Claybury Hospital
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Claybury Hospital was a
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
in
Woodford Bridge Woodford Bridge is part of the East London suburb of Woodford, in the London Borough of Redbridge. It is located on an old road between Chigwell and Leytonstone. Notable features Its notable features include Claybury Asylum, a psychiatric ho ...
,
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
. It was built to a design by the English architect
George Thomas Hine George Thomas Hine FRIBA (1842–25 April 1916) was an English architect. His prolific output included new county asylums for Hertfordshire, Lincolnshire, Surrey, East Sussex and Worcestershire, as well as extensive additions to many others. Bi ...
who was a prolific Victorian architect of hospital buildings. It was opened in 1893 making it the Fifth Middlesex County Asylum. Historic England identified the hospital as being "the most important asylum built in England after 1875". Since the closure of the hospital, the site was redeveloped as housing and a gymnasium under the name Repton Park. The hospital block, tower, and chapel, which is now a swimming complex, were designated as a Grade II
listed building In the United Kingdom, a listed building or listed structure is one that has been placed on one of the four statutory lists maintained by Historic England in England, Historic Environment Scotland in Scotland, in Wales, and the Northern Irel ...
in 1990.


History


The project

The building of Claybury Hospital was commissioned by the Middlesex Court of Magistrates in 1887 and would eventually become the fifth Middlesex County Asylum. It was built to a design by the English architect
George Thomas Hine George Thomas Hine FRIBA (1842–25 April 1916) was an English architect. His prolific output included new county asylums for Hertfordshire, Lincolnshire, Surrey, East Sussex and Worcestershire, as well as extensive additions to many others. Bi ...
who was a prolific, late-Victorian architect of mainly hospital buildings and asylums for the mentally insane. It was the first asylum to successfully use the echelon plan upon which all later asylums were based. The site was situated on the brow of a hill and was surrounded by of ancient woodland and of open parkland, ponds, pasture and historic gardens. These had been designed in 1789 by the landscape architect
Humphry Repton Humphry Repton (21 April 1752 – 24 March 1818) was the last great English landscape designer of the eighteenth century, often regarded as the successor to Capability Brown; he also sowed the seeds of the more intricate and eclectic styles of ...
.


Early years

In 1889 the uncompleted building passed to the newly created
London County Council London County Council (LCC) was the principal local government body for the County of London throughout its existence from 1889 to 1965, and the first London-wide general municipal authority to be directly elected. It covered the area today kno ...
which opened it in 1893 as the Claybury Lunatic Asylum. By 1896, the hospital had 2,500 patients. The first Medical Superintendent and directing genius was
Robert Armstrong-Jones Sir Robert Armstrong-Jones, (born Robert Jones; 2 December 1857 – 30 January 1943) was a Welsh physician and psychiatrist. Biography He was born in Ynyscynhaearn, Caernarvonshire, the son of a Congregational minister. He was educated at ...
. By the first decade of the twentieth century, Claybury had become a major centre of psychiatric learning. It was internationally admired for its research, its pioneering work in introducing new forms of treatment and the high standard of care provided for the mentally ill. Armstrong-Jones was knighted in 1917 for his exceptional work at Claybury and his general service to psychiatry. Armstrong-Jones held progressive views on community care, advocating in 1906 that city hospitals should have out-patient departments where patients could seek help for mental symptoms without loss of liberty. Each asylum should be a centre for clinical instruction where all medical practitioners could refresh their understanding of insanity. People showing early signs of insanity should be free to seek advice and if necessary be admitted on a voluntary basis and not have to wait until they became certifiable. The first voluntary patients could not admitted until 1930 when the Mental Treatment Act was passed. In 1895, the London County Council appointed Frederick Mott as director for their new research laboratory at Claybury. Over the next 19 years he carried out vast research, documented in his ''Archives of Neurology and Psychiatry'' published between 1903 and 1922. He was knighted in 1919 and is particularly remembered for helping to establish that '
general paralysis of the insane General paresis, also known as general paralysis of the insane (GPI), paralytic dementia, or syphilitic paresis is a severe neuropsychiatric disorder, classified as an organic mental disorder and is caused by late-stage syphilis and the chro ...
(GPI) was due to
syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
.
Helen Boyle Alice Helen Anne Boyle (1869 – November 1957) was an Irish-British physician and psychologist. She was Brighton's first female general practitioner, and the first female president of the Royal Medico-Psychological Association (now the Royal ...
was appointed as an Assistant Medical Officer in 1895, one of the first women to be employed as a doctor in an asylum. She became a pioneer of early treatment for the mentally ill and went on to found the Lady Chichester Hospital. In 1939 she became the first female president of the
Royal Medico-Psychological Association The Royal College of Psychiatrists is the main professional organisation of psychiatrists in the United Kingdom, and is responsible for representing psychiatrists, for psychiatric research and for providing public information about mental health ...
(now the
Royal College of Psychiatrists The Royal College of Psychiatrists is the main professional organisation of psychiatrists in the United Kingdom, and is responsible for representing psychiatrists, for psychiatric research and for providing public information about mental health ...
). In Pryor's words: "The work of this 'lady doctor' formed part of the pale new dawn of community care for the mentally ill." The asylum was renamed Claybury Mental Hospital in 1930 and simplified to Claybury Hospital in 1959.


