Thursday, 23 December 2010

Book Review - The Light in My Mind

I hadn’t expected to be blogging again before the new year, but having just read The Light in My Mind by Joyce Passmore (published by Speak Up Somerset) I just had to share my review of this very significant book.

The Light in My Mind tells Joyce Passmore’s personal story of having been a patient in a psychiatric hospital from 1957 to 1972 and her subsequent recovery from this horrific and unjust experience.

At the age of 13, Joyce was admitted to the Merrifield Children’s Unit (the very same institution, albeit in an earlier guise, which inspired my own book).   Merrifield was, essentially, the children’s wing of Tone Vale Hospital – an old Victorian asylum – in Somerset.  Joyce did not, however, have a mental health problem; she suffered with epilepsy, and she was told she would only be in the unit for three weeks while they attempted to stabilise her condition with medication.  She writes of the austere atmosphere of the unit, and the quiescent oblivion of the children who surrounded her – all numbed by tranquilising drugs.  Joyce, too, came to suffer the effects of excessive and inappropriate medication.  Joyce relates all of this using very direct and minimalist language, painting a remarkably unadorned picture of her situation.

Joyce goes on to describe how she was given a more thorough diagnosis of her condition by a neurologist at Guy’s Hospital, London, together with the recommendation that she be discharged from the unit in Somerset.  But Merrifield ignored the findings of this authority and continued to keep her incarcerated and subject to unsuitable drug therapies.

If Joyce’s experience thus far is shocking, it is nothing compared to the horrors she encountered when transferred to the adult hospital, Tone Vale, at the age of 16.  Joyce’s use of language continues to be plain and unadorned as she moves into this phase of her experience.  She doesn’t wallow in her misfortune, but simply portrays it in a matter-of-fact way, punctuated with the occasional insight enabled by more recently gathered information.  

In reading her account of this period (which continued for well over a decade) the various elements – including electroconvulsive therapy, violent attacks on her by other patients, and unconscionably abusive and dishonest staff – all merge to form a seamless nightmare.  But while we have the ability to put her book to one side for a moment if we wish, for Joyce this nightmare would have seemed never-ending.

Ultimately, however, The Light in My Mind is a story of hope and recovery.  One thing that supported Joyce through this nightmare was the Christian faith she had inherited from her early upbringing.  She writes of this hopeful thread running through her life with a tangible sense of gratitude – it is the only thing that offers her relief, and without expressing it explicitly, it is clear from her turn of phrase that she doesn’t take it for granted.

The background to this faith is located in the time before Joyce’s nightmare began.  Having been sent to a church Sunday School by her parents, she had absorbed teaching centred on the figure of Jesus, and so she clung on desperately to this figure, her only source of hope in the darkness.  In the present-day climate, where there are so many voices objecting to the exposure of children to religious teaching, it is interested to see that it was this kind of teaching that equipped Joyce for survival in the ‘hell’ she had to endure.

A good proportion of the book is devoted to the support Joyce received from Christian organisations and individuals following her final discharge from Tone Vale – most notably in Tunbridge Wells, well away from the geographical site of her torment.  After such a long period of institutional captivity, it is no surprise to learn that Joyce emerged ill-fitted for life in the outside world.  But it was people of faith who enabled Joyce to make the long and difficult transition.  It is also worth noting that, during this period, she found a real sense of satisfaction in her singing ability, using a talent affirmed by the validation of others – outside her immediate faith community as well as inside it.  If the earlier description of her troubles was matter-of-fact, her description of the pleasure she found in singing overflows with real delight.

Those who are sceptical, or perhaps hostile, to the whole issue of religious belief should pause for a moment to note what faith has actually done in Joyce’s case.  It is true that many injustices and wrongs can be attributed to religion, but here we see a life genuinely saved by faith (to use a very loaded expression). 

I can make no negative criticisms of this book, though I do have one fear.  My fear is that Joyce’s emphasis on her faith – which is inevitable, given how instrumental it has been in her recovery – will mean that some people may avoid reading this book (and, just to be upfront, I note this as a person of faith myself).  But this book is essential reading beyond those who share Joyce’s faith.  If you have an interest in mental health issues, in social justice, and in the mechanisms by which people can be rescued from victimhood, then this book is hugely significant. 


