth century – but it worked, and its use in Britain was pioneered at Horton. Up until the late 1920s, syphilis was an incurable disease with the potential to cause extreme damage to the brain and eventual death, and it accounted for around 10 per cent of all new admissions to asylums prior to the First World War. The concept behind malaria treatment was simple: patients already infected with syphilis would also be infected with malaria, and the intense heat generated as the body’s immune system fought the disease would ‘burn off’ the otherwise untreatable syphilis. Then, the malaria itself would be treated with quinine in the usual way, leaving the patient, in theory, free of both diseases. First trialled in Germany in 1919, early tests were then carried out in 1924 at laboratories in the LCC’s asylums at Hanwell, Cane Hill and Claybury, but there were fears that these locations – closer to slightly warmer and more densely populated urban centres – might see the disease spread if mistakes were made. It was felt that Horton’s isolation hospital in its more rural setting was perfect, although, as with so many other factors in the Epsom cluster’s early history, it seems doubtful the local populace would have agreed about their town’s suitability had they actually been consulted. A special room was created with no soft surfaces and double-sealed windows and doors with no fissures or cracks into which anything tiny could escape or conceal itself. Live mosquitos carrying malaria were then released one by one from a special contraption and left to do their bloodthirsty work on the bare flesh of the patient. Each animal was then painstakingly recaptured by hand and counted individually back into the box. Horton’s laboratory became the mosquito-breeding centre for the whole of Britain, shipping them out for use around the country. A 1935 study concluded that 50 per cent of all patients treated nationally, and 75 per cent of those treated at Horton, fully recovered from their syphilis infection, malaria infection, and their related psychiatric symptoms. There were subsequent discussions around the ethics of infecting patients before the syphilis had progressed to the stage where it might affect the brain, but in the end the LCC concluded such pre-emptive work could only be justifiably conducted upon voluntary patients. Unlike so many treatments used in asylums prior to the 1950s (and even some used after then), which were discontinued for ethical 165

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reasons – turning out to be demonstrably ineffectual, actively harmful, or even deadly – malaria therapy was only discontinued in 1942 after the introduction of penicillin, which could treat syphilis in a far simpler manner. The effects of syphilis were appalling; ‘general paralysis of the insane’ was the result of the untreated condition and a phrase which had adorned the death certificates of tens of thousands of asylum patients over the preceding decades. Partly due to the work done at Horton, that grim term was almost completely consigned to the history books by the end of the 1930s, and innumerable lives were saved. At the same time as such positive work was being done, the leucotomy (aka lobotomy – see Banstead chapter) had been introduced to the Epsom cluster in 1936, and many patients were subjected to that barbaric procedure: it was used fifty-seven times at Long Grove in 1957 alone. One such subject (many might say ‘victim’ would be a more appropriate description) was Josef Hassid (1923–1950), a Polish violin prodigy who came to Britain in 1938 and took the classical music world by storm. Hassid’s star rose rapidly, and he was said to have amazed all who saw him play, gaining rave reviews and even being declared a genius by those in the know. However, with the onset of schizophrenia, his will to perform vanished, and in 1941 he was admitted to the charitable public asylum of St Andrew’s in Northampton and subjected to insulin coma and electroconvulsive therapy (ECT). His condition was said to have improved temporarily, but in 1943 he was committed again and transferred to Long Grove. The death of his father in 1949 exacerbated his condition to the point where the superintendent felt it was appropriate to subject him to a bilateral pre-frontal leucotomy – a ‘double lobotomy’. Due to this completely unnecessary surgical intrusion, he developed an infection which progressed into meningitis, and he died at Long Grove in 1950, just before his 27th birthday. After the 1930 Mental Treatment Act, voluntary admissions (rather than committals) at asylums increased dramatically, with Long Grove’s own going from 7 per cent of the total in 1932 to over 35 per cent by 1938. West Park was linked with University College Hospital in 1930 and their consultants would attend the asylum to advise on medical and surgical treatments and procedures. The asylum’s small operating theatre was considered satisfactory at that time, but it was closed in the 1950s as by then it was unable to offer anything near the standards available 166

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at any general hospital. By the 1930s, cinema equipment had been introduced to the Epsom cluster, and West Park also had a telephone system installed with a lavish array of four different extensions. In 1939, the outbreak of the Second World War saw Horton again commissioned for war use, but this time as an emergency services hospital. Its residents were again discharged or sent to other asylums, with 463 patients conveniently taken just across the road to Long Grove, resulting in that asylum’s population reaching its peak of 2,633. Another 400 were sent just a little further along the road to West Park. Life must have been incredibly cramped, with patients living on top of each other as travel even into Epsom was banned. Only six voluntary male patients at Long Grove were permitted to go outside the boundary wall at all during the war. After the bombing of Colney Hatch in 1940, fifty of its patients who were literally without a roof over their heads, were sent en masse to the Epsom cluster, and while Long Grove was never classified as a war hospital itself, casualties with mental health problems who were obviously going to require longer-term treatment were decamped there from Horton, followed later by hundreds of Polish war casualties. By 1947, 284 Polish ex-servicemen were still in residence at Long Grove and subsequent attempts to have the Polish government (who only paid for their upkeep during wartime) repatriate their own citizens in peacetime were snubbed. Most ended up stuck in Britain permanently and either settled in the UK upon eventual release or else ended their days at an asylum in England, far from their homes and families. One such character, nicknamed ‘The General’, was still there by the late 1980s, and even forty years after the war he still dressed in his military stripes and hat and could often be found hosting a poker club for residents to gamble with their money and cigarettes. Between 1939 and its reversion to mental health work in April 1948, Horton treated 32,870 service patients and 47,488 civilian sick and wounded including air raid casualties. The management team who had run West Park since it opened in 1924 was completely rebooted just as the war began. Dr Roberts had to retire for health reasons, and the clerk also retired; the house steward, a Mr Agar, was tragically hit and killed by a tram on the Thames embankment while out attending a meeting to discuss how the asylum would prepare for the coming of war. Dr Alex Caldwell (dates unknown) 167

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was appointed as the new superintendent, and one assumes his relative youth may have been both a boon and a burden in this new challenge; he came fresh to the incredibly demanding role of running a huge asylum at the same time as the country went to war. At least one air raid shelter was built within the western central airing court, with blackout curtains hung and windows treated throughout the buildings to minimise shattering from any nearby explosions. Water pumps and fire buckets were also distributed around the wards, the sanatorium blocks were converted – one becoming a ration store and the other a casualty hospital – and the isolation hospital was turned into a decontamination unit. The Central Pathological Laboratory and its staff were evacuated from the Maudsley Hospital at Denmark Hill in Central London to Male F ward at West Park, where they and it remained until the 1960s. Thoughtfully, ward accommodation rearranged the usual order of things, with the ground floor day rooms all being converted into dormitories while the evacuated space on all the first floors was turned into the daytime space instead; this allowed all the patients to be located on the safer ground floor while they slept (and were thus more vulnerable), to aid evacuation in the event of an attack. One evening, while male patients in the reception block played cribbage and listened to the radio, a 1,000lb high explosive bomb fell on the main drive between there and the chapel, but West Park’s extra-hardened brickwork seemed to do its job as the logbook recorded that many patients simply thought it was a car backfiring or some other innocent sound, despite windows at one end of the building being blown out. One patient took advantage of this situation and made good his escape, scarpering through a door that had been blown open and disappearing into the night. In summer 1944, a German ‘doodlebug’ flying bomb hit the centre of Manor, and the original Georgian house was mostly destroyed, along with the wings for staff accommodation and the boiler house. Remarkably, no one was killed, and the institution continued to function, with this central area being only partially rebuilt until after the war had ended. The light railway system was used mainly for coal transportation, with around 15,000 tonnes delivered and distributed to the five asylums each year. The line employed four different 0-4-0 saddle-tank steam engines over its tenure, with ‘Hollymoor’ (known to the locals as ‘Puffing Billy’) being the first. ‘Crossness’ joined and eventually replaced ‘Hollymoor’ (which was sold) until 1935, when he too was 168

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considered worn out and suffered the seemingly undignified fate of being cut up on site and strewn around next to the track; pieces were still partially visible in the undergrowth for many years to come. His replacement, ‘Hendon’, carried ‘Big Bertha’ anti-aircraft guns around the site, guarding the asylums and war hospitals during the Second World War. A fourth replacement, dubbed ‘Sherwood’, arrived in 1947, but the track had been damaged in several places by German bombs and needed significant restoration and replacement; with the proliferation of the motor vehicle, this was not considered a worthwhile expense, and the whole system was soon taken out of use. The lines were cut up in 1950 and sent to Nigeria, where they were used in the construction of Lagos harbour, although a few small sections of track and some other clues remain today; the principal footpaths through Horton Country Park still follow the line’s route, and some of the brickwork for the bridge erected after a deaf elderly woman was killed by one of the trains in 1906 (at the level crossing which preceded it) can still be seen near the entrance to the park’s golf club. All five of the Epsom asylums survived the war and were incorporated into the NHS in 1948 along with the rest of Britain’s former county asylums. The new range of anti-psychotic drugs such as chlorpromazine were introduced in the 1950s, along with increased occupational and social therapies and increasing use of outpatient services. A somewhat more understanding attitude in medical circles as well as society in general saw most wards gradually being unlocked and a more permissive regime put in place across the cluster. By the late 1950s, only around 8 per cent of the total patient population at Long Grove were still living in locked wards, and this figure was similar at Horton and West Park. At West Park, voluntary admissions had more than doubled from 30 per cent of the total in 1939 to over 70 per cent by 1959 when the new Mental Health Act was introduced, much of it designed to encourage that trend. Compulsory admissions became the exception and by then most of the remainder who were forcibly committed to an asylum were there as the result of court orders. Many longer-term patients who had originally been committed also had their status regraded to ‘voluntary’ and were thus able to leave if they wished. A social centre was built at Long Grove in 1952, providing a library, film group, dancing group and many other social activities, and was intended to offer a place for patients to go which was still nearby, but 169

