Social Therapies

Sports day at the DCMH, 1933

Social therapies aimed at improving the patient’s capability to cope on their return to the community by assimilating life in hospital to life outside. This included dances, plays given by various drama groups, lantern lectures as well as cabaret and choir performances. In addition to entertaining the patients within the walls of the hospital, weekly char-a-banc outings to the seaside and Dartmoor and trips to Exeter were organised during the summer months. In August 1934 a film apparatus was installed in the hospital (Medical Superintendent’s Monthly Reports, August 1934) and frequently used to entertain the patients who, according to the Medical Superintendents’ reports seemed to appreciate this novel form of entertainment very much. In 1944 this was supplemented with the DCMH’s first wireless (Medical Superintendent’s Monthly Reports, March 1944). Engagement in sporting activities such as cricket, football and tennis was encouraged with annual sports days for patients and relatives. In particular the cricket team used to compete against the teams of other mental hospitals.

An integral part of patient 254’s treatment was occupational therapy (OT). Although patients had been employed in the DCMH before, systematic organised employment with therapeutic benefits did not start before the 1930s. Richard Eager, then Medical Superintendent, was instrumental in introducing OT to the DCMH. After spending some time visiting Dutch mental hospitals he explained the concept to the Commission: ‘with regards to Occupational therapy I have returned with the conviction that we are not using nearly active enough methods in this respect in the majority of mental hospitals in England. Practically every patient in the Dutch mental hospitals is occupied and none are allowed to sit about doing nothing or disturb others. […] Some are employed in simply pulling threads out of rags and making up balls of waste and others who reach the level of weaving carpets […] All patients are divided in groups of 5 to 20 under the special supervision of the nursing or artisan [sic] staff and any disturbances met by immediate isolation. A spirit of industry and activity is thus created even amongst the most troublesome patients. I am therefore anxious to try and introduce something of this sort here and shall be obliged if you will allow me to purchase some of the mat-making, book-binding and other machines to enable a start to be made’ (Medical Superintendent’s Monthly Reports, October 1932).

His efforts seem to have bore fruits, as ‘the number of patients occupied has increased since the end of last year from approximately 45% to 65% as a result of the introduction of more intensive occupational therapy. Indeed, taking the male side alone, the number of occupied patients this week has reached 70%. I am satisfied therefore that the staff generally are co-operating in the occupation of patients here, although some have not yet shown much enthusiasm in this direction’ (Medical Superintendent’s Monthly Reports, July 1933). In his monthly reports, Dr Eager continues to emphasise the effects of OT on patients, and his pride at developing the system can be gleaned from the report of a tour of mental hospitals he took accompanied by other medical officers to inspect OT on an intensive system ‘as a result of the tour round the English hospitals I feel that although some, like Cardiff where they have an up-to-date building and Cheslic where they have gutted a century old building and remodelled it at considerable expense, all in advance of what we are doing, we were able to demonstrate what could be done in a hospital a great part of which is nearly 90 years old without the need for the introduction of “occupational therapists” as recommended by the Board of Control and without the erection of many occupational workrooms to meet their requirements’ (Medical Superintendent’s Monthly Reports, October 1934). For the occasion of the medical officers’ visit to the DCMH, the hospital created an ‘occupational film’ compiled from films taken with their own camera. This would later go on loan to other hospitals for training purposes. Additionally, staff from mental hospitals across the country travelled to Exminster to be trained in OT before introducing it in their own mental hospitals. By the mid-1930s the DCMH had regained some of its former celebrity status owing to Eager’s tireless efforts to promote OT. The OT system was so successful that it won the hospital contracts from local councils, which Eager assured was ‘very encouraging to the patients and those who are supervising these various occupations’ (Medical Superintendent’s Monthly Reports, May 1935).

During the war years patients in the DCMH produced large numbers of camouflage nets for which the hospital was paid by the British government. But while the DCMH was praised for its OT in the 1930s, it experienced serious difficulties in filling the post of a trained occupational therapist under the NHS, and OT received repeated criticism from the Board of Control. Female OT was resumed in 1949, limited to activities such as knitting and embroidery (Visitors’ Handbook,1949). While it was considered good on the male side, there were fewer opportunities for female patients to engage. OT was also severely compromised by the lack of space for facilities with the male OT centre being housed in the old kitchen. Pt 254, being female, was undoubtedly disadvantaged with regards to OT. Her case notes reveal that she did some work in the laundry in 1933 and 1935, but otherwise merely helped with simple ward work.