Periodic Reporting for period 1 - GART-PSYSPAC (Psychiatric spaces in transition: discourse, dwelling, doing)
Reporting period: 2017-01-01 to 2018-06-30
The objective here is to foster an experience-based and overtly ‘spatialised’ perspective on European psychiatric transition between older institutional and more recent de-institutional mental health care. Specifically, it explores the experiences of different cohorts of patients, staff and others for whom Gartnavel Royal Hospital, Glasgow (Scotland, UK) has been a central point of reference, encounter and meaning. Gartnavel comprises a near-unique site, having housed a ‘lunatic asylum’ since the 1840s now closed and in partial ruins, alongside smaller wards/facilities added subsequently and a state-of-the-art acute in-patient facility opened in 2007-8. The overall site encompasses a diversity of spaces, each tied to different phases of psychiatric transition, and the project recovers experiences correlated with both Gartnavel as a whole and also with particular spaces (buildings, wards, corridors, gardens, walks). Probing and interpreting such experiences enables us to scale up to re-evaluate the intersections of psychiatric transition and social transformation.
A crucial conclusion is that ways forward for future psychiatric landscapes need to fuse the obvious gains from modernised, ‘enlightened’ and dignity-enhancing environments with what appears to have been the more organic production of sharing, community and busy-ness attendant on the less segregated geographies of older institutions. Additionally – mirroring reflections from participants, many of whom acknowledge the inevitable imperfections and risks associated with residential-institutional settings – we believe that there is still a crucial place for ‘the asylum’ (in all of the positive senses of refuge and respite) as one facet within a distributed portfolio of deinstitutionalised mental health provisions.
The findings are detailed and nuanced, but we venture the following:
• Gartnavel as institution and site has been incredibly meaningful for all participants, central to their senses of self (personally and/or professionally) – proving that the material spaces of mental health care are fundamental to how psychiatric transition is lived, perceived and sensed (as success or failure);
• For many, Gartnavel has been “a happy place”, even across different incarnations, providing sanctuary, nurture and inclusive social relations, with powerful evocations of Gartnavel as ‘community’, ‘village’ and site of ‘belonging’;
• For some, it has also been a place of sadness, frustration and tragedy, acknowledging too that it can never entirely escape being a place of surveillance and control;
• There is pronounced recognition of specific ‘territories’ and ‘boundaries’ across the site – delimiting different subgroups of patients, types of activity, domains for patients and ones for staff – all supporting complex sets of meanings, negative and positive;
• There is clear valuing of the outdoors resources of the site, whether in past days (with horticultural work) or today, with participants speaking of therapeutic and social benefits deriving from gardening, walking or even just sitting, viewing and chatting;
• Different perceptions arise about the boundaries of Gartnavel – for some, it is the old boundary wall; for others, it is the entrance to the new building – and many accounts tell of a place that is much less sealed-off from the surrounding city than was true of earlier years;
• There is broad consensus about improvements in the built fabric of Gartnavel, now offering lighter, spacious and fit-for-purpose facilities, affording greater privacy, dignity and protection of patients than was previously the case – with appreciation for the range of specialist activities now on offer for patients;
• There is also some consensus about what has been lost from the social fabric of Gartnavel, in that older regimes – even if seeming more chaotic and crowded – arguably permitted a greater ‘busy-ness’ on the part of patients, less opportunities for boredom, and a more enhanced overall sense of shared community (across/between staff, patients and volunteers);
• Thus, despite undoubted gains in how the environment of the Gartnavel campus is now organised and maintained, there is concern about a spatial and temporal over-compartmentalisation of cohorts and activities, with a feeling that the overall ‘liveliness’ of the institution has been compromised – and with opportunities for mutual learning and local solidarities thereby diminished.