Towards a Conceptual Understanding of the Continuing Presence of The
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UNIVERSITY OF SOUTHAMPTON FACULTY OF SOCIAL, HUMAN AND MATHEMATICAL SCIENCES Geography and Environment Towards a Conceptual Understanding of the Continuing Presence of the Psychiatric Asylum in Contemporary Urban Britain by Joshua J Green Thesis for the degree of Doctor of Philosophy July 2016 UNIVERSITY OF SOUTHAMPTON ABSTRACT FACULTY OF SOCIAL, HUMAN AND MATHEMATICAL SCIENCES Geography and Environment Thesis for the degree of Doctor of Philosophy TOWARDS A CONCEPTUAL UNDERSTANDING OF THE CONTINUING PRESENCE OF THE PSYCHIATRIC ASYLUM IN CONTEMPORARY URBAN BRITAIN Joshua James Green In the latter half of the 20th Century there has been a policy of mass psychiatric asylum closure in the United Kingdom, North America, Australasia and much of Western Europe. In the aftermath of this psychiatric asylum sites have experienced five key ‘fates’: ‘Retention’ – those asylum sites which have been retained within the health care profession; ‘Residential’ - those sites that have been converted into housing; ‘Redevelopment’ - those sites which have been reused in a separate institutional capacity; ‘Dereliction’ those sites that have been abandoned; and ‘Demolition’- those sites that have been destroyed. In this thesis the focus has been on the former psychiatric asylum sites which have been retained within the National Health Service in England and Wales. Only approximately 12 former county psychiatric asylum sites have had retention as their main ‘fate’. After uncovering the extent of psychiatric asylum retention, this thesis looked to answer two key questions: how have they been retained?; and what has led to their retention? This thesis utilised a wide variety of qualitative research methods performed at four case study sites: Cefn Coed Hospital; Kingsway Hospital; St Nicholas’ Hospital; and St James’ Hospital. The key methods used in this thesis were: semi-structured interviews; multi-sensory autoethnography; archival research; and content analysis. The semi- structured interviews were performed as face-to-face interviews and were with a variety of participants including MPs, AMs, local councillors and NHS staff amongst others. This thesis found was that there are three key forms of retention: those former psychiatric asylum sites which have been retained for mental health care purposes; those which have been retained for National Health Service administrative purposes; and those which have been retained for both of the previous two purposes. It was found that the sites have been retained largely due to inertia; and that it would take only an imbalance in the multitude of factors affecting psychiatric asylum retention for this situation of inertia to be broken and the sites to be closed. This inertia was caused by a variety of factors, which included: NHS Estates and planning policy; stigma (or lack thereof); and conservational factors. What we see from this is that it makes financial sense to continue to utilise former psychiatric asylum sites. One of the key hurdles to this in the past has been the stigma surrounding the spaces; however this thesis has found that these sites are accepted by the communities in which they stand. In addition to these, various factors, especially those relating to conservation, have made the sale of such sites by the National Health Service unappealing to buyers, with restrictions on development at the sites. This thesis shows that former psychiatric asylum sites which have been retained within the National Health Service can function well if they are maintained and if they are utilised appropriately. However this is not always possible, as some sites are restricted in their development options by aspects of heritage management. It also shows how policy in relation into mental health care can be protracted in its enactment; with some policies taking decades to take shape. Table of Contents Table of Contents ............................................................................................................. i List of Tables ................................................................................................................ vii List of Figures ................................................................................................................ ix DECLARATION OF AUTHORSHIP ...................................................................... xiii Acknowledgements ..................................................................................................... xv Definitions and Abbreviations ................................................................................ xvii Chapter 1: Introduction ................................................................................................. 1 Theoretical Perspectives ........................................................................................... 2 Conclusion .................................................................................................................. 7 Chapter 2: Post-Asylum Geographies ......................................................................... 9 Introduction ................................................................................................................ 9 A Brief History of Psychiatric Asylums ............................................................... 10 The Asylum ...................................................................................................................10 Asylum Closure ............................................................................................................24 The Fate of Asylum Sites ........................................................................................ 29 Redevelopment .............................................................................................................32 Residential .....................................................................................................................35 Retention .......................................................................................................................37 Private Retention ..........................................................................................................37 Public Retention ...........................................................................................................39 Dereliction .....................................................................................................................41 Demolition .....................................................................................................................43 Conclusion ................................................................................................................ 45 Chapter 3: Methodology.............................................................................................. 47 i Introduction .............................................................................................................. 47 Research Design ....................................................................................................... 47 Research Questions ...................................................................................................... 47 Case Studies .................................................................................................................. 48 Research Methods ................................................................................................... 52 Qualitative Research .................................................................................................... 52 Ethical Considerations ................................................................................................ 73 Conclusion ................................................................................................................ 81 Chapter 4: Case Study Sites ........................................................................................ 83 Introduction .............................................................................................................. 83 Psychiatric Asylums – General Background ....................................................... 84 Site Histories and Walkthroughs .......................................................................... 86 Swansea and Merthyr Tydfil Joint Asylum - Cefn Coed Hospital .................. 88 Walkthrough................................................................................................................. 97 Derby Borough Asylum - Kingsway Hospital .................................................. 102 Walkthrough............................................................................................................... 109 Newcastle Borough Lunatic Asylum - St Nicholas’ Hospital ......................... 116 Walkthrough............................................................................................................... 122 Portsmouth Lunatics Asylum - St James’ Hospital .......................................... 131 Walkthrough............................................................................................................... 138 Evaluation ............................................................................................................... 144 Conclusion .............................................................................................................. 151 Chapter 5: Policy, Planning and the Surviving Asylum....................................... 153 Introduction ...........................................................................................................