Baillie Henderson Hospital: A Century of Care 1890 - 1990

By
Rev. Eileen Thomson


AUTHOR

This history was prepared by the Reverend Eileen Thomson who was formerly the Senior Social Worker at Baillie Henderson Hospital and who worked in the Hospital from 16th May, 1978 to 19th July, 1988. The Department of Health and the Baillie Henderson Hospital Executive express their gratitude to the Reverend Eileen Thomson for writing this article as part of the centenary celebrations of the Baillie Henderson Hospital


CONTENT

FOREWORD 4
INTRODUCTION 5
CHAPTER I: BEGINNINGS 1877-1898 7
THE DECISION 7
PLANNING AND BUILDING - BRICKS AND MORTAR 7
MEDICAL SUPERINTENDENT AND STEWARD 9
ARRIVAL OF STAFF AND PATIENTS 11
SETTLING IN 12
CHAPTER II: EXPANSION 1898 - 1928 13
NEW MEDICAL SUPERINTENDENT - DR. NICOL 13
BUILDING AND LAND 16
THE GREAT WAR 17
STEWARD RETIRES 18
POST WAR LIFE AND CONDITIONS 20
CUSTODIAL CARE 21
DR. WHISHAW 22
EARLY TREATMENT 23
ATTENDANTS AND NURSES 23
CHAPTER III - CONSOLIDATION 1928 TO 1946 24
LEADERSHIP AND PHILOSOPHY - DR. MCDONALD 24
MEDICAL AND LEGAL 25
WORLD WAR TWO 26
BUILDINGS AND FARM - WORK AND RECREATION 26
CHAPTER IV - CHANGES 1946-1975 29
OPEN HOUSE - DR. BOYCE 29
PATIENT CARE 30
CHAPTER V - DR. BAILLIE HENDERSON 31
AUSTRALIAN FOCUS ON MENTAL HEALTH 31
COMMUNITY AND ATTITUDES 32
EFFICIENCY AND HARDSHIPS 34
PATIENTS, FAMILIES, STAFF AND COMMUNITY 36
THE SIXTIES - TOOWOOMBA SPECIAL HOSPITAL 36
WORKING WITH CHANGE - DR. DE GROOT 37
FOCUS ON STAFF AND VOLUNTEERS 37
ADMINISTRATIVE CHANGES 38
VISIBILITY 39
CHAPTER VI - COMMUNITY SERVICE 1977 - 1987 40
DR. RIDLEY 40
FUNCTIONAL GROUPS AND REHABILITATION 41
ORGANISATION AND EDUCATION 41
REHABILITATION AND DEINSTITUTIONALISATION 42
COMMUNITY - VOLUNTEER SERVICES AND SUPPORT 44
COMPREHENSIVE SERVICE 46
BEHIND THE SCENES 49
BAILLIE HENDERSON HOSPITAL ACCEPTED BY CITY 50
CHAPTER VI - PROFESSIONAL PSYCHIATRY 52
DR. THOMPSON 52


FOREWORD

The idea of a book to celebrate the centenary of Baillie Henderson Hospital was conceived by Dr. Joan Ridley, fostered by Dr. Mike Ryan and supported by the Hospital Executive; but it might never have left the starting blocks without the practical help and patience of Mr. Peter Whitby and Mrs. Kay Collins.

It is impossible to list the many people who provided information and encouragement. Present and past staff shared their memories; relatives and friends and some older patients reminisced about the past.

The outline of the history came from hospital reports and records; and detail from many sources, most notably Works Department archives and newspapers kept at the University College of Southern Queensland. My thanks go to Ms Lea McGregor, State Archivist, for providing initial references, and to The Chronicle of Toowoomba for most of the photographs.
There is such a wealth of information that several books could be written about the Hospital and about individuals who gave so much of their lives to its service. If the publication sparks memories please write these down or record them on tape, as such enliven the bare bones of official records. Personal records that are preserved can be stored in some of the lockable rooms in the Museum at Baillie Henderson Hospital.

I would stress again that this book is the result of a community effort, in that so many people contributed information and ideas; but I hope it will be the beginning, not only of a new century of care, but of further sharing of memories and fellowship.

Eileen Thomson
May, 1990


INTRODUCTION

The story of Baillie Henderson Hospital is the story of the growth of a community which was at first imposed on and isolated from Toowoomba, but later surrounded by settlement and adopted by the city as a service for its residents and offered to south-west Queensland.

From the beginning the real spirit of the hospital grew out of the common life and interests of staff and patients, and when the fences came down that spirit strengthened it to share the life of the wider community.

The story of the first hundred years is a good story. There was suffering, sadness and tragedy, but the hospital began at a time when some men were beginning to look at residents in asylums as people whose behaviour had origins in illness or social conditions. The history of this hospital parallels the advances made in knowledge, with each medical superintendent attempting to apply the latest ideas as they were published. The result is that the fear and mistrust associated with mental illness is giving way to acceptance, co-operation and community support.


CHAPTER I: BEGINNINGS 1877-1898

THE DECISION

Australia's troubled beginnings brought many people who had been discarded by their families and countries. Some came to find their pot of gold at the end of the rainbow, and others came to escape harsh economic or climatic conditions. No doubt some already had incipient psychiatric illnesses. Some became ill due to the stresses of the new country. Some were dreamers who were unable to cope with the loneliness and hardships of the bush. Some resorted to alcohol. The result was that the eastern settlements all had people who weren't coping, so, in line with European practice, these people were "put away". At first they were held in gaols and hospitals, and then in asylums, as places of refuge. The Woogaroo Lunatic Asylum was the first of these in Queensland and it was opened at Wacol in 1864.

Almost immediately it was realised that would be unable to keep pace with the admissions from all over Queensland. The question was asked: Should Lunatic Asylum be extended or should an outstation accessible to Wacol and closer to the people of western and southern Queensland be established? The latter proposal advocated by Dr. Patrick Smith, Medical Superintendent at, was accepted and Toowoomba was chosen for the outstation.

Toowoomba, one hundred and twenty miles by road from Brisbane, had been linked by rail with Brisbane in 1867 and was known as the gateway to the west and south. The town, with a population of about ten thousand people, was the centre of a developing agricultural and industrial region. It was becoming quite a cultural and educational centre with its Austral Hall and schools. At two thousand feet, its climate was cool and fresh, giving it the reputation of being a healthy place. Brisbane people came for holidays, mothers came from the west to have their babies, and men came to trade horses and property. The many wide-verandah’d hotels did as good a trade in family accommodation as in alcohol. The Toowoomba Base Hospital was proving an important treatment centre for the Downs and country areas. Toowoomba seemed ideal for an asylum outstation.

PLANNING AND BUILDING - BRICKS AND MORTAR

Planning a public facility in Queensland took a long time last century as decisions were made by the British Parliament. All correspondence was with the Colonial Secretary in London and had to go by sea. After some initial exploratory work at the Australian end correspondence which began in 1877 led to approval in 1878 to build on one hundred and seventy-five acres (71 hectares) near Toowoomba. The cost of the land was £2,800.

In 1885 the Colonial Architect, J.J. Clark, drew a sketch plan of the land and even then recommended the purchase of more land. A plan for the asylum was ready by December.

The Department of Public Works and Mines called tenders on 29th July, 1886 for the contract to erect “a Lunatic Asylum at Toowoomba". The plans, drawn up by the Government Architect were for buildings similar to those built in England at the time with verandas added for Australian conditions. Plans for the first stage could be examined at the Toowoomba Court House where a deposit of one hundred pounds had to be lodged with each tender. The price accepted for the first section of four buildings was £28,750.

This was made by Mr. James Renwick, whose deposit was lodged with the Bank of New South Wales as a fixed deposit. The work was supervised by George Conolly as Colonial Architect. The land purchased for the asylum adjoined the Police Paddock, where there were some initial problems when Mr. Renwick's employees camped on the paddock. Permission was sought and refused to quarry and make bricks there.