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felt ‘apart’ from the asylum and more akin to a place one might visit at leisure in everyday life. In the 1960s, West Park formed a ‘League of Friends’ who would organise trips and outings for its patients, as well as visit or write to any patients who did not have visitors or anyone to correspond with; they would even make sure that any patient who had no friends or family at all would get at least one card and a present to open on Christmas Day. The 1950s saw Long Grove receive its most infamous patient, Ronald ‘Ronnie’ Kray. Along with his brother Reginald ‘Reggie’ Kray, the notorious ‘Kray twins’ had glamorised and terrorised London’s gangland during the 1950s and 1960s. Born at Haggerston in London’s East End on 24 October 1933, some saw the identical twins as workingclass heroes, while others felt they were little more than thugs. They were undeniably stylish and charismatic icons of the darker side of their era; however, Ronnie’s mental health problems formed a significant element of their terrifying reputation for violence and unpredictability. After being sent to Wandsworth Prison in 1956 and separated from his beloved twin brother, Ronnie’s mental health deteriorated, exacerbated by a move to Camp Hill prison on the remote Isle of Wight. On Christmas

The social centre at Long Grove, 1990s. (Copyright J. Harvey. Courtesy of Bourne Hall Museum)

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Day 1957, he was restrained in a straitjacket, then committed to Long Grove in February 1958. While on the secure care ward there, it is said he was so unwell that he ‘formed a relationship’ with a radiator and believed a man in a nearby bed was in fact a dog. But Long Grove’s regime was nowhere near as impenetrable or strict as a prison, and when the twins realised that his time spent there – which would be of an unspecified duration – was not even going to count toward his sentence, an audacious plan was hatched to break him out. Reggie and the twins’ older brother Charlie visited Long Grove along with two others, having agreed in advance that Reggie would wear clothing as similar as possible to that which Ronnie would wear. Under this more relaxed regime, the twins were allowed to visit the toilets together, where Ronnie then handed his distinctive, black-rimmed glasses over to Reggie and the two came back onto the ward; Ronnie then walked out with Charlie and the others as Reggie stayed behind. Due to the glasses, staff assumed Reggie was Ronnie, while his brother made good his escape. After enough time had passed, Reggie then took off his brother’s glasses and signed himself out, telling staff that Ronnie had gone off to make a cup of tea and had simply not returned, before leaving unchallenged to join the others back in London. When they finally realised Ronnie was missing, staff at Long Grove called the family promising that if he returned immediately, he would be readmitted with ‘no questions asked’; unsurprisingly, the offer was not taken up and he did not return. Ronnie remained on the run for another five months but was eventually apprehended and served the remainder of his sentence in prison, the lengthy period without treatment possibly having led to his condition deteriorating further. Both twins were arrested and finally sentenced to life imprisonment for murder in 1969, with Ronnie deemed unfit for prison and transferred to Broadmoor in 1979, where he would remain until his death in 1995. Reggie would remain in prison until being released on compassionate grounds in 2000 and died of cancer a few months later. At Horton, Dr Henry Rollin (1911–2014) had joined as deputy superintendent in 1949 and would go on to be in charge of the asylum as its last superintendent, having a big impact on the way it was run for its remaining years of service. As well as being a leading voice of opposition against the closing of the county asylums and the introduction of Care in the Community, he would also open the first outpatient clinic for Horton 171

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at New End Hospital in Hampstead. By 1961, he had introduced music therapy specifically aimed at those who were not responding to any other approach; The Daily Telegraph of 12 December 1961 reported in relation to this that ‘these patients, normally silent, apathetic, and asocial, could be persuaded to join in [and] the success of the performance judged from the volume of complaints from neighbouring buildings and offices.’ Horton’s music therapy provision became the pioneering example for the whole country. During the late 1960s, as hospital boards and their related areas of jurisdiction changed incessantly, the catchment areas of Horton and Long Grove shifted away from the East End of London, and by 1974, the former was picking up patients from the northwest of the Thames area, with the latter focusing on the closer Kingston and Richmond boroughs and the Elmbridge district of Surrey. While this was certainly a positive for any new patients who were not having to go so far from home, it did mean there were many elderly long-term patients who would have to remain in one of the Epsom asylums as the surrounding bureaucracy often meant there was nowhere nearer to their home for them to go. By the mid-1960s, staffing issues saw most of Britain’s mental and general hospitals casting further afield to find new staff, with recruitment from the Commonwealth and Europe increasingly relied upon and many nurses arriving at Epsom from France, Ireland, or India. The British Ministry of Labour had an office in Port Louis in Mauritius and up to 50,000 Mauritians came and worked in British hospitals in the 1960s and 1970s, although many who had trained in nursing were disappointed to find themselves mainly washing, cleaning, feeding and changing patients – essentially doing auxiliary nursing or ‘care work’, rather than the qualified nursing roles for which they had trained and travelled to the UK. This reflected a broader dismissive attitude toward the ‘bank’ of foreign workers repeatedly called upon to plug gaps in the workforce of various British industries at the time; lured by promises of better work and conditions which were often found sorely lacking when they finally arrived, it was also indicative of an unwillingness to pay higher wages to British workers. Similar complaints were later made by many junior staff because, by the mid-1970s, in-patient places were being reduced and the former asylums were mainly admitting or retaining elderly patients – predominantly females who were often too old to respond to treatment and were likely to stay in hospital for 172

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the remainder of their lives, requiring basic care work as opposed to psychiatric nursing work. The acute, usually younger cases, as well as the more ‘difficult’ cases, were by then instead beginning to overwhelm GPs, day hospitals, hostels, charities, and outpatient clinics as options for dedicated in-patient care were being whittled away nationwide. In the mid-1960s, the National Association for Industrial Therapy was founded at Long Grove, aiming to ensure that patients’ labour should be useful and genuinely therapeutic, and not exploited by the asylum or any business or company. The unit was so successful that in 1973, the visiting Hospital Advisory Service named it one of the top three in Britain, although with bitter timing – the following day it burned down completely as the plastics and other materials stored on the site caught fire; the building had been torched deliberately by one of the patients who was eventually caught in the process of starting another in a string of subsequent, albeit less serious, fires all around the asylum. In February 1962, St Ebba’s role was changed to specifically serve what were then designated ‘mentally handicapped’ children, and by 1960, Manor was performing a similar role for both adults and children, and its population would peak at around 1,200 in that year. By 1969, only half of all admissions to the Epsom asylums were ‘new’ cases who had not resided there or at any other former asylum or mental hospital before; the demographic was beginning to change and, by the early 1970s, all of Long Grove’s voluntary patients were housed in the detached villas, with only the increasingly elderly community of longstay patients still occupying the main building. By 1981, it had only 823 patients and around 60 per cent of those were over 65 years old: sixtyfour had been there since before the Second World War, twenty-five had lived in the asylum since before 1920, and another four had been resident since the First World War, which was by then more than sixty years earlier. The organist who worked at Long Grove’s chapel retired in 1977, by which time the foundations in one corner of the building were failing, spreading cracks across the interior, leading to damp and rot as its increasingly ramshackle appearance attracted vandals and metal thieves who only made the situation worse. Although propped up with scaffolding for some years, it was eventually felt that it was no longer suitable for worship, nor safe enough for any other purpose. A former upholstery workshop within the main building was cleared out and 173

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funds raised to build a new chaplaincy within it, which included a multi-faith chapel, a vestry, and offices, all of which could be reached without patients having to venture outside the main building at all. This opened in September 1981 and the old chapel was demolished, with the bell, beams, and parts of the stained glass apparently retained and incorporated into a chapel in Addlestone, Surrey. Long Grove’s water tower was surveyed a few years later and it appeared possible that the chimney part of it might collapse, so the whole thing was taken down in 1985. Structural flaws came to light many years later in at least two of the other asylums designed by George T. Hine where the chimney and water tower were similarly combined into one structure; flaws occurred at Rauceby (Kesteven County Asylum of 1902) and St Mary’s (Gateshead Borough Asylum of 1914), with the chimney of the latter actually collapsing onto part of the corridor network beneath, albeit after the whole asylum’s closure. So, although it is a shame that the Epsom cluster lost its most handsome landmark, it does seem that Long Grove’s surveyors were vindicated in exercising such caution. By the 1970s, Long Grove had become home to a thriving colony of more than fifty feral cats, some of whom had earned affectionate, or perhaps not-so-affectionate, titles such as ‘Bambi’, ‘One-eyed Jake’, and ‘Warthog’; the latter was apparently host to an equally thriving colony of sheep ticks, which gave him a warty appearance and earned him the name. While some were chased away from the kitchens with brooms and others only stalked the silent buildings by moonlight, the more sociable and enterprising members of this community found lives of cossetted luxury, hosted in boxes lined with carpeting placed atop the hot-air vents, growing fat on generous leftovers from loving patients and doubtless a few staff. Since management had regularly organised culls over the years to reduce the cats’ increasing numbers, the ‘Cat Care’ group was set up in 1983 to pay for the spaying, neutering, and veterinary needs of the animals as well as to find new homes for the legions of kittens born in the grounds each year. A group of intrepid volunteers set out to catch as many as they could, doubtless with no little protest on the part of these semi-feral animals, then delivered them in turn to a local vet, each returning with a clipped ear to show which had been ‘seen to’; this was enough to ensure the culls were no longer deemed necessary. 174

