The first year, 1963: initiating a therapeutic community in a closed system

When I came to take up my post at Dingleton Hospital in December 1962, I found the traditional hierarchical structure of a 400-bed British mental hospital. My predecessor, Dr George Bell, and the Matron (Director of Nursing), Miss Mullen, both perceived their roles in terms of status and authority. They showed little or no tendency to bring about decision-making by consensus, and unilateral decisions were a commonplace. The Deputy Physician Superintendent, Dr Ken Morrice, who remained in post, had been at Dingleton for five years before my arrival. Although he had attempted to liberalize the social organization by introducing more democratic procedures, his efforts had met with little success. The role relationships between this doctor, my predecessor and the Matron were far from satisfactory, and communication had largely broken down. The Hospital Secretary, Jimmy Millar, had acted as a go-between for my predecessor and the Board of Management, and tended to identify with the Physician Superintendent rather than the other hospital personnel.