Photo: John Brooke
PSYCHIATRIC BRIDGES By PAUL VAUGHAN A
Little while ago
^rpington, east
Mrs.
A.,
a
housewife in
it sounds the remarkable thing in the world, it was a tr'Umph in its way?because Mrs. A. had for Months had a fear of leaving her own house, which dipped her with a panic hand if she as much as stepped across the threshold. Marooned in her semi-detached just as irrevocably, it seemed, as a castaway, Mrs. A. had reached l^e point when the only solution appeared to be went on a bus.
Though
in a mental hospital. She had already weeks in one as an in-patient. But it didn't come to that. Mrs. A's bus ride was one of the small victories of a psychiatric social club?a club to help people with mental illness to become once again members of the community. The one that helped Mrs. A. was the Anchor Club. Like others of its kind, it is run voluntarily, by a small group of Orpington citizens who happen to have an interest in helping the Mrs. A's of another
spent
spell
some
29
the neighbourhood. By understanding pathy they are managing to lower the
and symbarricades which mental illness?that loneliest of afflictions? builds around its victims. The names chosen by various groups in and around London give a fair idea of how they see their function: the Anchor Club, the Helping Hand, the Stepping Stones, the Rendezvous Club. Each has its own approach but they are all doing the same thing, if in different ways?helping to make a reality of the principle of community care by giving their members a regular meeting-point and, for many of them, a bridge between the protective environment of hospital and the stresses of daily life. 'Our members are mainly people referred by psychiatric social workers, GPs and mental hospitals', I was told by Clarinda Attlee, Secretary of the Orpington Local Association for Mental Health. 'Occasionally though we have people who might have to go into hospital if they did not have some support of the kind we can give them. They're isolated people mainly'. The rescue from isolation is brought off in unspectacular ways. On Thursdays from two till four there's a meeting where Anchor members can do handicrafts, play cards, or just sit and gossip. Every other Wednesday morning one of the other club leaders, Mrs. R. Poland, runs a discussion where, she says, 'we might discuss a book, in a very permissive, informal way'. Then there's a monthly film show, also attended by patients from the local hospital. At the Rendezvous Club in Wimbledon, about a dozen members come to the meeting every Monday, to sit and talk or play whist, have a cup of tea and, some of them, to make things?little things like Christmas labels or scrap-books. 'What they make isn't all that important', said the Secretary, Mrs. Harris. 'It's helpful for people to be doing something and to be able to talk at the same time'.
Ping-pong A
to drama
professional worker who was involved in starting the Helping Hand Club, told me, 'Activities were provided for the club?anything from chess to ping-pong and drama. But if the activity is too specific you may not be giving the members what they want. It's no good giving the idea, say, that it's a club just for chess-players. 'We used to think the thing was a failure if everyone wasn't taking a very active part. But we came to see that something was happening if they were just there. Over-organisation can kill a club.' The helpers have to learn that to some extent they're in the members' hands. The members themselves will shape the pattern of an evening and gauging what's wanted at the opening moments of 30
a meeting can be quite a tricky business. An organ' iser tells of the chagrin of well-intentioned volufl' tary helpers whose carefully-laid plans for tbe evening came unstuck. 'They couldn't bear f?r members to come in and just start talking wfae11 they had a film they'd booked and were keen t0 show. Meantime, all the members wanted to was to talk about the rail strike.'
Over-organisation By trial and error most clubs learn the pitfall5 of over-organisation ('It pays to be a bit duflifr and helpless at times', said Mrs. Attlee, 'too mu^ efficiency puts people off'). Even more of a mistake is any attitude which might be construed by men1' bers as patronising. Nothing can kill a club faster A psychiatric social worker found the people wh" volunteered to help run the club were adequate!) self-selecting. The ones who wanted to help came
forward and these were usually the ones y needed. The only trouble was, one or two of tb* would-be helpers needed help themselves, bu1 they were 'not the sticking sort' and soon stopped
coming.