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The plan drawn up for the Epsom cluster in 1985 was to close Long Grove by 1991 and place any remaining patients who could not be sent back to their local authorities in either Horton or West Park. The same process would then take place with Horton, set to be closed itself by 1994, with West Park finally closing at some later stage then still to be determined. The first such transfer took place in May 1987, with one ward’s worth of patients transferred from Long Grove to West Park’s newly-refurbished Jayneford ward, accompanied by most of the staff members from their now closed ward at Long Grove. West Park’s long-disused chapel was also demolished that year to provide additional car parking space in response to the main building’s anticipated longer-term use. A rehabilitation team was formed to find suitable accommodation outside the asylum for as many patients as possible, although in practice this often meant doing the best they could to acquire accommodation deemed suitable enough until the set period of time had passed when such patients would become the responsibility of some other local authority. Sadly, this was not unlike the strategy adopted at most of the former asylums as they were rapidly cleared out and closed down from the mid-1980s onward. Rehousing options mainly consisted of beds in small units at general hospitals local to the patient, or rooms in hostels – some suitable for psychiatric patients, some decidedly not – and a surprising number were housed (or rehoused) with their families. The latter raises some interesting questions about whether patients living with their families rather than being removed to, or retained within, an asylum could have worked more often throughout the history of the asylums (with suitable community-based support and other measures in place), or whether such families had only agreed to take their loved ones back when the asylum closed in preference to seeing them end up either on the streets or placed in unsuitable or unsafe accommodation, regardless of how willing or able they were to adequately care for them at home. With bespoke housing options being far more costly per patient, the grand plan for the closure of the former county asylums and subsequent move to Care in the Community on a national level had always been to use the sale of the land and other assets to fund whatever was set to replace them. However, 1989 saw a serious crash in the property market and therefore a sudden reduction in the amount of money lenders were willing to offer in anticipation of land sales right at the point at which 175

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this plan was being implemented across Britain. This delayed the closure of some asylums including Long Grove and, having been expected to close earlier than it did, money had not been put into repairs, security, or the upkeep of the grounds for quite some time, giving it what certain visitors described as a ‘deserted air’, with some referring to the place as having become ‘eerie and unsettling’. The Mid-Surrey Health Authority felt that keeping such a small number of patients there was financially unviable, since there was a certain point below which basic running costs of such a huge building could not be reduced. It was also considered unfair to the remaining patients as the buildings continued to deteriorate and opportunities for social interaction and use of the various facilities declined in tandem with the falling numbers of patients and staff. The health authority committed to seeing Long Grove closed at the earliest possible opportunity, even if it meant having to move these elderly and vulnerable patients twice: once to either Horton or West Park, and then eventually once again to the new facilities at Tolworth Hospital, which was the overall long-term plan for any patients who would not be going home and who originated from the catchment area for which the authority were responsible.

An empty ward at Long Grove in 1991. (Copyright John R. Rifkin Photographer)

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The usual ‘consultation period’ drew varied reactions. Among the most critical voices was a press release from the organisation Caring for Relatives Assisting Schizophrenics and Helping Siblings (CRASH), which echoed some of the concerns which tended to be heard in relation to the closing of any one of the former county asylums and the associated promises of better provision in future: It has been apparent for some time that the so-called consultation period has [been used] to tell relatives, users, and staff that Long Grove will be closed regardless of what they think. That Long Grove may still have a useful life in the treatment of mentally ill patients if its approach to their treatment was radically changed seems to have been completely ignored. Instead, the experiment is taking place with people’s lives [and] if it fails, there will be no going back, for by that time the hospital will no longer exist.’ Whether or not CRASH’s perspective that Long Grove, or any other former county asylum, could or should have continued to play a beneficial role in mental health care was (or might have been) true in the long term was then, and still is, an extremely divisive topic only touched upon in this book’s introduction. However, they were certainly correct that it was never really intended to be a ‘consultation’ (which would imply those being consulted had some degree of influence toward the outcome), since it could now be said without any degree of bias that remaining open in any capacity was never going to be the case, and that the writing was already indelibly ‘on the wall’. December 1991 saw the last dance take place in the main hall at Long Grove, with the 500 attendees still being kept warm by the electric motor which pulled hot air from the service tunnels into the huge hall just as it had done since it was first installed in 1907. Over the preceding years, its patient population had been whittled down to just a couple of wards’ worth of geriatrics, and these ‘old patients’ (a formal term surprisingly, albeit referring to their length of residence rather than their actual age, despite the two numbers being inevitably correlated) were seen to pose a specific set of problems. As areas of jurisdiction had changed so often, long-term elderly patients often found 177

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themselves almost ‘stateless’, with no local authority wanting to take responsibility for them and therefore no funds being made available to accommodate them anywhere other than where they already were. While many individual frontline workers cared deeply about their patients’ welfare and whatever future remained for them, patients like these in asylums up and down the country essentially became a number on a spreadsheet as far as the closing of the asylums was concerned; they were an inconvenience to a system that no longer had any obvious place for them and was essentially just waiting for them to die of old age in order that the buildings which had been their homes for decades could be sold off to balance the books for a few years more. One of the genuine considerations toward this type of patient at the Epsom cluster saw a clause built into the plans which meant that wherever those clinging so inconveniently to life might end up being transferred, all efforts should be made to ensure they were relocated together as a group, along with as many familiar items and existing staff members as possible; that way at least there would be some comfort of the familiar and any existing friendships might endure. On the day of any given ward finally closing and being moved out at Long Grove, patients were helped into an empty neighbouring ward, with tea and coffee awaiting them in these mostly familiar surroundings; they would remain there until lunchtime while all the furniture and their personal belongings were packed away and hurriedly driven over to their new ward at either Horton or West Park. Everything would then be laid out in as similar a way as possible, to the extent of even trying to place vases of flowers and pictures in the same positions at similar locations on the new ward. Despite such efforts, the move was still traumatic for many long-term and very ill patients, and the sight of these elderly people crying in sadness or confusion as they were shepherded into ambulances to finally leave their home of so many decades was also very distressing for staff, who in many cases had known the patients and buildings for long periods of time. While some staff transferred along with the remaining patients and others moved elsewhere, many had their own deep attachments to Long Grove, sometimes spanning up to four generations; some had been employed since as far back as the 1950s, with one employee in the works department recalling being given rides on the light railway by his father who had been an engine driver for the Epsom cluster back in the 1930s. With closure having 178

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been rumoured for decades, many simply could not believe the final day would ever really come. On a somewhat happier note, it was recorded that most of the patients who transferred to the other asylums settled sooner than expected. While there was a period where typical reactions included disorientation and ‘searching’ behaviour, restlessness, agitation, incontinence, withdrawal and loss of sleep, all were considered to have settled back into routine in just over a fortnight. However, at least two residents flat-out refused to leave, the first relenting only when offered a personal taxi to his new accommodation at Horton, along with the promise of a cigar to smoke upon arrival; over the next few weeks, before the offices had also relocated, he would reappear at the admin block at Long Grove, having walked over from Horton on the other side of the road, and each time, a taxi or a lift had to be arranged to persuade him to go back. The other was a man of Polish origin who became the very last patient still in residence by 1 April 1992 – which also served as Long Grove’s formal closing date. He was one of the former soldiers who had been there since the Second World War and was transferred to West Park when his ward at Long Grove was closed. Not liking his new and unfamiliar surroundings, he invited himself back on to a different ward at Long Grove and refused to leave, even as that one too was being cleared out and locked up around him. Still wandering the empty corridors all alone by the afternoon, he presented quite a challenge as no one wanted to have to forcibly remove him; staff were sent over from West Park, and he was eventually persuaded to enter an ambulance of his own accord, then driven the short distance without incident. He reportedly settled in eventually and remained reasonably happy at West Park until his death there several years later. Long Grove’s feline population, doubtless wondering where all the free food and attention had vanished to, were rounded up just before closure; efforts were made to rehome them where possible, and one even ended up as the family pet of the departing director of mental health services. In 1992, while other parts of the cluster were closing down for good, the Henry Rollin Unit opened at Horton, covering two ward blocks of the main building, with one used for admissions and the other for long-stay patients. This was a secure unit with a higher than usual staff-to-patient ratio, taking mentally ill offenders from the whole of the London area; 179

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it was named after Dr Rollin of course, who had made such significant advances working with similar patients in the mid-1960s in his role as a forensic psychiatrist. After Long Grove’s full closure in 1992, a general plan was formulated by Epsom & Ewell Council regarding what would happen to the buildings and grounds of the five asylums, as well as offering proposals for West Park, which at that time still had no fixed date for closure. It was expected that approximately 1,500 houses would be built across the estate and good protection was given to much of the grounds, landscaping, and mature trees as well as to the original wooden airing court shelters which still stood around West Park. Over a hundred structures across the whole estate comprised the asylums, but only the central boiler house (which eventually became a gym) and Horton’s chapel (set for conversion to community use sometime in 2022) had listed status at the time, with West Park’s water tower gaining a Grade II rating some years later. After closure, Long Grove’s empty recreation hall was hit by the first of several serious arson attacks across the cluster and burnt out beyond any hope of salvation. It was demolished along with most of