The main buildings were brick and it is probable that the bricks for the first wards came to Australia as ballast in the holds of ships. Some bricks, dated 1842, can be seen built into walls. By mid 1887 most of the bricks were being made at Murphy's Creek. The brick walls stood on concrete foundations and the roofs were of corrugated iron. Tenders for a residence for the medical superintendent were called in the Queensland Gazette early in 1889 requiring a £30 deposit. This contract also went to Mr. Renwick. In the middle of the year, tenders were called for the building of an assistant medical superintendent's residence. The Gazette invited contractors to supply ironmongery, drapery, stationery, furniture, china, and glass in 1890.

Long lists of requirements were made. These were for carpenter's tools, general ironmongery including horse combs, a large bell to weigh 20lbs. and swing on an iron frame, stone breakers and grubbing axes. Numbers of hurricane hand lamps, a large fuel stove, heavy pots and pans, earthenware and enamel cups, saucers and plates and cutlery were itemised. Details of furniture and bedding were specified. Amongst the desks one was to be a cedar table six feet by three feet six inches with the best blue carriage cloth top, five inch turned legs, two drawers and the best lever locks polished. The iron bedsteads were to be as made at Woogaroo. The first mattresses were to be hair mattresses with sturdy tick.

Mr. Keogh's tender from Ipswich for furniture was accepted in June 1889. The present charming Willowburn Railway Station was just a stop along the line where a siding known as Asylum Siding was built for unloading materials for the new asylum. The contractor had to pay half the cost. For many years, goods and people came “up the line" from Brisbane or Goodna to this siding, to be met by horse or hand carts for heavy items or an escort to accompany them as they walked up the slope to the asylum.

The buildings, once built, stood empty for some time after they were finished, to the annoyance of the administrators in Brisbane who were trying to cope with increasing admissions. The delay was due to the lack of a reliable water supply. From the beginning there had been problems between the Department and the local Council over providing water. At first, water was carted daily from a well near the present K.R.Darling Downs Factory. Very soon this supply was inadequate. By September 1889, arrangements had been made to pump water from a better well in the Toowoomba Railway yard. In April, 1890 William and John Erskine tendered £332.10s to sink and slab a well in the Lunatic Asylum Reserve. In June that year the Toowoomba Foundry Company Ltd. sent a sketch of a windmill suggesting one should be installed for pumping water. The delay was exacerbated by many of the pipes arriving broken from Sydney on the "Barcoo" due to severe weather on the voyage. Eventually enough water could then be pumped to a reservoir on the hill for distribution to all buildings. Water was needed for general household, farming and gardening work but not for sewerage as earth closets were used.

Finally the authorities decided buildings, equipment and staff were ready for inmates to be admitted. There were the four main brick buildings, exercise yards with ten foot high hardwood fencing, furniture and equipment for a modern asylum and staff appointed for maintenance of the property and others ready at to accompany the first inmates.

MEDICAL SUPERINTENDENT AND STEWARD

Two remarkable men, both called James, laid the foundations of the new institution, and set a tradition of working together which enabled the community to grow and change to what it is today.

*Dr. J. B. Hogg*

James Jaffery Burn was appointed as Steward in 1888 and James Ballantyne Hogg as Medical Superintendent soon after. The other significant person at that stage was Richard Battersby Scholes, the Medical Superintendent and Inspector of Asylums, Goodna. Dr. Hogg was Dr. Scholes' Assistant at the Asylums for the Insane, Goodna and Ipswich. The three gentlemen were able to confer and plan for the day when inmates would move into the Toowoomba building. It was clear that Dr. Hogg expected to take charge of a hospital with patients rather than of an asylum with inmates. With an academic background and proven skills and drive, he explored whatever was available on the treatment and care of insane persons and the management of institutions for them.

Dr. James Hogg was a brilliant Scot who began his medical studies at Edinburgh University where he won medals for success in examinations. He became ill before his finals, but when he was well enough, he finished his studies and graduated through the Royal College of Surgeons and Physicians of Edinburgh. His studies under Dr. Lister led him to become one of the first doctors in Australia to insist on disinfectant in treating wounds when operating. Concern about his health led him to accept the advice of the day to move to a sunnier climate. He tried Geelong first and then Echuca before he realised he should be in Queensland. He was only in Echuca from late 1882 to mid 1883 where he was the Medical Officer at the Echuca Hospital, which he left with a reputation for skill and care beyond the usual. When Dr. Hogg came to Queensland he worked at the Goodna and Ipswich institutions getting to know people suffering from "Insanity". As an academic he gleaned whatever knowledge he could from Europe and America. He belonged to the era of men like Maudsley, Hill, Browne, Conolly, Tredgold, Ray and James; men who in their turn were building on the traditions of Jofre, Pinel, Rush and Tuke. These are all familiar as names of houses at Baillie Henderson Hospital today. He would also have known how Joseph Thomas Digby, Supervisor of Tarban Creek (Gladesville, New South Wales) had insisted a few years earlier on a humane system for his inmates by negotiating tirelessly for tolerable living conditions and the minimum of restraint. Dr. Hogg's overall policy was one of sympathetic custodial care because there was little treatment he could offer. He wanted life made as comfortable as possible for his patients, while insisting on strict cleanliness to prevent the spread of "scourges" like tuberculosis and hookworm. He deplored the overcrowding and wrote in 1893, "I anxiously await the opening of the new ward, which by relieving overcrowding and permitting the classification of patients according to their various conditions, will make them much more comfortable.”

Dr. Hogg, as a medical man, saw each person admitted as a patient and wrote all the original entries in the big Case Book himself. After the initial information on name, age, residence, religion, relatives, he wrote a summary of the patient's history to that time, lamenting the frequent lack of information due to the patient's recent arrival in the country and the unavailability of relatives and friends to fill gaps. He then wrote a diagnosis according to the classification of the day, using clear and detailed descriptions of mental and physical conditions.

Mr. James Burn's responsibilities as Steward were similar to those of a manager today. He was a practical man whose first job was to ensure that the material surroundings were ready for the staff and patients. As the on-the-spot man, he was the liaison person with officials in Brisbane, with local administrators and suppliers, and with the Medical Superintendent. He had unwavering standards for detail and insisted on having contracts honoured to the letter.

Much of the furniture and equipment came by rail from Brisbane and Ipswich to be transferred by cart up to the hospital. If a contract stipulated delivery to the hospital, he expected the goods brought to the door. If goods were not as requested, he wrote straight back to the supplier. There was no telephone at first for him to berate suppliers so he wrote letters. These were preserved in a Letter book on tissue-like pages with ink that browned and ate into the paper. Many of the stores came from Keogh's at Ipswich and the orders read like lists from any large western property of that time - flour, sugar, treacle, soap, disinfectant etc. At one time he complained about the quality of the sugar. Another time he found the hoop on a treacle cask loose. When he ordered, through the Inspector of Asylums, ninety wooden chairs "of strong serviceable pattern - NOT Australian Bentwood", he explained, "The chairs are asked for as being nearly as cheap as forms and as being so much more homelike." This gives us a glimpse of the atmosphere sought for the hospital as well as illustrating the clarity of his order. The Government Architect was called into the debate, but Mr. Burn insisted on his chairs, even to the extent of offering to send a sample to show the style and the wood to be used.

In pre-refrigeration days, the suppliers of perishable goods had to be locals. Mr. Burn kept a very close eye on the quality, quantity and regularity of such deliveries. Letters soon went to providers of meat, eggs, bread and others when standards were not as agreed. Butchers and bakers earned the most rebukes. One time the bread was sour, another time it was late, resulting in quite a diatribe from Mr. Burn on when and why the timing of the delivery was important. Mr. Burn was exacting in his demands, but fair in seeing that bills were paid promptly, and that staff were employed with reasonable conditions and wages.

