by Ian Wheeler
Service Class Patients
Military or ‘service’ class patients were accommodated in 1923, perhaps earlier, although numbers are not known until 1933, when eighty were present. Seventy arrived from Great Yarmouth in 1940, displaced in the face of wartime priorities. These men enjoyed extra comforts and privileges and the overall impression is that the military normally looked after its own.
Children
Minors with severe learning disabilities were accommodated up to 1930, when Berkshire and Oxfordshire County Councils jointly set up the Borocourt Institution, in nearby Peppard, to provide more appropriate care: however, recognised classes such as ‘idiots’, ‘imbeciles’ and ‘cretins’25 were not directed to Moulsford as a matter of course. In 1896, Dr Murdoch complained of having to house hopeless ‘congenitally defective, epileptics … demented and aged … idiots and imbeciles’. He was not unsympathetic towards them but felt that the asylums were being used as an easy and unsuitable solution that imposed a burden on his undertaking.
The asylum authorities were generally uneasy about taking in children. In February 1875, an 8-year-old boy from Abingdon was listed as being almost ready for trial discharge. Superintendent Gilland wrote, ‘It is very important that he should be sent to school’. A December 1908 entry in the Visitors’ minutes contains a resolution that it is undesirable that children associate with adult patients of either sex. Children nevertheless found themselves in the BMH at times; in 1931 Commissioners Hodgson and Adamson noted, ‘In Male 8 we saw a boy of 8, a trainable imbecile, who has improved considerably since admission but who should be dealt with under the Mental Deficiency Act and removed to an institution where special training can be afforded.’ The most recent instance discovered in this research was in October 1944, when three children with learning difficulties were being cared for. Visitor J.L. Etty commented, ‘I am strongly of the opinion that boys of 15 or less ought not to be housed with adult patients’. The reason was a lack of accommodation elsewhere and the Commissioners clearly sought to remedy this.
Geriatrics
Problems associated with old age were handled at the asylum from its earliest days and mention has already been made of feeble souls being transferred from the workhouses, where the necessary support and understanding could not be provided. It is tragic that many of these problems were rooted in malnutrition and the harsh workhouse regime. There is a telling comment from 1926, when sixty-eight out of 146 admissions were from Poor Law Infirmaries and others were from home: ‘With regard to the former, we thought that a fair proportion of the senile cases might with adequate nursing have been properly dealt with in infirmaries, without removal to a mental hospital.’
Thankfully, we live in times that address dementia more sympathetically and with better resources.
Voluntary Patients
The Mental Treatment Act of 1930 permitted voluntary admission to mental hospitals, although the available archives make little mention of the subject. In 1936 the Commissioners seemed almost disappointed that the number of voluntary and temporary patients was low, questioning whether GPs and relieving officers ‘… are not making nearly as much use of the Mental Health Act 1930 as they properly might’. If they were touting for custom, they would have been pleased with the 1939 figure of 25 per cent of cases, any celebration being dampened by curtailment ‘for want of adequate accommodation – which is regretted’. Voluntary patients remained a feature of the hospital’s activities until its final years, although the proportion was not always as high.
Needless Incarceration
The author has often been asked, or told in general terms, about unfortunate individuals who were confined to a lunatic asylum on the slenderest of pretexts – the first of which is invariably pregnancy out of wedlock. There is an immediate difficulty in answering this question because so many of the patient records remain closed; no evidence of such events has been found to date. What seems more likely is that the unfortunate women were suffering from what we now recognise as post-natal depression or one of the infections that can attend childbirth which, perhaps adding to stress and humiliation, temporarily unbalance the mind. Mark Stevens, Senior Archivist at the BRO, offered his opinion that Victorian sensibilities were robust enough to recognise that ‘fatherless’ babies are a fact of life. If we also consider the conditions that had to be satisfied before the Bodies in Union were prepared to spend public money on care and rehabilitation, the chances are that instances of families having their errant daughters ‘put away’ were either exaggerated or very few in number.
Depression, sometimes described as ‘laziness’, caused individuals to remain at the asylum for extended periods and could be seen as unjust cause for confinement. Such cases could lead to patients becoming institutionalised and losing their ability to cope with the world outside.
The present-day availability of effective drugs and other therapies tends to distort our perceptions of what was considered acceptable and possible a century ago. No doubt future research on the Fair Mile archives will have a few surprises for us all.
Daily Routine
Mary Fairbairn (see Chapter 10) left a description of her ward’s weekday routine in the 1930s. This began with day staff arriving at 7 a.m. for breakfast. At 7.30 a.m., after checking dressings, wet beds and suicidal patients, they took charge of the ward from the night nurses, who would have got the patients up and dressed. Patients took breakfast in the Day Room and all the cutlery was counted before they could leave. Medications were issued at 8.15 a.m., after which the ward had to be tidied and cleaned, assisted by those patients who were willing and able.
After 10 a.m., there was time for outdoor exercise or indoor handicrafts and a tea break, before working patients were escorted to the workshops or gardens by Occupational Therapy staff. When they had gone, there was equipment to clean and sterilise and, on visiting days, a change of uniform so as to look fresh and smart.