So what kind of person is wanted? Someone
sensible and sympathetic, obviously, and it's necessary to have an academic training or an) detailed factual knowledge about different kind5 of mental illness. One of the worst crimes is play the amateur psychiatrist, a brand of cofl' descension also guaranteed to lose members with a rush. All the club leaders and helpers I spoke to stressed the virtues of knowing when to become inconspicuous. The whole point of having a social club like this, they say, is that members and helpers mix in together. There is no 'us' and 'them'. Every one is a member, though the leader is known to be on hand for advice if anyone wants it. 'The thing is to have everyone anonymous", MrsAttlee said firmly, 'not to distinguish between one kind of members and another, and if you have everyone thoroughly muddled, not knowing which is which, then you've achieved something. It's this question of not being "us" and "them", all tbe time. If you can't tell one from the other, the i" people realise they've nothing to be frightened ot You get the "us" and "them" situation in a hospital. If they find this anonymous atmosphere if the club, they do slip into the community mucb better. 'And it slides into the position where the patient becomes the helper. After they've been for a fe^' months and someone new comes in, you say, g? and have a chat to her, she's lonely. And they fee'
they're
no
longer being helped?they
are
It's a source of tremendous pride.' At the Rendezvous Club, Merton's
helping-
Principal
Rental
Welfare Officer, Frederick Rainer, drops regularly and, on the night I was there, sat smoking his pipe and chatting to the members. in
Wis comfortable, reassuring
the need for
presence
exemplified
working relationship with the Professionals which the clubs, as a rule, make a Point of creating. For no psychiatric social club can work miracles and there is often danger of a Member relapsing and becoming ill again?in ^hich case the club's leader has a big responsibility. One club leader told me: 'One can have lots of little conversations, or one organised discussion, but I felt my role was to intervene if situations some
Sot too
painful for a particular member. For instance there were times when a member c?uld be scapegoated. There was a conversation ^hen a member brought up her problems with her adolescent daughter. And there was more talk, and the other members began to get quite punitive towards her. They began by making helpful com-
ments,
of course. But I felt I had to intervene when
the members began to say things like, we never had problems like that with our children. Meaning : we are perfect but you are just a bad, awful Mother. I told them if this had not been a problem for her she wouldn't have brought it up. I think
those
members were able to learn from this and the mother did come again.' Finding a home for the social club is one of the hig difficulties. The Rolls Royce of the clubs as ^ar as accommodation is concerned is undoubted y |he magnificent Stepping Stones Club at Bromley, in what was a large private house in its own grounds, bought with an ?18,000 gift from the King Edward's Fund. At Wimbledon, the Rendezv?us Club meets in a room made available in the Guild of Social Welfare. It's not theirs alone, and
^either is the
hitherto occupied by t e Their premises have borrowed room in a large Elizabet an manor house owned by the Council and let to them at 50s. a time.
Anchor heen a
room
Club in
Orpington.
Raising money
But the Anchor
now
has
a
house of its
own
Anchor House, naturally?a 50-year-old, threestorey house in the middle of town, price ?7,60U. Clubs of this kind are perennially hard up. But t e Anchor managed to raise enough money within
five
years. When I asked Mrs. Attlee how, she said 'Oh, we accumulated it, you know. A cut ?f ?100 to ?150 from flag days, sales of work, a nearly-new shop in someone's house, somebody else had a little fete in the garden. Of course we got ^uite sizeable lumps from well-wishers the City Parochial Foundation give ?300 and there was t e Walk the Bromley Council of Youth
Usually,
Hastings ^hich
by
raised ?2,600'.
One can only marvel at initiative like this, which should prove just as necessary an asset in the Club's next stage. When Anchor House is ready they hope to have a more ambitious range of activities though no doubt there will be practical problems to match. Problem number one on many clubs' list is transport. Municipal bus services being what they are the clubs rely on members with cars, but a carefully-worked-out itinerary for collecting and delivering four people may collapse if a car breaks down or the member's husband claims it for the
evening.
Involving members
Solving some of the practical problems can be involving members in a mildly therapeutic procedure. Even if the difficulty is no more weighty than deciding whether to change to a different brand of tea, or how much to charge for it (3d a it can be an imporcup at the Anchor, extras free) tant step forward to full social involvement. But first place is often a even joining the club in the major victory. 'I can instance a girl', one leader said, 'who had been in hospital some years and first step towards came to the club. She said the a
way of
getting out of hospital was the hospital, which we ran
the social club within
every Saturday evenClub which made me pluck up courage to leave the hospital".' Outside, the psychiatric social club is partly an outpost of the hospital. It's also a haven where help in an unfriendly-looking world, 'a can be had means of safety', someone wrote recently of the
ing. She said
to me "It was the
Stones Club, 'whereby ex-patients can the great chasm which divides them from
Stepping cross
the world'. Words like 'bridge' are constantly being used by the people who run the clubs to express what they as they do they are doing. But knowing the pitfalls about what brash claims from making shy away successes they have achieved. 'I know we have kept three people out of hospital', one of them said. 'There was one girl who couldn't be left alone look after her until so we had a rota of people to she got better'. And another: 'There was a woman with a travel phobia. What happened was that she but one would was referred to us by the hospital have thought it was impossible to help her through the club. Still, she was helped, by one of the volunher. And then because tary people transporting she made relationships within the group which tremendous efforts were important to her she made to overcome her difficulty. 'She started to go out for other occasions. And
she left the club over Strange, when you
social club should member leaves.
a
year
come
ago?and got to think of
count it as a
a
job'.
it, that
a
when
a
success
PSYCHIATRIC BRIDGES By PAUL VAUGHAN A
Little while ago
^rpington, east
Mrs.
