Mental health - treatment and stigma, 1940-1991: A plea for vigilance
Back in the 1940's, my great-aunt Jane’s hospital, St Andrews, Northampton, looked like a grand stately home, but she couldn’t leave it without a doctor’s permission. The Second World War was raging. There was no hope of a peaceful environment within which to recover. Those she trusted left to fight, and her nightmares became a living reality she couldn’t block out.
When my grandfather returned from war, he found his sister a shell of her former self, reliant on shock therapy and eventually drugs. Leucotomy and other aggressive treatments had destroyed the vibrant, dynamic personality that he knew and yet the family felt they had nowhere else to turn. The doctors knew best. How were they to care for Jane at home? Might there still be hope of a recovery, of some new treatment that could help her?
In writing, ‘A Thin Sheet of Glass’, I knew I had to investigate what happened to Jane in hospital as well as why she became ill. Could anything have been done to improve her chances of remission?
I applied for access to my great-aunt’s medical notes and St Andrews sent me an extensive history of her treatment from the 1940's right through to January 1991 when she died. The change in tone and approach from her early admission to her final years was incredible. I found notes in the 1940's that were inhumane, impersonal, and hostile towards my great-aunt. Doctors found her difficult. She was viewed as belligerent. They sought ways to contain rather than to support her.
By the 1980's, my great-aunt’s medical notes became more person-centred. Treatments were planned around her individual preferences and needs rather than those of the doctors. She went out with my grandfather and a nurse instead of being confined to the hospital grounds. Doctors actively looked for signs of happiness and a positive response. However, stories in the newspapers, even today, continue to show how vulnerable people are when they are partially or wholly dependent on the decisions of others for their care, and how quickly you can become institutionalised.
In the 1940's, treatment was painful and intrusive. Mental health professionals gained status and respect for their treatment of the mind with physical interventions. Patients were used as guinea pigs, stripped of their individuality, constrained and humiliated by the labels they were given.
A new film, starring Emma Stone is currently in production focusing on the tragic life of Rosemary Kennedy, whose father ordered a lobotomy for her in 1941 when she was just 23 years old. Her story and countless others show how easy it is for people suffering from mental illness to be mistreated.
While writing, ‘A Thin Sheet of Glass,’ I turned to the internet and to books like Ronald Senator’s ‘Requiem Letters,’ in which he writes about his time at St Andrews Hospital. I even found footage on YouTube from the 1940's – stark, black and white images of electric shock and insulin treatment alongside patients exercising and attending therapy sessions.
When you’re at your most vulnerable, reliant on others at times for decisions about your life, openness and transparency are essential. Checks and regulation must be in place to make sure that treatment is always in the best interests of those receiving it - stigma and fear replaced by support and empathy. Those who are diagnosed with mental illness must be treated with the same compassion and care as those with any physical condition.
- Do you want to find out more about the treatment of mental health today?
To support campaigns for greater awareness and better quality care - follow the work of mental health charities, mind, the Mental Health Foundation, Rethink Mental Illness, and the Royal Foundation’s, HEADS TOGETHER.