‘Dinner’ was at about midday, staff taking their meal at 1 p.m., after which outdoor exercise was again encouraged until 3.30 p.m. Supper arrived at 4.30 p.m. and there was time for newspapers, radio and games while nurses attended to the more needy patients, who were sometimes segregated in the side rooms.
Another round of medications, laxatives, painkillers and so forth was followed at 6.30 p.m. by cleaning and tidying, sorting out the next day’s clothes and getting everyone ready for bed at 7.30 p.m., with everything ship-shape in time for the night nurse to take charge at 8 p.m. Needless to say, the night attendant did not always enjoy a quiet time!
Creature Comforts
Luxury was never on the hospital’s agenda but decent standards were always desired, if sometimes a little slow in arriving. November 1934 brought criticism of uncomfortable chairs and obsolete beds, hopefully to be gradually replaced. Some of these matters took years to be resolved.
A patients’ canteen was opened in 1931 or early 1932 and operated on three days a week, selling tea, sweets, tobacco, oranges and other treats. It immediately proved very popular and was well stocked and well run, attracting favourable comments from the Commissioners. In 1935 they suggested that ice cream would be a good line in summer, perhaps sold on the cricket field. The canteen showed remarkable resilience in the face of wartime rationing, rarely suffering from shortages.
Sweets were popular among those with money to spend, which prompted Commissioner Devas to comment in 1945:
We discussed with Dr Ogden the question of the patients’ sweet and chocolate ration, and asked him to consider whether something could be done to ensure that no patient was without sweets or chocolate because of lack of money to make a purchase at the canteen. In many hospitals now the ration is issued free as part of the hospital dietary.
In 1957 there was a suggestion of modest pocket money for just such purposes as this.
The hospital’s League of Friends came into existence in 1953 and did much good work to improve patients’ lives by funding a range of equipment and indulgences, and by run
ning the canteen on six days a week.
Clothing and Personal Effects
Whilst we don’t have much detail of hospital clothing, it is clear that it was functional first and stylish second. Realising that self-esteem was important, the Commissioners were keen to see a change to more attractive apparel. In 1924, Commissioner R.H. Trevor criticised the absence of nightshirts for men and the ‘skimpy’ nightdresses worn by women, adding that he also thought more slippers should be supplied. The next year, Commissioner Rollisham observed patients in the open air and complained that neither they nor staff were supplied with overcoats. ‘This should receive early consideration from the Committee.’
Women patients had a choice of modern styles of clothing by 1935 and could choose their own pattern, made to measure. Undergarments had been similarly updated, either by alteration or replacement. Women also got thinner stockings of various colours. Men were wearing light-coloured socks but it was hoped that dark ones, as worn outside, could be made available.
It is rather shocking to learn that, despite promises to the contrary, patients’ underwear was ‘pooled’ as late as 1959. No doubt the marking, sorting and delivery of personal items was a logistical headache in an overstretched laundry but, out of concern for patients’ dignity, this shortcoming attracted just criticism. This apparently did not apply to private patients, who wore their own clothing from at least the 1930s.
Hanging space for clothes, already an established issue, was still non-existent in 1935, even in the newly completed Villa, but was to be provided for some wards. The practice of rolling clothing into bundles at night – overcoats in particular were mentioned – was still normal. During her 1936 visit, Flora Calder, one of the Commissioners, saw bedside lockers for personal possessions in most of the wards and was moved to comment, ‘the spectacle of female patients walking in the ward gardens with a bulky bag containing all their small belongings is now conspicuous by its absence.’ However, this shortcoming affected male wards into the 1950s.
Men’s outfits were moving towards sports jackets and flannels in 1939 and looked smart when ironed. Women’s clothes were seen to be attractive and soft but destructive patients still had to wear heavy-duty clothing. The next year, the hospital was criticised for not allowing patients to wear their own clothing, as was the practice elsewhere: laundry difficulties were cited and, given the dire state of the laundry (see Chapter 3), the reason was probably valid.
Personal Grooming
The basics of personal appearance were important but largely limited by the abilities of the nursing staff and patients themselves. A hairdressing salon was installed on the Female side only in 1950. Basic services were free but patients had to pay for perms and suchlike. Meanwhile, the men were still shaved only twice a week, although the Commissioners suggested a minimum of three times.
Complaints
One of the Commissioners’ duties was to hear any complaints from the patients; there were typically very few, other than the expected objections to being detained. They regularly commented on the atmosphere of care and consideration for the patients’ wellbeing and the cordial relationships between patients and staff, although a few exceptions may be detected in some of the anecdotes offered below.
