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Allegations of Abuse
in Institutions |
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Patients say state mental health care was indifferent, callous,
threatening, abusive or violent. The treatment they endured includes solitary
confinement and being lined up naked to be hosed down. Haydon Dewes braves
the stark assessment of past life in our psychiatric institutions. - The testimonies of 400 former
psychiatric patients paint a chilling picture of life within the walls of former
institutions. Though individual experiences are not detailed in Judge Patrick
Mahony's report, he said there was "a potency about common themes
emerging from the experiences of unconnected persons from different places at
different times". From the detailed stories of 493
submitters, mostly former patients but also some family members and former
staff members, Judge Mahony pulled together an overall image of severe abuse
and cruelty. Patients in institutions from Most spoke of over-crowded,
unsanitary conditions. Some talked of poor sanitation -- and the presence of
rats and cockroaches. They slept in large dormitories
with beds close together and spent highly regimented lives with days spent in
dirty, noisy, smoke- filled dayrooms with few activities available. Routines were degrading and
humiliating. Patients were lined up naked and hosed down before showering, or
made to bath in dirty, cold water. Government-supplied tobacco led to
many learning to smoke. It was used as currency between patients and led to
stand- over bullying and lifelong smoking habits. Communication between patients and
staff, including doctors, was minimal. Many described rarely seeing a doctor
and most had never seen a psychologist. Care was described variously as
indifferent, callous, threatening, abusive or violent. Patients were told by
staff and family they would never get out of hospital or recover, and should
not have babies. Some staff spoke of sterilisation of patients without
consent, particularly those with an intellectual disability. A number of voluntary patients
talked about being bullied into consenting to treatment, particularly
electroconvulsive therapy (ECT). Others spoke of their consent for ECT being
sought while they were heavily medicated. They spoke of an atmosphere of
violence, and of witnessing or experiencing physical violence from other
patients or staff. Patients were placed in dayrooms or dormitories with
patients that were aggressive, distressed or predatory. A number felt staff
condoned physical abuse, and even goaded patients till they reacted and then
punished them. They described a culture of
threats, verbal abuse, taunting, goading, and bullying and described patients
being dragged by their hair to seclusion rooms. Graphic stories were told of
patients witnessing and hearing frightening situations such as crying and
wailing from the seclusion units, episodes of physical or sexual violence,
patients who had harmed or killed themselves, and people screaming while
having ECT. Some spoke of their abiding regret or shame at not intervening or
not having been able to do more. Males and females spoke of
experiencing or seeing sexual misconduct, both by patients and staff. A few
spoke of rape. Staff were aware of, but ignored, sexual misconduct by
patients. Though psychiatric hospitals were
supposed to be safe for patients, the experience of many was that they were
not. Patients spoke of the futility of
complaining about aspects of their care or about matters such as physical
assault or sexual misconduct, saying that patients' complaints usually went
nowhere. Many experienced fearful and
degrading experiences in solitary confinement in a small locked room,
sometimes as a matter of routine on admission and at other times for extended
periods. The rooms were dark, often without a visible clock and often very
dirty. They had only a mattress, blanket and chamber pot. Some recounted having no drinking
water, and having to use the floor as a toilet. Many described calling for
assistance and no one answering. Others spoke of being sexually or
physically assaulted while in seclusion, of losing a sense of time, of fear,
humiliation, and a sense of powerlessness and degradation when in seclusion.
It was used as part of a reward and punishment regime. The continuing effects described
by those who were secluded included fear of small and locked rooms,
claustrophobia, and intense feelings of loss of dignity. Many, including children and
pregnant women, related distressful experiences of receiving ECT, often
without explanation or consent. Before the 1960s it was often given without
an anaesthetic or muscle relaxant. They spoke of waiting with others
for ECT and mounting fear as their turn approached; of hearing the screams of
the others; of their own terror as they were about to receive it; unpleasant
and undignified effects and of supporting or observing other patients after
they had received ECT. Many spoke of forgetting skills
they once had, for example cooking and needlework, or the ability to play a
musical instrument or do mathematics. Others spoke of having forgotten
segments of their lives and of increasingly poor memory as they got older. Medication was often the only form
of treatment for patients. The quick-acting hypno-sedative paraldehyde and
antipsychotic agent Largactil were commonly used. Some remembered vividly the
pain associated with the administration of paraldehyde and its smell. Patients spoke of the effect on
their lives and self-esteem of the side-effects, such as weight gain,
tremors, burning easily in the sun, tongue rolling and facial movements,
shuffling gait, drowsiness, difficulties with concentration, slower thinking,
sexual dysfunction and agitation. Often the side-effects were worse than
their illness. Some spoke of organ damage already identified. Child patients described desolate
experiences, with virtually no schooling, and being starved of affection.
Some became sexually active, modelling their behaviour on how they had been
treated. Many described a lack of caring
and sometimes cruelty by staff members. Some described developing survival
strategies, trying repeatedly to escape, and experiencing feelings of
hopelessness. A common thread was the loss of youth and innocence. Mothers spoke of losing their
children, or of the sadness of not remembering periods of their children's growing
up due to ECT. Some lost custody of their children at the time of divorce
because of having been a psychiatric patient, while others had their fitness
to be a mother questioned by staff and were told not to have further children
or to consent to sterilisation. Many were troubled by their
clinical records. A number who had seen the records spoke of hurtful and
judgmental comments, of experiences trivialised or not recorded, and of the
patronising way in which they were described. They were concerned their old
records were still available for others to see. Former staff described a testing
practice environment with high patient numbers and a mixture of types of
patient, including those who were very ill or difficult to handle. There were
patients hospitalised under criminal justice provisions, and some who did not
have a mental illness but for whom there was no other provision for
residential care. Some said it was important to bear
in mind the historical context, that what was obviously wrong now was
considered right then. Patients were not expected to get
well and there was a societal attitude of "out of sight, out of
mind". There was a prevailing fear of mental illness; even staff were
stigmatised. The report reveals a culture of
silence. Though staff witnessed cruel and inhumane treatment of particularly
vulnerable patients such as the elderly, the dying, children, and those who
were physically or intellectually disabled, attempts to intervene met with
reprimand or intimidation. --------------- CAPTION: Barren lives: Patients spent days
in dirty, noisy, smoke-filled dayrooms with few activities available.
Bullying was common in such circumstances. Row upon row: Patients slept in
large dormitories with beds close together. Others might endure the periodic
torments of solitary confinement. Water ordeal: Patients might be
lined up naked and hosed down before showering, or made to bath in dirty,
cold water
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