In Winterton Hospital, Sedgefield, there are few wards - one female, one male and two mixed - where relatively normal people are kept as in-patients. They may be depressed, or hysterical, or nervous - and all have some mental problem; but they are in no sense of the word insane. Many have had treatment as out-patients before they were finally committed to hospital.

In this sense, the wards represent a failure on the doctor's part to help people, in that they have been forced to take normal people out of their normal environment and place them in an asylum built for lunatics.

While not suggesting that Winterton is totally ineffective where the insane are concerned, the central failure of the system lies in this: all the sane patients are very sensitive people, people who are liable to be hurt more easily by the strains and tensions of ordinary life, and to one who has actually been a patient it is obvious that Winterton, rather than removing the strains, substitutes others of its own. To the sensitive, it is often an ordeal to have to meet and deal with the mentally subnormal who are allowed out into the grounds of the hospital; to married men and women of middle age it is humiliating to have to ask the permission of a young girl nurse before they can even go out to buy a packet of cigarettes; frequently the patients in one ward have nothing in common with each other but their depression, and conversation becomes morbid, leading the patients to brood more and more on their individual difficulties. Many are left with no idea of how long they will be in, and they are frightened and frustrated by the feeling of being caught up in an impersonal machine over which they have no control.

Unfreedom
The layout of the female ward consists of a dormitory, a room containing few beds, several single rooms, a lounge-cum-dining room, plus toilets and bathrooms etc. Some of the toilets have no locks on them. The decoration is bright and cheerful, and many improvements have been made in the last two years. But the atmosphere is inevitably one of an institution. Mealtimes, times of getting up and going to bed are rigidly regulated, and the patients are expected to help with ward duties which are sometimes distasteful. One patient, told to clean out the toilets, was angry and distressed. Under-staffed as Winterton is, restrictions on freedom are inevitable; but it can seriously be doubted whether the three nurses on duty should have to look after so many patients at once.

But then the question arises - what can Winterton do to help? So many of the patients have been in these wards for periods of years, and so many speak of having to come back inside time and again, that the system must be defective somewhere. Treatment basically consists of prescribed tablets for all, electroconvulsive therapy for most - out-patients can also have these - and occupational therapy for those who choose it. All are encouraged to take part in the latter, and its main value lies in teaching patients a hobby for when they come out. The women can learn crocheting, knitting, sewing, basket-weaving and other things. Some, of course, don't enjoy handicrafts; nothing is provided for them except the hospital library.

But all this treatment seems to be basically inadequate for perhaps the majority. One has to discount, of course, the overload of geriatric patients who simply cannot look after themselves and are in hospital because there's nowhere else for them to go. This is a problem that the National Health Service is in no position to solve, purely because of the lack of trained staff. If there were more nurses, geriatric patients could go into a geriatric ward or hospital, and leave the beds in mental hospitals for mental patients. If, of course, it is worth calling the sane mental patients.

Apathy
The atmosphere in the ward is generally one of apathy. People sit smoking and staring about. There is not much conversation - markedly not amongst the middle-aged people. One feels that the patients, by the very fact of having nothing to do, are losing what capabilities for normal life they may have. Certainly the number of long-term patients and the number who regularly return, seem to point in that direction.

Why no group therapy? The mornings are unoccupied, and so are the evenings unless visitors come. Why not get the patients out of their easy chairs and start them talking?> Possibly because it is felt that a trained psychologist or psychiatrist should be in charge, and they are simply not available for more work. But purely for the sake of stopping vegetation it might at least be worth trying with one of the nursing staff in charge; some patients might be uneasy about revealing their private thoughts, but most will certainly talk if only someone will take the trouble to set the ball rolling. And at least it will make them use their minds.

Understaffed as Winterton may be, the nurses are not always as sympathetic as might be expected. One non-Christian patient who refused to join in singing grace was severely rated and the nasty little scene which ensued did nothing to keep other patients happy. Another girl, a student, was suddenly told to take a largactil tablet, which sent her to sleep, and she was very worried what effect this would have on her exams she was taking at the time, until another nurse was kind enough to explain that the tablets were not to be taken regularly. On the whole, shutting someone up in a hospital may stop them from committing suicide, but apparently it doesn't stop many from wanting to. So many times the words are heard "This place makes you worse not better" - and isn't the very fact of being shoved into a mental hospital enough to make anyone miserable and upset? An actual cure I have heard of is that of one patient who was so terrified by the atmosphere of Winterton that she discharged herself and resolved to suffer anything rather than go to a doctor and be put back in. In her case, it worked; but one wonders how many patients have left such wards and at last quietly committed suicide out of sheer inability to believe that the medical profession had any more help for them.

