My journey through the psychiatric system began in 1998. I started thinking about this book almost as soon as I went off sick from work with depression back in March 1998. I thought writing about what was happening – my life disintegrating, everything collapsing – would keep a fingertip on the tiller. Give me a tiny bit of control over something which, at the time, seemed so helter-skelter, wild fairground-ride, tumultuously out-of-my-control. Of course I couldn’t really write about it then – it was the just the beginning of something that was to last over a decade - so I kept a diary. At first. Each day I recorded the detail, the quotidian of being a mental patient, much as people keep a holiday diary: a record of an experience they may never have again: of the strange, the new and the colourful. The places they visit, the food they eat: new landscapes, tastes, people, starry nights, oceans and sunsets. I wanted to do the same, because being mentally ill propelled me into an utterly new, unknown land.
The diary ended when I was upended. Shipwrecked. Drowned in an unfamiliar ocean. When, after a year I was so ruined by the drugs and the locking-up and the urge to kill myself I lost the ability to capture any of it in words. They had floated away in the storm. Language itself was lost, and nouns, verbs, adjectives, subject and object, prepositions, metaphor and simile and analogy had drifted off, out of my reach. Being a mental patient took language away from me. It was one loss among many but I mourned it because books, words on a page: fiction, poetry, biographies, crime stories, humorous novels had always been my anchor. I’d never known a life without the written word.
But the notion that someday I would write about it all never went. Most of the time it was simply an idea (a foothold) that eventually I would tell people what the strange land of lunacy was like: its landscapes, buildings, food, people, tastes, colours, smells and sounds. What the sunrise looks like, seen from the small window of a room in a mental hospital, the colour of a psychiatrist’s shoes. How it feels to be beached, washed up alongside a community of other patients. Both in and out of hospital we were stranded, away from everything that had gone before: our families, homes, jobs, pets, the food we liked, playing football or swimming, going to a film, walking the South Downs or Cheviot hills and ending up in a pub, downing a beer and eating a ploughman’s lunch. We were all as far away from life outside as travellers to the wildest, most isolated forests and plains, but one day, I thought, I would shine a light into the lost tribe of the lunatics because almost no one else had.
The role of medication was not part of my planned ‘Dispatches from the Asylum’ at first because I didn’t know, then, that the drugs were a crucial part of the strangeness. I’d been a naïve traveller, in retrospect, and only when I rediscovered language, the ability to tell a story, did the part that psychiatric medication had played emerge from the mist.
The use (misuse) of powerful drugs just at the time I took my trip into the unknown was climbing steeply at the end of the 20th century. I inadvertently embodied the fate of the archetypal mad person at that particular period in the treatment of lunacy. My road trip, which seemed at the time so unique to me, was in fact ordinary. Unexceptional. The medical equivalent of a trip to the Dordogne or Ibiza, or in a cottage in Cornwall. There was absolutely nothing special about my years as a mental patient, most of us who fell apart in the 1990s and the first decade of the new century travelled the same route. When I returned and began to describe that terrible journey I discovered that my extraordinary experiences were, in fact, mundane. Run of the mill to anyone, psychiatric worker or patient.
I did have one useful skill. I could use words. Once language returned, which it did, I had the tools to paint a picture of my road trip. Words. I could write my Travels.
It has never been my intention just to write about the medical treatment of madness at the turn of the 21st century. That would be like a holiday diary that simply recorded meals. An Instagram feed of plates of moules and frites, orange-yellow cocktails or ice-creams on the beach but no rolling hills or waterfalls or sunrises over the Alps. A limited record. I wanted to tell the story of my whole journey: the way people spoke, the clothes they wore, the places I visited – and, as I was doing so, I realised I was making a record – marks in the sand – of the collapse of the asylum system for the insane. The disintegration of humane care of the intensely distressed is entwined with the rise of antidepressants and other psychotropics: if a pill could cure madness and return people like me fairly promptly back into their lives again then clearly there was no need for places of safety, asylums, where we could be looked after. That was the theory. But things haven’t worked out quite so neatly.
The first mental hospital I ever entered – as a visitor, in around 1995 - was on the verge of closing. Knowle Hospital, was the Hampshire County Asylum, founded in 1852, was a standard Victorian institution. Every county had them eventually - designed and built on a grand scale, usually discretely situated 3 or 4 miles from the town, with large surrounding fields. Knowle had an imposing main building, a fine entrance with Grecian columns, a portico and topped with a faintly ecclesiastical bell tower. Tidy lawns and gardens, big blocks of wards and day rooms, a farm and workshop where the inmates worked, laundry, kitchens, infirmary, a large house for the medical superintendent, a church and a cemetery. It was a self-contained village. I went to Knowle to visit an old friend who’d pitched up there in acute distress. I was shocked but not horrified. Shocked by the high ceilings, the shiny yellow paint, the dormitory and the huddled figures sitting in the day room, and particularly by the size of the bolts on the doors. Not many patients because the new hospital was currently under construction a few miles away.
My next trip inside a lunatic asylum, three years later was as an inmate. This one was the brand new replacement for Knowle and called itself an ‘adult acute psychiatric inpatient unit’. Imposing it was not – more of a Travel Lodge. It bore no resemblance to a hospital of any sort but had been designed with considerable care. No dormitories. Plain, single rooms with washbasin and mirror and wardrobe and chest of drawers – bland but bright. Full of light. Floor to ceiling windows in the short corridors, a pointed glass atrium, which echoed the belltower at Knowle, and which filled the small sitting area with watery grey light even on a cloudy day. A canteen and kitchen, food cooked freshly each day by cheerful school dinner ladies. Us patients had a small kitchen of our own, with boiling hot water in an urn 24 hours a day, a fridge with milk and coffee and tea bags. Plenty of mugs. There was, somewhere, a gym with rowing machines and treadmills and a trainer who came in twice a week. An art room stocked with plenty of materials for painting and drawing and a potters wheel in the corner, damp clay wrapped in plastic in a black dustbin waiting for use. Outside a small patio for patients to sit, with benches. And, opening off the art room, through double French windows, a small garden with roses and honeysuckle. I imagine the architects had thought patients might like to do a bit of gentle gardening by way of therapy if they didn’t feel like painting or pounding the weights.The Meadows had been planned and designed to provide a pleasant place for people in despair or the fruitily deranged to recover. It wasn’t cheap. I can find no record anywhere either of the architects who designed it, the plans or the final cost but one nurse told me it had come in, probably over budget, at around £15 million. All trace of the Meadows seems to have been airbrushed from the records.
I must have been one of the earliest inmates in 1998, and benefited from the privacy of a single room, hot meals (had I been able to eat them but severe depression takes your appetite away), certainly from frequent cups of tea and coffee as the medication made my mouth permanently dry. The isolation was a great boon: surrounded by woods and fields it was quiet. And those of us who were there ‘voluntarily’, not sectioned, were free to come and go. The patients’ entrance was open always, only locked from 10.30pm till 6am. I spent a lot of time outdoors, sitting on the patio talking to other patients. Sometimes walked through the trees to a field and sat on a felled tree, smoking and watching. There were always rabbits and once a deer crashed out of the woods and seeing me stopped, waited a second then turned and walked quietly back.