A patient experience in the 1930s

The English artist,
Thomas Hennell Thomas Hennell (16 April 1903 – 1945) was a British artist and writer who specialised in illustrations and essays on the subject of the British countryside. He was an official war artist during the Second World War and was killed while ser ...
, published an account of his personal experience of
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
in his book, ''The Witnesses,'' in 1938. Sectioned and detained at St John's Hospital,
Stone, Buckinghamshire Stone is a village in Buckinghamshire, England. It is located southwest of the town of Aylesbury, on the A418 road that links Aylesbury to Thame. Stone with Bishopstone and Hartwell is a civil parish within Buckinghamshire district and also in ...
in 1935, he was then moved to the
Maudsley Hospital The Maudsley Hospital is a British psychiatric hospital in south London. The Maudsley is the largest mental health training institution in the UK. It is part of South London and Maudsley NHS Foundation Trust, and works in partnership with the In ...
in London, and finally, to Claybury. He disliked his treatment at the first two, and satirised the Maudsley psychiatrists, but he enjoyed the humane therapy at Claybury (though there is a signed drawing by him in the
Tate Tate is an institution that houses, in a network of four art galleries, the United Kingdom's national collection of British art, and international modern and contemporary art. It is not a government institution, but its main sponsor is the U ...
of staff stealing from a patient in Claybury). In the course of his illness he produced several pictures that depicted his mental state. Before leaving Claybury in 1938, the medical superintendent, Guy Barham, agreed to him painting a large mural covering three walls of the canteen. A photograph of this painting was rediscovered circa 2015. He became an official war artist during World War II.


Post-war years

Claybury became part of the
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
in 1948. The introduction of new drugs, the
phenothiazine Phenothiazine, abbreviated PTZ, is an organic compound that has the formula S(C6H4)2NH and is related to the thiazine-class of heterocyclic compounds. Derivatives of phenothiazine are highly bioactive and have widespread use and rich history. T ...
s in 1955 and 1956, and the anti-depressant drugs in 1959, dramatically altered the treatment of the major
psychoses Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior t ...
, reducing the severity and duration of many conditions and creating a setting where normalisation could flourish. From the mid-1950s Claybury again attracted widespread attention as, led by consultants Denis Martin and John Pippard, it pioneered a controversial
therapeutic community Therapeutic community is a participative, group-based approach to long-term mental illness, personality disorders and drug addiction. The approach was usually residential, with the clients and therapists living together, but increasingly residential ...
approach to an entire institution of over 2,700 people. In 1968, Martin described the development of Claybury's therapeutic community in ''Adventure in Psychiatry.'' In 1972 a collection of essays by staff members and edited by Elizabeth Shoenberg were published under the title, ''A Hospital Looks at Itself'': The three pronged attack of therapeutic community techniques, use of new drugs and minimal use of the physical treatments, led to a reduction of the patient population from 2,332 in 1950 to 1,537 in 1970. However, lack of community care resulted in the 'revolving door syndrome' with over half admissions being re-admissions. From the late 1940s it became increasingly difficult to recruit student nurses and other support staff from the UK. Many, with little English, were recruited from Europe and given English language tuition.Pryor (1993) p.124. In 1962,
Enoch Powell John Enoch Powell, (16 June 1912 – 8 February 1998) was a British politician, classical scholar, author, linguist, soldier, philologist, and poet. He served as a Conservative Member of Parliament (1950–1974) and was Minister of Health (1 ...
, then
Minister of Health A health minister is the member of a country's government typically responsible for protecting and promoting public health and providing welfare and other social security services. Some governments have separate ministers for mental health. Coun ...
, proposed that hospitals should seek recruits from the West Indies and Pakistan. By 1968 there were 47 nationalities represented at Claybury with different ethnic, religious and linguistic backgrounds, all part of the therapeutic community diversity.


