They had become to large, unwieldy and the system had opened itself up to abuse. In 1961 the Minister of Health, Enoch Powell was invited to speak at the AGM of the National Association for Mental Health. In his speech he announced that it the government of the day intended to “the elimination of by far the greater part of the country’s mental hospitals.” At the same time, regional boards were asked to “ensure that no more money than necessary is spent on upgrading and reconditioning”. This announcement had stunned the medical professions as there had been no indication that the government was going to head in this direction; only a handful of experimental community care programmes existed around the country. It would take 25 years for these plans to take afoot and the closures to start.
There were two reasons for the decline in the large institutions, the advancement in psychiatric treatment meant that a standard hospital was able to provide care to acute cases that required immediate attention, and the drugs available meant that patients did not need twenty-four hour care. This meant that the traditional asylum was left with fewer long term patients to care for – patient numbers reduced from over 150,00 in 1950 to 80,000 in 1975. The second reason for the closure of the mental hospitals was the passing of the Mental Health Act 1983 – this saw the people being committed to the large asylums being given back their full rights and having the ability to appeal their certification; it also saw the mentally deficient being moved back into the community under the care in community projects.
The first hospital to close due to the shift in medical treatment and public perception was Banstead Hospital in 1986, others followed suit over the next twenty years, with only a handful remaining open today. The medical staff at many hospitals still keep in contact with their old patients to make sure that the arrangements are working for them. The hospitals themselves either stand empty and derelict, or have been demolished and converted to cheap affordable housing, with only a few reminders to the residents of the previous history there.
The Victorian Asylums are now a long forgotten memory, however in a recent NHS study, they have found that people suffering from mental illnesses recover when they are in a safe environment and are involved in their treatment, rather than being allowed to fend for themselves. In speaking with a number of retired nurses who had worked within the system, they were unsure as to whether the mass closures and the entire move to the care in the community method was the right one. One even felt that the number of hospital that closed shouldn’t have been so high, with a few being kept as regional specialists that could provide a more comprehensive support system. At the grounds of Horton Hospital, two of the old villas have recently been refurbished to act as a care home for the mentally ill.