Mental health history ventures out of the asylum

On 26 June the Wellcome Trust played host to a symposium on the history of 20th century mental healthcare in Britain – Keeping Mental Health in Mind. Part of motivation for the event, organized by the Wellcome Library and the University of Warwick’s Centre for the History of Medicine, was to present the archives of Mind (The Mental Health Charity), which are held by the Wellcome Library.

MIND – Help a healthy mind leave hospital. A Mind campaign from 1976. Wellcome Library reference: SAMIN/B/80/40.

Mind – formerly known as the National Association for Mental Health (NAMH) – is one of the most important UK mental health charities of the 20thcentury. Its archive includes pamphlets produced by the NAMH and then Mind, informing the public about their activities, offering support, and debunking myths about mental health. Archivist Emma Hancox discussed the huge (ongoing) effort to catalogue the Mind papers. Some sections of the archive are already in the Library catalogue and available to researchers.

The most powerful point to emerge from the day was how the Mind archive could prompt, support and feed into a different kind of British history of mental health. As Dr Rhodri Hayward stressed in one of the morning’s presentations, the history of psychiatry in Britain (like all history) resembles its primary sources. Until recently the dominant sources have been those produced by the grand Victorian-era asylums. These are undoubtedly valuable and can tell us much about the practice of inpatient mental healthcare. However, during the 20th century there has been a dramatic shift away from the asylum as the central plank in mental health provision. A famous speech given by Health Minister Enoch Powell to the NAMH Annual conference in 1961 described asylums as “isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside.” The government’s Hospital Plan of 1962 heralded the running down of these huge psychiatric hospitals, shifting the focus to ‘care in the community’.

Park Prewett Hospital, Basingstoke. Opened as the second county asylum for Hampshire in 1921. Photograph by Niall McCrae, 1998. Wellcome Images reference: N0028861.

There is a heated debate about the success (or not) of this policy, but for historians of psychiatry, it created practical problems. The traditional source base(s) for the history of mental healthcare ceased to exist as the hospitals closed. As evidence of various kinds of psychological care fragmented, it became much more difficult to collect, collate and narrate a coherent story.

This is where the Mind papers come in. According to Sophie Corlett, Mind’s Director of External Relations, the charity and its federated local branches comprise the second-largest provider of mental health services in the country. The archive only represents the central office, but it occupies a central place in providing historical evidence about such care.

Of course, 20th century mental healthcare doesn’t begin and end with Mind, or the records of other mental health charities. Historians have already started adding to the stories of mental healthcare through general practitioner records, general hospital attendances, social work studies, child guidance clinics, and more. Some of these stories were elaborated as part of the symposium. They already add rich layers of meaning and complexity to the history of psychiatry. The Mind archive is an exciting and important addition to this diversification of sources.

The final session of the day provoked a lively discussion about the place of oral testimony in the history of mental health. Professor Barbara Taylor’s personal testimony of being a psychiatric inpatient during the last years of Friern Hospital in the late 1980s (The Last Asylum) was the jumping-off point for discussion. Taylor was questioned by Andrew Roberts, a mental health survivor, activist and historian, about the significance of her own ‘personal archive’ of journals and notebooks. From there, the discussion began to revolve around how far survivors’ testimonies should be collected and recorded in archives. They would form a valuable cultural monument in their own right, as well as adding to the richness and diversity of the source base for the history of mental healthcare.

Mental healthcare has long since moved away from the asylum model. The symposium showed us two things. First, how an important part of that new history might be preserved and made public. The documents in the Mind archive are the fuel for new stories about mental health, about power, resistance, healing, abuse, continuity and change. Second, it showed how the sources of psychiatric history are practically limitless – encompassing everything from medical records to oral testimony and survivors’ personal effects.

The Mind archive will become an important, unavoidable staging-post in British histories of mental health. But discussing the concept of psychological archives showed us more than that. Archivists, practitioners, survivors and historians saw that once the asylum-based habits start to break down, the world is your archive. Exciting times.

Author: Dr Chris Millard is a Wellcome Trust Humanities Research Fellow at the Centre for the History of the Emotions, Queen Mary, University of London. He is also Reviews Editor for the History of the Human Sciences journal. Twitter: @ChrisMillard83.