The dancer burst onto the street, creating a kaleidoscope effect, in her myriad of summer colours. Her carefree spirit brought light to an otherwise grey day and like the other shoppers stood watching her, I found myself temporarily captivated by her artful movements, admiring her expressiveness and charmed by the spontaneity of her dancing.
As the crowd grew however, her dancing became angrier in its expression and what had seemed free spirited, was now betrayed by her spiralling agitation. Sadly, as darkness follows light, the performance ended with the dancer being taken away by the police, dishevelled and wounded looking, her cry piercing the atmosphere with sadness and despair.
1991 was an era that was synonymous with the movement in Mental Health towards community care, but I stood there as a sixteen year old, trying to comprehend the situation and all I could hear were the whispered mutterings about how ‘they are all being released from the asylums’. The sense of discrimination, stigma and prejudice in the air was palpable. Yet, all I could see was her fragility and vulnerability, as she was taken away by the police.
Three years after this occurred, I had an interview at Dales Wing, which was the College of Health linked to High Royd’s Mental Health Hospital in Menston, Leeds. I was Nineteen and I had arranged the interview, as I was keen to re locate from North Yorkshire to Leeds, in order to complete the Mental Health Branch of my Nurse training.
I can vividly remember being driven up the long, winding drive and feeling disconcerted by the rural setting in which the hospital was located. I associated Leeds with the bright lights of the city and places like High Royds conjured up an almost mythical image in my mind.
We pulled up outside High Royd’s on a bright summer’s day. The weather contrasted heavily with the darkly dominating gothic architecture of the main building looming in front of me. It was on first impressions as ugly as it was visually appealing. Typically Victorian, it looked sturdy and well made, but also cold and unwelcoming.
I left my Dad in the car and travelled by foot up the long corridor, which led to the College. The Dales Wing was in fact situated at the furthest point of the main building and is now the relocated Social Club for the residential estate that most of High Royd’s has become.
The corridors were commanding in the scale of their Victorian grandness, but the sumptuousness of the main entrance and committee rooms was solely for the eyes of official visitors in history. The richness of the architecture was strikingly incongruent with the basic and functional look of the clinical areas, tucked away in the depths of the hospital. The effect of the corridor design meant that the clinical areas were not easily discernible and it was possible to visit the hospital without getting any sense at all of what the wards or other clinical areas were like. It also had these huge doors along the corridor, which separated the clinical areas from the public areas of the building. I used to say it was disorientating in an Alice in Wonderland kind of way, as you would never know what was behind the doors, whether they led outside or to another entrance and where the entrance might lead to.
We talk now in Health Care about the 15 Steps Challenge, which is about your first impression of a ward when you initially step onto it. Well reflecting on my first encounter with High Royd’s, I would say that the vastness of the corridors alone left me with a feeling of nervousness and uneasiness, so lets stop and think about how this must have felt for a person in hospital here or indeed a visitor stumbling up the corridor for the first time, on their way to see a loved one.
It’s only since High Royd’s closed its doors that I have really reflected upon all of this and it’s only now that I fully appreciate the significance of historical factors in relation to the cultures and practices of High Royd’s during my time. Typically, as a Nursing Student, we read the book ‘Asylums’ by Goffman, which is largely about institutional practice and care. This was written in the 1960’s and I remember that as students, we read it with a wistful eye towards times gone by. This book was cited as being hugely influential in shaping Health Care Policy, associated with the movement towards community care. The High Royd’s that I remember was not as closely associated with incarceration and hopelessness. It was no longer as highly populated as it was in a bygone era. For most people who were inpatients at the hospital during the 1990’s, discharge home following a period of inpatient care was always on the horizon. However, I think about this time now and I can see so clearly how the history of High Royd’s clung to every brick, wall and door of the hospital and was part of it’s very being. This reminds me sadly that sometimes cultures can be so insidious that you can’t always see what is right in front of you and that we must always be looking outwards and upwards rather than inwards and downwards.
