Mad Worlds
Page 27
He’s talked with Mac about the suicidal thoughts he had. Thank goodness the means didn’t present. Mac reckons that if life gets bad or meaningless enough for anyone, doing themselves in can seem the best move.
He’s also read about The Samaritans, a movement started in London by an Anglican priest who believes talking in confidence with somebody can help folk feeling suicidal or upset. He wants to get a similar service going locally.
His anger is often near the surface. The savagery and oppression in a supposedly caring institution with ‘hospital’ in its title, the destruction to lives, the waste of talent among his fellow patients. But he no longer feels bitterness on his own account. Without the passage through Springwell, he might still be teaching, with a breakdown about to happen. As it is, he’s enjoying work that he’s suited to, and that allows him to find time for reading and study.
At home, he savours being with Heather and their children. Life was unexpectedly rocky at first, and he owes Maggie for her work – listening to him and Heather and helping them sort things. Becky is settling in at school. He’ll always carry the pain of missing out on a year of her infancy. Heather says she loves the work at nursery. Now NNEB-qualified and Deputy Matron, this is her career – interrupted only by the births of their two youngest. Her pay’s not great, and neither is his, but they manage. And the child benefit’s a bit of a life-saver.
Right now’s not brilliant for Heather. She’s spending a lot of time with Elsie across the road. Mattie has died and the funeral’s tomorrow afternoon.
John’s not looking forward to it. There’s a good chance he’ll cry. He liked Mattie, and spent time with the old man in the latter stages of gasping with emphysema.
Perhaps it’s this triggering him into melancholic reflection – re-playing his childhood bereavements. And his whole being shakes at re-living the scene of Dave’s parting “See ya bruv”. A happy moment preceding unspeakable loss. This is the memory that gets him weeping. He’s not told Mac of his intensifying sadness, but he will. Hopefully after tomorrow he’ll pick up. And if he’s descending into depression, he’ll contact Dr Singh, his consultant at outpatient clinic.
After the kids were in bed last night, he and Heather had a weep-in. Not just about Mattie, and Dave. Heather’s lamenting Edward, the brother she never knew, and her parents having to move into a home for the elderly mentally infirm in Aversham. He never got on with her folks, but he wouldn’t have wished that on them. Heather really feels for Elsie, who befriended her and Becky while he was in Springwell. Elsie dotes on Becky and is great with their other kids. She’s like a grandma – and in fact, at Heather’s suggestion, they call her Grandma (and Mattie Grandpa). Heather’s own parents are Granny and Granddad.
He’s studying the history of mental health law and policy as grounding for his MA thesis at Manchester. He learns that in their nineteenth-century conception, the city and county asylums were built to provide a haven (‘asylum’ being Latin for ‘place of refuge’) for mentally afflicted ‘lunatics’. From 1930, the change of title to ‘mental hospital’ signalled the main intended purpose as caring. He notes that sadly, with few exceptions, the institutional emphases were (in line with prevailing public attitudes) on containment – locking eccentricity away from the public and using physical restraints, sometimes brutality, to keep control.
Part Two of his memoirs will focus mainly on the radical changes at Springwell, pioneered by Jamie Macdonald and supported by the Royal Commission findings and the ’59 Mental Health Act. As Chairman of the Friends of Springwell Hospital – a group Gill Macdonald set up and is active in – he has periodic meetings with Jamie, Deputy Medical Superintendent Lizzie McVeigh, Matron Caroline Dee and Chief Male Nurse Joe Macnamara, to review how the reforms are working out and discuss initiatives for involving the community. He admires Jamie’s dedication to creating a therapeutic environment for the patients, and to schemes ensuring that discharged ex-patients are supported. And Caroline, with her single-minded commitment plus strategic ability and vision of a caring hospital, is also inspirational in the Friends.
On the community schemes, Mac, who with Maggie heads up a department of eight social workers, plays an important part. Through Mac, John hears of Sam Newman, Aversham’s Senior Mental Welfare Officer – who, with fellow mental welfare officers from borough and county, goes monthly to the hospital’s social work department for training seminars and a review of discharged patients. The mental man! John has no ill feelings now (towards Newman) about being bundled off into Springwell. The man was doing a tough job, and on reflection didn’t seem the bullying type. Poor guy – apparently pretty crushed after being widowed recently.