Chapel at Horton in 2016. (Copyright Matt Spring)

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the remainder of the site, excepting the admin block, a couple of ward ranges, one villa, and the lodges, and a new estate named Clarendon Park was built around the scant remainder from 1998. Manor closed in 1996, with the original house itself and three ward blocks retained and converted in 2000; new houses were built across the rest of the site, which is now an estate of around 340 dwellings known as Manor Park. St Ebba’s closed in 2004 and demolition of the majority of it began in 2008, although the handsome admin block, the boiler house and its tower and four of the villas remain, all converted to attractive dwellings with new housing surrounding them. While Long Grove’s tower had been lost for some time through no one’s fault (besides perhaps George T. Hine), Horton’s was retained, although it was not included in the main conversion plans for the site. It sat derelict in the middle of the new housing estate which developed around it and came to be seen as little more than an eyesore by some of the new residents, who presumably had not really noticed this twelvestorey building when first buying their adjacent two-storey homes. They then complained that it was ugly, that it blocked out the sun, and that pigeons were constantly flying in and out of it, leaving droppings on their property. When a 5-year-old girl playing in a nearby garden was injured by glass falling from one of the tower’s windows, it was enough to trigger a campaign to have it removed, and permission to demolish it was granted in August 2011 and duly carried out. West Park finally closed in 2002, although the range of small singlestorey buildings to the north of the complex, as well as the former acute hospital remain in NHS use at the time of writing. As had happened earlier at Long Grove, West Park’s recreation hall – along with most of Honiton ward at the centre of the complex – was also burnt out in an arson attack, with this one occurring in 2003. The building had been deteriorating since the mid-1990s, with some areas out of use since long before that, and so – besides the outlying buildings mentioned above – the whole vast complex sat empty and sulking on the outskirts of Epsom for most of the 2000s. The grounds and shelters became overgrown as nature gradually reclaimed them and wildlife moved in among the gardens and corridors where the patients once walked. While nearly all the former asylums went through this same strange period of stasis between closure and their eventual demolition or redevelopment, West Park attained a legend 181

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West Park after closure. (Copyright Ed Brandon)

second only to Cane Hill during this period of its afterlife. This status was partly due to its immense size, but also because almost everything had been left behind after closure, so rumours of its darkened windows, eerie corridors, and fascinating remnants spread, aided by the then stillembryonic influence of the internet, attracting increasing numbers of photographers, urban explorers, journalists, ghost hunters and the idly curious, as well as a steady flow of vandals, arsonists, and thieves. For many years, the empty complex was quite well secured, with twentyfour-hour on-site security patrolling both the grounds and buildings, quickly repairing or boarding up any broken windows and doors and backed up by a hi-tech alarm system, meaning many of those who tried snooping around either found their nerve faltering or were simply unable to find a way inside. Others were intercepted and escorted off the premises even if they did get inside, often by a security guard dubbed ‘MC Hammer’ due to his penchant for carrying one around with him on patrols – it was ostensibly to repair broken boarding, but… The author visited several times during this period and spent dozens of hours in the buildings exploring, observing, and documenting the fascinating remains as nature reclaimed the site and the effects of similarly illicit visitors with their varying benign and less-than-benign 182

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motives gradually modified the environment in subtle and not-sosubtle ways. While a separate book could be written about the sights, sounds, experiences, incidents, and indeed smells, within that sprawling labyrinth, select examples include the endless corridors, by then waterlogged and shabby, with their paint peeling off in leaf-like flakes to reveal decades’ worth of vibrant colour schemes hidden beneath; and the dormitories, with their bedside cabinets untouched since the patients left, still containing neatly stored possessions and clothing hung on wooden coat hangers stamped with ‘West Park Hospital’. There were reams of personal paperwork, records and other documentation detailing the lives of the patients and everyday occurrences on the wards, including violent incidents and even deaths; but there were some odd or funny stories noted down too, all now lost and forgotten. There were storerooms stacked high with old bed frames, wheelchairs, exercise gear, radio equipment and maintenance tools. Forty-odd red metal fire extinguishers toured the building regularly, and despite their unwieldy number and weight, would inexplicably appear together in different parts of the building, arranged in an assortment of symbols or patterns; this may have been the handiwork of the same forces that positioned an array of old floor-buffing machines as if attending a wedding, complete with an improvised veil for the ‘bride’. Boot cupboards full of patients’ clothing dating back to the 1960s hung neatly on racks beneath old leather suitcases, still waiting for their owners to return and reclaim them. Everything was drenched in the sickly-sweet smell of dry rot in one area, old cleaning products in the next, the smoky residue from fire damage somewhere else, all creating a constant heady mix of astounding new sights and their accompanying rich, evocative smells. One might turn a blind corner and startle a fox or deer, or more often surprise a roosting pigeon; its loud flapping and squawking suddenly breaking the silence as it frantically searched for an open window. One ward had been turned into a staff crèche at some point, giving a bizarre juxtaposition of nightmarish painted cartoon characters, colourful but fading murals, and scattered toddler toys against the old cell doors, broken windows, tattered peeling paint and decaying floors. On a former female ward, with ‘women’s dormitory’ marked on the doors in fading letters cut from fashion magazines, patients’ artwork lay scattered around a battered John Broadwood & Sons grand piano (made in the 1870s and 183

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A day-room at West Park. (Copyright Ed Brandon)

now worth more than £20,000 in good condition) that was somehow overlooked and left behind in the disorganisation and haste of the ward’s closure. The corridor to the health services department was strewn with metal walking frames as if a dozen invisible geriatrics had been suddenly frozen midway through an impromptu race along its length; inside the adjacent dentist’s room, plaster casts of former patients’ teeth still lay on the old, rusting dental equipment. Many wards remained full of neatly arranged beds, with bottles of chlorpromazine and other anti-psychotic drugs scattered around. In wards where the roofs had been burned or deteriorated and water had leaked onto the concrete upper floors, it would not drain away, leaving an inch of water that created stunning reflections and an otherworldly mirrored effect throughout. On one ward, an inconspicuous-looking door opened to reveal the last in-situ Pocock Brothers padded cell left in any county asylum; its walls hardened over time and its springy floor stained with… who knows what. The long-disused pathology labs and mortuary were also accessible at certain times, the doors to the huge fridges yawning open to the room, exposing their sliding metal trays which could once preserve up to twelve bodies at a time. The mummified corpse of a cat sat in one corner 184

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of the attached laboratory, and a mummified squirrel in another; since the broken skylight above was usually the only way in after closure, one wondered if the cat had chased the squirrel inside and both had then found themselves unable to get back out. Boxes of glass slides with blood and tissue samples dating back to the 1950s sat on shelves, and dozens of blocks of Paraplast – a clear, waxy substance of paraffin and polymers – were scattered across a table; closer inspection revealed these contained surgically removed chunks of West Park’s former patients’ brains in an array of sickly yellows, browns, and greys and, again, all were simply left behind when the building went out of use. Demolition at West Park began in November 2010, and the majority of the service buildings were razed; all of the above-ground corridors and other debris were bulldozed into the underground corridor network and basements to help fill them up and flatten the ground ready for what would come next. The contents of the buildings as described above, including all those fascinating pieces of paperwork, artwork, possessions, and even the body parts, along with everything else that still remained by then, were either thrown in skips or burnt in huge bonfires across the demolition site; even the grand piano was dropped and smashed beyond repair by workers finally trying to remove it.

A day-room at West Park. (Copyright Ed Brandon)

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The new housing estate built atop the old asylum was titled ‘Noble Park’, and the associated marketing materials referenced only the ‘attractive Edwardian former hospital buildings’. While it is perhaps a shame the developers could not have stuck with the original name, it is also entirely understandable that they would not want potential customers searching online for ‘West Park Epsom’ and, instead of finding swish modern flats and houses, being bombarded with hundreds of images of a derelict lunatic asylum. Pleasingly, heating across the site was provided by an environmentally friendly biomass CHP (combined heating and power) system, which utilised the chimney part of the water tower to provide the necessary outlet and give it a functional role once more, while the main part of it was sensitively converted. While it was always likely that the admin block at least would survive and the water tower had to be kept, ten of the main ward blocks were also retained and sympathetically converted to ninety-one new dwellings. Excellent preservation was made of the grounds, and the wooden airing court shelters to the south of the buildings were renovated, with many more new houses crammed into the footprint of the demolished buildings to the north. The former site of West Park can still be visited, and while an experience remotely akin to the one described by the author is of course now impossible, it is one of very few of the really large former county asylums where, from the south side at least, some tiny residual sense of the scale and the ‘place’ that once was still remains.

