The Modern Mental Hospital How the Mental Nurse can play a part in Educating Public Opinion
- Author:
GIDDINS, Staff Nurse, Whittingham County Mental Hospital, Lanes
Winner of the “Lord” Memorial Essay Prize, 1941
What is it like in a Mental Hospital ? Most Mental Nurses have had this question put to them at one time or another.
This query is often accompanied by a scrutiny as though one were a creature from another world. A further barrage of questions usually follows, and, in a very short time, one realizes how utterly wrong is the conception of the general public in regard to the modern Mental Hospital. Then is the time to realize also that a golden opportunity has been presented for the pleasant disillusionment of a ” citizen in error “.
To be really effective in this task, it is well worth the trouble of giving a brief, but clear, description of the antiquated and bygone system in which the impressions of so many people have their origin. To the majority of people, a Mental Hospital is a closed book, and just as a closed book with nothing but the title visible leaves much to the imagination, so the name Mental Hospital, or ” Asylum “? as it is still termed by many?has a stimulating effect on the imagination of thousands of people.
Unfortunately little or no actual knowledge of the inside of these institutions accompanies the imagination, and the result is too often decidedly uncomplimentary. Visions are conjured up of dark and uncanny strong rooms, or of dim and depressing corridors, inhabitated by ” story book madmen An alternative impression is one of a community of genial idiots, who use wheelbarrows the wrong side up, or perform similar ridiculous antics. Yet another erroneous idea, held by many, is that once a patient is admitted to a Mental Hospital, he is permanently lost to the outside world, to news and affairs outside the institute, even lost to his relations and friends. In short, the impression has been created that a Mental Hospital is little more than a prison, to which are taken?and kept?persons who are ” not fit ” to be left at large. This impression has not been born in the past few months or the past few years ; its origin is far back in what were known as ” the good old days “, when sanitation was primitive or completely absent, and when children, little more than babies, worked from dawn to dusk in unhealthy factories and workshops, without the protection of public health services, child welfare inspectors, or even an adequate governmental law to safeguard them.
In keeping with the regrettable system of that area, persons who were mentally sick were catalogued under the general heading of ” Lunatics and as such were removed to a ” Lunatic Asylum “?a very different institution from the Mental Hospita’ of to-day. In many cases the unfortunate suffers1” was incarcerated for the good of society at large- whilst his own interests?such as treatment to bring about recovery, or the protection of his outside interests and affairs, were a very minor consideration- Added to this injustice was the unwarranted stigma which was allowed to be woven about both the afflicted and his relations, until the ” inmates they could hardly be termed patients?came to be looked upon as some strange type of criminal- This insult naturally reflected upon their relatives, causing incalculable misery. Such was the atmos- phere and environmentin which was born the present- day conception of many people, in regard to the Mental Hospital, and though time has pruned this ” poisonous tree of false knowledge ” its roots still cling to the soil in which it was planted. The modern mental nurse, realizing all this, can. and should, take advantage of every opportunity to break down this unsavoury and misleading traditional barrier ; and being in daily contact with the patients undergoing treatment, and know- ing intimately the routine, the just discipline, social activities and the general conditions within the modern Mental Hospital, the task is by no means difficult and opportunities are many.
Therefore, when the question is put to them?’ ” what is it like in a Mental Hospital ? ” the query should not be evaded?as it so often is?giving the uninitiated the impression that it must be eithe’ decidedly unpleasant, or that there is something to conceal. Any sign of concealment will immedi- ately give rise to suspicion. In the modern Mental Hospital there is nothing which need be hidden from the public, and the only points upon which silence must be strict and absolute, are in regard to names and personalities.
Tell your interrogator of the Mental Hospita’ as you know it to be, frankly and truthfully- Describe to him the recreation rooms, their spacious- ness and modern ventilation, central heating and general air of comfort. Tell of the ample amuse- ments provided for the patients?wireless, billiards, chessmen, chequers and cards,?and of the help and encouragement given to any patient who has the desire for a hobby. .
Explain to them the meaning of Occupational Therapy?its value in re-establishing confidence and self-respect in patients who, through the stress and worry of life, have come to look upon themselves as useless and unwanted. Talk of the work which physically fit patients are encouraged to do, and ot the rewards and privileges which can be earned stemGive them an insight, as to the under- anding and unobtrusive observation which is kept /-all .t’lese activities, and of the team spirit nich exists between Medical Officers, nurses and Patients. Describe the dormitories, with their P ished floors and spotless bed linen; the airing urts with their lawns and flower beds; the sick I 0rns with their air of restful quietness, where the ss fortunate are nursed with sympathy and Patience.
