Where is the Case for the Defence?

In some recent radio interviews (and a YouTube video) in which I have discussed my book, Delivered Unto Lions, I have made a number of general allegations in connection with the experiences and issues that ‘inspired’ it.  I have talked about the former Merrifield Children’s Unit at Tone Vale Psychiatric Hospital in Somerset (the basis for the fictional Oakdale Unit of my book), and I have suggested that some of what I experienced and witnessed there in the 1970s was abusive.

My allegations have, admittedly, been non-specific.  I haven’t named names, but focussed instead on the system that allowed certain things to happen.  I have criticised the institution’s reliance on drugs to treat and control its patients, along with my opinion that it was inappropriate to subject developing brains to these potent substances, and in such doses.  I have also referred to excessively aggressive forms of restraint, and the isolation of children in a small room with their clothes taken away from them (and I haven’t always remembered to point out that these things were occasional rather than regular events).

I could have said more, of course, but daytime radio may not be the best forum for a discussion on the horrendous response to incidents of sexual abuse (but such things are covered in my book).

What amazes me is that no one (as far as I am aware) has yet come forward to defend Merrifield Unit, or children’s psychiatric units more generally.  And no one (again, as far as I am aware) has yet emerged to condemn my book as sensationalist fabrication (though, if anything, I consider it understated in places).

It is true, of course, that my book is only a modest seller and that my radio interviews have only been broadcast on local stations, and have not therefore enjoyed an especially high profile.  But I have certainly heard from people who confirm the picture I have painted, so there is clear evidence that what I have said has reached at least some of those interested in the topic. 

What I have said in my interviews is, of course, the truth.  And the content of Delivered Unto Lions is a representation of that same truth.  But I recognise that there are at least two sides to every story.  So, where is the case for the defence?  Why hasn’t anyone challenged me?  

It would be nice to think that those concerned (where they are aware of what I have said) have recognised the validity of my arguments and accepted that I am in the right (in which case an apology directed at former child patients would be an appropriate response).  But it would be both naive and conceited to believe that that is the case.  So, what is the reason for the silence?  Maybe those who disagree with me simply think the issue isn’t important.

In some ways it is rather foolish of me to invite a challenge – I don’t actually want to be challenged.  But the issues that lie behind my book are important ones, and that makes the silence from certain quarters ‘deafening’.  Everything I have written and said on the subject is concerned with exposing the ‘hidden world’ of children’s mental health care in the recent past, but it seems that the former ‘rulers’ of this ‘hidden world’ are doing all they can to stay hidden – which is hardly encouraging if the same diffidence applies with regard to the current state of child psychiatric care.

I am aware that I am being unusually provocative here, and I continue in that vein by ending on a similarly provocative note.  I have asked, ‘Where is the case for the defence?’  Could it be that there is no possible defence?

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Delivered Unto Lions by David Austin is published by CheckPoint Press

ISBN 978-1-906628-21-5

For more information visit www.davidaustin.eu

Book Review - The Lives They Left Behind

I wasn’t quite sure what to expect of The Lives They Left Behind by Darby Penny and Peter Stastny (published by Bellevue Literary Press).  In a way, the subheading gave it away: Suitcases From a State Hospital Attic.  But what could possibly be so interesting about suitcases?  Could anything of any significance really have been left inside them?  Well, the answer is a very definite yes.

The hospital in question is the Willard State Hospital in New York – originally called the Willard Asylum for the Insane – which opened in 1869 and finally closed in 1995.  Soon after its closure, a very large number of patients’ suitcases were discovered in the attic of the Sheltered Workshop Building by the curator of the New York State Museum.  He had been exploring the site in search of artefacts worthy of preservation.

The various crates, trunks, and suitcases that were found there were not empty.  They contained all the remaining possessions of the patients they had belonged to: clothing, photographs, books, papers, mementos, and much more besides.  The luggage was saved, and a group of archivists and curators began a ten-year plan to sift through the materials.

