Where I live in Wales we have a lively association to help asylum seekers from abroad who are stranded either waiting for a visa or an appeal against the refusal of a visa. But there is also the spooky ruin of an Asylum, or institution where a century ago 'lunatics' were locked up. What is the connection? The word 'asylum' means 'a place of refuge' and the mentally  ill were supposed to benefit from 'a place of refuge' against the  stress and embarrassment of the world outside. 

I have written the history of the Mid Wales Mental Hospital, as the asylum became, to show how we treated the mentally ill over the last century. It was always less an asylum than a dustbin - hence the phrase 'loony bin' - for the most inadequate and unwanted people in society,  the mentally defective (as they were known) and senile as well as the mentally ill. Thus the name was changed to improve the image. 50 years later, after the illness  schizophrenia came to be commonly accepted in the UK,  mental hospitals like the Mid Wales tried out drastic treatments like frontal lobotomies, electro convulsive therapy and deep coma insulin treatment to  try and cure what was then thought to be incurable. This was a 'brave new world' in terms of innovation but it failed, and at a cruel cost to patients.

'Community care' must have come as a blessed relief, for by this time the mental hospitals were clogged up with incurable and institutionalised patients. It meant off-loading as many patients as possible for care in hostels, half-way houses and foster families. This turned out to be another drastic solution, as many patients were dumped outside who had, many years ago, been dumped inside.

Once again, western societies have much to learn from the supposedly less developed parts of the world where the extended family takes responsibility for its own members. However,  new medications and psychiatric treatment such as cognitive behaviour therapy have made considerable strides. Life for the mentally ill has become better. 

A depressing tale perhaps, yet full of heart warming and humorous examples of human behaviour. If you have seen the film "One Flew Over the Cuckoo's Nest" you will know what I mean. My conversations with many ex-nurses round the Mid Wales, and one or two former patients, have restored my faith in humanity.

The title 'Up Top' I took from the nickname for the Mid Wales Mental Hospital among the residents of the local town of Talgarth: 'Up Top', you see, because it was above and out of sight of the town - just as other asylums were built 'round the bend', away from other habitation. 'Up Top' is published by YLolfa, a Welsh publisher, and there are lots of pictures which you won't forget. Most bookshops in Wales will have copies or if you are further away, Amazon will oblige.