Starcross Hospital. What the voices tell us. Instalment 3

 Setting the scene

The Institution in 1876

The move to community care

 "Recycling the mental hospitals – better care, better value"  was written by David King, District General Manager of Exeter Health Authority, in June 1989. 

Foreword

... mental handicap institutions were designed to give their inmates a settled and permanent life isolated from ordinary society. This policy of “institutionalisation” was well motivated and intended for people considered to be incapable of fending for themselvesi n the hurly burly of life.

It persisted from the mid nineteenth century to the 1960s when a new attitude emerged: that people with mental illness and mental handicaps were capable of treatment and rehabilitation and should not be compulsorily separated from society but given the opportunity of remaining within it...

David King speaks of “mental illness” and “mental handicap” together because he was addressing how institutional care in several hospitals was transformed in the Exeter health district into care in the community.

It is interesting to note that the terms “mental illness” and “mental handicap” were those often used at the time – phrases which had been deemed far preferable to previous terminology such as “mental deficiency”, “idiocy” and worse. They became increasingly unacceptable, and better described as “mental health problems” and “learning disability”, “learning difficulty” or “special needs”.

A pioneer in championing de-institutionalisation, David was passionate about giving people, whatever their special needs, an opportunity to be part of society, releasing them from regimental controls and intolerable living conditions.

He explained: There are better ways of helping people than the system of institutionalisation.

Ways which... can increasingly take into account the individual needs and wishes of people.

The fervour was born

It was in the 1960s that there were the first glimmers of the move to community care and for David King these were seen at the “mental handicap” hospital, Sandhill Park, in Somerset, which he wrote about in a chapter called Consumer satisfaction – the proof of the pudding. 

King sets the scene:

If you think that life in a mental hospital is a happy existence, it is probably because you have never lived in one. It really was “life” for so many residents, in a sense akin to a life sentence.

Although hospital care was supposed to be beneficial, release from hospital has been as good as a cure for so many who were thought to be beyond hope.

King describes the fervour with which a house was set up for a group from Sandhill Park:

We all set about it with a degree of excitement and energy as if we were preparing them for a moon landing. The group were lifelong inmates of the mental handicap hospital and this would be their first taste of freedom.

It was a success, as King put it:

... within a short time the only remarkable thing about it was that anyone should ever have thought it remarkable.

I was very keen to see how they were getting on and called in one day. As I knocked at the door I realised that it was wrong to be visiting uninvited, though I would have walked through their wards at the hospital without giving it a thought.

Why Starcross existed

King explains the history:

For about 120 years, from the 1840s to 1959, “lunatics” and “defectives” were considered to be indelibly marked as sub normal and sub human. The main objective of official policy was to bring them under control in a separate world designed for their care and protection. 

Under the Lunacy and Mental Deficiency Acts “defectives” could be apprehended and placed in an institution.

At Starcross Hospital... there was a policy, initiated in 1879, to select only those cases possessing sufficient intelligence “to warrant the hope that permanent improvement could be effected.” The “lowest types of idiocy” were not deemed suitable for admission.

Reading between the lines, it seems likely that poor families were able to offer to the hospital authorities those children they neither wanted nor could afford to feed... ...for a hundred years, all sorts of people were admitted... for the remainder of their lifetime. There were people with learning disabilities, physical disabilities, moral reprobates, people with mental health problems and social misfits...

The Western Counties Idiot Asylum
Foundation Stone laid in 1874