What The Lives They Left Behind does is reconstruct – as far as is possible – the biographies of a few selected patients (mainly from the earlier part of the twentieth century), drawing on the content of their suitcases supplemented by any medical records or other documents that may have survived.  What emerges makes grim reading, as these few unfortunate incarcerated patients of Willard are (at last) acknowledged as real people with real histories.

It is notable that almost all of the patients portrayed in this book are immigrants to the United States.  Whether these few patients are truly representative of Willard patients in general is unclear, but if they are, there is a definite suggestion that factors such as nationality, social class and ethnicity played a role in deciding who was to be admitted to the institution.  A little more clarity about this would have been helpful.

It is certainly apparent that the psychiatrists who diagnosed these patients did so according to their own social and cultural assumptions.  Where there was evidence of psychotic delusion, the doctors made no effort to appreciate elements in the patient’s background – such as unfamiliar religious practices – that may have given rise to the delusions.  Symptoms were observed and described, but no effort was made to understand them.

But, as the book makes clear, until the 1960s, there was never any real thought given to ‘curing’ or rehabilitating patients; they were simply kept out of the way at Willard – often for many decades – and frequently put to work to maintain the hospital’s partially self-sustaining economy.  It is especially telling that following the death of a patient whose job was to tend the hospital’s cemetery, that that particular patient was given an anonymous grave and the cemetery he had cared for so meticulously was left to become overgrown.

Although the lives represented in this book are well reconstructed, I get the impression that the priority given to documentary facts and their interpretation sometimes gets in the way of letting these lost voices really speak.  But, on the whole, the authors achieve a good deal in bringing these hidden lives to public attention, and also drawing lessons from past psychiatric practices in a critique of the present state of mental health services.

The Lives They Left Behind has a lot to recommend it, though it may be a little ‘dry’ for some readers.  However, it resists the temptation to be overly academic, and therefore paints a picture of Willard State Hospital that will be readily accessible to most people.

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The  Lives They Left Behind: Suitcases From a State Hospital Attic (2009) by Darby Penney and Peter Stastny, with Photographs by Lisa Rinzler, is published by Bellevue Literary Press

ISBN 978-1-934137-14-7

Delivered Unto Lions by David Austin is published by CheckPoint Press

ISBN 978-1-906628-21-5

For more information visit www.davidaustin.eu

Interview for BBC Somerset, 13 January 2011

On Thursday, 13 January 2011, I was interviewed live (over the ’phone) by Emma Britton of BBC Somerset.  The interview went out shortly after 11 am, and it concerned my book, Delivered Unto Lions, and the experiences that inspired it: those of having been a child psychiatric patient in the former Merrifield Children’s Unit at Tone Vale Hospital, near Taunton, in the 1970s.  For copyright reasons, I cannot offer a full transcript of the interview, but I reproduce here a transcript of my own words as broadcast.

Emma Britton began by asking me how I became a patient at Merrifield.

‘I was 12 years old and I was suffering with depression.  It was causing problems at school, and things like that.  I went through the old Child Guidance system, as it was in those days, and it was suggested that I be admitted for a short time to Merrifield.  But a ‘short time’ stretched out into a much longer time, and I was there, on and off, for just over four years.’

Emma then asked what I had thought at the time about being admitted to the unit.

‘I think, prior to it actually happening, I felt quite positive about it.  I thought that it would be a good thing, that it would sort out the problems I had.  And a rather rosy picture of the unit had been painted for me by the psychiatrist.  So I was actually quite positive – until I actually arrived there.’

I was then asked to describe what it was like.

‘It was all very traumatic.  I suddenly found myself in this place surrounded by other kids with all sorts of other problems.  There were kids, similar to myself, with depression, but there were also kids with anorexia.  I’d never come across anything like that before, so that was quite a shock.  And there were also kids who had been in trouble with the police, and perhaps had some violent tendencies.  I was quite frightened of those, er, older kids, particularly.  We were really such a mixed bunch of people.  And although a lot of the staff were very good, very caring, a few of them weren’t really very sympathetic at all.  It very much felt like a punitive environment, as though I was being punished for being unwell.’  

Then Emma asked why a child of 12 would have been suffering with depression in the first place.

