What’s He Building in There?

Upon being asked by The Vacuum to write an article on a local asylum, the first images that sprang to mind were from Sam Fuller’s eerie black and white 1960’s melodrama Shock Corridor. It is in this film that a journalist (played by Peter Breck) gains admission to a lunatic asylum by feigning mental illness in order to solve a murder but is subjected to electro-shock therapy and subsequently fragments, albeit rather unconvincingly. Rather, my visit to Knockbracken Healthcare Park (formerly Purdysburn Asylum) was a lot more kosher, with Communications Manager Brian McDermott stepping far beyond the call of duty to drive me around the 600-acre site and divulge much fascinating information along the way.

Purdysburn House and Estate were acquired for the purposes of a mental asylum from the unfortunately named landowner Narcissus Batt in 1894 due to the need for expansion and relocation of the original site on the Falls Road (where the maternity ward of the Royal Victoria Hospital now stands). Construction and development from this point right up to the 1960’s has left a kind of villa colony, with various self-contained units erected across the rolling countryside. However, as with many Victorian mental institutions, this air of bucolic beauty initially concealed a much more bleak reality relating to internment and incarceration.

Brian tells me ‘Phrases like ’round the bend’ come from the fact that, in Victorian times particularly, places like this were built just outside of town and just out of sight, so they were quite literally round the bend. It’s that kind of ‘out of sight, out of mind’ attitude which governed early thinking towards mental illness. In the early part of the twentieth century, you even had people like unmarried mothers institutionalized here on grounds of promiscuity, and they would’ve spent most of their lives here, which is a scary thought’.

In an effort to confront the negative connotations attached to Purdysburn, the management and clinicians decided in the early 1990s to rename it and open it up for greater use by the public. Brian describes this move as a deliberate policy to try and break down the barriers between society and mental health, which has traditionally been defined by very closed environments. Today, over 30 voluntary organizations also sit on the site, including an equestrian center, an organic farm, and an Arts Care project which emphasizes the therapeutic qualities of music, art, and dance. The population of patients at the facility, which peaked at over 1,800 between 1956 and 1957, has now been whittled down to around 300. This is largely due to changes in mental health provision in the last 15 years, with much greater emphasis being placed on alternative ways of treating people such as support in the community, rather than simply locking them up indefinitely.

I ask Brian whether or not the upheaval of the Northern Ireland conflict has had any significant effect on the mental health of the population.

‘I think there’s no doubt that the violence of the Troubles here had a major effect on people in terms of psychological trauma. We did some research with Queen’s about the subject, and what’s interesting is that it wasn’t until the ceasefires in 1994 that the full effects of that started to be realized. There was a sudden increase of people under 30 who were turning up at their GP’s with quite severe mental health problems, and the initial thinking was that these people were suffering from a form of post-traumatic stress. While the Troubles kept going, people somehow coped and went through the routines, but when it stopped a lot of people not even directly involved began blaming themselves for certain things, like wondering why their mate or neighbor had been shot and not them, and were basically unable to deal with these kinds of pressures’.

As we drive around the vast expanses of Knockbracken’s grounds, Brian points out the unfinished Shannon clinic, which is to open in January 2005 and will become Northern Ireland’s first regional secure unit.

‘At the minute if you went to court and the judge deemed that your actions were committed due to mental health problems, depending on the severity of your crime, the chances are that you would have to go to a high-security facility in Scotland because to date there hasn’t been any middle ground in the form of a secure unit for people with medium requirements. So this building will house people who are a potential danger to themselves and others, some of whom may have passed through the judicial system. It’ll also have single bedrooms and ensuite bathrooms, which is something else we’re very pleased to have broken ground on here, as opposed to the old long open wards which just weren’t environments that were conducive to any form of recovery’.

Further around the site, the Dorothy Gardiner clinic acts as a facility for acute admissions, but it is the Shimna building that provides the most stark evidence of the grim realities of mental illness. It acts as a residence for longer stay patients and is staffed by people highly specialized in dealing with instances of chronic illness and delusional behavior. A sense of catatonia permeates the building as we pass through day rooms full of disturbed-looking people suspicious of our presence, who occasionally engage us in bizarre conversation. As Communications Manager, Brian also has to deal with all manner of official complaints from such patients, including wrongful detainment. One such letter he tells me of which landed on his desk was from a patient who felt he wasn’t receiving the right form of treatment and was being held in the institution when he should have been let out to pursue his ‘career’.

‘He had copied the letter to his local MP, who was a prominent Ulster Unionist politician and high-ranking member of the Orange Order. The MP in question is a very good friend of ours, so he phoned us up to satisfy himself that this guy was being treated appropriately. So, we invited him up and sat round a table with him and the patient, who relayed his concerns. When he’d finished, his MP said ‘Can we just go over the bit about your career being impeded again? I understand that if you feel you aren’t getting the right medication and treatment you mightn’t be able to work and so on, so exactly what is it that you do?’. To which the guy replied ‘I’m the Pope!”. At which point the meeting was presumably adjourned. However, while this may provide an anecdotal aside, to witness an environment such as Shimna where people do suffer from severe problems and delusions is unsettling and also tragically sad.

Indeed, the official figures which show that 1 in 4 people in Northern Ireland suffer from some form of mental health problem each year indicate something of the fragility of the human psyche. And while structures of health and social welfare have tended to be hierarchical, bureaucratic, and detached from local communities, there seems to be a concerted effort at Knockbracken to engage with the issues on a very human level. While it still suffers from a lack of funding and certain stigmas which remain, mental health treatment appears to have evolved considerably in the past 10-15 years. Purdysburn, included for years in the Belfast vocabulary in the context of ‘Yer doin’ my head in, I’m away to Purdysburn’, is slowly shedding its negative image and becoming increasingly referred to as Knockbracken, something which Brian McDermott sees as a victory in itself.