Читать книгу The Moral State We’re In - Julia Neuberger - Страница 21

The twentieth century started with an obsession about degeneracy of the ‘stock’. It was feared that a ‘submerged tenth’ of the population would outbreed everyone else. The Royal Commission on the Care and Control of the Feeble Minded (1904–8) suggested that mental defectives, so described, were often prolific breeders and that, if allowed, would resort to delinquency, excessive sex, and alcohol. Winston Churchill, then Home Secretary, supported proposals for the forcible sterilization of 100,000 moral degenerates. His views were thought too extreme, however, and his plans were thought so sensitive that they were kept secret until 1992. But he was not alone.

Some forcible sterilizations did in fact take place, and in 1934 the Brock Committee recommended voluntary sterilization as a cheaper means than physical segregation of separating moral defectives from the nation’s gene pool. Homosexuals continued to be ‘treated’ in mental health units into the mid 1970s, the treatments including oestrogen therapy, electric shock therapy, psychoanalysis and behaviour aversion therapy.*

All this has to be set against a gradual change in thought. Freudian theory, as well as the work of Jung and Adler, with their insights into the importance of the unconscious mind on emotions and behaviour, was just beginning to influence the way people thought about mental health. Containment, however, was still the order of the day, and concerns that the mentally defective would affect the genetic character of the nation only disappeared gradually. Even in the 1990s there were discussions about the forcible sterilization of young women with learning disabilities, ostensibly to protect them from unwanted pregnancies but presumably also because of fears about the children they might produce. Broadly speaking, however, theories about degeneracy and contamination of the gene pool had become unfashionable because of their Nazi associations. Therefore the assumption had to be made, for want of any other theory, that mental ‘defectiveness’, as well as insanity, was a health issue. With the establishment of the NHS, local authority hospitals were transferred to the Ministry of Health, but there was little change in conditions.

However, the drugs did change. Largactil, along with other anti-psychotic phenothiazines, appeared around 1955. It controlled symptoms without the sedative effects of the old drugs. Despite being a form of control, such drugs were widely used and community care became easier and less risky. In 1953, almost half the beds within NHS hospitals had been for mental illness or mental ‘defectiveness’. However, after 1954, the number of patients in mental hospitals began to decline and moves were made to change mental hospitals into institutions like those for physical diseases.

In 1959, the Mental Health Act excluded promiscuity or other immoral conduct as grounds for detention under the Act. The idea of moral degeneracy was beginning to fade, as well as the beginning of a realisation that institutionalizing people was bad for them.

No new large-scale asylums were built after the Second World War, but hospitals for mental ‘defectives’ continued to be built until 1971. And the old institutions remained. By 1966 there were still 107 mental illness and 66 mental handicap hospitals with two hundred or more beds. The following year Sans Everything was published, a collection of articles by Barbara Robb about how elderly people were treated in institutions, particularly in psychiatric and geriatric care. It caused a storm, and the official investigation, in 1968, substantiated most of what she said.