The main building of High Royd’s is still there, as it is a listed building and so to date, has not been the subject of redevelopment in the way that most of the hospital has. It is still dominated by a clock tower, which when the hospital was open, you could see from wherever you were on the site- I’m not sure whether this is the case or not now. The Clock tower acted very much like the central point of the hospital, drawing you back to it, like a point on a compass. I realise now that the clock tower was symbolic in a much more significant way than I had thought previously, because if the Victorian era in which High Royd’s was built was characterised by a preoccupation with order and restrained behaviours, then it is not a huge leap in thinking to appreciate how this influenced the culture around ritualistic and restrictive practices in Mental Health Hospitals during this period.
If you are interested in exploring the history of High Royd’s further, I recommend that you read the recently published book ‘West Riding Pauper Lunatic Asylum;Through Time‘ by Mark Davis (2013) and there is also a fantastically well maintained Digital Archive on High Royd’s which you can access here. I stumbled across both, whilst writing this post and I was moved with sadness when I was reminded about how regimented life was for the people who spent most of their lives in this institution, during times gone by.
High Royd’s wasn’t of course entirely negative and I know many people who reminisce about it with great fondness. There was something healing and relaxing about walking through the fields within the grounds and seeing various wildlife creatures roaming around in their natural habitats. To emphasise this point, I spent most of my earlier career in an inner city hospital environment, where a therapeutic walk with someone would involve a stroll around the hospital car park. I also know from speaking to people anecdotally in my personal and professional life that whilst many viewed High Royd’s as restrictive and incarcerating, others saw it as a place of safety and containment.
I went to work at High Royd’s as a Ward Manager in 2001. This was only two years before the hospital closed its doors for a final time. It was a time that was associated largely with endings and new beginnings and I remember that although many of the staff who I worked with looking forward to relocation, there were just as many who expressed feelings of sadness about leaving it all behind.
There was a sense of community between the staff that I saw when I went to work there that felt very positive, warm and welcoming and it was a cohesiveness that fostered a sense of team spirit and belonging. Colleagues still talk warmly about the various social, sporting events that went on at High Royd’s. Social events where people were people, rather than staff and ‘patients’.
However, despite all this, we have to remember that although the original ethos of High Royds was about creating a self sufficient community, the reality is that this served the purpose of separating people in institutions from the rest of society, thus creating a culture of exclusion and perpetuating stigma and discrimination, through ignorance and distancing.
It’s twenty years this year since I started my career in nursing and I think back to this time and to the story about the dancer at the beginning of this post. I’m reminded about how much progress we have made over the last two decades in terms of mental health care and treatment and wider issues around tackling stigma and challenging stereotypes about mental health. Campaigns by charities such as Time to Change and MIND have made huge progress in getting us all to talk more openly about our Mental Health, but we still have further progress to make.
As part of Leeds Time to Change (@changeleeds), a project being led by Tricia Thorpe called ‘Unheard Voices of High Royd’s (@voicesleeds) which is working in partnership with Leeds and York Partnership NHS Foundation Trust and Leeds Museums is encouraging people to talk about their experiences and memories of High Royds, with the intention of putting together a local exhibition about this in October 2013. I think this is an inspired project because not only do I think we should take time to celebrate the positive memories from our pasts, I believe that in order to recognise what the direction of travel should be in the future, we need to learn lessons by looking back in history.
On the High Royd’s Digital Archives and in the book by Davis ( 2013), there is a very poignant quote by Dr Snaith, who was a Leeds Consultant Psychiatrist, no longer with us. It really strikes a chord for me in thinking about this:
Here’s the quote:
‘A knowledge of history is no mere diversion; without it , those fertile avenues of thought which have so often led to innovation and advance must be explored again, and without it the lesson of many a disastrous mistake which should have been learnt will be suffered once more’
Dr R.P Snaith
Psychiatrist and Chairman of Committee for Progressive Care and Rehabilitation (Deceased)
Thank you for taking the time to read my post. I welcome any thoughts or comments about this subject.
In my next post, I intend to explore how some of these historical factors might influence nursing practice today and the ways in which I see Social Media as being influential in changing nursing culture.