Views And Reviews

Makin' over the asylum

BMJ 1994; 309 doi: (Published 22 October 1994) Cite this as: BMJ 1994;309:1093
  1. M Smith

    When failed double glazing salesman and part time disc jockey “Ready Eddy” agrees to revive the radio station at “St Jude's” hospital, he has little idea of what he is taking on: until his arch rival disc spinner informs him that “It's a loony bin…you'll fit in well there, Eddy!” From here on in, the plot in BBC Scotland's new six part drama “Takin' Over the Asylum” is well signposted.

    From the cuckoo poking in and out of its clock in the first scene, to the standard bin-quip “you a patient or a member of staff?” (reprised thrice in the inaugural episode), writer Donna Franceschild has succumbed to the temptation to use all the usual mental health funnies.

    Gartloch Hospital is the Victorian Gothic asylum that plays “St Jude's” in the programme. It doesn't require cinematographic yellow and red sky filters to register the fact that Gartloch, its twin castellated towers rising from a hill outside the grim Easter-house housing scheme, is an intimidating place. Yet the institution that was once linked with nearby HM Prison Barlinnie in the public mind is now a prime piece of real estate on the M8 corridor. The long stay patients have left the wards in the main building (where the film was shot), and the scaffolding is up for site development.

    That community care is a reality for most clients of the old institutions will be no surprise to doctors. What might disappoint is the persistence in the series of the “One Flew Over The Cuckoo's Nest” leitmotif that did so much to promote the antipsychiatry movement of the late sixties and seventies. We've seen a resurgence of this in recent years, as social workers take over responsibility for psychiatric patients since the advent of the Community Care Act, and the medical model loses sway. When Ready Eddy plays a record of Baltic folk songs to “Nana,” a wild haired woman apparently talking gibberish, she is revealed as a Latvian refugee trying to communicate in her mother tongue: her mistaken “insanity” is exposed. So she is discharged: to reappear in a dark alley beneath a peep show sign, dossing in blankets and slugging her native Wodka. “Lock ‘em up or chuck ’em out” - not much of an advertisement for the medical model of mental health care. Psychiatry as a form of social control also makes an appearance: when the young hypomanic Cambell recovers sufficiently to be given a discharge date, he is threatened with “a section” if he doesn't agree to sit his A levels.

    Yet the truly insane are all Outside. Eddy's boss at the Twinview Glazing Company discloses this ethos in a pep talk to his recidivist employee, when he describes his customers: “Half of them are daft, and the rest are loonies.” It transpires that Eddy's listeners' latent talents are released by their record requests (guess what - “Help!” …I Did it My Way…If you Don't Know Me By Now”): the manic is an inspired promoter, the obsessive great at big cleaning jobs, and psychotic Fergus with auditory hallucinations is…an audio engineer. We are given to understand that institutionalisation has prevented these otherwise normal people from making a useful contribution to society. This progressive, optimistic message is torpedoed by Fergus's evil chuckle when he describes his voices - the sinister demon within is revealed. (Yet this Norman Bates has a talent for escape. I wonder what could happen in the episodes to come?)

    Apart from these criticisms, the dialogue is brisk, and some effort has been made to flesh out the background of the characters - though this is clumsy at times. One character, Francine, “breaks down” when Eddy insists that the hospital cat is pregnant, rather than the fat tom that she had supposed: we are led to suppose that she has sexually related problems.

    The comment that life on the wards resolves around Neighbours, Coronation Street, and Emmerdale suggests that Ms Franceschild has spent some time observing life in a psychiatric hospital (though this soapy circadian rhythm is arguably just as true for non-patients). One can't avoid the impression, however, that her characters are ciphers for a simplistic philosophy in which their varied mental illnesses represent the social constraints that limit us all. Unfortunately, the pseudoradicalism on the psychiatric front betrays a flimsy insight into the difficult questions relating to the nature of mental illness, and new patterns of care and treatment. Though they may enjoy the show, doctors - as well as their patients - may have reason to feel disappointed.

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