Outings and Visiting Days
Vera Wheeler (née Talbot) was born and grew to adulthood in the Lodge and has contributed a good deal of information to this account. Here are some of her recollections of the patients from the 1930s and ’40s:
On a couple of afternoons a week, there was what was known as ‘the walk’. Patients were taken out – probably between 20 and 30, accompanied by uniformed staff – and they walked from the hospital to the village and back again. Whether they visited the shops – if they had the money to do so – I cannot say. Male patients had their walk on different days … and again, they were supervised by uniformed attendants. I always felt a little sad for these people, and of course a lot of them were left in the hospital because their families did not want them home. Some didn’t want to leave; they had been there so long that the hospital was their home, and the staff did their best to make it home for them. I remember one male patient whom I had known for years, got dressed up every Saturday and went to Reading by train, probably to watch football, but eventually it was decided that he really should be discharged. He was distraught … took himself down to the river via Ferry Lane, where there were plenty of people about, and laid himself down in the shallow water at the bottom of the lane. Someone raised the alarm; a member of staff collected him and, after a short time back behind locked doors, his life resumed as it had been for years. He was happy there and had no responsibilities and that was how he wanted things to continue.
On Sunday and Wednesday afternoons, visitors would arrive by bus. Contrary to normal practice, the main gates were closed and locked before the arrival of the buses; the visitors would wait until the gates were opened and they would walk down to the front hall. I imagine staff would accompany them to the appropriate ward to visit their relative. Visiting was, I seem to remember, only 2–4 pm, and certainly only twice a week.
Every weekday morning, the ‘hooter’ was sounded. This was not an unpleasant sound (unlike the one that took its place after the war) and could be heard on a still day as far as Wallingford. The 8.35 am sounding went on for about 30 seconds and was presumably to let workers know that they were ‘on the hurry up’ to get to work in time. If the hooter sounded at any other time it was because a patient had absconded. All off-duty staff were expected to turn up at the hospital to find out who was missing and in which direction to search. I never remember anyone being out for too long, unless they had decided to go into the river; this did occasionally happen. My father told me about one patient, completely harmless, but quite an old man, who walked out one day and, search as they might, the staff could not find him. That night there was quite a severe frost and they were all concerned for him but, before the search could resume the following morning, he walked back into the hospital, stark naked. When asked where he had been, he simply said he had been ‘out for a night’s bleaching’. He didn’t get even a cold. They bred them tough in those days.
Until after WW2 there were not many drugs for treating mentally ill patients, so some of the more disturbed people were housed in ‘side rooms’. These were rooms off the gallery, which was the long, highly polished ward with chairs along either side. The ward kitchen and dormitory were located either side at the end of the gallery. There were padded rooms where patients who would be likely to harm themselves were housed until they calmed down sufficiently to be back on the ward. Windows were covered with wooden shutters, and someone yelling their head off and banging the shutters was almost my lullaby as a child; certainly, visitors to our house found it a little noisy at times. We didn’t notice it. Once the tranquilising drugs were introduced, there was little need for the side rooms, and I believe they were used as bedrooms for the nurses.
Some Anecdotes from the Author’s Collection
After some consideration, a few tales from the asylum are offered as impartial illustrations of the real-life struggle between different realities. Consider, if you will, that even what we call normal life often contains events more bizarre than any of these.
During Dr Gilland’s tenure, a severely withdrawn and depressed man was, at length, placed in front of a harmonium, which he gradually began to play. As time went on, his evident musical talent was rediscovered, until he was arranging and transcribing music for use by the asylum. On his discharge, Dr Gilland regretted the loss of his very useful abilities.
A male patient persistently hallucinated, seeing pigs’ heads appearing out of the ground in front of him as he took his exercise in the courtyard. He kicked at these apparitions and rapidly scuffed out the toes of his boots. Being only human, besides sick and tired of replacing his footwear at frequent intervals, someone judiciously hammered a small nail into the toe of the patient’s boot. The next time the patient took a flying kick at the
imaginary pigs’ heads, he received an early form of aversion therapy. Although this kind of thing was clearly not acceptable, it was apparently quite successful.
A troublesome and destructive female patient in the 1920s had to be confined to a side room and, when needing to use the toilet, would be issued with a rubber chamber pot. On a memorable occasion, someone made a mistake and a china pot was provided. On entering the side room ‘post performance’, Nurse Lilian Brignall was the unlucky recipient of the flying pot and, worse, its contents. In the 1920s, although nursing staff were issued with winter and summer uniforms, they received only one of each and they did not lend themselves to easy laundering. In consequence, after recovering some of her dignity, Lilian had to wear patients’ clothing for the rest of the day.
An unfortunate lady developed a taste for arachnids. She would pop them in her mouth whenever she caught one and later announce to whoever would listen, ‘I had a beautiful spider today, dear.’
During the mid-1920s, another female patient was in the habit of using a chamber pot, rather than the WCs. Unless the nurses were vigilant, she was liable to stick her head into the pot after making water. Lilian Brignall observed, however, that ‘she had the most beautiful head of golden hair’!
A patient called John had charge of the horse-drawn mower that was used to tend the lawns and cricket field. He suffered from religious mania, a recognised psychiatric condition, and one day in the 1930s, to show his devotion he embellished the Oval – that sacrosanct turf inside the carriage circle – with an enormous cross of breadcrumbs. Although his masterpiece was short-lived, one imagines that the local bird population, and perhaps St Francis, were suitably appreciative.