‘Well, I guess we’d had a few problems in the family.  My father had been quite unwell, we’d also moved house quite recently, and I had a new baby sister.  Things were very much changing at home, and I’d only been in my new school for about a year or so, and I hadn’t really adjusted too well to our new circumstances – and I think that’s what really led to my depression.’

Emma enquired about my medical treatment.

‘It was mostly drugs – antidepressants, initially.  But then there were drugs like benzodiazepines, and even antipsychotics at one point.  Quite a lot of drugs.  And the prescription would be changed without any prior warning, so I never knew what was happening.  Although my memory of the whole period is pretty good, there’s a whole section in the middle that I really don’t remember at all, and I put that down to the effect of drugs.’

The depiction of mental hospitals in films like One Flew Over the Cuckoo’s Nest was raised, and I was asked if Merrifield was anything like that.

‘Cosmetically, it was different.  The actual building itself and the furnishings were a lot more pleasant than what you see portrayed in films like that, and, indeed, what you see in documentaries on the old asylums.  So, as I say, cosmetically it was rather better.  But I think in practice there was still a lot of the same sort of attitudes: the same sort of institutional culture prevailed.’ 

Emma then asked why I wanted to revisit my experiences in writing Delivered Unto Lions.  Was it difficult? she asked.

‘Yes, it was.  It was extremely difficult, actually.  I’d had it vaguely in mind for a number of years that I might try and do something positive with my experience.  But then, a few years ago, I came across this ‘urban exploration’ website.  Now, I don’t really know too much about ‘urban exploration’ myself, but they had a feature on the old Tone Vale Hospital, and there was a sort of forum there, and a number of former Merrifield patients had posted things on there.  I suddenly realised this was a very important cause, it wasn’t just about me, it was about my generation, and also about people who preceded me and followed me at Merrifield.  I very much felt we all had a story to get out, that this was very much a hidden world.  People in the Taunton area and West Somerset will have all heard of Tone Vale, but very few people will have heard of Merrifield – they won’t have known that children were treated in this sort of way.  So I wanted to get the story out.’

The question then came up of my book being described as a novel.

‘It falls between two stalls really, because it’s not, strictly speaking, biography – although there’s a lot of biography in it – and it’s not, strictly speaking, fiction.  What I’ve done, to protect the identities of other people, is to change names and alter some of the situations a bit, and relocate the whole thing to another location, in Sussex.  So, I’ve done that, so in that sense it’s like a work of fiction, but it very closely follows my own experiences and also the things I witnessed.  So a lot of it can be taken quite literally, but there is some sort of artistic invention in there as well, particularly to cover gaps in my memory.’

Emma then asked if I was pleased to hear that Merrifield and Tone Vale had been closed and a new village built in their place.  She also asked how I felt about the shift in the approach towards people with mental health problems.

‘On the whole, I’m quite pleased about that.  I know there’s been a lot of criticism of Care in the Community, and there’s been a number of high-profile cases where it hasn’t worked, with tragic results. But on the whole, I think it’s been a very positive move, especially for children.  And, of course, I was very pleased to hear that the hospital and the children’s unit had been closed down.  But I do have some reservations as well, because now, at Cotford St Luke [the new village built on the site], there’s no real sign that Merrifield Unit existed at all – you wouldn’t know it had ever been there.  Although that’s good in one sense – that something new and positive has been built on the site – on the other hand, it’s a bit like having your memories buried.  I very much think we should learn from history to make sure these things don’t happen again, so it’s almost as if the evidence has been removed.  But, generally, I think it’s a very positive thing.  In a way, that piece of land, as it were, has been kind of 'redeemed' or 'saved' by having housing built on it.  That’s great, really.

The issue of catharsis was then broached: had writing the book laid any demons to rest?

‘To a certain extent, but rather than the actual act of writing the book – which, as I said, was extremely difficult – what I have found very helpful for me is some of the reaction I’ve had to it.  I’ve heard from some other former patients of Merrifield, and other people who are interested, and just hearing that reaction, hearing that perhaps in a small way I may have helped one or two people, that has really helped me.  That’s made quite a big difference to me, and it’s put the whole experience into a new perspective.

