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Remembering St Augustine's mental hospital in Chartham, near Canterbury, 30 years after its closure in 1993

Opened in 1875 and at one time known as the East Kent Lunatic Asylum, for more than a century St Augustine's hospital was home to thousands of patients suffering a range of mental health disorders.

To mark 30 years since the final patients left the institution near Canterbury, reporter Rhys Griffiths sat down with a former nurse to hear his memories of life on the wards...

St Augustine's hospital at Chartham pictured in 1976
St Augustine's hospital at Chartham pictured in 1976

At just 17 years of age, Lawrence Whyte arrived at St Augustine's hospital in Chartham in 1972 to begin a career in nursing which would span five decades.

While he remembers it as a "happy time", he admits there "dark moments" which have stayed with him to this day.

It was a tumultuous period for the institution, which made national headlines over some of the treatments used there - particularly the controversial electroconvulsive therapy.

Meanwhile, as he began his career there were patients at St Augustine's who could have found themselves admitted for the sin of being a "promiscuous" woman, or veterans of wars who were suffering from "shell shock" - what we now know to be post-traumatic stress disorder.

Facilities were basic too, with many patients sleeping in large, open wards which afforded them no privacy whatsoever in what he describes as an "intimidating" environment.

Laurence Whyte began his nursing career at St Augustine's hospital more than 50 years ago
Laurence Whyte began his nursing career at St Augustine's hospital more than 50 years ago

Speaking to KentOnline 30 years since the institution's closure, Mr Whyte, now 68, told how the sprawling St Augustine's site was a self-sufficient community.

He had left Simon Langton Grammar School for Boys in Canterbury with a clutch of O-levels and got a job at the hospital a year later, following encouragement from his mother.

"The hospital itself was a great learning experience," he recalled of his early days training as a student nurse.

"It was three miles outside Canterbury, it was more or less self-sufficient. It had its own shop, it had its own laundry, it had its own tailoring shop, its own social club.

"It had nurses' residences and staff housing. A farm had been there but it had recently shut down. So it was its own community."

A photo showing inside the dilapidated former St Augustine's site in Chartham, near Canterbury. Picture: Stacy Leith
A photo showing inside the dilapidated former St Augustine's site in Chartham, near Canterbury. Picture: Stacy Leith

He says there were about 1,000 patients when he joined and it was one of the biggest employers in the area at the time, with doctors, nurses and "everything you needed to run a hospital".

Mr Whyte says there was a social side to his training - but the work was very hard.

While some students lived on site, others took advantage of an independent bus service that ran to the hospital and back.

They worked 42-hour weeks - including some night shifts - and were expected to be a full-time employee.

"There was no time other than the time you spent in the school of nursing for learning - that was done in your own time," he said.

In the 1970s the world of mental health treatment was changing. The practices developed by older staff members - many of whom would have worked in the same hospital for decades - were beginning to be challenged by a younger generation fired by new ideas.

He described how the facility was "very self-contained" and divided into two sections - a male side and a female side.

"It was intimidating. There was a lot of physical hard work, just in terms of people's personal care.

"There wasn't a lot of therapy. It was very much an institutional model. It was batch care, and that was one of the underlying reasons for the inquiry there - that there wasn't really any individualised care for people there.

"Patients fitted in with what was done. Or not."

"Things exploded - I think it was the front page of the Sun..."

Around the time he joined the staff at St Augustine's, other colleagues who were also studying at the nearby University of Kent were becoming increasingly vocal about what they saw as the shortcomings in care at the hospital.

These concerns were, Mr Whyte explained, largely ignored by the authorities until eventually they reached the national press.

"Things exploded - I think it was the front page of the Sun," he said.

"As a result of that the government decided to appoint a QC to look into these allegations. As you can imagine, it was a very divisive time.

"Most student nurses, most newly-qualified staff, were in favour of what was being said and most of the older generation were bemused.

"Out of that report they then started collecting evidence on maltreatment and incidents that had occurred.

"So that was another thing that was investigated, not just the mismanagement of the hospital and the mismanagement of the treatment process, but also the ill-treatment of some individuals by members of staff."

Mr Whyte says the care available at the "big family-run hospital" was limited.

As most of the patients were unlikely to ever leave the hospital "there wasn't any therapeutic motive, they weren't going to be discharged".

"There was a church there which performed births, weddings and funerals - and the graveyard. A lot of people from the hospital were buried there."

The former St Augustine's hospital pictured in 2014. Picture: Stacy Leith
The former St Augustine's hospital pictured in 2014. Picture: Stacy Leith

Lengthy evidence sessions were held at the hospital as the inquiry progressed.

Today, there is much greater understanding of how to treat mental health conditions. But in the 1970s there was still next to no community care. Patients seen as "incurable" faced a lifetime of institutionalisation.

"There were practices, which were not exclusive to St Augustine's, like electroconvulsive therapy (ECT) which was still being used," he recalled.

"It was as modern as it was anywhere else in the country. But its use was perhaps inappropriate for a lot of people receiving it.

"There were individual cases of cruelty and harm which were peculiar to St Augustine's, and the evidence says those kind of things were also happening in other hospitals.