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Glossary

Acute: Short term and / or recently diagnosed or acquired symptoms. As opposed to chronic. Airing courts: ‘airing’ referring to the patients ‘taking the air’ (rather than needing to be aired), these were open spaces either contained within the main range of an asylum’s buildings, or directly adjacent to it and there was usually one provided for each ward block, although in some cases there was only a separate male and female court. When first built, they were almost invariably contained by an insurmountable fence or railings and intended to provide fresh air and exercise for patients without allowing them to leave, although these were lowered or removed in most cases by the middle of the twentieth century. Board of Control (BoC): This governmental organisation replaced the Commissioners in Lunacy in 1914 with the same mandate related to the updated legislation. Chronic: long term and ongoing symptoms. As opposed to acute. Commissioners in Lunacy (CiL): Governmental department responsible for overseeing the correct implementation of all legislation relevant to public and private asylums, initially reporting to the Lord Chancellor and later to the Home Secretary. This evolved into the Board of Control in 1914. Compact arrow plan: See Echelon plan. Colonies / Colony plan: A hospital design with detached buildings distributed across the available grounds rather than centred around one single interconnected building. 187

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Echelon plan: A type of asylum layout which saw the main ward blocks arranged en echelon (see Claybury chapter) with each parallel row of blocks projecting further outward from the centre than the one in front; also often described as a ‘compact arrow’ or ‘wide arrow’ plan. Idiots and Imbeciles – These were terms originally used as formal medical parlance and only became pejorative through public slang use. Although concrete definitions vary, ‘idiot’ generally implied those we might now describe as having learning disabilities/differences, or Down Syndrome. Imbecile is from the Latin meaning ‘weak-minded’ and was generally used to refer to those who had a lower cognitive or intellectual ability than average, although the terms have been somewhat interchangeable over the years. Imbeciles – see ‘Idiots and Imbeciles’ JPs: Justices of the Peace; local magistrates who oversaw the application of the law within their allocated area of jurisdiction. London County Council (LCC): Formed in March 1889 as London became its own county, separating from the former ‘parent’ county of Middlesex. Madhouse: this was the formal term for a small, privately-run lunatic hospital for fee-paying patients. Prior to the County Asylums Act of 1808, anyone with a moderate-sized property, some beds, and some hired muscle could set themselves up and run one. While some were run at least as well as any public asylum, and the more expensive, exclusive ones such as Greatford House near Peterborough (which treated King George III) provided luxurious surroundings and experienced staff, most were set up by men with no sound medical background and were run appallingly, with profit as the primary motive. As regulations tightened from 1808, meaning they had to be run to certain minimum standards, employ at least one medically qualified staff member, and make themselves available for regular inspection, they became far less appealing and lucrative for shady entrepreneurs; as a result, the majority had disappeared by the mid-nineteenth century and those which remained were of a significantly higher standard. 188

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Glossary

MetropolitanAsylums Board (MAB): Formerly the M.A.D. (Metropolitan Asylums District); overseers and administrators of the Lunacy laws at asylums (mostly dealing with idiots and imbeciles, rather than lunatics) within the metropolitan area as well as having responsibility for some other hospital types, particularly sanatoria. It was created to simplify the former system which saw individual parishes take responsibility for the same role, which as London grew exponentially, became increasingly difficult to manage without a single body to oversee it. NHS (National Health Service): Amalgamation of all existing public health services, county asylums, and former workhouse infirmaries (as well as many formerly private and charitable institutions) to provide ‘free at point of entry’ standardised care for all British citizens funded via standardised public taxation. POWs: Prisoners of War. Public asylum: An asylum accepting paupers and/or middle-class patients primarily funded by public ‘subscription’ (charitable donations or regular payments), different to a county asylum or private madhouse. Superintendent: The person (invariably a man due to the prevailing notions and opportunities of the time) in charge of the running of the whole asylum. His job was to oversee all elements of daily activity, and implement the regime drawn up by the asylum’s committee, which in turn would have been based on the County Asylum legislation of the Commissioners in Lunacy. TB: See Tuberculosis. Tuberculosis (TB): A bacterial infection caused by Mycobacterium tuberculosis (MTB) which usually affects the lungs, causing night fevers and the coughing up of blood. Weight loss is another frequent symptom, hence the common Victorian name for the disease being ‘consumption’, as sufferers would appear ‘consumed’ with rapid reduction in bodyweight. Villa plan: See Colony plan. Wide arrow plan: See Echelon. 189

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Endnotes

1. This was London’s second large-scale charitable public lunatic hospital, which was also based at Moorfields from 1751 before moving to a bespoke new building at Islington from 1787–1930. 2. Bedfordshire in fact ended up becoming the second county to build an asylum, as early as 1812; however, this was almost exclusively because of the intervention (after the survey mentioned above) of Bedford’s MP, Samuel Whitbread (1764–1815), who was a key figure in organising the County Asylums Act and had made it his personal mission to get one built. He was a sufferer of what was then termed ‘melancholy’ (now possibly diagnosed as depression) and sadly he would take his own life in 1815, just a few years after the asylum he fought to get built was opened. 3. This figure is deliberately imprecise as there were 104 institutions which formally opened as ‘county asylums’, but others which served essentially the same purpose, either throughout their operating years or only at certain points, without necessarily having had the formal ‘county asylum’ or ‘county mental hospital’ suffix. 4. To a lesser extent, this was also carried out in order to get them out of harm’s way as anti-German riots and lynching swept across towns and cities in Britain including Peterborough, where the 200-year-old Riot Act of 1714 was invoked and read aloud for the last time in history to a mob attacking a German butcher’s shop on 7 August 1914. 5. A dictionary definition of ‘society’ (where it does not pertain to an organisation) is the body of human beings generally associated with or viewed as members of a community; they are one and the same thing. 6. London’s St Thomas’ Hospital of 1871 (which faces the Thames opposite the Palace of Westminster) is a good example of a pavilion plan which can still be easily seen today, although only three of the original seven pavilions remain. 190

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Endnotes

7. Along with Cane Hill, Whittingham (4th Lancashire County Asylum), the 1884 annexe at Prestwich (2nd Lancashire County Asylum, opened in 1851), and Graylingwell (West Sussex County Asylum of 1897) make use of the same concept, but not in quite the same way, making Cane Hill arguably unique. The term ‘radial pavilion’ was not used at the time and has been applied later by those who, like the author, have scrutinised the many historical variations of asylum layouts in more recent years; it was first coined by Simon Cornwell in the early 2000s via his eponymous website, discussed toward the end of the Cane Hill chapter. 8. The largest private asylum or ‘licensed house’ in Britain, which opened in 1813. 9. Napsbury was built by Middlesex near St Albans in Hertfordshire to replace the provision they lost when all their county asylums were transferred to the LCC’s control. During the Second World War it was fully given over to use as a war hospital. 10. Thomas Story Kirkbride (1809–1883) is the most important figure in nineteenth-century American psychiatry and he co-founded St Elizabeth’s Hospital in Washington, DC; a progressive asylum which opened in 1855 designed to his ideal of how such an institution should be run and constructed, the most indelible external feature of which was that the wards were laid out in his favoured echelon formation. 11. These slats were a ubiquitous feature at asylums and could still be seen even at the handful which remained in operation by the 2010s; a wooden block was screwed or nailed into the runners of the sliding sash windows to facilitate ventilation, but only allowing the windows to open to a gap of around four or five inches – not nearly enough for even a small child to squeeze through. 12. Mary Mallon (1869–1938), aka ‘Typhoid Mary’ worked as a cook in the New York area, and at least three deaths were attributed to direct contact with her. She ignored the advice of doctors and continued to work under aliases largely because she had experienced no symptoms herself. She is remembered to this day because she was the first identified ‘asymptomatic’ carrier and she also continued to work simply because it was the only income she had and there was no system to provide her with any other means of support. She was eventually forcibly detained at New York’s notorious North Brother Island Infectious Diseases Hospital where she would live (if that is the correct word for her miserable existence from that point) until her death there in 1938. 191

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Select Bibliography

Annual Report from the Commissioners in Lunacy to the Lord Chancellor by The Commissioners in Lunacy. Published by Hansard & Sons, various editions and dates, 1858–1913 Annual Report from the Board of Control to the Home Secretary by The Board of Control. Published by Hansard & Sons, various editions and dates, 1914–1930 Asylum, Hospital, Haven: A History of Horton Hospital by Ruth Valentine Published by Riverside Mental Health Trust, 1996 Bedlam: London and its Mad by Catherine Arnold Published by Simon & Schuster, 2008 The Bethlem Royal Hospital: An Illustrated History by Patricia Allderidge Published by Beric Tempest & Co., 1995 Claybury: A Special Character Appraisal Published by London Borough of Redbridge Council, 2006 English Hospitals 1660-1948: A Survey of Their Architecture and Design by Harriet Richardson Published by The Royal Commission on the Historical Monuments of England, 1998 The Friern Hospital Story: The History of a Victorian Lunatic Asylum by David Berguer Published by Chaville, 2012 192

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Select Bibliography

A History of Mental Health Nursing by Peter Nolan Published by Chapman & Hall, 1993 The History of St Luke’s Hospital, London: 1751-1948 by C.N. French Published by William Heinemann, 1951 Hospital & Asylum Architecture in England 1840–1914: Building for Healthcare by Dr Jeremy Taylor Published by Mansell, 1991 A Hospital Looks at Itself: Essays from Claybury edited by Dr Elisabeth Shoenberg Published by Bruno Cassirer, 1972 Hospitals & Asylums of the World: Their Origin, History, Construction, Administration, Management, & Legislation by Henry C. Burdett Published by Churchill Press, 1893 Institutions of Confinement: Hospitals, Asylums & Prisons in Western Europe & North America, 1500-1950 by Norbert Finzsch & Robert Jutte Published by Cambridge University Press, 1997 Light Through the Cloud: The History of The Retreat, York, 1796-1946 by L.A.G. Stong Published by Friends Book Centre, 1946 Medicine and Magnificence: British Hospital and Asylum Architecture 1660-1815 by Christine Stevenson Published by Yale University Press, 2000 Mind Over Matter: A Study of the Country’s Threatened Mental Asylums by Marcus Binney, et al. Published by SAVE Britain’s Heritage, 1994 More Like Home: The History of Long Grove Hospital by Tony Day Published by Pavillion, 1993 193

