This winter will mark the anniversary of the birth of Asylum, a magazine that has been advocating for democratic mental health care for the last four decades. The magazine started at a ‘rank and file’ meeting in Wakefield, South Yorkshire in 1984, where mental health workers, patients and activists came together to build resistance to a psychiatric system which they recognised as oppressive to both patients and workers.
The meeting was inspired by the resistance shown by miners and their families during the 1984-5 Miners’ strike and the Italian democratic psychiatry movement. In Trieste, a town in Northern Italy, the old asylums were closed and turned into collective cultural and social facilities for the local community. Ex-mental patients were actively employed in workers co-operatives and collectives. This transformation offered a democratic alternative to the old asylum system which trapped both patients and workers in a damaging and repressive total structure.
In the UK, the closure of long stay Asylums was largely supported across the political divide and by workers and patients’ movements. Yet there were deep concerns about it being implemented under a right-wing Government which prioritised cost cutting and stressed individual responsibility over socialised care. Given the devastation the Government was inflicting on working-class communities, especially in the north of England and Wales, there were concerns about what they would do to mental health care. Activists were anxious that patients might be liberated from the old mental hospitals but end up isolated and unsupported in the community.
This was the context in which Asylum was founded, a group of workers, activists and patients coming together to explore the possibilities of a new mental health system and to voice concerns about the shape of ‘care in the community’. Yet, even at its inception, it was at the centre of controversy. The Wakefield meeting was initially supported by the local Health Authority, but when it’s Chairman discovered that trade union activists were involved, he tried to cancel it. One of the organisers, Lin Bigwood, was a psychiatric nurse who had already established a reputation as a troublemaker for trying to expose two Consultant Psychiatrists for systematically sexually abusing female patients in a hospital where she had worked in York. Not known for doing as she was told, she refused to cancel the event, and it went ahead.
At the end of the lively meeting, which involved participation from mental health workers in Trieste, delegates decided to establish a magazine to introduce the idea of a ‘democratic psychiatry’ to a British audience; to debate how community care could be developed in a more progressive way; and to create a dialogue between mental health workers and service users or patients. The founders wanted an alternative to stuffy professional journals, a magazine that was not overly technical, and did not privilege psychiatry or psychology, including supposed ‘alternatives’ like psychoanalysis (which was often promoted by mental health radicals at the time).
The first issue of Asylum magazine was published in Spring 1986 and included an exclusive interview by Bigwood with the infamous radical (anti) psychiatrist, R.D Laing, one of the last before his death in 1989. In the interview, Laing was quite critical of the Italian movement because he believed it put political ideology before the provision of support for vulnerable patients. Despite this, both Laing and Democratic Psychiatry were heralded in the pages of Asylum, for many years to come. This was one of the many contradictions that Asylum has sought to engage with over the last 40 years.
The title of the magazine was chosen ironically; ‘Asylum’ was the original name of the journal produced first in 1851 by the Association of Hospital Doctors, a precursor the present-day British Journal of Psychiatry. It was also about embracing the ideal of genuine asylum. Asylum is a Latin word derived from the earlier Greek asulon which means refuge and is related to asulos meaning inviolable. So the idea was that the magazine would be an inviolable refuge for heretical views and people.
It became the magazine’s policy to include content that more mainstream publications wouldn’t publish by critical service users, dissident workers, and other activists. Its original subtitle, ‘a magazine for democratic psychiatry’ clearly linked it to the Italian movement, but it was equally influenced by the emerging independent psychiatric survivor’s movement which blossomed in the 1980s. The birth of the survivor movement was linked to the growing alliances between feminist activists and psychiatric survivors who were increasingly exposing the effects of sexual abuse on mental health, including self-harm and eating related distress.