John’s work for the National Association for Mental Health – he’s on their National Executive – will also feature in Part Two. He plans to continue part-time study for a PhD, surveying ex-patients’ experiences of their stays in mental hospitals.
The Macdonalds are now personal friends. He and Heather enjoyed an evening with them last week. A lovely couple, older than they. Jamie told him, over the after-dinner coffee, of their deep sadness at the miscarriages and, with Gill past childbearing age, their application to adopt.
An alarm’s going off upstairs. Without sleep, the day ahead – at the library, then the funeral – will be tough. But John knows he will survive.
The End
The 1950s English Mental Health Context:
A Brief Note.
The administrative settings and people’s job titles were different then. An outline of these should help you appreciate nuances in formal relationships.
Within the NHS were the Mental Hospitals – built in the 19th and early 20th centuries as the city and county asylums (and re-named in the 1930 Mental Treatment Act). In each of these the boss was the Medical Superintendent, a consultant psychiatrist by profession. The institutions varied a lot in their regimes. Many still reflected the harsh containment approach of most asylums, despite recent developments in drugs known to alleviate and control the worst behavioural symptoms of the major afflictions. Others (probably a minority) were relatively enlightened, with fewer constraints on patients’ behaviour and efforts to heal and rehabilitate. As you’d see in the latter part of this drama, a Medical Superintendent’s attitudes and personality would greatly influence the nature of a regime.
Within each local authority was the Health Department. Heading this up was the Medical Officer of Health (MOH), a public health doctor by profession. In the MOH’s empire were public health inspectors, health visitors, home helps, district nurses, midwives, and at least one duly authorised officer in mental health – the DAO (who carried enforcement powers).
Mental health liaison between hospital and local authority tended to be quite minimal. In ‘Mad Worlds’, at least our fictional MOH valued cooperation with Springwell, and DAOs could attend psychiatric lectures to student nurses. By the early 1960s, some close partnerships were developing – e.g. between hospital social workers and local authority mental welfare officers (as the ‘59 Act renamed DAOs).
The legislative context would soon change. Still in force was the 1890 Lunacy Act, reflecting a legal approach, with two main underlying premises – that only folk certified insane should be taken to an asylum, and that the public must be protected from such ‘lunatics’. To safeguard liberty, lay magistrates would be involved in certifying. The 1930 Mental Treatment Act modified this to allow people deemed ‘of unsound mind’ to enter as voluntary patients, and advocated the setting up of outpatient clinics. The name ‘mental hospital’ also came in then. By the 1950s in some areas the JP bowed to medical opinion. The DAO, with mental health knowledge and experience, was increasingly a key figure in emergencies. But the 1890 Act was not repealed until the 1959 Mental Health Act, which reflected a medical approach (without JP involvement) and was aimed at helping ‘mentally ill’ people. In 1956-7, when the main action in this novel occurs, the 1954-7 Royal Commission on Mental Health was yet to report, and have its mai
n recommendations adopted in the 1959 Act.
Bill Douglas
Acknowledgements
I have lived with and nurtured this novel from its conception through many drafts over several years.
I wish to express thanks to the many who have helped me at some time or another by commenting or simply listening. You are too numerous to be mentioned here. Among you are my children and their partners. My main support throughout has come from my wife and fellow-writer Elisabeth, an ever-patient listener with helpful suggestions.
I will mention others who also have read through and fed back comment (always constructive and helpful) on earlier drafts, or provided especially valuable resource material:- Margaret Brunskill, Peter Buckman, Ian Clark, John Cossins, Anne Eckersley, Barbara Fryers, Tom Fryers, Val Harrington, Tony Higginson, Patrick Janson-Smith, Richard Jones, John Nelson, Marjory Ramage, Chantel Scherer-Reid, Geoff Seale, Peter Sharkey, Rob Watkins.
I’ve drawn further support for my writing from Writers’ Bureau, Lancaster University (mainly my tutor and fellow students on an on-line starting-your-novel course), the writers agents publishers and book doctors I met at Writers’ Workshop and NAWG Festivals, and from Formby Writers.
Finally, my thanks go to the publishing team at Troubador/ Matador. It’s good working with you.
Bill Douglas