Historical mental health research helps service users of today

The University of Dundee is helping mental health service users to explore the experiences of asylum patients from the past as a way of improving their own wellbeing.

Dundee is one of six partners in a UK-wide community programme, ‘Scaling Up Change Minds’, that uses archive collections to promote better mental health and social interactions. It connects isolated people with local heritage assets and each other in a way that challenges them to use their creativity, a factor that is known to improve mental wellbeing.

It follows on from a pilot which saw the University’s Archives Services team work with Dundee Mental Health Network (DMHN) to carry out research into the ways mental health patients had been treated historically. The project was shown to imbue those service users with a new set of skills and improved confidence.

The University holds historical records for NHS Tayside, including archives from former asylums in the area. DMHN service users were invited to examine archive materials and contribute their own stories to the archive at the close of the project.

One of the participants, Marion Fraser, from Dundee, says the project has changed her life and that of her fellow participants, who have subsequently formed a group looking to help others with a history of similar issues.

“I am 65 and looking towards getting qualifications that will allow me and my colleagues to help others with mental health problems and this is all thanks to the Archives project,” she explained.

“It was a battle for me to even go to the Archives but from the moment I got there I didn’t want to leave. When we started the research we learned so much about the way asylums worked at that time and discovered both good and bad aspects. I felt energised by the research and the people I met doing it. It has done so much for my confidence and mental health.

“The project has led to so many more opportunities for me and the others who took part. We are raising awareness of these issues in the community and have written a play about mental health that has been performed about a dozen times across Scotland.

“We formed a recovery group that meets every week to help people with mental health, drugs or alcohol problems. I have contributed to research looking at how people’s mental health was affected by Covid and we received funding to set up a Mental Wealth Academy and will be going round businesses in the local area to demonstrate to management the strategies they can put in place to stop their staff going off with mental health problems.”

Scaling Up Change Minds will see the programme, originally developed at Norfolk Record Office before being trialled in Dundee, rolled out into six areas that will test new resources before being made available to organisations looking to use archive material as a way of engaging with mental health service users.

Jacqui Eccles, from the University’s School of Health Sciences, will also evaluate how the project impacts on the wellbeing of participants.

She said, “The pilot demonstrated the value of the archives in bringing communities together, in giving voices to individuals under-represented in the university environment and in wider society, and in creating spaces for difficult conversations.

“These projects provide opportunities to recognise the skills and experience service users bring to the University. Sharing the rich University resources with service users helped bring the voices of mental health patients to the archive, something that was entirely absent from the asylum records.

“This work also encouraged conversations about mental health care. As part of the evaluation process, we will produce a systematic review of peer-led education projects for mental health service users.”

Participants in the Dundee pilot were given access to the University’s archive resources, learned about storytelling, helped analyse the asylum records, and took part in round-table discussions about how the experiences of the asylum patients compared to their own.

They also helped deliver a lecture to Nursing students on the history of mental health care, with both students and service users commenting on the enriched learning experience this provided.

Participants of this first round have gained skills which will allow them to be involved as facilitators of future iterations of the project in addition to confidence building, access to a resource of which they were hitherto unaware and the ability to converse about their own difficult experiences in a safe and supportive environment.

The new programme will be led by the Restoration Trust charity, who received a National Lottery Heritage Fund grant of £250,000 to roll Change Minds out nationally.

A multi-media website hub managed by the Restoration Trust and Norfolk Record Office will contain resources relating to advocacy, partnership formation, delivery and evaluation to enable organisations to develop their own projects with service users.

Six Change Minds iterations across the UK, including one at Dundee, will test the hub through working with dozens of individuals from excluded backgrounds and diverse communities who live with mental health challenges.

Case study – Edith Swankie: a beacon of hope

Participants in the trial uncovered the story of a young woman, whose experiences demonstrate the way health services in the early 20th century treated mental health and whose tale ultimately provides hope.

Edith Swankie was just 14 when she was admitted to Dundee Asylum on 19 June 1902. The records show that the cause for admission was recorded as “symptoms of hypomania linked to hormones”. While the prospect of a teenage girl being admitted to a mental health facility for such a reason might seem abhorrent now, Edith at least appeared to have familial support to rely on. After she became very low in mood and withdrawn, her mother removed her from the asylum six months after she was admitted, but the paucity of information contained in official asylum archives raised many questions about how she fared in life after being discharged. Did she encounter mental health problems the rest of her life? How did a chauvinistic society treat a girl diagnosed with mental health problems at such a young age? Intrigued by Edith’s story, the participants and their partners from Archives Services set about filling in the blanks.

They found that Edith married James Alexander Brown on 26 April 1911, and the couple went on to have a son, Alexander, who died in 1999.

There is no evidence Edith experienced mental health issues in her adult life, and she passed away at Dundee Royal Infirmary in 1955 in Dundee Royal Infirmary, over forty years after she was admitted to the asylum.

One of the most striking things about these records is the paucity of representation of patients’ own voices, with most of their stories being recorded solely in the records kept by healthcare professionals. Despite this, participants said they felt they got to know Edith and felt tremendous empathy for her and her situation, and were delighted that she had gone on to enjoy a normal family life despite the difficulties she had encountered in adolescence.