The Light in My Mind by Joyce Passmore is published by Speak Up Somerset
ISBN 978-0-9549772-5-2

Delivered Unto Lions by David Austin is published by CheckPoint Press
ISBN 978-1-906628-21-5
For more information visit

Monday, 20 December 2010

Children’s Welfare and Entitlements, Needs and ‘Givens’

I woke up this morning, as I generally do, to the Today programme on BBC Radio 4.  I continued listening for a little longer than I often do and happened to catch ‘Thought for the Day’ just before eight o’clock.  Today’s ‘thought’ was offered by John Bell of the Iona Community, who had chosen speak on the ‘culture of entitlement’.  I won’t repeat his observations and conclusions here, but I will follow his lead by offering a few observations of my own (while, hopefully, also following John Bell’s example of not being too preachy).

‘Culture of entitlement’ refers to the supposed expectation on the part of individuals and society that we all have a right to certain things, such as employment, food and shelter, health care, etc.  But the ‘culture of entitlement’ notion can be extended to the (suggested) belief of children that they have a right to the latest games console or designer trainers.  At Christmas, and given the current economic climate, this can be a real problem for struggling parents faced with their children’s demands.

But what should children be entitled to?  What should any of us be entitled to?  Although this isn’t really the same thing as entitlement, we do all have needs.  In the 1940s, the psychologist Abraham Maslow proposed a ‘hierarchy of needs’, i.e. a list of things we each need in order to function properly.  Our most basic needs (such as the requirement for survival) form the foundation of the hierarchy, with other needs (such as the requirements for security, health, intimacy, etc.) built on top.

A similar idea to this hierarchy can be found the current Human Givens approach to psychotherapy developed by Joe Griffin and Ivan Tyrrell.  This approach assumes that there are particular ‘givens’ (resources) we need in order to live successful and fulfilled lives.  There are several of these ‘givens’, and they include the obvious things like food, water and shelter, but they also include:

  • having some control over our lives
  • having emotional connection to others
  • having a sense of competence/achievement
  • having a sense of meaning/purpose

Many of us, at some time or another, are denied certain of these ‘givens’.  Many of my posts have referred to the situation of a child caught up in residential psychiatric care.  In such circumstances a child will be (at least partly) denied many of the needs suggested by these ‘givens’.  While it may be perfectly justifiable – indeed, quite proper – to say that a child is not entitled to the latest games console, can we really say the same about the ‘givens’ of human existence?

There will, inevitably, be children who are at this moment facing the prospect of spending Christmas in institutional care.  Far fewer of them will be psychiatric patients than was once the case, but some will be.  And there will be others who are detained for other reasons, whether as a result of their own fault or that of others. 

And so I would like to suggest we consider carefully what our entitlements are (as compared to our wishes or desires) while also remembering the entitlements of others, especially troubled children.  Whether you are about to celebrate Christmas (25 December or 6 January) or Winter Solstice (21 December), or whether you have just celebrated Hanukkah (2-9 December, this year) – or if you have some other December/January festival that is special to you – please also celebrate young life, all life, and respect (in your own way) the ‘givens’ of that life.   

May I wish you all the best for this season and for the coming year.


Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit

Thursday, 16 December 2010

Child Pscyhiatric Services and Unjust Institutional Trends

As an author I regularly visit to see how Delivered Unto Lions – my only published book (so far) – currently ranks in the Amazon bestsellers.  As write this, I see that it is placed at No. 70,247!  This Amazon chart is updated hourly, so my book – like most books – will drop down the chart as more and more other titles outsell it, but occasionally someone will buy a copy and send it leaping up to a much higher position. 

While checking on how my book is doing, relative to the competition, I will also look to see if a new customer review has been added.  Earlier this week I found that there was indeed a new review, and reading it left me quite stunned.  The review was by someone calling him or herself ‘Tworth’, and it said the following:

A ‘must’ read if nothing other than to make sure that this type of cruelty is non-existent in the future. Having been a student nurse at the actual real childrens unit that this is based in (names have been changed) I can remember with horror specific aspects of this sad but very well written book. [...] I sincerely hope some of the ex-staff are able to read this and feel remorse, horror and sadness for the effect their actions have had on the reader throughout his adult life, not to mention the poor children who were not so lucky. [...]

To be honest, I had half-expected some former member of staff (from the children’s unit where I was once a patient) to surface and contradict or discredit my book (and, of course, it could still happen).  But here we have an ex-student nurse coming out and endorsing what I have written.  Tworth’s comments reveal another aspect to the story that is only partly explored in my book: namely the impact that working in such an institution can have on a member of its staff.

