The End of Bedlam?

Once there was Bedlam, where curious Londoners could while away an afternoon by staring and laughing at the insane, who were kept in chains, writhing and screaming. Over the centuries, the treatment of the mentally ill has slowly improved. Yet just this month, an official inquiry into cruelty at a Lancashire mental hospital described how patients were locked in closets for being "mischievous," how they were half-strangled with wet towels if they became violent, and how one victim had been injured when male nurses filled his dressing-gown pocket with alcohol and then set it afire.

According to a new plan drawn up by Britain's Department of Health and Social Security, all of the nation's 116 mental hospitals--many of them grim Victorian fortresses--will be shut down over the course of the next 25 to 30 years. As for the 116,000 patients, they will be temporarily maintained in small psychiatric units in local general hospitals, then rehabilitated through outpatient care, either at home or in clinics. Teams of doctors, nurses, therapists and social workers will be set up in each town to smooth the integration of former mental patients into community life. Only a few who are considered dangerous will remain confined.

The move toward releasing mental patients has been under way for some time, largely because of the development of calming drug therapy in the 1950s. During the past ten years, the number of patients in British mental hospitals has dropped by 23%.

Problems remain, however. More than one-third of the inmates of mental hospitals are over 65 and suffer not from mental disorders but from illness or senility. Families unable or unwilling to care for elderly patients now are unlikely to accept the burden of care in the future. Some patients --notably severe schizophrenics--may also get into trouble if released. The program will require a considerable increase in the already inadequate number of social workers.

Noting these deficiencies, the secretary of Britain's National Association for Mental Health has warned that the plan to close the mental hospitals may be Utopian. Said Mrs. Mary Applebey: "It is wishy-washy, platitudinous and dangerously superficial."

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