For those of us who grew up in the Sixties and Seventies, lunatic asylums were part of the landscape. 'You'll end up in the loony bin,' kids used to taunt each other in the playground (round our way it was Claybury, but everyone had one). The local asylum loomed in the imagination, as it loomed in reality: a forbidding institution behind big gates, fortified with shrubberies, in which, almost certainly, wild-eyed inmates lurked with drooling mouths.
Today, fewer than 20 of the original 120 Victorian asylums remain. But their patients are still with us, if in diminishing numbers with every passing year. Many spent decades inside and consequently know far more about asylum life than any of the staff who worked with them. And when they talk about their experiences, themes emerge, not least the constantly renewed faith of doctors in a series of 'miracle' treatments. From insulin therapy through ECT and psychosurgery to Prozac, there was always some fashionable cure. But in practice, treatments were often simply a means of containing troublesome patients.
And who would not be troublesome? - especially if, as many were, you had been locked up for having sex before you were married, or for being gay. Often the diagnoses that got people put away were meaninglessly vague: imbecile, or feeble-minded (where the only proof might be having got pregnant out of wedlock). Not that the asylums were uniformly, still less intentionally, cruel. Some former patients remember the beautiful grounds, the friends they made, the optimistic dedication of doctors and nurses.
Asylums were places for people whom civil society could not accommodate, largely because of its own limitations. In practice, that meant that their families couldn't cope. Most had some crisis for which families simply couldn't summon the resources. Those who are alive and able to recall the banging on the windows and cold baths are survivors; many died behind the locked doors, and some are still unable to talk about their time inside.
Mental Health Media, a charity that works to improve the way that people with psychiatric diagnoses are seen, set out to record the life stories of 50 former asylum patients a couple of years ago. The tapes - which average four hours and often exceed six - now form part of the National Sound Archive at the British Library, providing a variegated view of asylums from 1925 to 1985 and a vital piece of oral history of Britain.
Today, most former asylum patients have been decanted into the community. For some it is their first experience of life in the real world: it was not unheard of to move straight from children's home to asylum and only acquire your own space in your sixties. The overwhelming impression, when you listen to former patients, is of the coercion and restraint of people who were unable to articulate their feelings, or were trying desperately to do so but no one was listening.
Users of mental health services, as we are now encouraged to call them, may live today in comfortable flats instead of locked wards (though they may equally live in squalid bedsits). But it is doubtful whether the number of nurses with time to sit and listen to them has gone up, or that the rest of us are doing so, any more than we did when the 'loonies' were locked away.
Annemarie Randall
Annemarie Randall was born in June 1941 on Hackney Road, in east London, and never knew her real parents. She was adopted by a couple from Kent, but her new mother died of TB, and her father remarried a woman who frequently hit her. 'I learned to hide my feelings, because if I cried, I was hit.'
She left school - where she had been reasonably successful at English and maths, and good at games - at the age of 14, to work in a greengrocer's. At weekends, she also worked in the Naafi in Gillingham, where, when she was 15, she met a 21-year-old military policeman in the Royal Engineers called Brian Marks.
They married the following year. 'He broke my jaw twice. You didn't say so, though, in those days, and there was no help for you anyway. I used to say I'd fallen over.'
Annemarie had a baby, whom she called Donna Louise, who lived for 17 hours. Then she had another child, Laura Jane, who died when she was three days old, 'a Thalidomide baby, although we didn't realise it at the time'. Finally, she had a son, Robert - six weeks early, but healthy.
When Robert was six, his father 'brought his girlfriend to the house. She was preggers, and he wanted her to live with us until she'd had the baby. I packed my bags, and told Robert to get his things, and we left. We went to Hackney Road. It was the only other place I knew of. It was a good time. I set up a catering business, doing weddings, birthday parties, cake designing. We lived in a two-bedroom flat. We had what we wanted and how we wanted it. I was trying to keep my head above water, working, earning a living and keeping things going for Robert. I was determined he was going to have a good life.'
