Warlingham Park Hospital's Open Doors and Farms

In 1999 my colleagues and I were tasked with packing up and closing down Barbara Ward and moving to Gresham Ward at the Bethlem Royal Hospital a few miles up the road. We were part of the march of progress, stepping towards Care in the Community for the 21st century. A middle-class housing complex was planned for the newly vacated, beautiful site that once was Warlingham Park Hospital. 

To enter the new ward at the Bethlem there was a locked door and a security camera that captured our image and sent it the few yards up the corridor to the nurses' station, which looked directly onto this entrance. The ward doors at Warlingham were almost always unlocked.   

It is only now, browsing the archives kept by the Museum of the Mind at the Bethlem, that I discover that the open door policy at Warlingham was the initiative of T.P. Rees, who had taken over as medical superintendent in 1935. On his arrival "he ordered that the gates of the Hospital were to be left unlocked, and thus embarked on a course of reform and progressive administration in the treatment of mental disease for which he was to become widely famed. During the next twenty years he abolished nearly all restraint and isolation of patients; the doors of all the wards in his hospital were unlocked." [1] It's rather disconcerting to discover that the unlocked doors were the consequence of this man's vision more than sixty years earlier, and that the spirit of his policy seemed to be evaporating without a backward glance.

I remember someone, Rory I think, telling me of workshops and a farm at Warlingham. We were standing outside Barbara ward, gazing across the beautiful, empty grounds around us: magnificent trees, open green spaces, a picturesque cricket pavilion. My interlocutor was looking back over his years there and speaking of a time when the place was a-buzz with activity with people flowing back and forth over the boundary between the hospital and the local community. Some patients went out into the community to work, he said, and people living nearby came in to work. At this time of our chat (the end of the 20th century), only two wards, Alice and Barbara, remained open. These were adult acute psychiatric wards, and they served the local population. Two smaller secure units were tucked away in a central block, reserved for those few patients deemed to present a danger either to themselves or to others: Farleigh, I think they were called.

This idea that there was a farm at Warlingham returns to prick my curiosity now. I wonder how this began, and what animals there were, and how patients of the hospital were included in the work of the farm. The archivist at the Museum of the Mind was good enough to pull out half a dozen box-loads of carefully kept material, and John and I spent a few hours last week quietly leafing through old typewritten records on flimsy carbon copy paper. We could almost hear the voices of people long gone whispering to us in the quiet sunlit room. Sure enough we found lists that bore witness to 20 pigs, a bull, and 20 bulling heifers in November 1944. The farms, it seems were eventually sold in 1955, just before Rees retired.

A report written by the Commissioners of the Board of Control dated 6 April 1944 had this to say about his effect on the place:

Perhaps the most striking thing about the Hospital is the encouragement of freedom and activity among the patients and the success which attends it. Such encouragement is common in well-run mental hospitals, but we have never seen it elsewhere to the extent found here. Sixty female and 120 male patients work on the ground or the farm. Men and women who were barely articulate, and certainly unable to give any account of themselves, were pushing barrow loads of garden material about the grounds with a minimum of supervision. A woman patient was wandering about the coal yard; a male patient who came in a few days ago with depression among his symptoms was walking alone round the drive; he had been here before and already admitted that he felt better. We saw a girl who frequently makes what are meant to be taken for attempts at suicide: she was sorting potatoes at the farm. Male and female patients with very varied types of mental disorders, staff and visitors (including ourselves) were using the club-room, which is run as a cafe. ... We are, in fact, satisfied that the general relaxation of rules and restrictions has not only been harmless but has been actively beneficial ...

Rees's style as well as his vision and his abilities were fundamental to the success of Warlingham Park in this era. This was in the days when the system of patriarchy still held sway. The kinship structures that define a family could be found in institutional forms of society. The position in the organisational structure that he occupied, and the respect that people still gave that position, would also count towards his success. The changes in family and kinship structure and the effect this has in our institutions and society today mean, among other things, that there is no single named person in overall charge of the Bethlem in anything like the same way; each unit seems to be run as its own independent territory – something that is also reflected in the different architectural styles that each one exhibits. 

I'm still curious about those farms. From the bits and pieces that we were able to piece together on our first trip we found documents referring to farms in existence at Warlingham before the war. I had formed the idea that the farms were something to do with the war, and I seem to have used the fact that they were closed in the mid fifties to support that idea. But one of the Commissioners Reports dated 7 December 1938 clearly states "We did not visit the Farm; otherwise, we have seen practically all parts of the Hospital, and most of its grounds, and have endeavoured to see every patient, and conversed with a considerable number of them." We did not visit the Farm. Another document, whose page is headed "County Borough of Croydon Visiting Committee" contains a two page spread of neatly displayed, detailed accounts relating to the Mental Hospital Farm and Garden Accounts, for the year ended 31 March 1935. There were pigs, poultry, beef and vegetables and whole section of the report was devoted to "Maintenance of Horses."

I shall have to return and do some more digging.

[1] Richard R Trail, Obituary of TP Rees reproduced on the RCP website. 

Thomas Percy Rees, "Back to Moral Treatment and Community Care,  the Presidential Address delivered at the 115th Annual Meeting of the Royal Medico-Psychological Association," The Journal of Mental Science, Vol 103, No 43, 1957,

Thomas Percy Rees, "The Hospital as a Dynamic Unit", Chapter 10, Mental Health and the World Community, ed. Prof Fraser Brockington, World Federation for Mental Health, London, 1954, 91-95.J.R. Rees, "The Thirty-First Maudsley Lecture: Psychiatry and Public Health," Journal of Mental Science, op. cit.

John Rawlings Rees, The Shaping of Psychiatry by War, New York: Norton 1945.

Jacques Lacan, "British Psychiatry and the War," Psychoanalytical Notebooks of the London Society of the New Lacanian School 33, June 2019.

Bedlam: Channel 4 series 2013 Anxiety Disorder Residential Unit (Simon Darnley, Principal Cognitive Behavioural Therapist and Head of the Anxiety Disorders Residential Unit at SLaM).

Carol Reed, Director The New Lot, 1943, with Peter Ustinov, Eric Ambler, John Laurie (see BFI notes), also, The Way Ahead, 1944.

Thomas Salmon, The Care and Treatment of Mental Diseases and War Neuroses ("Shell Shock") in the British Army, 1917

Sam Thompson "Not a word from Geoffrey" LRB

Sam Thompson, Jott, London, JM Originals, 2018

Samuel Beckett, Murphy, 1963, London, Calder & Boyars