Buildings and provisioning were only part of the first stage of establishment. The Steward had to oversee the building of roads, fences, gardens, sports fields and the farm. The farm, especially the piggery, came to be Mr. Burn's chief interest. Letters showed how his piglets and advice were in demand, and certainly later ribbons were a testimony to the quality of the herd.

Sometimes a person with so many practical things for his attention does not relate well to the ideas and visions of professional people. This was not so with lames Burn. He seemed to be on the same wave-length as James Hogg. In the early years it was vital to have people who could work together, especially as much of the work of the hospital was to be done by patients. The Steward needed to understand what the Medical Superintendent had in mind and the Medical Superintendent had to be assured about what was realistic in practice.

Extent of original hospital - Ward B (now Rush House) and Ward C on the left and ward 2 (now Pinel House) and Ward 3 on the right. Note the covered ways which are still standing one hundred years later - a tribute to the builders.)

ARRIVAL OF STAFF AND PATIENTS

It is clear from the records that Doctors Scholes and Hogg selected the first patients from for transfer to Toowoomba according to the following criteria: Good physical health, links with Toowoomba or the area beyond, and some ability to work. The first ten, who arrived on 17th May, 1890, were women capable of working in the kitchen and laundry. Many of the larger group of men and women who came three days later were soon at work chopping and carting wood, building paths and fences, working in wards, sewing and doing kitchen and laundry work. The patients travelled by train with their attendants. The male attendants were recruited from the prison service and they wore blue serge suits with metal buttons and wide brimmed hats. In summer they wore a khaki uniform, also with metal buttons. The female attendants were untrained. They wore blue serge dresses with white cuffs and collars and white aprons. All trooped up from the Asylum Siding to be greeted by Dr. Hogg and Mr. Burn. Together they laid the foundation of the community that became home to generations of patients and staff.

By the end of twelve months, eighty-three males and one hundred and twenty-four women had been admitted, mostly from. Most of these came originally from Ireland (ninety-seven) and England (forty-three). Twelve had been born in Queensland. The others came from Scotland, Germany, Switzerland, Norway, Poland, Sweden and China. Most of the women had experience in domestic work and a few had special skills like dressmaking. The ladies in the sewing room with treadle sewing machines made, in the first year, six aprons, two bed ticks, sixteen window blinds, thirty-eight dresses, twenty-¬seven night gowns, sixteen serge petticoats, two hundred and seventeen women's flannel singlets, two hundred and six women's shifts, twelve men's flannel drawers, forty men's flannel shirts, fifteen mosquito curtains, five hundred and fifty-¬nine pillow slips and twenty-nine towels.

SETTLING IN

Dr. Hogg and Mr. Burn collaborated so that their respective responsibilities furthered the common plan. Whether a person was employed as an attendant, a carter, a nurse, a laundress or whatever, that person worked with patients and often shared the same recreation activities. Discipline was strict and everyone knew his "station in life". The separation of males and females was accepted without query. Dr. Hogg did not just sit in his office, planning projects, seeing patients, receiving reports and writing letters to officials and relatives; he was out and about, encouraging and seeing for himself as Mr. Burn arranged the clearing of ground, the erection of fences, the building of roads, the planting of vegetables, and the purchase of stock.

Many patients had serious psychiatric disorders. Many were unreliable workers. Staff often had no training and little experience and their hours and conditions were hard. Transport was by horse or on foot and town was miles away. There were extremes of climate, with cold, floods, heat and drought. On the whole, however, there was a spirit of enthusiasm and in no time the hospital looked like a small town which functioned like a country estate. The difference was that staff had to be alert, whether they were with patients chopping wood or stitching dresses, for fear of sudden changes in patients' behaviour. Dr. Hogg recorded an incident of a patient going with a carter to collect pig scraps from his residence. The patient suddenly took a child "by the legs and held his head down and struck him viciously till he was stopped". Restraints were only used as a last resort. One of Dr. Hogg's records in early January 1891 said of a patient, "As she was sitting with all her clothes undone openly abusing herself so I was compelled to restrain her by muffs unless she kept her clothes in order". Then in March that year he wrote, "The restraint has done her good."

CHAPTER II: EXPANSION 1898 - 1928

NEW MEDICAL SUPERINTENDENT - Dr. Nicoll

Dr. Hogg's successor was Dr. James Robert Nicoll. He, with Mr. Burn beside him, continued the traditions of sympathetic care, and activity in work and recreation. In his time the hospital expanded to meet the need for places while absorbing the new ideas on treatment and staff training as promptly as anywhere in the world.

*Dr J.R. Nicoll*

Dr. Nicoll, like Dr. Hogg, was a Scot; and he also was Assistant Medical Superintendent at Goodna before taking over at Toowoomba. He came to Toowoomba in 1898 also believing that such institutions existed for the care of the people. Dr. Nicoll did his medical training in Aberdeen and worked in London, Mackay and Brisbane before coming to Toowoomba. He was a small quiet man, insistent on definite standards of behaviour, and capable of coping with the immense changes of the first quarter of the twentieth century. He and his wife were well liked and respected. One member of his staff described him as "a lovely man and understanding to work for".

There are stories of his handling of staff discipline. One attendant was returning from the nurses' quarters at 11.30p.m., an hour after attendants were supposed to be in their rooms. Dr. Nicoll happened to meet him, and after expressing his disapproval very fiercely, he said, "Have you got a rule book in your room? Well, go and read it." Another attendant did not attend work on Anzac Day, and when asked to explain, he said that the newspaper had announced a holiday for Anzacs. Dr. Nicoll replied, "Irrespective of what you read in the papers I am the Medical Superintendent, not the Press."

At the turn of the century, the young hospital impressed rail travellers as their trains chugged up the Range. Its massive buildings stood out starkly and were described in the Darling Downs Advertiser and Gazette as "The Lion of Toowoomba … set in a noble park over Gowrie Creek." The land around was being developed like a country property with plenty of well controlled, if sometimes reluctant labour. Dr. Nicoll was very conscious of the practical problems of country living and their effects on health and behaviour. Some such problems were overcrowding which provoked disturbances in wards and dining areas; flies causing ophthalmia; drought with its subsequent water shortages restricting bathing, laundry and cleaning; and heatwaves leading to sunstroke.

Discipline, safety and cleanliness were the backbone of Dr. Nicoll's regime. He saw staff discipline as the key to patient behaviour and efficient property management. For his part he introduced safety precautions in case of fire, replaced the old boundary fence and had the cattle tuberculin tested. Strict cleanliness was the mark of a hospital so when the doctor and his assistant went on their rounds they expected to find everywhere clean, and everybody, staff and patients, where they should be.

Hospital staff about 1900 preparing for a fancy dress ball. Included in this picture are Mr. James Bowden (bottom left), Mr. Brown (bottom right), Mr. Kettle (second left at back), Mr. Harry Brown and his wife, formerly Miss Campbell (couple, top right).

Dr. Nicoll, like Dr. Hogg, and all later medical superintendents, knew that the atmosphere and life of the community was important. As staff numbers increased he encouraged staff activities. Many families lived nearby and the building of the quarters for nurses with good sized dining and recreation rooms made for quite a community, thrown together because of distance from town with no telephones and little transport. From the beginning there had been a sports field for cricket and football, a new one in 1899 and after a time, a proper level oval. Tennis courts were built as necessary for country social life.

Interior of nurses' dining room, Toowoomba 1910.