For his twelfth birthday, she bought Robert a bicycle. The following day, he was killed by a hit and run driver. 'For years and years I blamed myself for buying that bike. I started shutting the world and people out. He had a good life till he was 12, bless his soul. We had a car and we used to go out together. I helped him with his homework. He helped me with the catering business. He was one of my waiters. He was taller than me when he died, though: he was 5ft 10in.
'Afterwards, I was completely broken. He was my life story - someone to work for, someone to do things for. The solicitor wrote to Brian, to tell him, but he'd remarried. He didn't come to his own son's funeral. So I was really on my own. My father was dead. My stepmother didn't want to know.
'I gave away a lot of stuff and left the flat, just wandered. I'm not proud of it, but I abused my own body. I stuck a bread knife in myself 11 times and opened up all my arms. I wanted to punish myself all the time for buying that damn bike. I had no pain, no nothing.'
Annemarie returned to Kent. 'I just drifted. Then one day the police picked me up near Chatham and put me in hospital. They told me I had to stay there because I was a danger to myself. I attacked myself with razor blades, broken bottles; I used to put my hands through glass.' She shows her arms and her wrists, criss-crossed with long scars.
The hospital was Oakwood, near Maidstone, where Annemarie was prescribed insulin therapy. 'They thought that was good therapy, many moons ago. They'd inject you with insulin and you'd go into a coma. Then they'd wake you up and feed you, and after you'd go back to sleep. But it frightened me all the more when I woke up and remembered. I was depressed, but I didn't understand that then. I couldn't tell anyone because I didn't know how to trust people, and I thought it was wrong for them to know about my life.
'I found the nurses a little bit brutish, I don't know why. They were very strict. And if you didn't do what they said when they said it, you got put in a side room, and I got put in a padded cell a lot.
'I was given ECT. I didn't sign up for it. I was told I had to have it, and I had no one to fight the battle for me. They said it made you forget, but it was worse afterwards, to be frank, when it all came back. I used to think, Why haven't I got anybody? And I used to hate Annemarie more and more.'
She spent four years in Oakwood. 'I used to do runners - say I was going for a walk and jump on a bus and go to the seaside. Over the years I escaped from hospitals and went to Manchester, Birmingham and Liverpool. But I always got picked up again.'
When Annemarie came out of Oakwood, she moved to London. 'I thought you could make your living there, but I wasn't prepared to be a prostitute or anything. I found it hard going. I still couldn't settle.' While flitting 'from hostel to hostel, bedsit to bedsit,' she met an older woman. Pat, who was sick with cancer, and nursed her until she died. 'I wasn't going to let her be on her own. I knew what that was like.'
After Pat died, Annemarie 'felt as if nothing could hold me any longer. I saw myself as a jinx. Anything I touched fell ill or died. The police found me on a park bench, slitting myself open with a dirty bottle.' She was taken to Banstead Hospital, in Surrey, for more ECT, and stayed there for 10 years. 'It was better in Banstead. They listened more. I worked on the hospital radio. I'd meet people who phoned in to say they were having a bad time. I got quite a lot of friendships that way. I enjoy helping other people, but I cheat, because at the same time it helps me.'
Banstead closed in 1989 and Annemarie was transferred to the Gordon, a small hospital in London. Today, she lives in a hostel in Westminster, with her cat, Flo. She has to take 25 pills a day for her heart and to control her blood flow (she has had two cerebral haemorrhages), but is no longer on any kind of medication for her mental health. 'All the treatment I had didn't make any difference. I was on so much dope at Oakwood; I was just given pill after pill and I didn't know what they were for. I couldn't go out in the sun because I'd burn to buggery, and I ballooned up on another one, got a moon face and everything.
'The one thing that would have made a difference, I think, would have been someone to talk to. That was what I was always wondering, when I went into hospital: would there be someone to talk to? But I used to shut myself off. Maybe if depression had been explained to me earlier...'
