Listening To The Silence: Remembering St James’ Hospital

Christine Lawrence takes a walk around St James’ Hospital, tracing the long history of the building and recalling her time working there in the 1980s as she wonders about the plans to sell and convert the Hospital buildings to housing.

St James’ Hospital, a beautiful example of Victorian architectures standing proud at the end of a tree-lined drive, is a monument to mental health treatment in the 19th and 20th Centuries. Visited and feared by many, loved by some, it remains imposing, regal even, set in a green island in the midst of a busy city.

The canteen is still there, now called “The Restaurant”, once only for staff and visitors, now open to all. It’s 11.45 am and quiet – just one or two workers coming in to grab a pre-wrapped sandwich or take-away coffee. I remember a busy, noisy room, back in the 1980s, barely a free seat, the room loud with laughter and filled with smoke. These were the days when the wards were still full, when the hospital cared for adults from the age of 18 upwards. They came from all over Portsmouth, Havant, and even Petersfield for treatment.

Community teams were in their infancy then and included specialist services for children and adolescents, and for those with substance misuse problems. My job was to run the clinics in the city to ensure that all of those who were living in the ‘community’ regularly attended for their long-acting injections, a treatment for psychotic illness. I had an office in the main hospital but most of my work was undertaken in GP surgeries across Portsmouth. Only when my clients (the word ‘patients’ had already been replaced) missed an appointment did I have to chase them up with a phone call, reminder letter, or occasionally a home visit. I liaised with the Community Mental Health Teams based in offices found within the grounds of St. James’ itself.

The coffee lounge was the hub of the hospital for staff who took proper lunch breaks and met to gossip, laugh and relax in the middle of the working day. Noisy corridors bustled with staff dashing to the pharmacy, or escorting patients to the ECT department or the Patients’ Affairs office (a sort of bank for the patients and was open only for a limited number of hours). Porters rushed regularly from the big main kitchen, wheeling trolleys of food to be delivered to the wards in time for lunch or supper.

Standing in these corridors today, I listen to the silence, wondering at the ghosts born of misery that walked here only a short time ago. I feel the emptiness, the peace as it settles and I spare a thought for the souls who lived and worked here over a hundred years ago. I am still surprised that this building opened its doors only 136 years ago, some 70 years before my birth – barely a lifetime – and yet now St James prepares to fade into the history of Portsmouth.

Following the County Asylums Act in 1808, asylums were built to offer a more humanitarian environment in which to care for ‘pauper lunatics’ – those with a mental health problem who had no money to pay for treatment. St. James’ was built later in the 19th century and finally opened in 1879. The environment was designed to be humanitarian: the buildings were light and airy and a significant improvement on the workhouses patients were used to being housed in. However, the regimes were hard, care and treatment very limited, and the food basic and unpalatable. Despite the hard conditions, restraint was rarely used in the early years. Treatments as late as 1932 were limited to hydrotherapy, narcosis (deep induced sleep treatment), convulsive therapy, malarial treatment, pre-frontal leucotomy, medication and the management of faulty habits and behaviour.

The hospital was gender-segregated well into the middle of the 20th century for staff and patients alike. There were two driveways into the main hospital: one for each of the sexes. Annual events such as the sports day and the masked ball brought the genders together and caused much excitement amongst the community.

Today I walk past the entrance hall, down a corridor towards where my old office was located. I pass the gallery displaying photographs of the hospital when it was newly built. Nurses stand next to neatly-made beds in wards of 100 or more, alongside views of the farm where many of the patients worked as part of their ‘therapy’. The hospital was almost entirely self-sufficient then. A picture of the Entertainment Hall shows off the hospital’s architecture: the high ceiling above stained glass windows and the proscenium arch which would have been the envy of any late Victorian theatre. In another picture, male patients take the air in one of the courtyards, clustering around a wooden hexagonal shelter during their daily exercise in the grounds. The shelter is still there in the courtyard, now an open green space leading to one of the car parks.

I walk past the Entertainments Hall, looking in through the open door. Little here has changed since my time here in the 1980s. Looking back on the old photographs, the hall is pillared and decorated beautifully. The pillars are still there and if you peak behind the curtains of the stage you can catch a glimpse of the original brick and tile-work. The proscenium arch is now boxed in and painted an institutional cream. Looking up, the high ceiling remains open and you can see the colourful stained-glass windows, still in perfect condition. I pause to imagine the many concerts which would have been held here, the masked balls packed with costumed dancers – patients and staff alike – and later still, the movie shows that were a weekly event.

I wander back to the coffee lounge. It’s just past noon and the room is noisy. Through the doorway I see a long queue of people waiting for hot cooked food, as others flit in and out, grab a sandwich and leave. The place is alive, as it used to be back in the 1980s, but the patients are all gone now. I wonder to myself who all these people are. I sit and look around, making up stories for each of them. Some are in uniform working perhaps in one of the new units which have sprung up in the beautiful grounds of the hospital: The Limes, Kites Unit, The Orchards. Gone are the services that filled many of the original villas scattered in the grounds; the only one remaining is Baytrees, the service for drug and alcohol detoxification and treatment. Many of the old villas still stand, but they are empty now, nestled amongst the trees where foxes roam.

So what will happen next in the history of this exquisite building? There are plans for the newer services to remain in the modern buildings in the grounds of the hospital, but also proposals to vacate the main building by the end of December 2016. Many of the existing facilities at St. James’ will be moved to the St. Mary’s site or to the Battenburg Avenue Clinic after March 2015. A new facility for mental health services and ancillary support services will be built within the existing grounds and a small area of land will be retained for these services.

The remainder of the property belongs to NHS Property Services Limited and is in the process of being prepared for housing development, as follows:

Phase one: Land in the South East of the site including three former villas from the old hospitable has been identified as suitable for housing and NHS Property Services intends to sell it to help meet the Government’s commitment to release surplus public sector land for housing….an application for planning permission will be submitted to Portsmouth City Council for residential development and then the intention is to market the land in the autumn of 2014.

Phase Two: To vacate the main block of St. James hospital and other ancillary buildings on site – to vacate them by the end of 2016 with sale to follow thereafter.

There has been strong opposition from local people to these plans. Opponents point out Milton is already swamped with traffic, that roads and schools will be placed under more pressure. Others worry about the loss of green space on an island where it will not be easily replaced. But despite the protests of residents, the writing seems to be on the wall for St James’ Hospital as we know it.

Is it sentimental to wish we could keep at least a part of the hospital building and its beautiful architecture, retain just a small relic of the Entertainment Hall, or Ballroom as it was originally called? In my dreams the Entertainment Hall is restored to its original splendour and becomes a theatre, or an arts centre – a gathering place for the Milton community who have come to love St James’. But perhaps too many of the people who passed through this place only want to forget it ever existed.

Yet until the day St James’ closes its doors for good, I will continue to go back, and remember. And in the future I hope that there will still at least be some green spaces to walk in, where we can stroll, and remember, and admire the rich history of this wonderful building.

Photography by Sarah Cheverton.