Developments in community care

Enoch Powell had predicted in 1961 that all psychiatric hospitals would be closed within 15 years. In reality, the first,
Banstead Banstead is a town in the borough of Reigate and Banstead in Surrey, England. It is south of Sutton, south-west of Croydon, south-east of Kingston-upon-Thames, and south of Central London. On the North Downs, it is on three of the four main ...
, closed in 1986. In 1983 the North East Thames Regional Health Authority (NETRHA) committed itself to a 10-year plan for the re-provision of care currently provided by Friern and Claybury hospitals. The number of patients on Claybury's statuary books at the year end in 1980 was 1,057 and in 1990 was 429. For some long-stay patients, thoroughly institutionalised, Claybury had been both home and local village for decades, in some cases for over 40 years. The challenge to manage their rehabilitation in a new environment, that they had never experienced and might well treat them with suspicion, was immense. In 1988 the Health and Social Services Research Unit at South Bank Polytechnic published a research paper detailing the post-discharge experience of a group of former long-stay Claybury patients.


Closure

To mark its centenary in 1993, the Forest Healthcare Trust published a comprehensive and well documented history of the hospital entitled, ''Claybury, A Century of Caring'', written by Eric Pryor who had been a member of the nursing staff since 1948. With the
Care in the Community Care in the Community (also called "Community Care" or "Domiciliary Care") is a British policy of deinstitutionalisation, treating and caring for physically and mentally disabled people in their homes rather than in an institution. Institutional ca ...
Programme and the planned decline in patient numbers, the Claybury site faced a difficult future. The
NHS The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
pressed for extensive demolition and maximum new build, whereas the
Local Planning Authority A local planning authority (LPA) is the local government body that is empowered by law to exercise urban planning functions for a particular area. They exist in the United Kingdom and India. United Kingdom Mineral planning authorities The role ...
and
English Heritage English Heritage (officially the English Heritage Trust) is a charity that manages over 400 historic monuments, buildings and places. These include prehistoric sites, medieval castles, Roman forts and country houses. The charity states that i ...
argued for maximum retention of the historic buildings and restriction of new build to the existing footprint, in accordance with the
Green Belt A green belt is a policy and land-use zone designation used in land-use planning to retain areas of largely undeveloped, wild, or agricultural land surrounding or neighboring urban areas. Similar concepts are greenways or green wedges, which hav ...
allocation in the
Unitary Development Plan In United Kingdom planning law, a unitary development plan (UDP) is a development plan prepared by a metropolitan district, London Borough or some unitary local authorities. Background UDPs contains policies equivalent to those in both a struct ...
. A 60-day
Public Inquiry A tribunal of inquiry is an official review of events or actions ordered by a government body. In many common law countries, such as the United Kingdom, Republic of Ireland, Ireland, Australia and Canada, such a public inquiry differs from a royal ...
was held in 1997 and the Council/English Heritage position was accepted. The hospital was shut down and converted into luxury flats called Repton Park by
Crest Nicholson Crest Nicholson is a British housebuilding company based in Chertsey, Surrey. It is listed on the London Stock Exchange and is a constituent of the FTSE 250 Index. History 1963-2000 The company was founded by Bryan Skinner in 1963 as Crest Hom ...
, working closely with English Heritage and the
London Wildlife Trust London Wildlife Trust (LWT), founded in 1981, is a local nature conservation charity for Greater London. It is one of 46 members of the Royal Society of Wildlife Trusts (known as The Wildlife Trusts), each of which is a local nature conservatio ...
.
Historic England Historic England (officially the Historic Buildings and Monuments Commission for England) is an executive non-departmental public body of the British Government sponsored by the Department for Digital, Culture, Media and Sport. It is tasked wit ...
identified the hospital as being "the most important asylum built in England after 1875...
t was T, or t, is the twentieth letter in the Latin alphabet, used in the modern English alphabet, the alphabets of other western European languages and others worldwide. Its name in English is ''tee'' (pronounced ), plural ''tees''. It is deri ...
the first asylum to successfully use the echelon plan, upon which all later asylums were based." The hospital block, including the chapel, which is now a swimming complex, were designated as a Grade II
listed building In the United Kingdom, a listed building or listed structure is one that has been placed on one of the four statutory lists maintained by Historic England in England, Historic Environment Scotland in Scotland, in Wales, and the Northern Irel ...
in 1990, as was the stable block, which is located to the north west of the main building.


See also

*
Healthcare in London Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England. History Early history The earliest state hospitals in the UK were set up in L ...


References


Sources

* {{authority control Hospital buildings completed in 1893 Former buildings and structures in the London Borough of Redbridge Defunct hospitals in London Health in the London Borough of Redbridge Former psychiatric hospitals in England Hospitals established in 1893 NHS hospitals in London