Annemarie has ferociously bright eyes and exuberant levels of energy. When she was refusing to be docile in hospital, she would have been a handful. But how difficult can it have been to see what she needed? Even now, she lavishes affection on her cat, and seems more interested in her than in herself. She says she is waiting for the cerebral haemorrhage that will kill her. 'I didn't used to have much faith in God when the kids died. I used to think he was a horrible bloke. When I wanted to die, he didn't want me, the old git. Now he's practically telling me he's got room for me, he can blooming wait.'
Edna Martin 'Twenty years of hell,' is what Edna remembers of asylums. She was born in 1923 in Crumpsall Institution, a former workhouse, and brought up by her grandfather, a Salford alderman. When she was nine, she worked out that the woman who occasionally came to clean her grandfather's pub was her mother.
Edna's grandfather had had his daughter locked up in a mental hospital for having two children out of wedlock. Her older brother took her to see the woman they called Emily. 'I said "Hello, Mum," and she broke down. We both cried. She had a teddy bear for me.' One of Emily's sisters eventually got her out of the hospital, but she never lived with her children.
At the age of 15, Edna 'met this man. I went to his house. It wasn't abusive, no, because he showed me affection, and no one had ever done that before.' But her grandfather saw them going into the pictures together, and called the police. 'They said, did I have intercourse? and I said, "What's that?" Nobody talked about it. I had no idea what they meant.
'That Monday, I was taken to the juvenile court, and they asked my grandad, did he want me home? And he answered: "No. Send her away, shut her away for the rest of her life. I never want to see her again." And he didn't.'
(Her boyfriend, who was 62 and married, committed suicide before his scheduled appearance at the Assize Court a couple of months later.)
Edna was taken to Parkside Approved School. 'I played up. I didn't think I should be there. So before my eighteenth birthday they brought in a psychiatrist to see me and he diagnosed me as an imbecile, a mental defective and feeble-minded. I was transferred to Calderstones, which is where my mother had been.
'I thought to myself, "I'm not, I'm not those things", and I retaliated against everybody - the doctors, staff, everybody. So I got put in a side ward and I got doped for it. They gave you paraldehyde to sleep at night, but if it was for punishment, it was the needle.
'I was put into a dormitory with women who were getting into bed with each other. I didn't know what they were doing, so I asked. And when I found out I told the staff I didn't want to stay there, but they said I had to, so I smashed the window of the sewing room with my fist.
'I was put in a straitjacket on the isolation ward. I was naked underneath: they kicked the chamber pots into you and you had to manage as best you could. The windows were shuttered, so it was dark. They also kicked in your food on a tin plate and you had to eat it off the floor.
'They used enemas for punishment. I was once sitting with my legs up under me, and a nurse pulled out the chair from underneath me so I fell on the floor. I asked what she'd done that for, and she marched me to the bathroom.'
It was widely believed in Calderstones that if you could get sent to Rampton, you might get out quicker. Edna transferred to Rampton before she was 21; she remembers having her twenty-first birthday in there, because her grandmother (who was illiterate, and under the thumb of her husband) sent a cake. It was the only time her birthday was acknowledged, in the asylums or at home.
'Rampton was worse than being in prison. Bedtime was between 6pm and 7pm, and then the doors were locked until 8am. There was no privacy. There were two baths, and the nurse would stand in the middle and, all the time, she'd be passing remarks about your body. They thought nothing of giving you a cold water bath for punishment. Or they'd get a wet bath towel, put it under a cold tap, twist it, and hit you with it. I was very angry, because I knew I shouldn't have been in those places, but my grandfather had said he wanted me locked up for ever, so I thought that was what would happen.'
Edna stayed more than 10 years in Rampton, during which she had almost no sense of the outside world. 'We knew there was a war going on, but that was it. My brother said he was trying to get me out, and I went before, like, a committee, and they said "Do you want to go?" but I'd got that institutionalised I didn't know whether I did or not.'