Whilst the early 1970s had seen a network of Mental Patients’ Unions in England and Scotland, the late veteran survivor activist Peter Campbell has referred to 1985 and 1986 as the ‘breakthrough years’ for UK survivor activism. Not only Asylum magazine, but many key survivor organisations were established in 1986, including the influential Survivors Speak Out; Bristol Crisis Service for Women; and Nottingham Advocacy Group. It was also the year that a psychiatric survivor activist, Mike Lawson, was voted Vice Chair of Mind, getting more votes than an eminent psychiatrist and replacing a professor of psychiatry. This was considered a major turning point, as another survivor activist, Louise Pembroke put it, “the cat was now out of the bag.”
While Michel Foucault famously referred to society’s ‘monologue of reason about madness’, Asylum aimed to promote dialogue, between workers, survivors and activists, giving survivors ‘a proper seat at the table.’ Whilst dialogue has been an ongoing struggle to achieve, the magazine has perhaps been more successful in providing a space in which madness, or people seen as ‘mad’ can speak for themselves, on their own terms. This is, after all, a prerequisite for any meaningful dialogue.
As such, the magazine supported the rise of Mad Pride in the late 1990s and 20 years ago, in 2004, handed over editorial control to a group of survivors called Women at the Margins who produced one of the magazines most popular special issues: BPD: Bullshit Psychiatric Diagnosis, highlighting the way that women and girls’ understandable responses to sexual violence are often pathologised through diagnoses like Borderline Personality Disorder.
On the back of these developments, the new critical discipline (or, as some have referred to it, in/discipline) of Mad Studies has emerged in the last decade. In 2016, thirty years after its birth, Asylum devoted two special issues to Mad Studies, announcing its ‘coming of age’.
In 2018 Asylum dropped its tagline ‘democratic psychiatry’ to reflect broader concerns than just psychiatry, and wider inspirations than the Italian movement which was, after all, still led by psychiatrists. Psychiatric survivors no longer wanted just a ‘seat at the table’, or to be beholden to either psychiatric knowledge or ‘alternative’ knowledge produced for and about them. They want to produce their own knowledge.
Grassroots feminist and survivor activism has resulted in certain experiences like self-injury, eating distress and hearing voices being reclaimed and politicised. Moving forward, Asylum is actively platforming new knowledge produced from intersections with other contemporary liberation struggles such as the neurodiversity, trans and abolitionist movements. For example, with the enduring Government emphasis on employment and the demonisation of sick and disabled people on welfare benefits, Asylum is keen to highlight the plight of the so-called ‘unrecovered’ through links with activist collectives like Recovery in the Bin and the National Survivor and User Network.
Coming full circle, we are now faced with a new spin on the original concerns that inspired the founders of Asylum. Under neoliberalism we have entered a period of post-community care, characterised by the simultaneous organised abandonment and criminalisation of the most severely distressed in our society. Lin Bigwood has recently come out of retirement to voice her anger over the poor treatment of people with serious mental health challenges. Looking back 40 years, she told me:
“Exposing the sexual abuse carried out by the two psychiatrists ultimately cost me my career. I was bullied and slandered in an attempt to silence and intimidate me. But I’ve never regretted my actions. I’ve always been glad that I pulled off the conference and cofounded Asylum before they kicked me out”
UK Mental health services are finally starting to look to developments in Trieste to rescue a system widely acknowledged to be ‘in crisis’. Inquiry after inquiry is investigating mental health service failures where patients, many of whom have trauma histories and/or psychosocial disabilities, are systematically abused, neglected and misunderstood. Time will tell whether democratic psychiatry will prove inspirational to a new generation; whether inspiration will be gained from the mad, neurodiversity or abolitionist movements; or from elsewhere.
One thing is for sure, without wider progressive social change, any new model or policy will be limited by the current context in which it is implemented. After all, context is everything. Whatever the future holds, hopefully Asylum will be around to tell the tale.
The first issue of Asylum is now displayed in the new ‘activist’ section of the Mental Health Museum in Wakefield, on the grounds of Stanley Royd Hospital, where the original meeting was held.