Care in the community causes real fear for some of those being forced out of hospitals, as Nicola Barry reports

ON May 27, 1937, Helen Taylor was admitted to hospital. Now, almost 60 years later, she is facing the prospect of going home.

Not surprisingly, Helen is heartbroken by the prospect of leaving Bangour Village Hospital. All she can remember of life outside in Edinburgh are old haunts which no longer exist: places like the Carlton Cinema and the Piershill Ballroom.

From Villa 18 at Bangour, Helen remembered back to 1937. ``Originally I was put into Gogarburn. It wasn't bad, but the floors were bare and there wasn't any TV in those days. Then, in 1956, I was moved to the Village, into a dormitory. My friends are all here. And the staff are like the brothers and sisters I never had. I feel so safe in Bangour and I have no regrets about my life.

``The world outside has really changed since my day. I wouldn't fit into society now. I won't return to the community. I don't want to.''

But, Frank feels differently. Until two years ago he was also a patient in Bangour. When Frank was eight, something happened which was to change his life for good. One morning his mother left the house to go and empty a bucket of water. As she crossed the road, a butcher's van, busy doing its rounds, struck her down. She died instantly. Young Frank witnessed his mother's death and the shock scarred him for life.

Frank and his three sisters were sent to an orphanage. Frank started drinking heavily and absconding repeatedly from care. In time, he was admitted to a psychiatric hospital.

This time, when he absconded, staff caught up with him. Frank says they threatened him with a pill which would ``do away with him for good''. The staff said Frank threatened them with a knife. Frank says he had no knife. Nevertheless, he spent the next 18 years in Carstairs State Hospital. He thinks about those years often from the comfort of his new home in West Lothian which he shares with two other former patients of Bangour.

After the horrors of Carstairs Frank was transferred to Bangour. In all those intervening years no-one thought to explain to Frank why he had been admitted to hospital in the first place. He wasn't ill, after all. Unlike Helen, Frank does have regrets. Now 44, he says: ``These last 25 years have deprived me of everything. I could have been married and settled down with children by now. I could have had a job and a home of my own years ago.''

All the same, Frank appreciates having his own front door key at last. He and his two flatmates do their own shopping. They want to stay in their own home.

Bangour Village, a large psychiatric hospital in West Lothian, still provides some 120 patients with accommodation and care. Instead of just listening to what potential neighbours might think about patients moving next door to them, Lothian Health has been inventive and canvassed patients' opinions on their proposed move into the community. The plan is to close Bangour once everyone has moved into supported accommodation, or, into new wards at St John's Hospital in Livingston.

But many of the patients whose opinions have been sought feel the community is not yet ready for them. ``It's a jungle out there, not a community,'' said one.

Hostility, abuse, intolerance, and crime are among the fears patients noted to the researcher from the health board. The younger patients, in the main, were enthusiastic about leaving hospital and looking forward to having privacy, more space, and their own possessions as well as some independence.

A few of the patients said they were prepared to move out on condition they could remain with the friends they had made in hospital. They also wanted the members of staff they knew best to move with them. They said they would miss the hospital grounds, which they saw as representing peace and safety.

There is, however, a small group of patients, people like Helen, who can't imagine life outside Bangour. They have been there so long they see the hospital as their home and have no desire to start all over again. All the patients talk about wanting to feel ``secure'' in the community, without having to fear break-ins and people harassing them. In recent months the patients got to hear about a hostile campaign mounted by neighbours, against some Bangour patients who moved into a rehabilitation unit in Whitburn. The experience has left those still living in the hospital feeling a bit wary.

Quite reasonably, those patients still in Bangour would like to sample life in the community before they commit to moving.

One of the people speaking on behalf of patients is Chris Galbraith, project co-ordinator of Friendset, an organisation providing an advocacy service for people with mental health problems. Based at St John's, Chris's job is to support anyone who wants to speak up for themselves to ensure people like Helen and Frank have some influence over decisions which affect their lives.

``If people don't know their rights,'' Chris says, ``they need an independent person to help them. Friendset can speak with doctors on a patient's behalf. People sometimes bottle things up. Then, they find they're not able to say exactly what they want to say. We're saying to patients, `You don't have to leave unless you have somewhere to go'.''

There are two cottages in the grounds of the hospital as well as the unit in Whitburn. But these are supposed to be short-term and any other services in West Lothian are currently in use. If Bangour is to close, more services will be needed to resolve the current crisis.