Staying Relevant With the Times—The Changing Face of an Asylum

Abstract

Last year, the Institute of Mental Health (IMH) celebrated its 85 th anniversary. From its origins in 1928 as what was then simply called The Mental Hospital, this nondescript name was later changed in 1950 to Woodbridge Hospital. 1 The establishment of the Mental Hospital was at a time when there was no effective treatment for mental illness. The only humane option at the time was "moral treatment", which meant kind, individualised treatment in the form of occupational therapy, exercise, and recreation in a sheltered environment. The hospital was, in fact, an asylum in the original meaning of the word: "a refuge, protection, or sanctuary".This humane idea of looking after the mentally ill reached its apotheosis in America when the early mental hospitals built in the 19 th century took the form of large, stately buildings, with large sprawling grounds and comfortable accommodation that also created a sense of community and companionship for the patients. There were farms and dairies that provided therapy for the patients in the form of work, and these agricultural activities also helped to sustain the running of the hospitals. Antipsychiatry MovementHowever, it was also in America where the page turned with the precipitate decline of this high-minded ideal. An infl ux of an increasing number of patients and shortage of funds strained these mental hospitals to their limits and forced them to closure. Within a few decades, most morphed into "warehouses" for the mentally ill, and became synonymous with neglect, misery and abuse.Journalistic exposé of the appalling conditions of these hospitals whipped up a sense of public revulsion and outrage, which was further stoked by Ken Kesey's novel 'One Flew Over the Cuckoo's Nest' and the subsequent blockbuster movie with its graphic depiction of the sequential brutalisation of a wayward patient at the hands of the staff of a mental hospital.