Society
And who should help them? This is the whole crux of the matter. The reason why depressed and nervous people are sent to Winterton is because they are not accepted in normal life. People will sympathise with a broken leg, but not with fits of crying and unhappiness. So you have to go into a mental hospital, and when - or if - you come out, you are labelled a neurotic and frequently treated with contempt, even by intelligent people who should know better. The mental hospital cannot treat you. It can treat your symptoms, but it just hasn't time to psychoanalyse every sane patient and get to the cause of your symptoms; even if it does, it can only diagnose the cause, not get down to doing something about it. If a person is depressed because he is shy and lonely, for instance, busy doctors can't provide him with the companionship he needs.

The answer to the problem lies with every one of you who are reading this. Human beings are made to come into contact with each other, and in a proper society everyone will help the next person, not just dismiss them as nuisances. All of us have problems, and all of us can help. If you know somebody who develops a serious problem, don't wash your hands of them; local GPs can prescribe to reduce depression and other sufferings, but it is only those who are willing to give their own time freely to unhappy people who can genuinely help and lighten the burden of sane cases on our mental hospitals. In the final analysis, Winterton cannot be blamed for its many failures to help the sane; psychiatric medicine is still far from being fully developed, and no doctor or nurse has the time fully to sympathise with and help an individual one of their patients. It is the apathy of society which has put sane people in mental hospitals; the blame rests with society, and society must do something about it. Whether it will or not is, of course, doubtful.

Winterton Hospital is for some a home, for others a prison and for a small minority a hospital where they can receive the treatment they need in order to return to the outside world. Most of the patients in Winterton receive tablets or capsules in one form or another, which in many instances are either dropped down the toilet or simply dropped on the floor by patients who pretend they have taken them.

Most of these patients, I believe, could be discharged if first of all they had relations or friends who could look after them. These are the long-term patients who know the ins and outs of the place from the tea room to the betting shop; most of them having been in Winterton and other hospitals for as long as they can remember.

It's a home for these, and when one mentions going into a hostel they refuse, saying if they are moved they will commit suicide or run away. They have grown up in the place, know what goes on, where and when, everything they need is taken care of. In a sense, I don't blame them for refusing to budge - if you have lived in a house all your life how would you like to be moved on into a strange place. The hospital league of friends do a great job in that they see all patients are visited at least once a year as well as raising funds for the many activities they carry out. It's heartbreaking to know that the relatives and friends of these patients could do so much if they bothered and thought of others once in a while instead of themselves. For too long people have been saying "I'm all right Jack, look after yourself" and then going to the bingo, for a pint and even to church.

I can remember one instance of a minister asking for volunteers to visit Winterton, and of a congregation of over 50 at morning and evening service he got one. And then we call ourselves human. The birds of the air and wild animals have more respect for each other.

For the short-term patient, Winterton is just another hospital where tests are carried out and treatment given. For those receiving the electric shock treatment, a maximum of eight is given but some get six. No-one I have met likes this sort of treatment as it destroys the memory. After each shock it takes a good while for one's memory to return, and even then, I know of people whose memory of things is not as good as before the treatment, many having to return for a further six to eight shocks.

This, however, is something which I cannot write about much as I haven't had the shocks myself and if I'd been asked to have them I would probably have refused. The shocks are given twice a week and if the patient has to have the full treatment this will mean at least a month in hospital. After the last shock he will probably be discharged and become an out-patient.

If anyone would like to help patients in Winterton hospital, they can help in the following ways - by joining the league of friends who do a fantastic job in visiting and helping patients, or by sending donations which can be used for a variety of things such as improvements to the wards, books for the library, coach trips to the coast - to name just a few. But for many, a smile is better than a packet of smokes and to know someone cares. This is enough to help a patient get out of the shell he has put himself in and to regain his confidence. Both regular visits and donations are important. This, however, is only my view and I have no experience in any part of the medical field. I'm writing as an ex-patient and visitor.