Finally, Emma asked about my current state of health.

‘Well, I have my ups and downs.  I’m pretty good, on the whole.  Not perfect, but not bad.’

 

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Delivered Unto Lions by David Austin is published by CheckPoint Press

ISBN 978-1-906628-21-5

For more information visit www.davidaustin.eu

Demolishing the Asylum

With the rise of Care in the Community in the 1980s and ’90s, the old Victorian asylums were finally closed.  What is less well known is that this period also saw the closure of children’s psychiatric units – places like Merrifield in Somerset and Gwynfa in North Wales (both were closed in the mid-’90s). 

The reason why the closure of these units is less well known than that of the adult mental hospitals is that very few people were aware these places existed in the first place.  Before Care in the Community reached its height, most people in any given area would know the name of their region’s ‘madhouse’, but hardly anyone would be aware of the equivalent provision for children.

Although my book, Delivered Unto Lions, is set in a fictional children’s unit in Mid Sussex, I make no secret of the fact that it is inspired by the Merrifield Children’s Unit which used to stand in the grounds of the former Tone Vale Hospital in Somerset.  Merrifield is gone now, completely demolished, as is most of the Tone Vale complex – only a few (Grade II Listed) buildings remain. 

Tone Vale is not unique in this respect.  This is what has happened to many of the old asylums in Britain – parts have been demolished (or allowed to fall down) while features considered to be of architectural merit have been preserved.

In some cases, new housing has been built on the sites of old mental hospitals, and some former hospital buildings have been converted into flats.  This is what has been happening with High Royds Asylum in West Yorkshire and the Cumberland and Westmorland Counties Asylum near Carlisle, to name just two.

This is also what has happened with Tone Vale.  A whole new village – called Cotford St Luke – has been built on the site.  But while the few remaining parts of the old hospital have been incorporated into the village, there is nothing left of the children’s unit whatsoever – you would never know it had been there.

On the whole, I think this is very positive.  To my mind it is quite right that a place where children were subjected to unpleasant institutional ‘care’ should have been ‘rescued’ from its dark history and put to new and better use. There is a sense in which Merrifield has been ‘redeemed’. 

Merrifield was an institution where children with a wide variety of mental health disorders (and sometimes with no real disorders at all!), were placed in isolation from normal society.  It was common practice to drug these children excessively, and often inappropriately, with no thought to what these substances might do to the developing brain.  Some children were also occasionally subjected to abuse, and many were treated in a generally punitive way, as though being depressed or anorexic, for instance, was some sort of moral offence.  But the site where these things happened is now a housing estate, providing homes for individuals and families.  It has been saved from its past.

Of course, not all of Merrifield’s former patients can say that they too have been saved from their past.  While some have made substantial recoveries from their original conditions and also overcome the trauma of their time in residential psychiatric care, others have had their lives permanently blighted by the way they were once treated – even if that treatment was well-intentioned.  As a former Merrifield patient myself, I can say that I am very lucky, having been able to live a relatively full and satisfying life since leaving that place – though I am still very much haunted by my memories.

This introduces another aspect to the demolition of Merrifield – and places like Merrifield.  While it is good that the unit is gone, having been replaced by something of greater community benefit, I have one particular concern connected with its destruction.  There is now no concrete reminder at that place of what once happened there.  While there are many adults still troubled by their experiences at Merrifield, there is a sense in which the evidence for these past traumas has been swept under the carpet.  While few people would have known of Merrifield’s existence when it was open, now there is no sign that the place ever existed at all. 

And so I conclude with a challenging paradox.  It is good to build over a place of past distress with something new and positive.  But it is also bad to bury the past as though it never happened.  In rescuing places and people from troubled histories, we should still remember those histories and learn from them.  How else can we make sure that history is not repeated?

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Delivered Unto Lions by David Austin is published by CheckPoint Press

ISBN 978-1-906628-21-5

For more information visit www.davidaustin.eu