I certainly hope that my book does not cast all the worker’s in the institution it portrays as villains!  One or two of them – obviously – are shown in that light, but on the whole, Delivered Unto Lions reserves its fire for the institution and its culture.  What we have here is an institution, a particular setting with its own rules and conventions, which allows – almost encourages – inappropriate, unpleasant, and sometimes abusive actions on the part of its staff.  Certain staff members get away with things because the system lets them, while others find themselves either unable to challenge what is going on or drawn in (possibly) to acting in ways which conflict with their consciences. 

Tworth expresses the hope that ‘some of the ex-staff [of the real unit which inspired my novel] are able to read this and feel remorse, horror and sadness’.  I am aware that some of these individuals are no longer living, so it’s too late to hope for remorse from them.  But of those who may still be around, I certainly hope that they can acknowledge where they went wrong, and if any of them are still involved in children’s psychiatric services, I hope they will have learnt from their past ‘mistakes’.

There is, however, something more that I hope for.  I hope there can now be a greater awareness of the impact that institutional cultures can have on the individuals working within them.  Just as we have seen institutional racism brought out into the light and challenged, I want to see any tendency towards unjust institutional trends in psychiatric services – especially those aimed at children – openly acknowledged and guarded against. Continued vigilance is needed if we are to avoid a return to how things used to be. 


Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit

Monday, 13 December 2010

Children’s Mental Health and the Inequality of Knowledge

In my last post (9 December 2010) I commented on two particular challenges among those identified by the Children and Young People’s Mental Health Coalition.  These challenges relate – obviously – to children’s mental health, and centre on (1) the ongoing problem of stigma surrounding mental health issues, and (2) the matter of the unheard voices of children from particular backgrounds.  In both cases I referred to how these things can delay people (i.e. children and their families) from accessing help.

The assumption is that if you access help for a mental health condition early on, then there is less opportunity for that condition to worsen and require a more drastic intervention.  I am very aware, however, that my novel, Delivered Unto Lions, is all about a drastic intervention (residential psychiatric care) directed at a child who happens to be suffering from depression.  Are we to suppose that this child and his family did not seek help early enough, hence the severity of the intervention?

This question is not answered (or even raised) in my book.  But given that this novel is based substantially on my own childhood experience in the 1970s, I am able to say, with reasonable confidence, that the timing of the intervention is not the issue.  What matters here is the nature and the appropriateness of the intervention.

In a media release that was issued at the time of my book’s publication, I am quoted as expressing the hope that Delivered Unto Lions might not only increase awareness of how children’s mental health problems were once treated, but also encourage parents and professionals to consider the possible unintended consequences of treatments used today.

The main character in my novel, Daniel, became a residential psychiatric patient because his parents accepted the advice of the professionals (as did my own parents).  This does not imply a criticism of the parents (in either case), but hints at some essential differences between (most) parents and (most) psychiatric professionals. 

Parents (in common with all of us) may have their own areas of experience and skill, but this won’t usually be in psychiatry or psychology.  This inequality of knowledge places parents, and their children, in a disadvantaged role in relation to the psychiatrist (or other mental health professional).  While child psychiatrists may have the best of intentions (and we all hope they do!), they are in a position of power because, as the saying goes, ‘knowledge is power’.  It doesn’t necessarily matter whether that knowledge is being used appropriately or not, it is a source of power either way.  Faced with this, parents have a choice: they can submit to this power and agree to everything the professional suggests (as many have done), or they can resist (as many others have done) and accept the incredible responsibility that goes with defying the ‘expert’.

But there’s another significant difference between parent and professional.  The professional is not involved in the child’s life in the same way that the parent is.  Good parents care deeply for their child’s wellbeing; professionals – while they may well be caring people – do not care in the same way, and so they have less at stake. 

Obviously, if a professional makes an obvious blunder it may well harm his or her career, but the ‘best guess’ which later turn out to have been a mistake is not likely to have the same effect.  Professionals (mostly) do not have to live with the consequences, but children and their parents do.

What I am suggesting (not that I expect many people to hear me) is that parents and child mental health professionals both need to think about what could go wrong with the treatments being considered for a particular child, and weigh-up these possibilities against the hoped-for benefits. 

I would also urge parents – and children, where they are able – to ask plenty of questions of the professionals, and not blindly accept everything suggested.  The professional is, after all, the expert, so get him or her to share some of his expertise – but not in a ‘this is how it is’ sort of way, but in an open and scrutinised way.  Clearly, the more assertive and better educated the parents, the easier this will be, but hopefully all parents will be able to wrest some power from the expert.  And hopefully the expert will be pleased at the opportunity of working with more actively involved parents and children.

And what qualification do I have for making these bold (and possibly arrogant) pronouncements?  Well, I make no claim to being an expert or professional, but I do claim the knowledge of what can happen when a child is ‘delivered unto lions’, subjected to unchecked professional and institutional power, though no fault of his own or his misinformed parents.


Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit

Thursday, 9 December 2010

Today’s Challenges for Children’s Mental Health

My book, Delivered Unto Lions, is centred on an unpleasant aspect of children’s mental health care in 1970s Britian.  We have come a long way since the ’70s, and hopefully today’s services for young people are more compassionate and understanding.   But there remain, even now, a number of challenges that need to be overcome if we are to treat our troubled children and teenagers with proper care and dignity.

The Children and Young People’s Mental Health Coalition has identified a number of particular challenges, including:

  • promoting good mental health in the early years
  • tackling the ongoing problem of stigma
  • encouraging emotional resilience
  • filling the gap in mental health care provision between adolescence and adulthood
  • listening to the unheard voices of some children

And there are more.  But I am just going to focus on the issues of stigma and unheard voices.

I have already written about stigma in previous posts.  This is a particular interest of mine as, I believe, it is the stigma of mental health problems that has kept many of the injustices of past psychiatric ‘care’ hidden – a topic that Delivered Unto Lions tries to open up.

The charity YoungMinds wants the UK Government to back a high-profile anti-stigma campaign to be fronted by young people.  There is a fear, however, that in these financially difficult times, the current administration will not want to channel the country’s limited resources into such a campaign.  But stigma and discrimination can have serious consequences for the economy.  If people with problems are made to feel ashamed or guilty because of stigma, then they are less likely to ask for help at an early stage.  And so they will enter the mental health care system much later on when their problems have become worse and more entrenched, needing far more expensive – and often less helpful – specialist treatments.  They will also be likely to have become too unwell to work.

Society’s attitudes to mental health are absorbed by children, and so a lot of anti-stigma work needs to be done in the early years so that future generations are not burdened with the same discriminatory and damaging views of mental health that persist in the present generation.

The issue of ‘unheard voices’ is also of special interest to me.  I am currently a postgraduate student on an archives administration course, and I am especially fascinated by the question of which voices get preserved in archives and which voices get ignored.  Obviously, in centuries gone by, only the wealthy and privileged were literate, so only they were capable of making the records that can still be read today.  The voices of ‘peasants’, however, were not recorded.

Some archives and museums (if they can afford it) are involved in ‘documentation strategies’.  These are efforts to go out and actually record the thoughts and memories of people whose voices might not otherwise be represented in archives.  These are the voices of ‘ordinary’ people and members of minority groups, etc.  For example, as time moves on it is becoming especially important to preserve people’s memories of World War II before it is too late.  We already have governmental and military records, of course, and the writings of important figures, but what was the war like for other people, the people who stayed at home or served the war effort in less obvious ways?

The issue of unheard voices is also very important when it comes to children and mental health services.  My memories of the 1970s suggest that all of us who were child psychiatric patients had difficulty making our voices heard – the ‘powers-that-be’ did not listen to us.  Today it is particular groups of children, rather than children in general, whose voices are not heard (though I imagine that most children have trouble making themselves heard in certain circumstances).  

In adult psychiatric services, Black and African-Caribbean communities are overrepresented.  In 2002, a study found that fear often delays people from an African-Caribbean background in seeking help for their problems.  And so, when they finally do seek help, their problems are often more severe. The (perfectly understandable) fear of both children and parents means that voices don’t get heard by those who could help those who are suffering.  It is only when the problems have become much more serious that those voices get noticed – and sometimes treated very harshly. 

There are many more challenges that our society needs to face with regard to children’s mental health – I’ve just covered two of those issues very briefly.  But if our society is to grow into one that is more healthy and happy, we really must face up to all of these challenges.


Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit

Monday, 6 December 2010

Children's Mental Health Care and the Language of Judgement

My book, Delivered Unto Lions, is set in a children’s psychiatric unit in the 1970s.  The consultant psychiatrist Dora Black has written a ‘brief history’ of the mental health care model reflected in my book.  She identifies a 1920s ‘child guidance clinic’ in Boston, Massachusetts, as the originator of the ‘scientific’ approach to ‘deviant’ children.  It is, of course, very telling that children with mental health problems were described as ‘deviant’ (or even ‘delinquent’), and this may well account for the persistent impression held by child patients (right up until the 1970s and later) that they were being punished.

‘Child guidance’ came to the UK in 1927 with the founding of a clinic in the East End of London.  The honorary director of this clinic was Emanuel Miller, who had trained in Boston, thus reinforcing in Britain the assumptions maintained in that first ever clinic in the US.

