The patient experience is at the heart of Jay’s project and he highlights examples of art by patients which provide glimpses into their inner worlds. James Tilly Matthews, a Bedlam patient in the 18th century, for instance, produced a detailed drawing of the Air Loom, a huge machine that he believed controlled his mind.
“I first got involved in the subject 15 years ago when I wrote a book about Matthews”, Jay explains. “He insisted he was sane and accused the Home Office of wanting him locked up because he had been a double agent during the French Revolution.”
If the Air Loom suggests that Matthews was delusional, the plans he submitted to a competition to design an asylum were eminently sensible. He envisaged a sympathetic regime in which patients were involved in their own care, growing food in gardens surrounding a light, airy and pleasant building – the antithesis of the squalid conditions he had to endure himself.
Meanwhile near York, the Quakers opened a hospital run along similar lines to Matthews’s ideal institution. Patients and staff lived and worked together in a therapeutic community intended to benefit the whole person by fostering good relationships in a friendly and stable environment.
“Places like the York Retreat depended on friends and family – passionate volunteers. Staff and patients lived together, but it still needed resources”, explains Jay. “Health care needs to be properly funded; you can have good or cheap treatment; but not both. I want to encourage thought about where we are today, since the end of the asylums 50 years ago, and I hope my cultural take on mental health gets the level of interest up.”
Recently, cases of autism among children have risen dramatically, but so have claims that autism and even schizophrenia can be cured by diet. So instead of swallowing pills, sipping a kefir may soon become the norm. What does Jay think about these claims?
“There are many examples of cultures where the role of food and nutrition are intertwined with wellbeing and familial and cultural relationships,” he replies. “It’s a complex and interesting subject. I’d like to do research in Japan and China, for example.
“The millennial generation has very high levels of mental illness, which is a challenge we have to face. Pills offer a very atomised model; they avoid blame and the thought that it could be a social problem. We should welcome pills as far as they work, but we can’t continue with the assumption that they solve all problems. Nutrition therapy is a medicalised idea, but care and support are just as important as clinical intervention.”