King’s College research (2011), found that a third of all patients admitted for mental illness are involved in violent incidents with other patients or staff. The focus on prevention has centred on identifying the ‘unsettled’ patient, and training staff in their management. Many years ago, I worked in an old fashioned psychiatric hospital, which nestled within a 12 foot high perimeter wall that encircled the hospital for 2 miles. The Victorian hospital was built in the grounds of a former stately home park. It had many mature and beautiful trees, acres of grassland, and paths with regular benches. The hospital had its own farm, produce from which was used in the making of hospital meals.
The grounds were always occupied. Little communities from various wards would congregate around ‘their’ benches. Those patients who required escort could be seen ‘walking the wall’, or playing football, or working on the farm. The therapeutic effect of this outdoor activity was impressed on me by Charlie, my charge nurse: “The more tired people are, the less trouble they are” was his mantra. I thought he was partly right, for I also observed that patients felt psychologically lifted by being out under a blue sky and pleasant wind, or a greying sky and falling leaves. They felt less claustrophobic, Max, the consultant psychiatrist, explained, less likely to panic and “explode”. Again, I thought that he was partly right, for I continued to observe the intrinsic healing effects for patients of growing flowers and vegetables. I am not saying that the old ‘bins’ were a nirvana of psychiatric care, they most decidedly were not, and at an earlier age, the strict enforcement of a work discipline within them made ‘working on the farm’ more task than pleasure. Yet, things had relaxed enough by my day for me to see the therapeutic potential that nature could have on a troubled mind.
I often wondered in my later nursing years why we confine mentally ill patients in modern buildings of enclosed spaces and artificial lighting, devoid of fresh air, the smell of scented flowers, and any potential to exercise. I thought that my profession was complicit in treating human beings like battery hens. When I began working in a private prison, my overwhelming sense was one bewilderment, for we caged mentally ill patients two to a cell, which greatly seemed to increase levels of anxiety, unpredictability, and self harm. The mentally ill prisoner’s life was a claustrophobic hell, devoid of any contact with nature.
The answer to why prisons are built in concrete jungles is clearly that of cost, the same determinant of the cheap, ‘gimmicky’, and discredited cognitive therapies that are claimed to replace prisoner’s ‘negative’ thoughts with ‘good’ ones, as if we are machines in which malfunctioning parts can be replaced – the intellectual gossamer on which such as Care UK’s private prison programme is sold to the government.
What I do suggest is needed are gardens as therapeutic spaces. I was greatly impressed with the recent initiative of Turning Point Mental Health facility in Chicago, which is turning some of its parking space into a therapeutic garden.
Can anyone imagine that happening in ‘no care’ UK?
lenin nightingale 2015