The Middy July 15, 1999

Compassion at the asylum

200 years ago, people with mental illness were social outcasts, left to wander the streets, hidden in attics or cellars by their families, or abandoned in prisons, workhouses or private asylums.

The infamous Bethlem hospital in London was the only public institution for the insane and patients were shackled and sometimes beaten.

The Sussex County lunatic asylum, one of the more liberal institutions of its day, was set up, like other lunatic asylums, to rid the streets of "pauper lunatics.”

Opened on St. James’ day, July 25, 1859, the asylum became Saint Francis hospital with the onset of the National Health Service in 1948.

Designed by London architect H. E. Kendall, the huge edifice was built on the south-eastern outskirts of Haywards Heath at a cost of more than £50,000.

The asylum, apart from the railway Common was Haywards Heath’s biggest employer sparking rapid development in Asylum Road (later Colwell Road).

The first superintendent, Charles Lockhart Robertson, was a compassionate Doctor who discouraged the use of straps and leg irons.

He introduced weekly balls with music provided by the patients.

Beer, later brewed on the premises, was part of the daily diet and male patients were encouraged to play outdoor games such as cricket, croquet and fives. Periodicals and books were also provided.

Robertson's institution became a model for others to follow. A reporter wrote in the Brighton Gazette on October 4, 1866: "throughout the building everywhere is cleanliness… Blankets, counterpanes.… strips of carpet near to each bed with scarcely a stray thread. The bathrooms, used twice a week were clean to a nicety. Vases with flowers, cage birds in the corridors, and even a small terrier and a cat, both great pets.”

The "cure" for lunatics was fresh air, a good diet and hard work and undoubtedly, some of the lunatic poor, no longer deprived of vitamins and shelter, made good progress.

The Victorian definition of "lunatic" was loosely interpreted to include social misfits and habitual petty criminals. It was rumoured for example that a Haywards Heath doctor’s two illegitimate daughters were secreted away at the asylum.

The cost of keeping a patient when the asylum opened was about 13s a week, but this was significantly reduced by making the institution virtually self-sufficient.

A farm and market garden were established in the grounds supplying meat, milk, vegetables and fruit. Male patient worked as farm labourers and gardeners.

They were also encouraged to learn a trade in the workshops, which included a shoemaker’s and a tailor’s.

Female patients worked in the laundry, kitchens and sewing rooms.

Arguably, the patients were exploited for their labour, but the work provided positive, occupational therapy.

As the 20th century dawn, the asylum contained almost 1,000 patients and overcrowding blighted the humane environment Robertson had tried to create.

Overcrowding was dealt with by sending long-term chronic or incurable cases to the workhouses in Brighton and Cuckfield where patients could be kept at a much cheaper cost to ratepayers.

The pressure which overcrowding placed on staff produced instances of alleged brutality.

Any injury to a patient was the subject of an internal inquiry. But the public findings all too frequently reported "no lack of care."

From time to time, patients escaped from locked wards but were quickly recaptured.

Albert Jenner fashioned a key out of an old brass button and Olive Burgess squeezed through a window pain measuring only 9 inches by 11.

With virtually no medication for severe depression, suicides inevitably occurred. In 1911, a patient jilted by his wife, drowned himself by submerging his head in a drinking trough containing a few inches of water.

Mary Ann Weston, died in 1901 after swallowing vast quantities of cherries "without mastication, causing acute dilation of the stomach.”

The First World War put added pressure on the asylum when ‘shellshocked’ soldiers were admitted as private patients.

By the outbreak of the Second World War there were between 50 and 60 military patients still at the asylum – most as a direct result of their experiences in the Great War.

The arrival of radio and electricity in the interwar years brightened patient's lives and, for the first time, categories of patients were allowed to wander the grounds or to go outside the asylum unattended.

For others the asylum meant a lifelong ‘sentence’.

According to asylum historian James Gardner: "one female admitted in 1861 at the age of 22, died there in 1924 aged 85. She had spent 62 1/2 years in the asylum. A conscientious council official calculated that she had cost the ratepayers £1,200.”

The Mental Health Treatment Act, introduced in the 1930s, was designed to eliminate compulsory certification and such a long term confinement by calling for clinical assessment before a patient could be admitted and certified for treatment.

Hurstwood Park hospital opened as an admissions unit for the asylum in 1938, but its role quickly changed.

During the War, surgeons, staff and patients were evacuated from the National Hospital in London and Hurstwood Park became a pioneering centre for neurosurgery with more than 2000 major operations being carried out.

ECT or Electro Convulsive Therapy was introduced at Hurstwood Park in the early 1940s, but without today’s range of anaesthetics a few patients sustained injury as well under treatment.

According to James Gardner, records revealed that one broke a leg and another died.

Compared to with today's range of modern drugs early treatments appear bizarre and life-threatening.

Insulin was given in controlled doses to induce temporary, convulsive coma is in patients with schizophrenia.

Patients in the advanced stages of syphilis were given mosquito bites to induce malaria. They result in high temperatures were said to relieve their manic attacks.

The introduction of the tranquilizing drug Chloropromazine in the early 1950s revolutionised the treatment of schizophrenia – paving the way for "community care.”

By 1995 there were just 100 patients at Saint Francis and the decision was taken to close the hospital.

In the run-up to its closure a bizarre event occurred. A long stay mental patient hijacked a hearse at the end of of a funeral service being held in the hospital chapel.

The patient drove the vehicle erratically to Wivelsfield before colliding head-on with another car outside the Royal oak. Miraculously, no one was seriously hurt.

The patient was said to be distraught about the prospect of going out into the community to start a new and uncertain life.

The new system of community care is not without its critics and low secure units continue to provide the best alternative for some patients.

At the end of the next year, a 26 bed unit for people with mental disorders is due to open on the Princess Royal site.

The cost of keeping one patient at the unit is estimated to be £82,000 a year compared to £676 when Saint Francis opened as the Sussex County lunatic asylum in 1859.

Hurstwood Park neurological Centre continues to expand. In 1994, plans were announced to move its services up to London.

But they were thwarted by a huge campaign in the Mid Sussex Times involving local MPs and a petition with 300,000 signatures.

Acknowledgement: James Gardner at the St Francis Museum trustees.