"St Augustine's was probably the first and the most widespread [investigation] and that led to a number of recommendations about the standards of care that patients should expect."

Mr Whyte says a lot of the medication for longer-term patients was still being developed, so their chances of rehabilitation were relatively small.

While some did eventually leave, "there wasn't any real infrastructure in the community for them to go to".

"So they would be leaving a long-term placement at the hospital, in which they had been accommodated and become institutionalised, and then thrust out into a community that had no facilities to help them."

The findings of the inquiry at St Augustine's revealed instances of both physical and psychological violence again patients.

The water tower on the site of the former hospital pictured in 2002. Picture: Jim Bell
The water tower on the site of the former hospital pictured in 2002. Picture: Jim Bell

As a result, changes were made and practices improved.

A good example of this is in the prescribing of ECT, which is now used much more discriminatingly rather than being seen as a blanket treatment for all kinds of mental illnesses.

"At the time it was the administration of an electric charge into the hemispheres of the brain," Mr Whyte said.

"It was controlled, the person would have a muscle relaxant and an anaesthetic in order to control what would result, which would be an epileptic grand mal seizure.

"It was administered by a doctor. There would be an anaesthetist or somebody with anaesthetic training there as well, and a team of nurses.

"It would be in some designated wards on some mornings of the week. You could have maybe 20 to 30 people coming for treatment. And the treatment would be usually twice a week for six weeks."

Mr Whyte recalled that the issues raised by the inquiry focussed on which patients were being given ECT.

"We now know that it is an effective treatment for people with very severe depression. When antidepressants or therapy have failed then ECT can be a front line treatment still.

"At that time the diagnosis of the person wasn't that important for the administration of ECT.

"So, you could have people who were suffering from psychotic illnesses like schizophrenia or manic depression or bipolar, or people who had what we now know as personality disorders, having ECT administered. That was all kind of discredited as a result of the inquiries that happened.

Princess Diana visited St Augustine's in October 1990 as part of her role as patron of the charity, Turning Point, which helps those with drink, drug and mental health problems. She toured three wards and met patients before joining in a seminar on mental health
Princess Diana visited St Augustine's in October 1990 as part of her role as patron of the charity, Turning Point, which helps those with drink, drug and mental health problems. She toured three wards and met patients before joining in a seminar on mental health

"It has a specific purpose, but it has to be much more gentle than perhaps it was then."

Mr Whyte says patients who had received ECT would suffer from short-term forgetfulness, a severe headache and a period of confusion immediately afterwards that might last for a few hours.

"It may not have changed some people's mental condition, but it may have changed their behaviour.

"For people with depression, they would come out of the depression. It was very effective given to the right person in the right way.

"So you would see people improve and that kind of reinforced the need to continue.

"The type of drugs that were available were very small in range and their actions were not very good really.

"So it was difficult. You only had a limited range of treatments and at the end of the day if nothing else worked, well, let's try ECT."

And how did such a dramatic upheaval in hospital culture impact the working lives of staff at the hospital, as the authorities shone a light on how St Augustine's was run?

"The reports and the inquiry were divisive, they had split groups," he said.

"The younger group, they were basically in support of what was being said about the treatment regimes and the lack of therapeutic drive.

Some of the former St Augustine's hospital buildings at Chartham in 2016. Picture: Chris Davey
Some of the former St Augustine's hospital buildings at Chartham in 2016. Picture: Chris Davey

"The oldest staff I think were a bit shocked and a bit fearful was being said, and a bit scared of what the consequences might be.

"It was for a time not the most pleasant place to work, and there was a lot of suspicion and mistrust, and of course people split along family lines and generational lines."

After leaving St Augustine's following training, Mr Whyte worked for a spell at Kent and Canterbury Hospital while also studying for a degree at the University of Kent.

Following another short spell at St Augustine's in the 1970s he moved to a new role in nursing in Yorkshire, where he lives to this day.

He retired in 2015, but when the pandemic came he answered the NHS's call for retired nurses to return. Today he works on short-term contracts with patients suffering from eating disorders.

A career in caring stretching for more than half a century allows him to reflect on just how far care for people with mental health conditions has progressed - and how the lessons from the 1970s inquiries have been learnt.

"There is much more patient empowerment. They are much more involved in their care, making choices and making decisions.

"The range of treatments that are available in terms of the medication, and the talking therapies, is huge.

"The methods for managing people in terms of progression are much more mapped out and clear, and I think the training is obviously more evidence-based and academic."

St Augustine's shut in 1993 and most of its buildings, although not the chapel, were demolished. In the late 1990s, work began on redeveloping the area as a housing estate, which is still known as St Augustine's.

Princess Anne visited St Augustine's in 1984. Picture: Stacy Leith
Princess Anne visited St Augustine's in 1984. Picture: Stacy Leith

How does Mr Whythe now look back on his time at the hospital?

"It gave me the basis for how I wanted my caring to develop," he said.

"It was a very, very happy time for training but there were dark moments in it, and I think the dark moments are the ones that stayed with me because they were the most powerful.

"They were the ones that most underpinned how I thought I should be as a nurse."

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