ASYLUM CRICKET CLUB
Premiers Toowoomba Cricket Union, 1912 and 1913

Dances were held fortnightly and nurses had a piano for "singing around the piano". Staff generally attended entertainments for the patients whether they were on duty or not. In 1910 the building designed as a recreation hall, now known as McDonald Hall, was returned to its original purpose and, although Dr. Nicoll worried about the safety of the kerosene lighting, it was more convenient for dances and visits from outside entertainers than the ward area used previously. An enterprising Assistant Medical Superintendent, Dr. Whishaw, organised a staff entertainment club which presented programmes over several years. Some of the outside entertainments were Canon Warner's concert parties, Mr. John Melvin's gramophone entertainments and the Salvation Army Band. In 1911, a staff orchestra was formed. Dr. Nicoll must have been relieved when kerosene lamps were replaced in 1912, with a dynamo for electric light. (1912 Report: "The electric plant consisted of dynamo and accumulators, the existing boilers driving the dynamo, so that all the current is generated by this institution for its own use.")

BUILDING AND LAND

Dr. Nicoll and Mr. Burn made an excellent team during these expansion years. The building of more wards went on and some ancillary buildings to service the hospital and farm were added. A stores building was completed in 1911. Thorn's Farm was purchased. This land at the back of the female wards was good arable land and a valuable addition to the hospital farm. "The risk of this land falling into the hands of the speculator and being cut up into residential areas has long been a menace to the privacy essential to the comfort of the patients. By the closure of the road leading to this farm it will now be practicable to lower the fences of the female division, whereby to a large extent the suggestion of imprisonment inseparable from the present high enclosures may be replaced by a pleasant outlook along the valley of the Gowrie Creek." (1911 Report.)

In 1913 a disused house was moved to be the sports ground pavilion. (This was moved again in 1916 to a new recreation ground.) A cottage was rebuilt for the engineer and electrician in 1914, a covered way was built from the nurse’s home to Ward 1, and an isolated brick room was completed to be a meat safe and larder for the home. A two horse buggy was purchased and a groom engaged "to convey nurses and other female officers between the hospital and Toowoomba".

*Female Ward dining room, Toowoomba, 1913.*

*A single room in Jofre House. This room, photographed in 1984, had interior and exterior window shutters.*

THE GREAT WAR

The 1914-18 War hardly affected the hospital. There were some economic restrictions and three attendants joined the A.I.F. but the life of the hospital had to continue. The building programme went on with four wards and a hospital block being completed in 1917. The hospital within the hospital (now Tredgold) boasted a bath, hand basins on wheels and a disinfecting room. Considerable effort went into building gardens on the female side and into increasing recreational opportunities. Maintenance, as buildings and fittings aged, white ants and dry rot in the floors and cracks in some of the older wards, drought causing water shortages and crop failures, stretched the steward and his staff.

The engineer had to use two assistants to pump water in shifts up to the reservoirs. In 1913, the railway authorities had given notice that it was unable to supply any more water. All water then was pumped from a well in the hospital grounds to a reservoir at the top of the hill. In 1915 a new pumping house improved reticulation so that water closets could be built into the new wards.

*Building formerly used as the female admission ward, photographed in 1984.*

STEWARD RETIRES

Mr. Burn retired in 1918. That year's Annual Report said, "For the long period of nearly thirty years he served the interests of this hospital with conspicuous efficiency, and with a zeal particularly his own." He must have been a remarkable man. He worked co¬operatively with medical superintendents and staff and carried responsibility in his own areas. He saw to the maintenance of buildings and equipment attending to problems promptly. The provisioning of the hospital and the overseeing of the daily functioning of water supply, lighting, heating, farm, grounds, staff facilities, pay and changes, the management of finances and the many crises which any institution has but which can be more unusual and traumatic in a psychiatric hospital than elsewhere, showed that he must have been a very competent man. The Audit Department appreciated him because it said he was known "for his practical knowledge and sound judgment in all matters pertaining to farm stock, the excellence of the hospital's dairy herd and the pride of place held by its breed of pigs both on exhibition and in the market place."

Mr. Burn's departure drew Dr. Nicoll closer to the day to day management. For example, in 1923 he persistently demanded better laundry facilities to cater for the extra patient numbers and he campaigned vigorously for the changeover from earth to water closets to be speeded up. He understood the difficulties under which his staff worked in the twenties, while assuming, like most people of that era, that if a job needed doing it had to be done. He saw the whole institution as important to his charge as medical superintendent. He expected his staff to be punctual on duty, to record their observations of patients, and above all to be about their duties. He, for his part, tried to ensure that any treatment available was provided, and that activities whether work or recreational were meaningful and supervised, while giving staff as reasonable settings and conditions as possible. Overcrowding, lack of treatment, numbers of difficult patients, shortages - particularly of clothes and water - were all felt as soul destroying to Dr. Nicoll and staff as well as to patients.

1915 - General view of the Toowoomba Hospital for the Insane, showing the recreation hall and garden.

*Administration block, 1910*

*Internal view of the old kitchen, which was replaced in March 1974.*

POST WAR LIFE AND CONDITIONS

In the inter-war period, caring reflected a military style system whereby staff had long hours and formal ward inspections. Patients were made to rise early in the morning, put on, or have put on, whatever issue clothing was most intact and cleanest. It did not help when some patients shredded bedding, clothes and even tore blucher boots. Toileting was primitive and the smells in the buildings by morning were overwhelming for new staff, let alone for patients used to the fresh air of the bush. Beds had to be made and everywhere tidy before the breakfast arrived at 7.00a.m. Food was always plentiful and similar to that provided for men in stock camps. Food was delivered in big tins and bread in huge baskets. Breakfast was corn meal and porridge followed by bread and treacle.

At this time most food came from the vegetable garden and farm so it was fresh and helped keep costs low. Lunch at midday included meat and vegetables. Tea at 4.30p.m. was generally bread and jam and a cup of tea.

The farm workers rose first and went off to their jobs. Other able patients went to other tasks such as ward cleaning or lighting the kitchen range. It is worth saying that many patients were well most of the time and these considered themselves superior to the wet, dirty, sloppy, rowdy patients. The men in the gangs and the women who worked in the sewing room, kitchen and laundry looked after themselves with a minimum of supervision and many "adopted" the more helpless patients and helped look after them. Workers generally took pride in their work and built up good relations with staff. These were the ones who helped build up the community spirit with staff, establishing a tradition of pride which carried through to recent times when men boasted "I worked on the farm", and women, "I helped in the sewing room." Smokes were often the reward for good behaviour and work. The workers were the ones who shared recreation with staff after work - football, cricket, quoits, dances, games and entertainment. Some patients even had occasional town outings.

Caring for the many who were deranged and the seriously retarded before modern medication was hard and distressing. Most staff survived with a spirit of camaraderie. A newcomer might be the butt of jokes at first, but as in any community, the one who was able to "take it" and come up laughing was accepted for good. Staff had to be alert enough to be a jump ahead to keep control of jobs and watch for signs of psychosis or disturbance. By 1927 the average daily residency was 598 males and 581 females. From the beginning there were always some who could be discharged because they had been inappropriately admitted or because they were considered to have recovered. Many were re-admitted, but always the tradition was kept that no-one was detained without good reason.

CUSTODIAL CARE

Many patients continued to come "up the line" from Goodna. Others were brought by the police from the south and west. Some arrived in canvas straight jackets to prevent them attacking their escorts. On admission a patient was kept in a room for a day or two under observation and then allowed into a yard with others. The observations made in the admission ward enabled staff to make broad classifications of patients. Patients in the twenties included those we would now say had psychiatric illnesses. There were also many including children who were intellectually handicapped (then described as mentally deficient, aments, dements, idiots, imbeciles), epileptics, alcoholics and people with G.P.I. (General Paralysis of the Insane). The assumption of society was that anyone seriously disturbing the peace that seemed unable to control themselves should be removed or "put away".

