This is a book about a world which people may believe no longer exists – the world of the closed psychiatric ward. Enoch Powell’s famous “water tower” speech of 1961 announced the imminent wholesale closure of the old 19th century lunatic asylums. Henceforward there would be “Care in the Community”, and things would be so much better.
Things are “better”, in a perverted sense of the word. Many of the patients described in this book would nowadays have been aborted in the womb. Many who might have spent their lives locked away in institutions have been turned out into the “community” – which for some has meant the streets. Our health service is no longer being kept ticking over by a seemingly inexhaustible supply of cheap Irish labour. We now get our nurses from further afield, or from agencies.
In 1961, the year in question, the author was employed as a mental health nurse – or more precisely as a nursing assistant. Unlike “proper” RMNs (Registered Mental Nurses) – of which there were and still are all too few – nursing assistants had nothing but on-the-job training. Barely out of school, with no experience of adult life, the author found himself caring for people with the most appalling disabilities, some of them hard indeed to care humanely for. He spent hours of night-duty closeted with people whom even the police had found a handful. The experience marked him for life. This is why he considers himself, like any mental sufferer, a survivor of the system.
This novel is...