Repton Park, Woodford Green, London. It was Christmastime and The Virgin Active sign was filled-in with tinsel. Glass barriers slid open and a track-suited receptionist eyed me suspiciously: I was not a member of the health club. A personal trainer in a red hooded top nodded earnestly while holding a walkie-talkie. A mezzanine separated the receptionist and me from an arched ceiling, but not from the wood paneling, which was lustrous, rich and everywhere. Repton Park boasts a gym, a yoga studio, an indoor cycling room, a health and beauty center, a spa, two physiotherapy treatment rooms, and a twenty-four meter swimming pool.
Bright signs flashed at me:
“Win and work out!”
“Are you following us on Instagram? You should be.”
The Virgin website describes their spa gym at Repton Park as a converted cathedral. In fact it is part of an old asylum: Claybury Hospital. Built of red brick and terracotta to a design of George Thomas Hine selected by the Commissioners in Lunacy for England, Claybury was opened in 1893. An échelon plan allowed patients in each block an uninterrupted view south over a wooded landscape replete with “all the beauties of an English rural district.”
Asylums were built largely to protect sick people from society. Before them, the mentally ill were sent to workhouses if their family could not support them. The well-to-do stayed in private madhouses (where the main purpose was often to hide unwell members of prominent families from view).
Early asylums provided custodial care more than treatment. Bedlam opened in London in 1685, the Boston Almshouse in 1729. A Quaker family, the Tukes, opened the York Retreat in 1796. The Retreat created a calm environment close to nature where people were treated with kindness and supported by predictable routines. Many of their patients recovered. This success spurred the development of similar facilities across Europe and the United States.
At Claybury, the recreation hall was the focal point: one hundred and twenty feet long, sixty feet wide, and forty feet high with a Jacobethan proscenium arch, stage, and gallery with seating for twelve hundred people. A contemporary journal, The Builder, explained the rationale underpinning the lavish design:
“The modern treatment of lunacy demands more provision for the embellishment of the asylum than is to be found in the barrack like interiors of our older institutions. Hence the interior of Claybury Asylum is almost palatial in its finishings, its pitch-pine joinery, marble and tile chimney pieces, and glazed brick dados… the recreation hall… richly ornamented with Jackson’s fibrous plaster work, while the walls are paneled in polished oak, and the floors are to be finished in a similar manner.”
The hospital closed in 1997 and was converted into luxury flats. Now it is a gated community managed by Hunt Property Services Ltd. The chapel floor was dug up and filled with a swimming pool. I swam through the water counting stained-glass windows. There were at least fifty, many showing the coats of arms of local borough councils. Bubbles ran against my back and around my body in the hot pool where the altar used to be.
In the sauna I spoke to one of the club’s members, a man from Walthamstow who grew up knowing the place only as being “where they sent the nutters.” He runs a garage and comes here every weekday in his lunch hour. He believes it is good for his mental health.
Notions of wellness became popular in the late 1950s in part through Halbert Dunn who, in a 1959 article of the Canadian Journal of Public Health, described high-level wellness as a “condition of change in which the individual moves forward, climbing toward a higher potential of functioning.” Wellness was considered an active, open-ended pursuit, an “ever-expanding tomorrow with its challenge to live at a fuller potential.” As John Travis, founder of the Wellness Resource Center in Marin County, California, told Dan Rather in a 1979 episode of 60 Minutes: “Just because you aren’t sick, you don’t have any symptoms, and you could go get a checkup and get a clean bill of health, that doesn’t mean that you’re well.”
Wellness has since become an industry worth $1.5 trillion, as valued by McKinsey in 2021. Yoga, mindfulness, acupuncture, fasting — wellness companies have a tendency to appropriate and whitewash cultural and religious practices and repackage them for profit. But this barb seldom lands, and the industry is projected to grow by five to ten percent annually.
Toweled-off and back among the wood-paneling, I noticed the vending machine had dietary filters: gluten-free, high protein, lactose-free, low sugar, vegan. Organic energy drinks, flapjacks, white chocolate and almond protein bars vied for my attention. Members walked past me looking at their phones. I imagined the targeted ads they might be seeing: for sleep-trackers, for expensive static bicycles, for self-appointed life coaches.
It would be naïve to draw too many conclusions on the basis of a Jacobethan arch and a grand view. Several former Claybury inpatients and their family members describe their experience of the hospital as frightening in the comments below a 2015 architectural article on the history of the estate.
Over time the Victorian asylums grew overcrowded and recovery rates fell. Neglect and abuse were too common. Institutional routines could be inflexible, uncaring and insufficiently personal — particularly in large asylums with over 400 patients. The counterculture of the 1960s and early 1970s framed psychiatry as an effort to control those who would not conform to social norms. Erving Goffman’s Asylums (1961) and Ken Kesey’s 1962 novel One Flew Over The Cuckoo’s Nest and its 1975 film adaptation shaped this view.
From the 1950s, the coming of effective antipsychotic medications made it more viable to discharge partially recovered patients to their communities. Long stigmatized, asylums were denounced as hopeless places insusceptible to reform. They were also colossally expensive to run. Thus the movement to deinstitutionalize married therapeutic optimism, cultural skepticism, and fiscal conservatism. Such an alliance rarely forms, and perhaps it was the power of this alignment that led to so precipitous a fall in the number of mental health beds in the United Kingdom: down from 67,000 in the late 1980s to 23,782 in 2022. Many former asylums — from Claybury in London to Ysbyty Sully in Glamorgan, Wales and Craig Dunain in Inverness, Scotland — have been gutted and refurbished as luxury apartments.
The cuts have gone into the muscle. During my on-call shift for psychiatry I encounter banks of distressed patients in the Emergency Department. They are unwell and in need of a safe place to recover. Often we do not have room for them. As a consequence, many are shunted vast distances across the land to receive treatment far from family, friends, and their regular mental health teams.
Leaving the gardens and grand apartments of Repton Park, I passed a sign containing an implied threat: “Security for Repton Park provided by Sentra Solutions Ltd”. The company patrol the estate overnight with dogs. The symbolism felt heavy-handed: Beautiful places designed for healing transferred from the needy to the rich; the downgrading of what we hope for from our healthcare institutions; the rise of high-priced wellness. I thought of a line by Abi Palmer in the Guardian: “The difference between those of us who are able to treat feeling well as a lifestyle, and those for whom it feels unattainable, has never felt so marked.”
Prevailing social attitudes have always shaped the form and quality of care for those with psychiatric illness: from the workhouse, to the asylum, to the couch, to the pharmacy, to the man I walked past in New York in February 2024 whose name I will never know who shuffled forward stooped, responding to voices no one else could hear, with shit-stains down his black trousers tied up by a cord. There has never been a good time to be mentally ill. Yet more so now than at any other time there is much that can be done: to find, to treat, to support, to understand, to enable recovery. This sort of raveling often requires physical space. If politics is about who gets what and how, then it is primarily the lot of citizens to decide if the pendulum has swung too far away from furnishing sufficient room for those with acute psychiatric illness. Sometimes wellness should take second place to care. Sometimes the pendulum should be un-swung.
Click here for Adam Boggon's list of references.
Image: Woodford — Claybury Lunatic Asylum Prior to 1905, Postcard, licensed under CC 2.0.
- Swimming in an Asylum - October 26, 2024