Medical staff strove to find cures for the conditions they identified. They and nursing staff observed and wrote their observations of each patient, and tried to provide skilful management of the various conditions year in and year out. This custodial care was restrictive to many patients and staff and not unlike military discipline, and yet it was tempered by sympathetic care especially for the young, sick and elderly. Overcrowding and difficulties with classifying patients in the large wards made treatment difficult. Staff worked long shifts e.g. 6.00a.m. to 6.00p.m. During the day, staff members spent two hours at a time in yards with a variety of unpredictable patients, some of whom were aggressive enough to require physical restraint. In such cases, a staff member blew his whistle for someone to take his place by the fence while he restrained the disturbed patient. At night most patients slept in dormitories where there were rows of beds. Violent patients had single cell-like rooms with wooden shutters. Staff on night duty patrols had to clock in at fixed points. The unpredictability of some patients made life dangerous. Sudden changes of mood might mean a blow or kick or even a head charge strong enough to Jay out someone who turned his back or relaxed attention. Perhaps the greatest tragedy was the death of Dr. Whishaw.

DR. WHISHAW

Dr. Reginald Whishaw, F.R.C.S., had joined the staff on 1st December, 1906 as Assistant Medical Superintendent, with very enlightened views on patient care and staff training. It was extremely unfortunate that he was the medical officer who was on his formal inspection round the day a patient hid in the big triangular gap behind a door and held a big brass fire hose nozzle. This man hit Dr. Whishaw over the head as he passed through the doorway and Dr. Whishaw died as a result of the blow.

Dr. Whishaw had initiated a staff entertainment club and reorganised the course of instruction for staff so that eight nurses and five attendants obtained St. John Ambulance Association Home Nursing certificates. This course continued until it was superseded in 1910 when regular nursing training began. Dr. Whishaw was buried in Toowoomba and his name is now commemorated in the Whishaw Day Centre.

*Dr R. R. Wishaw*

EARLY TREATMENT

Willowburn medical staff were aware of, but rarely used, the treatment used for different conditions in western countries. Examples were Convulsive Therapy using Cardiozal injections, and Water Therapy where a patient lay in a bath under a restraining cover with his head out while water flowed through at an even temperature. Drug cupboards held big bottles of Cardiozal, Bromide and "white medicine". Most of the medical attention was for routine conditions which would be treated today in a general hospital, or for broken limbs or accident wounds. A regular chore was rolling bandages from strips of old sheets. Jeyes fluid was the main disinfectant. Patients with G.P.I. were hard to nurse. Their disease was caused by syphilis and most patients died within three years of admission. Alcoholics also required considerable attention. They clamoured for anything with alcohol in it such as boot polish, so had to be watched. Some of these were physically fit and good workers who had occasional episodes of climbing fences or trying to get to the carefully segregated women.

ATTENDANTS AND NURSES

Nursing training with work conditions to match needs was obligatory from 1910. In 1909 Dr. H. Byam Ellerton, Inspector of Asylums, demanded better training and conditions for staff in asylums. He visited the three Queensland hospitals and the three reception houses and initiated detailed standards based on the principles of (1) the welfare of the patients and (2) the welfare of the staff. After receiving a deputation from the institutions, he agreed to prepare regulations recommending that salaries, annual leave and sick leave be graduated according to the responsibility of the post held with length of service. He wrote, "Lately text-books for the nurses and attendants have arrived from England, and I hope soon to have regular instruction and training as a matter of routine … so that these institutions will become really hospitals for mental patients, and not merely places for putting away the undesirable insane." From 1910 onwards there were improvements in pay and conditions and in 1911 a Board of Registration of Nurses was set up to control examinations for certificates. In 1912 the Health Act was amended to require the registration of nurses in Queensland. New nurses had to take an examination but those employed three years by the due date were given a certificate of competence. Toowoomba had twenty males and fourteen females registered in that year.

Attendants and nurses were the bricks and mortar of the community from the beginning. They implemented the care and concern policies by supervising patients in wards, yards and on the property. They were practical people who had to be able to clean lofty ceilings, filthy earth closets, muck out pigs, handle cattle, garden and fence; and all the time they had to keep their eyes on gangs of unpredictable patients while encouraging, cajoling and driving them to get on with and finish their jobs. The hours were long and the work included waking, bathing, dressing, feeding, and toileting, observing and settling patients for bed. Remarkably clear observations and reports were written in the big record books, and even before training courses, the description of mental states and behaviour gave vivid pictures of patients' conditions.

Dr. Nicoll retired in 1928 at the age of seventy after thirty years at the hospital. He had over seen the years of expansion when more accommodation was built, old buildings repaired and updated. He had encouraged medical and nursing staff to study and share their knowledge. He had seen the grounds and farm developed, and the whole property made as safe and efficient as possible.

CHAPTER III - CONSOLIDATION 1928 to 1946

The hospital's momentum continued in a forward direction through the thirties and forties. Materially it grew and was improved. It adjusted to new insights into the treatment and care of the mentally ill. It absorbed changed expectation of staff training and conditions and it began to welcome community interest and to expect mutual acceptance by the town.

LEADERSHIP AND PHILOSOPHY - Dr. McDonald

*Dr. J. E. F. McDonald.*

Dr. James Edward Fancourt McDonald was Medical Superintendent from 1928 to 1946. He had been Assistant Medical Superintendent under Dr. Nicoll from 1918 to 1927, then Medical Superintendent at Ipswich Mental Home. He returned to Toowoomba as Medical Superintendent in 1928 and served until after the Second World War. Dr. McDonald was an Australian who had served in the 1914-18 War and subsequently ran his hospital like a military establishment. This tall man expected staff to stand to attention when he passed them and to be addressed as "Doctor". He was a traditionalist in many ways and greatly respected for his integrity. His medical interests and appreciation of efficiency enabled him to support the changes in treatment for patients and the moves towards better staff training. He was strict in holding staff responsible for patient care and never hesitated to dock pay for misdemeanours or unsatisfactory work.

MEDICAL AND LEGAL

The improved knowledge available to medical staff in the thirties was illustrated in the way schizophrenia began to attract research interest. The Annual Report for 1937-38 said, "This mental disease, attacking as it does the promising youth of the community, presents a scourge that is probably greater than the combined effects of cancer and tuberculosis. The treatment of this condition has aroused world-wide interest." Research into a wide range of drugs focused attention on mental conditions in time for war casualties to benefit, and success with such treatment accelerated the psychological-neurological research focus.

Staff training improved and certificates for nursing staff became obligatory in time to match the new knowledge available to medical officers. The Handbook for Mental Nurses was reprinted in 1938 to include the advances in knowledge and to ensure nurses would be able to observe and report the effects of medication. In it advice was given on restraints for epileptics, delusional, suicidal and surgical cases, and there were warnings about them. "Now and then, it may be necessary to control the actions of such patients by mechanical restraint. This term signifies the restriction of the bodily movements of a patient by any appliance whatever, such as a sheet, bandage, towel, strait-waistcoat, strap or pack. Such restraint, of course, must never be applied except under medical order, which specifies both its nature and duration. If continued for more than a short time, the patient should be released from it every hour or so, and care should be taken to prevent any chafing of the skin. Any use of mechanical restraint must be reported to the Board of Control." The Queensland Government's Mental Hygiene Act of 1938 was very significant legislation. It required active treatment for the mentally ill, and attempted to reduce the stigma associated with mental illness by referring to 'mentally sick patients' instead of 'lunatics' and using the words 'mental hospitals' not 'asylums for the insane'. Voluntary patients could be admitted and the powers of the Public Curator were written in modern language. A Backward Person's Act was passed in the same year to provide training for backward patients. The medical focus was reinforced in the Regulation of May, 1941, which made it clear that Medical Superintendents were to concentrate on medical duties and senior nursing staff were to have their clerical work reduced.