She also spent eight years in Ashworth, which was then called Moss Side - 'and it was just like Rampton' - before her brother arranged a transfer to Borough Court, in Reading, close to where he was living. This was an open hospital, where she looked after mentally handicapped children - 'there was two boys, and I really loved them' - and began to adjust to going out and using money.
The 1959 Mental Health Act ended certification, and Edna - who had never received a different diagnosis from her original one - was told that she was free to leave. For 10 years she lived in digs in Reading. She worked in Woolworth's, and an engineering works. At the age of 49, when she was visiting her mother in Blackpool, she met a neighbour, Bill Martin.
Bill was 60 and had lived alone since he was 22, when his young wife had died in childbirth with their baby. 'We married on 28 March 1973. He was one of the best men you could ever meet. He told me he was impotent before we married, and I said "Well, that doesn't matter". I always said I wanted Bill, and if I couldn't have Bill, I wouldn't have nobody.
'We had a great marriage. He looked after me. We had wonderful holidays. He died of a heart attack 11 years after we married, and I was really scared, wondering if everything would go back to how it was before. I couldn't manage on my own. I used to get depressed, and walk around the town at midnight.'
Edna eventually got into a Mind hostel in Blackpool, where she lives now. She sits on the executive committee of her local branch of Mind, goes on holiday with them, raises funds, and has attended conferences. 'In Brighton, someone there was speaking about abuse - and I remembered that, when I was 13, I had an operation on my toe. Afterwards my uncle used to carry me up to bed, and he'd come to me in the night, and he'd always say he knew who my father was. He was married to one of my mother's sisters, the one who wrote letters saying she didn't want me to come out of the asylum. There were rumours about him being my father - I don't know how true they were.'
In recent years, Edna has been reunited with her cousins. She has also become a devout churchgoer. 'I don't feel bitter. I can't explain it really, but I felt if I wanted to become a Christian, I had to forgive. It was very hard, but I did. I never think about my grandfather now.'
Derek Hutchinson Derek Hutchinson's mother was an alcoholic and used to lock him in the coalhouse overnight. His father was a bare-knuckle boxer. They had Derek in 1946, and he grew up in Leeds, developing a reputation for being a tearaway, the boy who'd always do the naughty thing. 'If you think what kids get up to, I used to get up to it, because I didn't know any better, basically.'
His parents had no control over him - 'All they did for us really was bring us into the world' - and, from the age of 10, he was in and out of approved schools. He had a high IQ and he was talented at football, rugby and boxing, 'but those places, they knocked violence, embedded it into you'.
In his late teens, when he was working as a welder, Derek had a motorbike accident that left him with one leg shorter than the other and killed off his chances of becoming a professional sportsman. It was a terrible disappointment. It did mean, though, that he met his wife, Ruth, a nurse. 'I'd never met anybody, never been involved with anybody, who'd cared about me, who'd had my welfare - or thought about me, and she did, for some reason.'
They married in 1967, and had three children. 'We were happy. She went to church and I went to the pub.' But, in 1973, Derek was followed by the police when he was driving a mini-van without a licence. He can't precisely remember what happened after that, but recollections of Borstal flooded back and he suffered some sort of black-out. 'Ruth says I came in like a zombie. I couldn't speak, couldn't rationalise.'
He thinks now that he was suffering from mild depression, triggered by memories of his adolescence. But he visited his GP, who sent him to High Royds, the local psychiatric hospital. 'All I remember is waking up in that place. Once those people have got you, there's not much you can do: you're powerless.'
Derek was given 10 sessions of ECT and prescribed Largactil and other psychotropic drugs. His psychiatrist, Dr Todd, suggested that it was time something was done to control his aggression. Derek objected that his aggression had never been irrational, 'but this Todd said, "How would you like to be responsible for the death of one of your children?" I told him there was no possibility of that, but he said that violence was self-progressing, and I could hit one of my kids and they could die afterwards. I couldn't allow that to happen, no matter what. So then he said that there was this operation.'