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Mystic London: Or, Phases of Occult Life in the Metropolis by Rev. Charles Maurice Davies Published by Tinsley Brothers, 1875 A Pictorial Review of Claybury Hospital by Eric H Pryor Published by Mental Health Care Group, Forest Healthcare Trust, 1996 A Proper House: Bedford Lunatic Asylum 1812-1860 by Bernard Cashman North Bedfordshire Health Authority, 1992 On the Construction and Government of Lunatic Asylums by John Conolly, M.D. Published by John Churchill, 1847 Psychiatry for the Poor: 1851 Colney Hatch Asylum, Friern Hospital 1973 by Richard Hunter & Ida McAlpine Published by Dawsons, 1974 Sans Everything: A Case to Answer compiled by Barbara Robb Published by Nelson, 1967 Stanley Royd Hospital, Wakefield, 150 Years: A History by A.L. Ashworth Published by A.L. Ashworth, 1975 The Story of the Horton War Hospital, Epsom by Lieut-Colonel J.R. Lord, CBE, MB Published by William Heinemann, 1920 A Treatise on the Nature, Causes, Symptoms and Treatment of Insanity by Dr William Charles Ellis Published by Samuel Holdsworth, 1838 The Treatment of the Insane Without Mechanical Restraint by John Conolly, M.D. Published by Smith, Elder & Co., 1856

194

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Select Bibliography

The Village on the Heath: A History of Bexley Hospital by Britta Von Zweigbergk & Michael Armstrong Published by Doppler, 2004 West Park Hospital, Epsom, Surrey: The First Sixty Years by Bryan C.T. Johnson Published by West Park Hospital Management Committee, 1969

Significant websites consulted academic.oup.com countyasylums.co.uk eehe.org.uk ezitis.myzen.co.uk historicengland.org.uk historic-hospitals.com ncbi.nlm.nih.gov/pmc simoncornwell.com studymore.org.uk wellcomecollection.org 28dayslater.co.uk

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Index

Abandonment, 91-3, 95-6, 138-9, 181-5 urban exploration, 91-3, 182 see also Closure (of asylums) Administrative (admin) blocks, 2 Banstead, 57 Bexley, 121 Cane Hill, 72-3, 90, 94-6 Claybury, 104-105, 116 Colney Hatch, 33-4 Epsom cluster: Horton, 143 Long Grove, 150-1, 181 Manor, 142 St Ebba’s, 148-9, 181 West Park, 154-5 Hanwell, 3, 26-7 Alexandra Palace, 45 Alcohol, 14-15, 145, 160 breweries, 6, 22, 35 consumption and distribution at asylums, 22-3, 27, 39, 59-60 temperance movement, 59-60 Alderson, William, 2-3 Anatomy Act of 1832, 7 Architecture and construction: construction, xv-xvi, 1-7, 17, 21, 32-5, 54-7, 60, 69-75, 97-110, 119-22, 142-5, 148-57 conversion, 28-30, 52-3, 96, 116-17, 139-40, 180, 185-6 plans/layouts: colony/villa, 147-9 corridor, 2-3, 70-1, 100

echelon, 71, 94, 101-102, 120, 188, 191 pavilion, 55, 190 dual/parallel, 55-6 radial, 70-1, 101-102, 191 radial plan, xv, 2-3 see also Demolition Armstrong-Jones, Dr Robert, 105, 110, 112 Art, artists, and writers in asylums, 51, 94, 133-5 Fraser, Olive, 127-8 Hennell, Thomas, 112-13 Lawrence, Dorothy, 45-7 Pell, Cynthia, 134-5 see also Luck, Andolie, Medicines, cures, and treatment; therapies; art and music therapy Baldwyn’s Mansion, 118-19, 122, 126-7, 139 Baldwyn’s Park, 118-19 Banstead Asylum, 26, 54-68, 101 Bathing see Hygiene Batty, Dr William, xiii Bedlam see Bethlem Bethlem Bethlem (at Bishopsgate, 1247-1676), ix-ii Bethlem Museum of the Mind, xii, 29, 113 New Bethlem (at Moorfields, 1676-1815), xi-xvi, 13

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Index Royal Bethlem (at Southwark, 1815-1930), xvi, 1, Bevans, James, xiv-xvi Bexley Asylum, 43, 47, 109, 118-44, 150-1 Big Audio Dynamite, 93 Biven, Edward see Giles & Biven Board of Control, 85, 89, 129, 158, 187 Bond, Dr Sir Hubert, 151 Bowie, David, 94 Boyle, Dr Helen, 112 Bracton Centre, The, 137-9 Bradley, Thomas, 123-4 Breweries see Alcohol Bridewell Prison, 11 British Medical Association, 17 Broadmoor Asylum/Hospital, 28, 79, 135-6, 171 Brookwood Asylum/Hospital, 69, 76-7 Burial see Death; burial grounds and graveyards Burns, Terry, 94 Burrow, Stephen, 72 Buxton, Sir Thomas, 142 Caine, Michael, 93-4 Calderstones Asylum/Hospital, 56 Caldwell, Dr Alex, 167 Cane Hill Asylum, 67, 69-97, 101-102, 105-106, 153, 165, 191 Care in the Community (and Parliamentary Act of 1983), 51, 90, 132, 171, 175, 190 Caring for Relatives Assisting Schizophrenics and Helping Siblings (CRASH), 177 Carter-Pegg, Hallam, 103-4 see also Hine, George T. Caterham Asylum, 54-6 Catering see Diet Cats, 130, 134, 137, 174, 179, 184-5 Cerletti, Ugo, 61 Cemeteries see Death; burial grounds and graveyards

Certified institutions, 56, 161 Chalfont Colony, 147-8 Chapels at asylums: Banstead, 56, 58 Bexley, 122, 139 Cane Hill, 73, 83-5, 94-6 Colney Hatch, 33-4, 53 Claybury, 104-106, 116-17 Epsom cluster: Horton, 143, 180 Long Grove, 150, 173-4 Manor, 142 West Park, 154, 162, 175 Hanwell, 3, 10, 20, 26-7, 29 See also Religion / religious observance Chaplin, Charlie, 81-2 Chaplin, Hannah see Hill, Hannah Charlesworth, Dr Edward Parker, 18 Christmas, 25, 89, 122, 170 Churches see Chapels at asylums Churchill, Winston, 111 Cibber, Caius Gabriel, 12 Clarendon Park, 181 Clarke, Dr G., 123 Class see Social class topics Classification of patients see Patients; classifications/diagnosis Claybury Asylum, 17, 94, 97-120, 122, 143, 165 Claybury Hall, 98, 104 Clifford-Smith, William, 27-8, 45, 60, 67, 142, 148, 152 Clitherow, James, 1 Clock towers see Water towers and clock towers Closure (of asylums), xvii, xx Banstead, 66-8 Bexley, 138-40 Cane Hill, 89-94 Claybury, 116-17 Colney Hatch, 49, 51-3 Epsom cluster, 175-81 Hanwell, 28-30

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A HISTORY OF LONDON COUNTY LUNATIC ASYLUMS see also Architecture and construction; conversion, Demolition, Patients; admittance/ committal; discharge/re-housing Clothing: for patients, 11, 19, 25, 51, 76, 125 for staff, 25, 76, 164, 129, 163-4 Cohen, David, 39, 41-2 Colney Hatch Asylum, 31-55, 60, 79, 83, 105, 126, 167 fire of 1903, 43-5, 60, 142, 149 Commissioners in Lunacy (CiL), 12, 21, 35, 45, 69, 103, 108, 142, 151, 187, 189 Rulings, warnings, and interventions by, 37, 42-3, 50, 56, 59-60, 79, 99, 109, 143, 149, 151 Committal see Patients; admittance/ committal Committees (of or regarding asylums) Bethlem, x-xi, xiii-xiv County asylums, 12, 17, 21, 24, 32, 34-5, 37-8, 50, 79, 82, 84, 89, 126, 144, 147, 189 investigating or Select Committees, xiv, 1, 64-6 Connolly, Dr John, 17-18, 20-4, 26, 28, 32, 55 Cook, Dr L., 126 Coppice Asylum, The, 99 Cornwell, Simon, 93, 191 Corsellis Collection, 29 Coulsdon Deep Shelter, 86 County Asylums Act: of 1808, xiii, 1, 188 of 1845, xvi, 12, 21 C.R.A.S.H. see Caring for Relatives Assisting Schizophrenics and Helping Siblings Cubbit, Lewis, 35 Cures see Medicines, cures, and treatment Daukes, Samuel, 32-3, 54 Davey, Dr J.G., 35

