In order to discuss these issues I shall begin by introducing Howard Mitchell and his work. I will look at what written or printed sources he had access to and discuss what images and opinions these give. Then I will explore his interviews (the oral history), what impression these make and how these compare with the written or printed accounts. I also think that it is important to look at Mitchell's own background and discuss the possible influences this had on his own work. Finally I will introduce Goffmans model of "the total institution" and see how the different types of research prove or disprove his theories.
Howard Mitchell was born in Lennox Castle hospital in 1955 and then lived 400 meters from the hospital entrance. At 19 he got a job as a nursing assistant at the hospital and worked there for five years. He became interested in why people acted the way they did in institutions, why they followed regimes and where these regimes came from and why people were reluctant to change how they practiced despite these practices being seen as unnecessary and cruel sometimes (Block 4 DVD, Part 2).Howard Mitchell used many types of research to investigate these ideas; from daily record books and newspaper clippings to personal interviews and these all create a different impression of the hospital. Many, if not all, of the written, or printed records, which include patients' medical files, misconduct books and daily record books, were written by the staff, for the staff.
They were, therefore, completed very clinically and involved no information from the patients' point of view. The newspaper clippings were written to tell a story and sell a newspaper.For example the story describing a disastrous riot at the hospital (Unit 4 p157) reports patients barricading themselves in, setting furniture alight and stoning the firemen. While the following investigation describes it as an unpredictable event that the staff dealt with well, and quickly resolved. The oral account of Colin Sproul, who worked at the hospital, paints another picture of the incident saying that he felt that "something was going to happen" (Block 4 DVD, Part 2), implying that it could have been avoided.
There was also a book written for the opening of the hospital. It describes a hospital that is ahead of its time in the treatment of mental defectives and goes on to describe an amazing building that has acres of land, first class accommodation and kitchen facilities, workshops where patients will be trained in various skills and an assembly hall where entertainment will be provided. This was written for the promotion of the hospital and so emphasizes the positive aspect of the institution.If all we had available to us were the written and printed pieces of work, we would be led to believe that, apart from one small 'slip-up', the hospital was an amazing place, dealing with people with mental deficiencies.
The only details that were recorded were problems within the institute, incidents with patients and how these were resolved. There are no records of day-to-day lives. The oral history paints a slightly different picture. Colin Sproul comes across as a competent man who, nonetheless, had little support with dealing with patients with varying degrees of mental illness.
He explains that in his interview for the job, he was asked if he could play football as the hospital had a very good football team (Block 4 DVD, Part 2). This shows to me that there were little, if any, qualifications necessary for getting the job. We would not have known that if it were not for the personal interviews. When we have the opportunity to see an interview and use oral history, not only do we get the information first hand, we also get the chance to read peoples body language and facial expressions and can add these to how we may feel about certain evidence.Having said all this, oral history is not fool - proof we also need to be aware of the persons own perspective for example, when Colin Sproul was talking about the riot at Lennox Castle Hospital he may well have left out any information that he felt was detrimental to his reputation.
He may have also given false information unknowingly, as it has been some time since these incidents occurred and he may have forgotten some details. Some of the information may have also been his own opinions and feelings around a subject.Mitchell is very involved in the subject that he is researching. As I have explained he was born at the hospital, lived very close by and later got a job there.
He must have been very close to some of the staff and patients that he was interviewing and this must have had an influence on how he led his interviews and recorded the information he received. Mitchell was very aware of how his past may influence his work (Howard Mitchell in the Reader, p26) and this can only have been a positive thing. He would have limited its influence although not eradicated it.Many of the influences could have been positive ones. He would have known how to communicate with the patients to get the best from them but he may have also unintentionally led the conversations, knowing where they should end up, from his point of view. His relationship with some of the staff may have also resulted in better access to some of the written and printed records as well as a better response to requests for interviews.
Mitchell would also have had his own views and opinions of what life was like at the institute.After hearing the oral history from Colin Sproul we understand that the staff had their own problems in dealing with patients. They were un-trained and un-supported in their work. Then, after hearing from the patients themselves, we discover that they were sometimes happy with how things were done. For example Margaret Scally enjoyed the jobs that she had within the institute (Block 4 DVD, Part 2) although my initial view of them was one of cheap labor, while in the Lennox book it describes the work as a training and learning experience for the patients.Goffman defines a 'total institute' as having four main characteristics; batch living, binary management, the in-mate role, and the institutional perspective (K.
Jones and A. J. Fowles in the Reader p71). Lennox Castle Hospital displays all of these characteristics and much of the evidence of that can be found in the oral history.
Batch living is discussed by many of the resources; most of them speak of a number of people all living under one roof. Binary management is most clearly described, I feel, by Colin Sproul (Block 4 DVD, Part 2).He talks of how the staff had some seniority over the patients (being able to impose rewards and punishments) but how the staff also had restrictions. They were segregated from the opposite sex, the same as the patients. The role of the in-mate I think is covered by Margaret Scally (Block 4 DVD, Part 2).
She speaks of how her clothes were provided for her each morning and how those clothes were not her own but shared by the other hospital patients. Mitchell also talks of how much of the patients' case file was not available to the nursing staff.This allows no chance for staff to encourage any individuality even if they had wanted to. It may have been seen as unnecessary information, as from the time they were admitted they became 'another in-mate'. This was re-enforced with the rewards of 'woodbines' for good behavior and the punishment of the "five 'o'clock regime", where troublesome patients were got up at five and put back to bed at five (Block 4 DVD, Part 2).
Institutional perspective is about providing a false sense of community, which is best shown by the existence of the weekly dance and the football team.I feel that in order to gain as full a picture as possible on any subject it is important to have as much information, from as many different view points as possible. If we were to have only read the printed and written reports we would have believed that there were a few issues within the hospital, that were all dealt with quickly and efficiently. Further investigation shows that there were actually many positive and negative points to the hospital, and that many of the staff and patients shared views.
