An Ordered Existence - Vivid Memories of Life in Northern Irish Psychiatric Hospitals (Post-war - 1960)

Author(s): David Bamford and Judith Lee
Document Type: Report
Year: 1997
Publisher: Northern Ireland Association for Mental Health
Place of Publication: Belfast
ISBN: 0-907418-06-6
Subject Area(s): Health, Social Care
Client Group(s) : Men, Women

Abbreviations: NIAMH - Northern Ireland Association for Mental Health

Background to the Research

  • In the residential and day care facilities of NIAMH former patients and retired staff frequently recalled their memories of life in Northern Irish psychiatric hospitals. It was thought to be important to record these experiences of hospital life in the 1950s and NIAMH approached the authors to undertake this research.

Research Approach

  • The research was carried out in the autumn of 1994 and into early 1995 and included all psychiatric hospitals in Northern Ireland. The research was divided into two stages, stage one consisted of a set of unstructured group discussions and stage two used the 'Critical Incidence Technique' - where participants were asked to recall particular experiences or incidents. In all, a range of interviews were carried out with nurses, doctors, social workers and former patients. The results were reported in the form of nineteen themes that emerged during the discussions and interviews.

Main Findings

Friendship

  • This theme was frequently mentioned by former patients, many of whom had lived in hospital for a generation and who valued the social network within the hospital.

Security

  • The daily structured routine of life in the institution, with three meals a day and a set of rules to live by, provided a safe and secure environment for many patients and staff.

The Social Organisation of the Hospital

  • The hospitals of the 1950s had all the features of institutions, however the better ones offered a regular range of activities such as dancing, films, inter-war competitions (involving staff and patients) and various forms of work. In some hospitals, all the wards were locked and only opened when patients were lined up to go to the dining room. Many former patients and nurses commented that senior nursing staff were 'ex-service' and life was regimented.

Brutality

  • Mental and physical abuse of patients was common-place in the 1950s and paraldehyde was used to sedate patients. However, some former patients reported that there was no abuse.

Climate of Optimism and Change

  • This theme was mainly mentioned by retired doctors, some retired nurses and one or two former patients. Changes were influenced by enlightened staff and the introduction of the major tranquillisers. Outside the hospitals, lack of understanding of mental illness and stigma were very prevalent.

Indifference and Resistance to Change

  • In many institutions, care was often of a custodial nature. Nurses wore white coats and were called wardens. Some nurses and doctors were very resistant to reforms and new forms of treatment.

Electro Convulsive Treatment

  • Nurses and patients found this treatment very disturbing and their memories of it were still vivid.

The Farm

  • Most psychiatric hospitals in Northern Ireland in the 1950s had a farm, and former staff and patients reported positive experiences of the work carried out on the farms.

Bathing

  • Bathing was usually communal, with patients lined up for their bath and having to share the same bath and bath water.

Smells

  • Former patients and staff have vivid recollections of the smells within the hospital, usually these were of stale urine, rotten food, and wax and paraffin from the polished floors.

Clothing

  • Up until the mid-1950s, patients wore hospital clothing which were bought in bulk and communal, often the clothes did not fit the person. By the end of the 1950s, patients were beginning to be allowed to have their own clothes.

Sexual Exploitation

  • Some patients and some young female student nurses were exploited and these incidents were covered up.

Privacy

  • Patients had no privacy, with few windows having curtains. During the 1950s, the population of hospitals was relatively large and hospitals were often overcrowded giving little privacy.

Psychiatric Hospitals as a Place of Safety for the Vulnerable Sane

  • Some people were in hospital in the 1950s because they were vulnerable and had nowhere else to go. Once incarcerated, it was difficult for these patients to leave, and many became institutionalised.

Typical Daily Tasks for Female Patients

  • Women worked in the laundry, the kitchen, swept floors, knitted dishcloths and carried out general cleaning.

The Bedridden Population

  • A high number of patients were bedridden in most hospitals, this was based on an ethos of easy management and social control rather than on medical grounds.

Glimpses of Social Workers

  • Social workers promoted community alternatives to hospital and brought an emphasis on social therapy to the work of nurses and doctors in the hospitals.

Suicide

  • Many participants recollected suicides within the precincts of the hospitals, the two most common forms were hanging and drowning.

Containment of Disturbed Patients

  • The disturbed wards tended to be noisy and strident with an atmosphere of violence. Patients were frequently restrained by the use of straight jackets.

Conclusions

  • The recollections of participants paint a disturbing and shocking picture of the care of those with mental health problems in the 1950s, despite the period being one in which progress was made with the establishment of the National Health Service and the Welfare State.
  • Despite the impact of the drugs revolution and the beginnings of real change, the chronic asylum culture was resilient.
  • Patients in the 1950s were powerless, vulnerable and depersonalised. They lacked privacy, wore hospital clothes and their lives were very regimented. However, some hospitals offered security, safety, companionship and acts of kindness.
 

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