Davies, Reverend Charles Maurice, 24 Davies, Reverend D.V., 89 Death, 7-8, 38, 44, 110-11, 124, 165-6 autopsies/mortuaries/pathology, 7-9, 74, 184-5 body snatching, 7-8 burial grounds and graveyards, 7, 38, 58, 68, 74, 83, 90, 140, 160 death rates, 7, 74, 83, 158 suicide, 11, 36, 80, 94, 134 Demolition, xix-xx, 66-8, 94-6, 117, 139-40, 174-5, 181, 185 Diet: for patients, x, 22-3, 37, 39, 48, 76, 83, 85-6, 89, 127, 139, 158, 160 kitchens, bakeries, and food preparation, 35, 73-4, 108-109, 121, 174 Discharge (of patients) see Patients; admittance/committal; discharge/ re-housing Diseases, 159 flu, 124, 160 colitis, 112 syphilis, 16, 41, 110-12, 165-6 general paralysis of the insane, 110-11, 166 see also Medicines, cures, and treatment; therapies; malaria therapy tuberculosis, 64, 124, 145, 189, 191 typhoid, 124, 191 Dissection see Death; autopsies, mortuaries, and pathology Doctors see Staffing; superintendents and senior staff Ealing General Hospital, 28 Earlswood Idiot Asylum, 105 Echelon plan see Architecture and construction; plans/layouts; echelon plan Elgee, Dr Samuel, 83-4

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Index Ellis, Mildred, 13 Ellis, Dr William Charles, 12-17 English Heritage, 98, 116 English Partnerships, 94 Entertainment see Recreation, entertainment, and sports Epilepsy/epileptics, 14, 25, 36-8, 45, 58, 73, 147-9, 158 see also Chalfont colony, St Ebba’s Asylum/Colony Epsom cluster, 109, 141-86 see also Railways/Railway stations; at asylums; Epsom light railway Escape see Security; escape Eugenics, 111-12, 145 Ewell Epileptic Colony see St Ebba’s Asylum/Colony

Griffiths, Robert, 70, 101-102 Grounds and shelters, xix, 52-3, 75, 80, 87-90, 110, 116, 118, 126-7, 129, 138-9, 151-2, 159-60, 180-1 airing courts, 187 Banstead, 55 Bexley, 121, 125, 133 Cane Hill, 75, 80, 87-8, 90 Claybury, 104, 109-10, 116 Colney Hatch, 34 Epsom cluster, 151-2, 162, 168, 180-1, 186 Hanwell, 6, 29 buildings within, xvii, 34, 38, 49, 60-1, 71, 74, 86, 91, 126, 129, 180 landscaping of, 34, 98, 110, 152, 162, 180 see also Farms Gunnersbury Park Museum, 29

Fair Mile Asylum, 69, 101 Farms, 48-9, 75-6, 89, 129-30 Fires and arson, 17, 34, 58, 95-6, 130-1, 138, 142, 173, 180-1, 184 see also Colney Hatch Asylum; fire of 1903 First World War, 45-7, 60, 82-4, 109, 114, 124, 157-62, 165, 173 see also Prisoners of War, War hospitals Fisherton House Asylum, 80 Fraser, Olive see Art, artists, and writers in asylums; Fraser, Olive Freeman, Walter, 63 Friern Hospital see Colney Hatch Asylum Gardens see Grounds and shelters Gardiner-Hill, Dr Robert, 18 George III, King, xiii, 188 George V, King, 157 General paralysis of the insane see Diseases; syphilis Gender divisions/topics, 35, 51, 83, 164 Giles, John see Giles & Biven Giles & Biven, 55-6

Halliwick Hospital, 49 Hanwell Asylum, 1-32, 34-6, 41, 60, 134, 165 Harris, Dr John, 113-14 Hassid, Joseph, 166 Hayes Park, 24 Heath Asylum see Bexley Asylum Hennell, Thomas see Art and artists in asylums; Hennell, Thomas High Royds Asylum, 97, 102 Hill, Hannah, 80-2 Hine, George T., 57, 98-104, 119-22, 143, 150, 174, 181 Hine, Thomas Chambers, 98-9 Historic England, 116 Hollywood Lodge, 162 Hone, William, xiv-xvi Hood, Dr William Charles, 35 Horton Asylum, 66-7, 82-3, 86, 120, 143-7, 157-61, 165-7, 169, 171-2, 175-6, 178-81 see also War hospitals; Horton war hospital Horton Lodge see Hollywood Lodge

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A HISTORY OF LONDON COUNTY LUNATIC ASYLUMS Horton Road Asylum, 2 Horton, Sampson de, 141-2 Howell, Charles Henry, 69-71, 74, 78, 101, 103, 105 Humane treatment principles see Moral treatment principles Hygiene, 11, 34, 38, 61, 89-90, 125, 137, 160, 163-4, 172 see also laundry/laundries Idiots and imbeciles, 40, 54, 77-8, 105, 111, 188-9 see also Patients; classifications/ diagnosis of; Down syndrome Illnesses see Patients; classifications/ diagnosis of Industrial therapy see Medicines, cures, and treatment; therapies; occupational/industrial therapy Jack the Ripper, 39-42 Jewish patients /Judaism, 39 see also Jack the Ripper Jobs see Labour (within asylums) Jones, Maxwell, 114 Justices of the Peace, xiv, 13, 20, 188 Kaminski, Nathan, 41-2 Kirkbride, Thomas Story, 101, 191 Kosminski, Aaron, 39-42 Kray, Ronald and Reginald, 170-1 Labour (within asylums), 23, 35, 48-9, 76, 82, 86, 119, 129, 147-8, 150 hatters, 36 occupations (before committal), 35-6, 82, 119 see also Farms, Laundry/laundries, Medicines, cures, and treatment; therapies; occupational/ industrial therapy Langho colony, 148 Laundry/laundries, 22, 28, 35, 49, 79, 86, 108 Lawn, The (asylum), 18, 24

Lawrence, Dorothy see Art, artists, and writers in asylums; Lawrence, Dorothy Leavesden Asylum/Hospital, 41-2, 54-6 Leybourne Grange Mental Hospital, 32 Licensed Houses/madhouses, 17, 26, 191, 188-9 Lilly, Dr George, 84-7 Littler, Henry, 70 Local Government Act of 1888, 78 Lobotomy see Medicines, cures, and treatment; lobotomy/leucotomy London Asylum, The, xv-xvi London Burkers, 8 London County Council (LCC), xvii, 17, 26, 28, 43-5, 59, 80, 82-3, 113, 147, 150, 165, 188, 191 in regard to Banstead Asylum, 56, 60, 78 Bexley Asylum, 118-19, 122-4 Cane Hill Asylum, 78, 82-3, 86, 89 Claybury Asylum, 97, 104, 109 Colney Hatch Asylum, 43-5 Epsom cluster, 141-3, 147-8, 151, 158, 162, 165 Hanwell Asylum, 26, 28 Long Grove Asylum, 150-3, 158, 161-2, 164, 166-7, 169-81 Long Grove light railway see Railways/ Railway stations; at asylums; Epsom light railway Lord, Dr John, 147, 157, 160-1 Luck, Andolie, 51-2 Lunacy Commission/Commissioners see Commissioners in Lunacy (CiL) MacNaughton, Sir Melville, 39, 41-2 Madhouses see Licensed houses/ madhouses Malaria therapy see Medicines, cures, and treatment; therapy; malaria therapy Mallon, Mary see Diseases; typhoid Man Who Sold the World, The, 94

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Index Manor (The) Asylum / Hospital, 82, 141-2, 144, 158-9, 161-2, 168, 173, 181 see also Epsom cluster, War hospitals; Manor war hospital Mapperley Asylum/Hospital, 99, 101 Marshall, Dr W.G., 35 Martin, Dr Dennis, 114-15 Mary, Queen, 157 Maudsley, Dr Henry, 111 Maudsley Hospital, 111-14, 168 Maxim, Hiram, 118-19 McKenna, Reginald, 83 Mechanical restraint, 13, 17-21, 26, 171 Medicines, cures, and treatment: drugs and medicines, 14, 148, 169 lobotomy/leucotomy, 62-3, 86, 166 therapies, 84 art and music therapy, 132-4, 138, 172 electro-convulsive therapy, 61-2, 86, 166 malaria therapy, 84, 165-6 see also Diseases (at asylums); syphilis occupational/industrial therapy, 49, 85-6, 90, 125, 129, 132, 161-2, 173 therapeutic communities, 114-15 see also Moral causes of insanity, Moral treatment principles Media, 80-2 BBC, 84, 130, 135 cinema, television, and video games, 29, 52, 81-2, 84 newspapers and press coverage, xiii, xx, 7, 44-6, 52, 63, 79, 90, 115, 122-3, 130-2, 146, 158, 177 radio, 51, 135 Mental Health Act of 1959, 88, 114-15, 129, 169 Mental health conditions see Patients; classifications/diagnosis Mental Treatment Act of 1930, 27, 47, 60, 112, 124, 126, 161, 166

