50 years in mental health - how far we have all come

old psychiatric ward

In the past, the ethics and development of mental health care were poor. This image of an old psychiatric ward is a stark reminder of historic treatment

As we celebrate West Sussex Mind's 50th anniversary, volunteer Hunter Lake looks back at how treatments and attitudes about mental health have changed since 1970

Picture West Sussex 50 years ago. There were obvious differences that you’d expect to see in 1970. Less cars on the road, different architecture and even references to old money, which only changed in 1971. Behind closed doors, however, the differences would be starker than you could imagine.

For the first time, those with mental illnesses were being moved from the asylums of Victorian England to community care. Meaning they would now no longer live in isolation from the rest of the world but be cared for by the community in new hospital psychiatric wards and by an emerging profession called: social workers. It was the seventies, man had walked on the moon and mental health was being looked at in a new, scientific way. 

How exciting this brave new world seemed, but it was far from it. Society was afraid of the mentally ill who had previously been housed in Victorian asylums, never being spoken about or interacted with. This prompted the Victorian idea of them as a gruesome caricature of the dangerous maniac who, if they weren’t violent, were not to be trusted, even if only for their own good.

To say there was a stigma around the mentally ill would be an understatement. Something had to give to help the transition from the private asylum treatment to the public, community-based treatment of mental illness. This process was not a smooth one as administrative and financial restructuring was a complex issue to overhaul, with the most affected being those with mental health problems. 

Though anything seemed possible in the new technological age, unfortunately our knowledge about our own bodies was sadly lacking. Approaches to health care, particularly mental health care, were shaped by public opinion. The opinion of mental illness for a long time was a moral one, based on the traditional Christian thinking, that it came from a weakness of character. Before modern science, it was deemed that conditions with negative connotations had to then be a result of moral failing.

The beginnings of mental health treatment as we know it came after the Second World War with the NHS. This is when the earliest version of Mind was created, then called the National Association for Mental Health (NAMH), based on this new scientific thinking and the influx of returning soldiers with Post Traumatic Stress Disorder, at the time known as ‘shell shock’. The approach saw mental illness as an affliction of the brain, not just the mind and therefore physical treatment was needed. 

The intention of early modern treatment of mental illness came from a good place, but it is key to understand that both the ethics of treatment and its development were poor. This resulted in brutal and non-consenting treatments to the mentally ill with the viability of certain treatments being unproven to a modern-day standard and the long-term effects being unknown. From the 40s to the 70s, the common treatments for mental illness were: electroconvulsive therapy (ECT machine pictured here), experimental medication and more rarely a lobotomy.

ECT is a valid treatment and is still used today for those with severe mental illness that resists other forms of treatment. The development of better medication, such as SSRIs (selective serotonin reuptake inhibitors), however has meant the use of ECT has fallen over the decades.

The severe treatments for mental illness had been brought to the public consciousness through films, which often showed unrealistically dramatised treatments. The films then informed public ideas of mental illness as this was all that was available, since the mentally ill were largely separated from society, and the stigma kept many of the affected silent on their experiences. This is what to keep in mind when considering what stereotypes the mentally ill faced in the 1970s. 

Help was needed for those experiencing mental health problems and for the community trying to manage the adjustment and care needs of those now being treated outside of the asylum system.

This saw the creation of Worthing Mind, an offshoot of the charity Mind, which it is however now independent from. Mind is a charity created in 1946 to support and advocate for those experiencing mental illness.

Graylingwell in Chichester, which operated from the 1800s and was closed in 2001. It has now been converted into flats.

In its infant stages, Mind in Worthing had only three employees to do the vital job of providing both practical support for those with mental illnesses in the area and also to act as advocates for the fair treatment and de-stigmatising of mental illness. Mind in Worthing was the very beginnings of West Sussex Mind, which over the past 50 years has expanded across West Sussex. In the years since, there has been: Chichester Area Mind, Arun Mind, Worthing and Arun Mind, Shoreham and District Mental Health Association and Coastal West Sussex Mind, now all joined together as West Sussex Mind.

Through the tireless work of employees and volunteers alike, great strides have been made towards Mind’s goal of getting every person experiencing a mental health problem support and respect. West Sussex Mind now supports people in Worthing, Shoreham, Littlehampton, Midhurst, Chichester and Bognor and surrounding areas. There's the anti-stigma campaign work and the specialist mental health training. 

Though amazing strides have been made for the support of those with mental health problems over the past 50 years by West Sussex Mind, there is still much work to be done. But now is a time to celebrate the achievements and progress. West Sussex Mind now about 80 employees - quite a difference from the three in 1970 - and last year supported about 3,500 local people. So, here’s to another 50 years for the support and respect of every person with mental health problems. 



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