WORLD WAR TWO

The war years inside the hospital were difficult in many ways. Admissions increased as families requested care for relatives with whom they could no longer cope at home. The rationing of food and fuel added to management difficulties and the need for accommodation was desperate. There was such a serious shortage of staff that nurses were reluctant to work in certain areas.

1945 saw the end of the War and changes to the Mental Hygiene Service. A Director in Brisbane planned a northern mental hospital, separate institutions for the criminal insane and for backward persons, special accommodation for returned soldiers, the elderly and epileptics.

That year money was made available for improvements inside the hospital, for wireless sets, electrical equipment such as refrigerators, urns and toasters, and machinery for the kitchen and laundry.

BUILDINGS AND FARM - WORK AND RECREATION

Custodial care became easier as facilities and conditions improved. During the war, a large air-raid shelter was built. Towards the end of the war, the main building programme began again with the addition of fire escapes to Wards A and 1 and shelter sheds for Wards A, C, D and 1, 3 and 4. An occupational therapy building was mooted. New entrance gates, a proper blacksmith's shop, accommodation for the engineer, assistant engineer and assistant matrons were built.

Town water and electricity were extended throughout the hospital and a toilet block built on the farm. The nurses’ quarters were enlarged and kitchen, laundry, sewing room and artisan facilities were improved.

*"Harvest Time at the hospital."*

The farm was in its heyday with its large Jersey herd for which crops of maize and green feed were grown. The pigs were fed on kitchen scraps and skim milk. A small poultry yard produced some hens and ducks for the table, and the vegetable garden kept the kitchen supplied with potatoes, pumpkin and green vegetables. The sale of milk, pigs and vegetables helped meet the rising costs of the institution. Train passengers used to see the lines of blue coated workers raking crops and loading drays. Some patients began milking before dawn and returned later for breakfast. Gangs worked in the gardens, at fencing, stacking hay, washing milk buckets and cans, feeding animals, collecting scraps and delivering milk and produce.

Dr. McDonald took a personal interest in the farm. He walked through it each day and discussed farming methods with the staff. He worked with officers from the Department of Primary Industry on a soil conservation project, the contours of which can still be seen from the air.

Most women who were well enough did domestic work around the hospital. The more skilful worked in the sewing room on table cloths, bed linen and clothes. They kept increasing the output of garments but it was almost impossible to keep everyone adequately dressed. A few did fancy work and craft with the Willowburn C.W.A. ladies. The Staff Entertainment Club was very active in organizing dances with the staff orchestra, picture nights and visits from outside groups such as the Toowoomba City Band, the Municipal Band, the Salvation Army Band, the Caledonian Society and St. Alban's Choir. The winter dance season always finished with a gala fancy dress ball.

Dr, McDonald retired in 1946 but he continues to be remembered because the old recreational building in the hospital courtyard was given his name.

*Recreation hall with the new stage in 1913.*

CHAPTER IV - CHANGES 1946-1975

After the war, the hospital benefitted from some of the changes that had been accelerated, but on the whole these did not receive adequate expression in Queensland. Such changes covered knowledge and treatment of mental illnesses and the corollary that community attitudes needed to change to accept patients as citizens.

*Dr. C. R. Boyce*

OPEN HOUSE - DR. BOYCE

Dr. Clive Rodney Boyce (21. 4.1899 to 15. 8.1985) as Medical Superintendent introduced many changes represented by his enlightened attitude to treatment with an "open house" concept. He said, "You've got to tear down the doors, rip up the wire and treat them (patients) like human beings - not caged animals." This attitude was shaped presumably by his experiences as a prisoner of war in Changi and Kobe. His cutting down the bamboos along the drive symbolised the opening outwards of the hospital.

Dr. Boyce was born and educated in Toowoomba. During the war, he served with the Australian A.I.F. No. 2 General Hospital in Singapore. He was taken prisoner there and in 1964 he was awarded an O.B.E. for dedicated and humanitarian services to his fellow prisoners during and after the war. At Toowoomba Mental Hospital he was popular as a person. He was less formal than previous medical superintendents. He walked around in sports clothes while walking his dachshund dog. He encouraged the building of the nine hole golf course in front of the Nurses Quarters, which was the forerunner of the Toowoomba Golf Club. There were many dramatic changes in Dr. Boyce's four years. He had Dr. John Baillie Henderson as his Assistant. Doubtless the two talked, planned and worked together so that the hospital was virtually transformed.

PATIENT CARE

Quality custodial care continued to be the primary aim of Doctors Boyce and Henderson, and was also expected by the Inspector, Dr. Basil Stafford. It was announced that because patients were human beings staff must treat them humanely even during episodes of violence. This was easier after the introduction of the Eight Hour Day on 1st January, 1948, because more staff were appointed so no- one became as tired as they had on the old shifts.

For many years there was a shortage of female staff. They left due to moves and marriages and so some male staff worked on the female side. There was a public outcry when some girls were directed by the Government's Manpower Scheme to work and train at the hospital against their will. The situation was relieved by the arrival of twenty migrant women to work as nurses. The appointment of a housekeeper, Mrs. Higgins, for the nurse’s quarters added to staff comfort and eased the strain there. Patient comfort had high priority with Dr. Boyce. Extra services, such as chiropody and optometry were introduced. Bedding was improved after the employment of a mattress-maker who used a fibre-teasing machine to fluff up mattresses. The blanket issue was increased in winter from three to five. A male hairdresser was employed and plans made to have a beauty specialist and beauty parlour for women. An area at the side of the recreation hall was made into a canteen. In 1948 a telephone exchange was installed, and a doorway between the phone room and the dispensary was built for storing bulk chemicals.

The way of life for everyone was still "activity". An "occupational therapy" building was erected in the yard of Ward 5. The farm was well controlled and productive. The dairy herd supplied quality milk. The piggery, famous for its prize pigs, put pork on the menu. The vegetable garden was replanned and enlarged so there was always a plentiful supply of fresh vegetables. A small orchard was planted. The designing and planting of flower gardens and trees gave the property a park-like appearance. In 1949 there was a disastrous fire during harvesting which destroyed machinery used for harvesting and wood cutting. Even so, five hundred tons of ensilage was stored that year. Some new equipment, including a stationary oil engine costing seventy pounds was bought for cutting ensilage and fire wood, and a new motor tractor was purchased.

Outdoor sport, including cricket, football, tennis and basketball, continued to be popular with staff and patients. Indoor recreation centred on pianos, billiards and cards. There were weekly "talkies" and dances with the orchestra. The returned servicemen amongst the patients were especially well looked after by the R.S.S.A.I.L.A. and Red Cross with outings such as Christmas dinners, picnics and concert parties, and gifts of fruit, sweets and tobacco. Dr. Boyce's annual reports represented his clear thinking and deliberate expression. They were comprehensive and concise and everything was classified under relevant headings. He left to go to Brisbane Mental Hospital as Medical Superintendent in 1950. He eventually returned to Toowoomba in retirement and died there in 1985 aged eighty-six.

CHAPTER V - DR. BAILLIE HENDERSON

*Dr. J. Baillie Henderson*

Dr. John Hector Baillie Henderson (1.7.1902 - 1981) became Assistant Medical Superintendent in 1939, then Medical Superintendent from 1950 to 1969; thus his influence and service to the hospital spanned over thirty years.

Dr. Henderson was a Queenslander who studied at Queensland and Sydney Universities until 1929. He then worked in private practice until he joined the Queensland State Mental Health Service. Dr. Henderson's service to the Toowoomba scene covered years of change in the mental health field throughout Australia. Locally the name of Dr. Baillie Henderson became such a legend for the good in change that the name of the hospital was changed to Baillie Henderson Hospital in his honour on 27th August, 1968. He received a further honour from the Queen when he was made a Commander of the British Empire in the New Year's Honours List 1969 "for his untiring and devoted service to the mentally ill".

