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Work in a large and traditional Mental Hospital as a Consultant Psychotherapist provokes questions about the psychological adjustment of staff faced with the grim and often despairing tasks met within these institutions. When I first went to work in a large traditional Mental Hospital, one of my first impressions was surprise that people would be willing to work there. Many people had spent their whole careers in these institutions - institutions that had recently been publicly vilified in scandals and official enquiries (e.g. Inskip 1976).
I began to wonder how people coped. For myself, one way I coped was to approach it as a research problem worthy of investigation (Hinshelwood 1979).
The Mental Hospital appears to be an excellent opportunity to become familiar with the features of a demoralised institution. These include a sagging belief in the purpose and effectiveness of the institution. Often this is projected onto other groups within the institutions - like the administrators - ‘If it wasn't for them we would be able to get on without interference’; or the works department; or some other Aunt Sally. There is a retreat into cynical though often humorous stories about the parlous state of the institution. Individual members of staff seek a position for themselves and their own work or department, quite without reference to the needs of the institution's primary task. Personal empire building of this kind leads to considerable rivalry and bitterness as it is based on the attempt to secure a personal sense of work in an institution which cannot offer anybody a feeling of value or adequate job satisfaction. Such processes lead in the end to a fragmented institution with the parts working against each other, each one able to point to the uncooperativeness of someone else. A pernicious vicious circle develops that traps the institution into a permanently demoralised state.
Elizabeth Bott (1976) has described the peculiarly difficult task of the modern Mental Hospital t