A.,
a
housewife in
it sounds the remarkable thing in the world, it was a tr'Umph in its way?because Mrs. A. had for Months had a fear of leaving her own house, which dipped her with a panic hand if she as much as stepped across the threshold. Marooned in her semi-detached just as irrevocably, it seemed, as a castaway, Mrs. A. had reached l^e point when the only solution appeared to be went on a bus.
Though
in a mental hospital. She had already weeks in one as an in-patient. But it didn't come to that. Mrs. A's bus ride was one of the small victories of a psychiatric social club?a club to help people with mental illness to become once again members of the community. The one that helped Mrs. A. was the Anchor Club. Like others of its kind, it is run voluntarily, by a small group of Orpington citizens who happen to have an interest in helping the Mrs. A's of another
spent
spell
some
29
the neighbourhood. By understanding pathy they are managing to lower the
and symbarricades which mental illness?that loneliest of afflictions? builds around its victims. The names chosen by various groups in and around London give a fair idea of how they see their function: the Anchor Club, the Helping Hand, the Stepping Stones, the Rendezvous Club. Each has its own approach but they are all doing the same thing, if in different ways?helping to make a reality of the principle of community care by giving their members a regular meeting-point and, for many of them, a bridge between the protective environment of hospital and the stresses of daily life. 'Our members are mainly people referred by psychiatric social workers, GPs and mental hospitals', I was told by Clarinda Attlee, Secretary of the Orpington Local Association for Mental Health. 'Occasionally though we have people who might have to go into hospital if they did not have some support of the kind we can give them. They're isolated people mainly'. The rescue from isolation is brought off in unspectacular ways. On Thursdays from two till four there's a meeting where Anchor members can do handicrafts, play cards, or just sit and gossip. Every other Wednesday morning one of the other club leaders, Mrs. R. Poland, runs a discussion where, she says, 'we might discuss a book, in a very permissive, informal way'. Then there's a monthly film show, also attended by patients from the local hospital. At the Rendezvous Club in Wimbledon, about a dozen members come to the meeting every Monday, to sit and talk or play whist, have a cup of tea and, some of them, to make things?little things like Christmas labels or scrap-books. 'What they make isn't all that important', said the Secretary, Mrs. Harris. 'It's helpful for people to be doing something and to be able to talk at the same time'.
Ping-pong A
to drama
professional worker who was involved in starting the Helping Hand Club, told me, 'Activities were provided for the club?anything from chess to ping-pong and drama. But if the activity is too specific you may not be giving the members what they want. It's no good giving the idea, say, that it's a club just for chess-players. 'We used to think the thing was a failure if everyone wasn't taking a very active part. But we came to see that something was happening if they were just there. Over-organisation can kill a club.' The helpers have to learn that to some extent they're in the members' hands. The members themselves will shape the pattern of an evening and gauging what's wanted at the opening moments of 30
a meeting can be quite a tricky business. An organ' iser tells of the chagrin of well-intentioned volufl' tary helpers whose carefully-laid plans for tbe evening came unstuck. 'They couldn't bear f?r members to come in and just start talking wfae11 they had a film they'd booked and were keen t0 show. Meantime, all the members wanted to was to talk about the rail strike.'
Over-organisation By trial and error most clubs learn the pitfall5 of over-organisation ('It pays to be a bit duflifr and helpless at times', said Mrs. Attlee, 'too mu^ efficiency puts people off'). Even more of a mistake is any attitude which might be construed by men1' bers as patronising. Nothing can kill a club faster A psychiatric social worker found the people wh" volunteered to help run the club were adequate!) self-selecting. The ones who wanted to help came
forward and these were usually the ones y needed. The only trouble was, one or two of tb* would-be helpers needed help themselves, bu1 they were 'not the sticking sort' and soon stopped
coming.