AUSTRALIAN FOCUS ON MENTAL HEALTH

The year that Dr. Henderson took over as Medical Superintendent of Toowoomba Mental Hospital the first national conference of heads of mental hygiene divisions was held in Melbourne and this looked with concern at the number of patients, especially aged ones,
in the mental hygiene institutions. Dr. Basil F. R. Stafford, Director of Mental Hygiene, represented the Queensland service and reported on the success of the Jubilee Home at Dalby which was caring for sixty elderly women from the Toowoomba Mental Hospital. The major problems throughout Australia were the pressure of numbers, the need for mental hygiene services to be closer to the community implying a greater clinical orientation, and therapies to improve the social readjustment of patients to the community. Another common problem was the shortage of female nurses.

Dr. Stafford planned separate accommodation for the elderly and backward persons, especially children. He also expected the new hospital at Charters Towers would relieve some of the pressure on accommodation.

Dr. Henderson had worked closely with Dr. Boyce and there were no immediate changes when he moved down the road into the Medical Superintendent's house. The established formal hospital routine continued. Like his predecessors, Dr. Henderson emphasized the need for all areas to be clean and tidy and required that staff always be in attendance when he carried out his formal round.

He was a tall impressive man with grey hair who expected staff to be disciplined in their work. In return he gave and received respect. Behind this appearance there was an easy going man capable of carrying the responsibility for well over 1,000 patients and their staff. He used to be seen around Toowoomba in tweeds driving first a Mark III Zephyr and later a Renault. This Medical Superintendent who addressed staff members with formality at work greeted the same persons in town by their Christian names and stopped to chat. His care for staff members in turn generated the staff-patient relationship which he himself described as ‘outstanding’.

COMMUNITY AND ATTITUDES

Dr. Henderson's aim was to make life easier for patients, and this sort of caring embraced everyone involved whether staff, relatives or townspeople. He did not have staff meetings but in his own way he managed to convey his ideas and generate a caring community. Patient numbers reached a peak with nearly 1,400 in 1950.

A new post war era with changing attitudes to mental illness and hopes of effective treatment also ushered in immense changes in the society to which the institution and its patients belonged. Smaller nuclear families, many urban, were replacing the extended rural families. The world was shrinking as communication through books, personal contact and the electronic media reached ordinary people. Migration, rapid transport and economic expansion made Toowoomba feel part of the wider changing world. The quiet country mental hospital was emerging like the rest of Australia into the bustling twentieth century.

TREATMENT, CARE AND THERAPY

Toowoomba Mental Hospital/Special Hospital/Willowburn was fortunate in having started late enough to avoid some of the horrors of the old lunatic asylums, and it had a remarkable tradition of up-to- date caring medical superintendents. The hospital, that had been built over the hill and had developed an impressive community behind its fence, began to change during the fifties. The first changes were within its own community as it benefitted from new treatments, more staff working under better conditions, and deliberate moves towards community orientation for patients.

The old medicine cupboards with their big glass bottles gave way to rows of pharmaceutical boxes and little bottles containing injections and tablets. Already it was understood that the high hopes of cures from the new drugs were not being realized, but it was appreciated that their use made life better for patients and those around them. Electroconvulsive therapy with a modern machine was available for use under anaesthetic. X-Ray equipment was installed and a pathology laboratory set up to improve routine medical care.

Ancillary, or Paramedical staff, were needed to implement modern therapy. A psychologist, Mr. A. C. Proctor, was appointed in 1951. Approval was given for an Occupational Therapist at the same time but the position was not filled until 1957 when Miss Lucretia Watson was appointed. There were no qualified Social Workers until Miss Betty Fisher was appointed in 1966.

In the early fifties activity in real work and in recreation was still expected of patients of all ages. Adults worked on the farm or in the garden, in wards, laundry, kitchen or sewing room. Some of the children attended Miss Dorothy King's school at the Rockville Epileptic Home. A playground with see-saws and swings was established for patients and their visitors. Recreational activities and entertainments were encouraged by Dr. Henderson. When Miss Watson arrived she re-introduced the annual fancy dress ball and began a hospital magazine and Christmas Carol service. Like Occupational Therapists through the years she had her eyes open to see how life could be enriched for patients and what was available for use.

She said, "Out of cartons and a lot of nothing, patients made mock furniture, painted them and acted out their desires to grateful audiences". (Barbara Anderson and Janet Bell: Occupational Therapy 1988).

Country Women's Association ladies visited regularly to entertain and teach handicrafts and the Red Cross Society began a reading library.

All staff joined in recreational activities within the hospital and some took patients on outings to town or in small groups to their homes. Occasionally staff took patients on trips to Brisbane or the coast. The reality, however, was that most patients had little freedom and the efforts to improve their lives were restricted by their illnesses. Generally men looked after men and women looked after women, and staff and patients rarely spoke to each other except on social occasions. When staff reported for work they signed an attendance book, took their big bunch of keys and went off by separate paths to their wards.

In the fifties mental hospital work acquired professional status. Psychiatry, or Psychological Medicine, became a recognised speciality with the introduction of a diploma for medical officers. Nursing training became more academic and demanding. From 1953 their training curriculum was organized by the Nurses and Masseurs Registration Board, and from 1955 nurses were awarded certificates at Nurses Graduation ceremonies. Other disciplines were added to widen the care and treatment options. Any psychologists, social workers, occupational therapists, radiographers, dentists or teachers came with professional qualifications. Management secretaries handled the business management side of the Hospital.

EFFICIENCY AND HARDSHIPS

Other changes in the fifties were in the material and mechanical fields. There were easier to clean table tops, machines for the kitchen, laundry and cleaning as well as new equipment for medical treatment and for the farm. Certainly motorised transport, telephones and film projectors speeded up life and communication. Slow combustion stoves were put into some wards.
By the end of the decade town water was laid on. This made the engineer's job easier and bathing and cleaning less of a battle.

The other side of the picture was that the number of patients had not decreased, so there was overcrowding in the wards with rows of iron beds, inadequate toilet facilities and an outside bath house for most patients.

The many material and attitudinal changes had improved life within the hospital community. Those who came in as visitors knew this but the general public feared mental illness and spoke deprecatingly about "the nut house" or "the funny farm". In fact many people had never seen intellectually or mentally handicapped people as most were shut away and excluded from society as quickly as possible.

Bathing and clothing for so many people provided nightmares for staff and patients until shower blocks were built into wards and until patients had pensions to buy individual clothes. Bathing for most wards was done in a bath house in the central yard. Nurses donned oil skins, sou-westers and gum boots, and tried to control the water flow and temperature by using the tap keys on their key rings. Patients lined up, dropped their dirty clothes into a basket, were handed a piece of browny-yellow soap to wash themselves or they were escorted to a shower and scrubbed. There were problems of controlling water, slippery floors, patient behaviour, having enough dry towels and getting patients properly dry; and then ensuring there were enough clean clothes of the right size for redressing. Most patients had one bath or shower and clean clothes a week. On non shower days when they undressed they tossed each garment into its appropriate basket and took a nightdress or pyjamas. The clothes in the baskets were sorted to find enough garments to use the next day.

Over the years efforts were made to improve the clothes. In 1951 Dr. Henderson reported, "The type of garment has improved but destructiveness on the patients' part and inadequate and irregular supply on the other are the factors mostly responsible", for not reaching a desirable standard. A canteen was opened providing, "a most comprehensive assortment of delicacies and other foodstuffs and is very efficiently run by the staff".