Soon there were other children’s psychiatric clinics established in the UK capital: The London Child Guidance Centre in 1928 and the Tavistock Clinic in 1933.  By the late 1940s, there was child psychiatric service provision (of one kind or another) in most regions of Britain.  Some of this provision was of the residential in-patient variety.  A quick look at a British parliamentary Hansard transcript for 29 November 1961 reveals a handful of residential institutions for ‘psychotic or severely maladjusted’ children, including Gwynfa (Colwyn Bay), High Wick (North West London), West Stowell (Oxfordshire), and Merrifield (Somerset – the direct inspiration for Delivered Unto Lions).

It was by the end of the 1960s that the background scenario to Delivered Unto Lions was fully in place.  Child psychiatrists were being employed in the UK by the National Health Service (NHS) and were based in child guidance clinics alongside social workers, educational psychologists and ‘remedial’ teachers.  Many of these clinics represented joint provision by the NHS and the local education authority.

Dora Black describes how many of the children’s psychiatric services were based in isolated locations, thus separating child psychiatrists from most of their clinical and academic colleagues.  Black sees this separation – along with heavy workload – as a block to progress and development; child psychiatrists were left unable to engage in very much research, and in any case, they were largely bereft of the necessary collegiality to support such research.  This, therefore, left most children’s mental health disorders misunderstood and improperly treated.

One of the things I find particularly interesting is the use of language in reference to emotionally or mentally disturbed children.  The early labels from the ‘child guidance’ movement included terms such as ‘deviant’ and ‘delinquent’.  As time moved on the labels changed, but a notion of moral judgement remained; it was as though children were being punished for being unwell. 

In my own experience as a child patient I saw some evidence of an attempt by authority figures to change the language of judgement.  At the Merrifield Children’s Unit of the 1970s (and in the fictional unit of my novel), it was not uncommon for a child to be subjected to a ‘consequence of his (or her) actions’.  Children were not ‘punished’, but they had to endure ‘consequences’.  This language must surely have been intended to give the impression that unpleasant penalties (confinement, sedation, etc.) for distressed behaviour were ‘natural’, rather than the result of draconian decisions by institutional staff.

I would hope that since the 1990s, when residential children’s units began to give way to ‘care in the community’, that the closed environment of children’s mental health professionals was finally thrown open to admit some fresh air and new ideas.  But the fear emerges that, where ‘care in the community’ is seen as inadequate, the new children’s residential units (such as Orchard Lodge, successor to Merrifield) will withdraw into that same invisible world, isolated from scrutiny and alternative sources of insight.


Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit

Thursday, 2 December 2010

Blowing Your Own Trumpet

One of the challenges of being a newly-published author is the issue of publicity and marketing.  No doubt those who have been fortunate enough to be signed up by the big publishing houses will have more support in this area than people like myself who have been signed to small independent publishers.  But whatever the case, an author cannot simply sit back and relax once the book is out.  Indeed, an author has to put a good deal of time and energy into pushing his or her published work, and that leaves very little left over for writing the next one!

I can’t speak for anyone else, of course, but I suspect that most authors would rather be writing than selling.  I, for one, am not a salesman, and yet I’m having to behave like a salesman to help my book reach its audience.  It wouldn’t be so bad, of course, if the only thing I was selling was my book, Delivered Unto Lions.  But it isn’t.  An author has to sell himself (or herself).  This is especially the case when the book is so closely associated with the author’s own experience, as mine is.  But even if that isn’t the case, the fact is that the editors of newspapers, websites, etc., want stories about people, not inanimate objects like books.  So, you have to make yourself sound interesting, and you have to be prepared to ‘blow your own trumpet’ – and, to be perfectly honest, the trumpet lessons I had as a child did not produce very convincing results! 

But at least there are some good sources of information out there to advise the reluctant author-come-publicist.  For anyone else in a similar position – or anyone who is likely to be in the near future – I recommend three books which are packed full of good marketing ideas:

  •  The Frugal Book Promoter by Carolyn Howard-Johnson (Star Publish, 2004)
  •  Aiming at Amazon by Aaron Shepard (Shepard Publications, 2009)
  •  Plug Your Book! by Steve Weber (Weber Books, 2007)

These books are addressed primarily to authors in the US, but a lot of the advice can be adapted for non-US authors – and in any case, even if the US is not your main market, it isn’t a market you would want to ignore. 

Anyway, I need to get back to work now – no, not on my next book; there are media releases I’ve got to send out!


Delivered Unto Lions by David Austin is published by CheckPoint Press.
For more information visit