Patient 8076 entered the hospital as an ‘informal’ patient. This category had been introduced under the 1959 Mental Health Act, replacing the former category of ‘voluntary’ patients. The requirement of signing an application to be admitted as a voluntary patient had excluded a large number of elderly patients who were no longer capable of understanding and signing such documents. It was also seen as a feature setting mental hospitals apart from general hospitals where no application was required. Informal admission therefore achieved the same goals as voluntary admission, but without the formalities.

The proportion of volitional admissions to the Devon mental hospitals increased significantly from 1960 – partly because patients incapable of applying could now be admitted, whereas previously they would have been certified. Frequently, patients who were already hospitalised were regraded informal. The most spectacular change introduced under this act was the abolition of certification by magistrates, thus placing the decision about compulsory admission entirely with the medical profession, relying on doctors acting in the patient’s best interest. Doctors, ideally one with special expertise in the diagnosis of mental disorders in agreement with the patient’s general practitioner, could section patients for a limited time period. Figures from the DCMH confirm that compulsory admission continued widely after 1960. Although the proportion of emergency admissions did not increase dramatically under the new act, we find a greater number of observation orders – possibly to replace some of the former certifications. Patients were sectioned in cases of severe illnesses, and in many instances of disagreement between patient and psychiatrist or mental welfare officer. Family members pressurised patients to accept admissions, and many elderly and demented patients were simply delivered to the hospital. This confirms that compulsory admissions, although exercised through a medical professional, were initiated within the family community because the patient had become unmanageable or a nuisance to neighbours or the Police. The 1959 Mental Health Act, initially regarded as a piece of progressive legislation turning away from the much-criticised legalistic approach to mental illness, soon attracted its own critics. The act’s phraseology was criticised as being open to individual interpretation with key concepts, all sufficient conditions for compulsory admission, loosely defined. As a consequence, socially inadequate and unwanted people, including alcoholics, drug addicts and sexual deviants all found themselves detained with various psychopathic disorders[1].

A very large majority of patients were admitted directly from their own homes or from the address of relatives or friends.  A significant number were transferred from other hospitals (including rather more than a hundred from other mental hospitals outside Devon), or elderly persons’ homes or police and prison services.

[1] According to Section 4.4 of the act, a psychopathic disorder is “a persistent disorder or disability of mind which results in abnormally aggressive or seriously irresponsible conduct on the part of the patient, and requires or is susceptible to medical treatment”.