Metrobolist, The, 94 Metropolitan Asylums Board, 17, 42, 54, 56-7, 189 Middlesex: county authorities of, xvii, 1, 17, 31-3, 54-7, 78, 97-8, 108, 188, 191 see also Banstead Asylum, Cane Hill Asylum, Colney Hatch Asylum, Hanwell Asylum, Napsbury Asylum, Springfield Asylum Moniz, Antonio, 62-3 Moody, Dr James, 76, 79-80, 82-3, 90 Moral causes of insanity, 14-17, 36, 129 Moral treatment principles, 13, 17 Moseley, William, 17 Mott, Dr Frederick, 110-12 Murder Act of 1752, 7 Napsbury Asylum, 84, 191 National Health Service (NHS), 27, 48, 60-1, 86, 114, 116, 127, 169, 181, 189 National Society for the Employment of Epileptics, 147-8 see also Chalfont colony, St Ebba’s Asylum/Colony NHS see National Health Service (NHS) Noble Park, 186 Norris, James, xiv-xv Nurses see Staffing; attendants and nurses Occupational therapy see Medicines, cures, and treatment; therapies; occupational/industrial therapy O’Connor, Arthur, 29 Orbitoclast, 63 Orchard Centre, The, 28 Padded cells, 20, 25, 29, 58-9, 81, 90, 184 Pankhurst, Emmeline, 46 Parc Gwyllt Asylum/Hospital, 102 Park Prewett Asylum/Hospital, 104

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A HISTORY OF LONDON COUNTY LUNATIC ASYLUMS Parkside Asylum/Hospital, 70, 101 Patients: abuse of, x, xii-xiii, xiv-xv, xvii-xviii, 18, 50, 78-9, 63-6 admittance/committal of, 9-12, 108-109, 115-16, 127 discharge/re-housing, 37, 66-7, 91, 115-16, 131-2, 158, 175-9 voluntary patients, xviii, 49-50, 86, 111, 128, 165-7, 169, 173 classifications/diagnosis of, 14-17, 31-2, 36-7, 106, 125, 129, 145-6 depression/melancholy, 36, 61-2, 126, 190 Down syndrome, 161 neurasthenic, 158 schizophrenia, 94, 113, 127-8, 134, 166 cure rates of, 21, 77 elderly, 22, 50, 64, 80, 172-3, 175, 177-8 life and conditions for, x, xvii-xx, 12, 25-7, 37, 42-3, 66, 80, 86-90, 114-15, 125, 128-9, 132-3, 151, 162-3, 167, 169 visiting times, x, xii, 121, 125-6 see also Clothing; for patients, Gender divisions/topics Paupers see Social class topics Pell, Cynthia see Art and artists in asylums; Pell, Cynthia Peterborough, 31, 188, 190 Pinel, Philippe, 13 Pippard, Dr John, 114 Pocock Brothers, 59, 184 Police, xx, 8-10, 39-42, 44, 69, 80, 95, 131, 136 see also Jack the Ripper Pownall, Frederick Hyde, 54-5, 57 POW’s see Prisoners of war Princess Park Manor, 52-3 see also Colney Hatch Asylum Prisoners of war, 45, 61

Quaker movement, xiii-xiv, 2 Railways/Railway stations, xi, 138 at asylums: Cane Hill, 71, 76-7, 80 Claybury, 104 Colney Hatch, 31, 34-5, 44, 47 Epsom light railway (including Horton and Long Grove), 144, 150, 152, 157, 168-9, 178 Great Northern Railway, 31, 98 King’s Cross, 35 London, Brighton & South Coast Railway, 76-7, 80 Recreation, entertainment, and sports, 7, 24, 51-2, 80, 88, 107, 128, 147, 160-1, 169-70 cinema, theatre, and performances, 82, 147, 167 dances, 25-6, 73, 164, 177 sports, 7, 53, 76, 88, 128, 147, 160 Recreation halls, 164 Banstead, 57 Bexley, 121-2, 138 Cane Hill, 73, 88, 95 Claybury, 106-107, 116-17 Colney Hatch, 34, 52 Epsom cluster: Horton, 144, 160-1 Long Grove, 180 St Ebba’s, 149 West Park, 155, 163, 181 Hanwell, 26-7 Religion/religious observance, 9, 15-16, 74, 89 Catholic Church, ix, x, 54, 111 see also Chapels at asylums, Christmas, Jewish patients/ Judaism Repton, Humphrey, 98, 110 Repton Park, 117 Restraints see Mechanical restraint Retreat, The, xiii, xvi, 13 Richard II, King, 9

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Index Robb, Barbara see Sans Everything, a Case to Answer Roberts, Major Norcliffe, 162, 167 Rollin, Dr Henry, 171, 179-80 Roseberry, Lord, 146 Royal Bethlem see Bethlem; Royal Bethlem (at Southwark, 1815-1930) Royal Institute of British Architects (RIBA), 103 Sans Everything, a Case to Answer, 50-1, 60, 64 Seclusion see Padded cells Second World War, 27-8, 47-8, 60-1, 86, 111-12, 114, 126-7, 167-9 bombings, 28, 167, 47-8, 61, 86, 114, 126-7, 167-8 Polish military patients, 167, 179 see also War hospitals Sculcoates Refuge, 13 Security, 2, 4, 169, 191 escape, 123-4, 146, 152, 168, 171 see also Mechanical restraint, Police, Staffing; injury and violence (as victim) Select Committee on Middlesex Pauper Lunatics of 1827, 1 Shepperd, Dr Edward, 38 Shoenberg, Dr Elizabeth, 115 Schwarz, Isobel, 135-6 Smith, W.H., 38 Sneinton Asylum, 98-9 Social class topics, xiv, xvi, 7-9, 14, 23, 35, 37-8, 83, 90, 112, 145, 189 Sport see Recreation, entertainment, and sports Springfield Asylum, 69, 76-8, 89 Staffing, 64-6, 82-3, 107, 147 attendants and nurses, 20, 22, 25, 76, 82, 124-5, 127, 157, 160 accommodation for, 35, 58, 60, 74, 84, 105, 112, 121, 130, 142, 144, 157

conditions and rules for, 22, 35, 74, 78, 83-4, 122-3, 157, 163-4, 172 recruitment of, 76, 89-90, 158, 161, 172-3 foreign workers, 65, 84, 89-90, 172 injury and violence (as victim), 48, 78-9, 82-3, 135-6 superintendents and senior staff, 12-18, 20-1, 64, 76, 83, 87-8, 105, 110-15, 122, 144, 147, 151, 171-2 see also Clothing; for staff, Gender divisions / topics Stanley Royd Asylum/Hospital, xiv, 2-3, 13 Stansfield, Dr T.E.K., 122 St Andrew’s Asylum, Northampton, 166 St Augustine’s Asylum/Hospital, 56 St Bernard’s Hospital, Ealing see Hanwell Asylum St Ebba, 149-50 St Ebba’s Asylum/Colony, 82, 147-51, 158, 161, 173, 181 St Lawrence’s Hospital, Caterham see Caterham Asylum St Luke’s Hospital, London, xiii, 1, St Mary’s Asylum/Hospital, Herefordshire, 101-2 Sterling, Dr Pauline, 85 Strait-jacket see Mechanical restraint Suicide see Death; suicide Surrey: asylums of, 54, 69, 76-8, 80, 105 see also Brookwood Asylum; Cane Hill Asylum; Earlswood Idiot Asylum; Epsom cluster; Springfield Asylum; Warlingham Park Asylum authorities/county of, 69, 141, 172, 174, 176 Swanson, Donald S., 39, 41-2

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A HISTORY OF LONDON COUNTY LUNATIC ASYLUMS Starcross Idiot Asylum, 77-8 Syphilis see Diseases; syphilis TB see Diseases; tuberculosis Thatcher, Margaret, 51 Theft, 75, 80, 91, 93, 147, 182 Therapeutic communities see Medicines, cures, and treatment; therapies; therapeutic communities Thomas, William Broderick, 34 Three Bridges Regional Secure Unit, 28 Tooting Bec Asylum, 56 Treatments see Medicines, cures, and treatment Tuberculosis see Diseases; tuberculosis Tuke, Samuel, 13 Tyerman, Dr D.F., 35 Valentine, Ruth, 157 Victoria, Queen, 29 Violence: against patients see Patients; abuse against self see Death; suicide against staff see Staffing; injury and violence (as victim) Voluntary patients see Patients; admittance/committal; voluntary patients Walliams, David, 84 Wakefield, Edward, xiv-xvi Walk, Dr Alexander, 87, 89 War, 88, 119 see also First World War, Second World War, War hospitals War hospitals: Horton war hospital, 82, 157-61 Manor war hospital, 158-9

West Park Canadian military hospital, 157, 162 see also First World War, Second World War, War Warlingham Park Asylum/Hospital, 78-9 Waterhouse, Alfred, 107 Water towers and clock towers: Banstead, 56-8 Bexley, 122, 139-40 Cane Hill, 72-4, 90-2, 95-6 Claybury, 105, 107-108, 116-17 Epsom cluster: Horton, 143-4, 181 Long Grove, 150, 174 St Ebba’s, 149, 181 West Park, 153, 155-7, 180, 186 Hanwell, 6, 12, 29 Watson & Pritchett, 2 Wellcome Collection, 29 West London & Thames Mental Health Trust, 28 West Park Asylum/Mental Hospital, 28, 113, 152-7, 162-3, 166-70, 175-6, 178-86 West Riding County Asylums see Stanley Royd Asylum/Hospital, High Royds Asylum Whitbread, Samuel, 190 Whittingham Asylum, 70-1, 101 Woolford, Ada, 43-4 Workhouses, xvi-xvii, 1-2, 8, 10, 23, 36-7, 41-2, 78, 81, 145, 147-8, 189 York Retreat see Retreat, The Zephaniah, Benjamin, 28 Zweigbergk, Britta Von, 133-5, 138

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