Mansions in the Orchard: We need to talk about asylum

What is asylum? The word means a host of different things to different people, and many of these associations have also changed across history. The asylum, as used to describe a psychiatric hospital (most often the vast public hospitals, which were largely closed in the 1980s) has seen a corresponding shift in public understanding, from sanctuary to prison. But perhaps these changes are not as stark as we are often led to believe. A debate in 2014 at Queen Mary, University of London, around the launch of Professor Barbara Taylor's memoir, The Last Asylum included some revealing comments. Peter Campbell, a mental health system survivor and freelance trainer, noted that his students often ask him what has changed in his 47 years using mental health services, with the expectation that these changes will be considerable. Yet, in Campbell’s view, an awful lot has remained the same: acute care has not altered significantly in the past half-century, and a hospital day room in the 2010s looks little different from a day room in the 1960s.

Yet there are other sides to this story, not least the emergence of a psychiatric survivor movement and associated social and cultural change. Discussions about mental health care today are more likely to include a variety of perspectives, including those of service users themselves. In September 2014, the Museum of the Mind co-curated a month at the Dragon Cafe, exploring the different ways in which people find and achieve sanctuary (within and outside the mental health system), as well as the history of this idea in psychiatry and psychology.

A debate explored some of the context around a shift to 'care in the community', with some revealing perspectives from service users and mental health professionals. Diana Rose, Professor of User Research at Kings College London, explored the ways in which the mental health system has shifted towards avoiding 'dependency', while failing to acknowledge the support needs of many users. Nick Hervey, retired Head of Social Care at SLaM, spoke about the meaning of the word sanctuary through history. Artist David Beales considered whether asylums ever provided sanctuary - and whether the community can either, while Sarah Wheeler (Creative Director of the Dragon Cafe) spoke about finding sanctuary in the countryside and spirituality. You can listen to the full debate on the Dragon Cafe website, or download it to your computer.