This operation - 'the stimulation and destruction of the posteromedial hypothalamic nuclei in restless and aggressive behaviour' - had been pioneered in Japan by a neurosurgeon called Kajo Sanno. Only much later did Derek discover that Sanno had been struck off when all the patients on whom he tried it had died. He was told at the time that 12 people had had the operation in the UK; he has tried subsequently to track them down. 'I've only found one. He's in a private nursing home and can't speak.'
The neurosurgeon who was to carry out the operation, a Mr Wall, had worked - presumably with Sanno - in Japan. He explained that the procedure involved inserting, under anaesthetic, two nylon balls into the scalp and guiding rods through them into the brain to burn out the areas that were 'responsible for aggression'.
After the insertion of the balls - 'which involved pinning back a flap of my forehead' - Ruth was so horrified by Derek's appearance that she refused consent for the second part of the operation. Dr Todd himself went to visit Derek's mother. 'He went at 8pm. He knew she was an alcoholic, and by then she'd be out of it. Even though she didn't care about me a lot, she wouldn't have put me in that sort of danger if she'd known what she was doing.'
But she signed the forms, and, for eight-and-a-half hours, Derek was operated on while awake. (Knowing how far to go with the procedure apparently required the surgeons to watch the dilatation of his pupils). 'The only thing I can liken it to is having a tooth out without anaesthetic, putting a needle in to the nerve, wiggling it around and then burning it. I felt I'd been hit on the head with a sledgehammer, and then as if I was cooking.'
The operation did not make Derek less violent. One of his first actions after returning home was to storm into High Royds and physically attack Dr Todd. The hospital did not press charges. 'Previously, I might have got into a fight, but now I would plan violence. There was stuff going through my brain that's not the stuff people normally think about. I can't say what, without making myself seem a monster.' He came close to shooting somebody, and almost firebombed a house. 'I was meticulous about planning it. I came close to killing that man.'
Derek and Ruth had two more children, twins. But in 1978, while the rest of the family was out at church, 'I just walked out. I couldn't bear the thought that I might hurt one of my kiddies. But it didn't make sense. We'd been married 13 years and had five kids.' He is still close to tears when he talks about it.
For a couple of years, Derek lived with his mother. Then he met Carol, a single parent, and married her. 'She has looked after me for about 20 years. No one could have done it better.' She is evidently devoted to him: she explains that he is extremely sensitive to temperature and passes out if he gets too hot. He has no appetite and could happily go two weeks without eating. His short-term memory is terrible, and he often picks up the telephone, dials a number and forgets whom he is trying to call. His sleep patterns are disrupted: he naps throughout the day and wants to be up talking at 4am. He has had repeated flashbacks - which he now believes to be post-traumatic stress disorder - ever since the day of the operation. 'Sometimes I go through it 12 times a day. I know exactly which instrument Wall is going to ask for next.'
Dr Todd and Mr Wall are both dead. Their attempts to control aggressive behaviour by removing parts of the hypothalamus seem to have ground to a halt shortly after Derek's operation. 'You can see why they wanted to believe in it. An operation to control behaviour would be a breakthrough. There are still neurosurgeons who believe they will be able to do this. But they don't know where the mind is located in the brain and, unless they know that, how can they judge what they're doing?'
Derek has seen a letter in which Dr Todd advised Mr Wall that he would suitable for the operation because he had 'no gross psychological abnormality'. In which case, he asks, why did they butcher his brain? He has started an organisation called Scalps (Survivors' Campaign Against Lobotomy and Psychosurgery) and spoken at a conference in Germany. He has been invited to Paris, Japan, Holland and Australia. For the last year, he has received counselling for his PTSD, which seems to be helping. He helps out in the primary school along the road, and has 15 grandchildren, to whom he is devoted. He doesn't believe he was ever seriously mentally ill before the operation. 'But you can't put up a defence, if you're going to be mentally ill,' he says; 'because it just comes, and it can come to anybody.'
A video of former asylum patients talking about their experiences is available from Mental Health Media (www.mhmedia.com 020 7700 8171) at £19.95, or £14.95 for voluntary organisations. Mind information line: 08457 660163