Care in the Community

'Bedlam' is a word that has become synonymous in the English language with chaos and disorder. The term itself derives from the shortened name for a former 16th century London institution for the mentally ill, known as St. Mary of Bethlehem. This institution was so notorious that its name was to become a byword for mayhem. Patient 'treatment' amounted to little more than legitimised abuse. Inmates were beaten and forced to live in unsanitary conditions, whilst others were placed on display to a curious public as a side-show. There is little indication to suggest that other institutions founded at around the same time in other European countries were much better. Even up until the mid-twentieth century, institutions for the mentally ill were regarded as being more places of isolation and punishment than healing and solace. In popular literature of the Victorian era that reflected true-life events, individuals were frequently sent to the 'madhouse' as a legal means of permanently disposing of an unwanted heir or spouse. Later, in the mid-twentieth century, institutes for the mentally ill regularly carried out invasive brain surgery known as a 'lobotomy' on violent patients without their consent. The aim was to 'calm' the patient but ended up producing a patient that was little more than a zombie. Such a procedure is well documented to devastating effect in the film 'One Flew Over the Cuckoo's Nest'. Little wonder then that the appalling catalogue of treatment of the mentally ill led to a call for change from social activists and psychologists alike. Improvements began to be…