So what kind of person is wanted? Someone
sensible and sympathetic, obviously, and it's necessary to have an academic training or an) detailed factual knowledge about different kind5 of mental illness. One of the worst crimes is play the amateur psychiatrist, a brand of cofl' descension also guaranteed to lose members with a rush. All the club leaders and helpers I spoke to stressed the virtues of knowing when to become inconspicuous. The whole point of having a social club like this, they say, is that members and helpers mix in together. There is no 'us' and 'them'. Every one is a member, though the leader is known to be on hand for advice if anyone wants it. 'The thing is to have everyone anonymous", MrsAttlee said firmly, 'not to distinguish between one kind of members and another, and if you have everyone thoroughly muddled, not knowing which is which, then you've achieved something. It's this question of not being "us" and "them", all tbe time. If you can't tell one from the other, the i" people realise they've nothing to be frightened ot You get the "us" and "them" situation in a hospital. If they find this anonymous atmosphere if the club, they do slip into the community mucb better. 'And it slides into the position where the patient becomes the helper. After they've been for a fe^' months and someone new comes in, you say, g? and have a chat to her, she's lonely. And they fee'
they're
no
longer being helped?they
are
It's a source of tremendous pride.' At the Rendezvous Club, Merton's
helping-
Principal
Rental
Welfare Officer, Frederick Rainer, drops regularly and, on the night I was there, sat smoking his pipe and chatting to the members. in
Wis comfortable, reassuring
the need for
presence
exemplified
working relationship with the Professionals which the clubs, as a rule, make a Point of creating. For no psychiatric social club can work miracles and there is often danger of a Member relapsing and becoming ill again?in ^hich case the club's leader has a big responsibility. One club leader told me: 'One can have lots of little conversations, or one organised discussion, but I felt my role was to intervene if situations some
Sot too
painful for a particular member. For instance there were times when a member c?uld be scapegoated. There was a conversation ^hen a member brought up her problems with her adolescent daughter. And there was more talk, and the other members began to get quite punitive towards her. They began by making helpful com-
ments,
of course. But I felt I had to intervene when
the members began to say things like, we never had problems like that with our children. Meaning : we are perfect but you are just a bad, awful Mother. I told them if this had not been a problem for her she wouldn't have brought it up. I think
those
members were able to learn from this and the mother did come again.' Finding a home for the social club is one of the hig difficulties. The Rolls Royce of the clubs as ^ar as accommodation is concerned is undoubted y |he magnificent Stepping Stones Club at Bromley, in what was a large private house in its own grounds, bought with an ?18,000 gift from the King Edward's Fund. At Wimbledon, the Rendezv?us Club meets in a room made available in the Guild of Social Welfare. It's not theirs alone, and
^either is the
hitherto occupied by t e Their premises have borrowed room in a large Elizabet an manor house owned by the Council and let to them at 50s. a time.
Anchor heen a
room
Club in
Orpington.
Raising money
But the Anchor
now
has
a
house of its
own
Anchor House, naturally?a 50-year-old, threestorey house in the middle of town, price ?7,60U. Clubs of this kind are perennially hard up. But t e Anchor managed to raise enough money within
five
years. When I asked Mrs. Attlee how, she said 'Oh, we accumulated it, you know. A cut ?f ?100 to ?150 from flag days, sales of work, a nearly-new shop in someone's house, somebody else had a little fete in the garden. Of course we got ^uite sizeable lumps from well-wishers the City Parochial Foundation give ?300 and there was t e Walk the Bromley Council of Youth
Usually,
Hastings ^hich
by
raised ?2,600'.
One can only marvel at initiative like this, which should prove just as necessary an asset in the Club's next stage. When Anchor House is ready they hope to have a more ambitious range of activities though no doubt there will be practical problems to match. Problem number one on many clubs' list is transport. Municipal bus services being what they are the clubs rely on members with cars, but a carefully-worked-out itinerary for collecting and delivering four people may collapse if a car breaks down or the member's husband claims it for the
evening.
Involving members
Solving some of the practical problems can be involving members in a mildly therapeutic procedure. Even if the difficulty is no more weighty than deciding whether to change to a different brand of tea, or how much to charge for it (3d a it can be an imporcup at the Anchor, extras free) tant step forward to full social involvement. But first place is often a even joining the club in the major victory. 'I can instance a girl', one leader said, 'who had been in hospital some years and first step towards came to the club. She said the a
way of
getting out of hospital was the hospital, which we ran
the social club within
every Saturday evenClub which made me pluck up courage to leave the hospital".' Outside, the psychiatric social club is partly an outpost of the hospital. It's also a haven where help in an unfriendly-looking world, 'a can be had means of safety', someone wrote recently of the
ing. She said
to me "It was the
Stones Club, 'whereby ex-patients can the great chasm which divides them from
Stepping cross
the world'. Words like 'bridge' are constantly being used by the people who run the clubs to express what they as they do they are doing. But knowing the pitfalls about what brash claims from making shy away successes they have achieved. 'I know we have kept three people out of hospital', one of them said. 'There was one girl who couldn't be left alone look after her until so we had a rota of people to she got better'. And another: 'There was a woman with a travel phobia. What happened was that she but one would was referred to us by the hospital have thought it was impossible to help her through the club. Still, she was helped, by one of the volunher. And then because tary people transporting she made relationships within the group which tremendous efforts were important to her she made to overcome her difficulty. 'She started to go out for other occasions. And
she left the club over Strange, when you
social club should member leaves.
a
year
come
ago?and got to think of
count it as a
a
job'.
it, that
a
when
a
success