Side rooms are well worth mentioning, as many ^?Ple have a very distorted and unpleasant idea to their uses. Stress the fact that these rooms a ? not cells of punishment, but rooms wherein a torrnented and excited brain can find the peace n , solitude for which it craves. Explain the strict an .re’at^n8 to the use of side rooms, whereby y risk of abuse in their employment is entirely ruminated.
c_^e^ also of the way in which patients are en- a ^ra?ed to keep in touch with relatives and friends, d how, when a patient feels forgotten through Offfn?e visitors or correspondence, the Medical ann Cr vv’” 8et ‘n touch with the relatives concerned ^ u tactfully remind them of their duty. A few g(?r^s J? regard to the visiting of patients do not ?. .amiss. Describe the friendly manner in which sitors are received by the staff, and the pleasant siting rooms where the patient and his visitors ann S’1 ant* talk over their most intimate, private a family affairs secure in the knowledge that on .ing which may be overheard by the nurse a ^siting room duty will be treated in as strict confidence as though it had never been mentioned, trase the impression that mental sickness carries out ^ a s^8ma’ as tt did in the old days, and point t that illness of the brain, like any bodily com- aint, comes uninvited and unwanted. Above all, ake it absolutely clear that the aim of the Mental ospital is not to detain patients for the good of Cle.ty at large, but to effect a cure wherever Possible and to return the patient back to his people ar>d his normal life.
a Explain how all the methods of modern medicine ann met^cal science are employed to this end, o tell them of the pleasure you and your fellow share when a patient on discharge comes j,. thank you for your kindness and help during his t ness. If any doubt appears to remain in regard the treatment of patients, describe briefly the .ystem whereby every patient is sure of justice, every way, commencing with the regular atten- ance of the Medical Officer and so on to the visiting ^rdians, and the clergy of all denominations, the annual visit of the Crown Commissioners. % now you will have enlightened your com- panion considerably concerning mental hospitals, inf w^en one person is enlightened, many are?for formation spreads indefinitely.
th ally, enquire if he would care to go through e hospital and there see for himself the hospital s you have described it to him. A nurse can otain permission for this, particularly when he explains the reason for his request. Another t way in which the nurse can greatly assist in breaking t down some of the common illusions regarding I mental hospitals, is by inviting their friends and relatives to the sports, pantomimes and similar ; social functions, to which the public are admitted. Here they will see the patients at recreation, and the keenness and zest for the games, coupled with the standard of physical fitness which they can see for themselves, will assuredly score many points for the conditions within the modern mental hospital. Let them see the good fellowship and the clean competitive spirit at an inter-ward cricket or football match. It is at such functions as these that the public will learn that the majority of mental patients are likeable people with personalities of their own, and not just a community of simpletons or raving madmen.
A visit to a Christmas pantomime will in itself prove that one great trait of the patients is loyalty. This shows itself unmistakably in the enthusiastic applause given to the patients’ own particular nurses, and it is given quite regardless of the standard of talent which the performers happen to display.
Tell them also of the manner in which religious worship receives its full share of consideration in the mental hospital to-day, of the facilities granted for this, free from all bigotry or creed prejudice, and of the way in which patients are encouraged to continue in their own form of worship, during their sojourn in the hospital ; and so, piece by piece, the old conception of the mental hospital, and the conditions within, are destroyed, and in their place is born the true knowledge that they are hospitals indeed, as necessary and worthy of respect as any general hospital or infirmary.
Here in these institutions is nursed the saddest of all human ailments?mental illness?treated and nursed with a sympathy and understanding, which the patients could not hope to find in the outside world. Here certain abnormalities of behaviour are naturally expected, and are consequently never made the occasions for mockery or insult. The sole aim of the hospital staff is to bring about recovery wherever humanly possible and to eliminate suffering in all cases.
The voluntary system, whereby a person who feels he can no longer stand the mental stress of life can of his own free will enter the hospital, proves beyond a doubt that apart from the medical treat- ment to be had, there is also sanctuary and comfort, and protection from an outside world which cannot understand the doubts and fears of the mentally afflicted. The quiet regular routine, together with an abundance of rest and fresh air, good food and regular exercise, all of which are to be found in the modern mental hospital, are in many cases the key to complete recovery.
In conclusion, a nurse should always keep in mind that his own personal conduct and behaviour goes far in creating an impression, favourable or otherwise, to the layman. The nurse, therefore, cannot be too careful about his personal appearance. Cleanliness and tidiness are essential and this rule is by no means exclusive to duty hours. Temper- ance and kindliness are also essential qualities. It is only natural that a nurse who is untidy, boorish, or intemperate, will, in addition to creating a bad impression of himself, create also a decidely bad impression of his hospital, and the conditions therein. Every nurse should, no matter what rank he may hold, look upon himself as an ufl* official representative of the modern mental hospital and carry himself accordingly.
If this duty alone is carried out, much good vv” have been accomplished in the cause of mental hospitals and the first dent will have been made in the armour of the false impressionist.
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