*"Cutting flowers to send to Brisbane for the Coronation Tour of Her Majesty, Queen Elizabeth 11"*

PATIENTS, FAMILIES, STAFF AND COMMUNITY

Dr. Henderson steered the hospital through the change from a working country farm¬-like property until it was a place where people needing treatment and care could expect modern therapies focused on individuals and their needs. Patients and families remembered him as a kindly man. Many parents commented on how he understood the difficulties they had experienced before they accepted help and how he listened sympathetically and wrote supportive letters to those who lived in the country. Conditions for staff were still hard over his years but he understood the difficulties and tried to provide as attractive and workable an environment as possible. Ward tracks were made into bitumen roads. Car parking was provided. Trees and shrubs were planted to create "a park-like atmosphere of beauty and order". As early as 1953 he said, "The staff have been most co- operative and, with rare exceptions, understanding and courteous towards patients, relatives and visitors. It is to them chiefly that we must attribute the generally favourable feeling which the public has developed towards this institution". All this made it easier for relatives, especially for the parents who had to leave their children in the hospital, and for visitors from the town.

THE SIXTIES - TOOWOOMBA SPECIAL HOSPITAL

While the rest of Australia was rock and rolling and beginning to feel political and economic ripples, the life of the hospital continued to tick over with very few upheavals.

A new Mental Health Act in 1962 ushered in a new era. The detention of psychiatric patients was made easier and a Mental Health Tribunal was set up as a safeguard to protect people from unnecessary detention. It sought the integration of mental health with the Health and Hospital Services of the State by developing psychiatric services in general hospitals to enable patients to be treated at community level and reduce the number requiring treatment in special hospitals. Handicapped children and geriatric patients were to have care and treatment in more appropriate areas. Toowoomba Mental Hospital, colloquially known as Willowburn, became Toowoomba Special Hospital. As late as 1965 the Director said, "A unique situation exists at the Toowoomba Special Hospital. The Medical Superintendent has established a status in the community and developed such an atmosphere in his hospital that informed patients readily consent to admission to the hospital". He pointed out that the congestion made it imperative that an inpatient service be established at Toowoomba General Hospital.

At the end of 1962 Gowrie Hall was opened as a special unit for patients in mental hospitals suffering from chronic chest conditions.

Improved treatment, care and attitudes paved the way for an emphasis on rehabilitation and re-socialisation. Dr. Henderson left a hospital set in beautiful grounds, and by his personal efforts he had helped the city accept it as an asset that had earned its right to be there. A short time before he left, the name of the hospital was changed to Baillie Henderson Hospital. Dr. Henderson retired and lived on the Sunshine Coast where he died in 1981. The number of staff who used to visit him there showed the esteem in which he was held and he was honoured with a guard of honour of uniformed nurses at his funeral.

WORKING WITH CHANGE - DR. DE GROOT

*Dr. M. H. de Groot*

When Dr. Michael Henry Lawrence de Groot, M.R.C.S., L.R.C.P., M.B., B.S., M.A.N.Z.C.P., D.P.M., M.R.C. (Psyc.) became Medical Superintendent on 5th June, 1969, the winds of change were blowing strongly. The hospital had become a secure community with some good bonds with the outside world; but it was not really part of the local scene. Toowoomba people needed to understand the services the hospital offered and how people were needed to help inside and outside. Dr. de Groot was born in London (28th September 1933) and had most of his medical training at Guy's Hospital. He came to Baillie Henderson Hospital via New Zealand where he had been working as a psychiatrist.

FOCUS ON STAFF AND VOLUNTEERS

Inside the hospital Dr. de Groot built on the existing stable community by encouraging staff to accept and work with change. Greater emphasis was put on nurses' training with the appointment of three nurse educators, the broadening of the curriculum, the introduction of teaching aids and the upgrading of the staff library. In 1973 the positions of Chief Male Nurse, held by Mr. Herb Kimmorley and Matron, held by Miss Kit Hurley until 1972, were replaced by one position of Principal Nurse. Mr. Ron Broad was appointed to this position and he was supported by two deputies, one for clinical services and the other for administration. Ten nursing supervisors were rostered to cover all shifts and the integration of men and women working together as nurses became a reality despite some initial resistance.

The quality of all staff was seen by Dr. de Groot as the key to success. He asked for the "right sort of doctor", that is, suitably qualified ones, and began using paramedical staff. He supported the Psychologists already appointed; Social Workers and Occupational Therapists when available. In the seventies the roles of paramedical staff had to be adapted to the needs of the moment and personnel available at the times. In 1976 the Psychologist's role had four components: individual behaviour therapy and counselling on referral from medical staff, ward programming especially assisting arranged group meetings and patient activities, lecturing to nursing students, and pre-diagnostic testing of referred patients. The Social Worker was involved in admission interviews, casework, supportive psychotherapy, patient preparation for discharge and post-discharge follow-up, later assessment of patients' home environments. She also maintained contact with other government departments and community organisations. Recreation Officers were put on to widen the range of activities and a qualified teacher employed. Volunteers in the Hospital Auxiliary bridged the gap between hospital services and the town by manning a Community Information Service, by taking an interest in patients especially those moving into town, by running fetes and sponsoring a course of mental health lectures.

Throughout the hospital a number of committees and meetings were organized to improve the "interchange of views and ideas between the various levels of hospital employees". These included a case presentation conference and a patients' advisory committee. A Planning and Organization Committee, later known as "The Executive", was set up following a directive from Head Office.

ADMINISTRATIVE CHANGES

In 1974 a new Mental Health Act allowed for both informal and regulated admissions to be implemented with consideration for patients and relatives, protection against unnecessary admission or continued detention, and attention to the mentally ill involved in criminal proceedings.

Dr. de Groot was described by his Head Office as "a jovial fellow, but very intense and dedicated in his work." He tried to divide his time to give forty per cent to administration and sixty per cent to patients. He retained his interest in clinical work even to the extent of being rostered on as a medical officer whenever possible. Wards became houses by replacing the numbers and letters by the names of famous men associated with mental health - Jofre, Rush, Clouston, Browne, Ray, Penrose, Maudsley, James, Tredgold and Hill. As the number of patients with tuberculosis declined Gowrie Hall became an integrated admission ward. On 21st September, 1970 the Rockville Training Centre, originally known as the Epileptic Home was absorbed into Baillie Henderson Hospital making for administrative difficulties for a time; then in 1976 it was closed and the patients were moved into the main hospital houses.

At the beginning of the seventies accommodation was stretched but gradually overcrowding was reduced as patient numbers dropped due to improved diagnosis, treatment and rehabilitation (down to 770 by 1976). This made living in the houses more comfortable. Over the same time the houses were improved inside with more bathrooms and better furnishings.

Just as country life for many people was changing so it was for the workers, both staff and patients, at the hospital. The dairy and vegetable gardens were closed in 1970 because they were considered to be no longer therapeutically valuable or justified economically. The therapeutic emphasis went on to community preparation. Any building or decoration came to be planned for greater similarity to life outside. Three modern low ceilinged hostel style houses designed to allow for personal privacy and possessions were built and named Digby, Tuke and Conolly.

Two blocks of flats to be used as half way houses in town, were bought by the Department of Health. They were known as the Karakan Flats because they were managed by a voluntary organization called Karakan, which meant "spirit of caring". In 1974 a catering and services administration building, known as the Central Nursing Office (C.N.O.) was built where old Ward Three had stood. The kitchen and cafeteria catered for any patients able to walk from their houses to meals.

VISIBILITY

From Dr. de Groot's time onwards the hospital's presence became visible to the outside world. The number of outpatient clinics at Toowoomba General Hospital was increased and outpatient services were extended to Warwick and Dalby and occasionally to Roma. Lectures were given to schools and the Press was invited in behind the fences. In 1971 a scientific meeting of the Queensland branch of the Royal Australian and New Zealand College of Psychiatrists was held at the hospital. There was also a seminar held for clergy.

The volunteers who formed the Hospital Auxiliary decorated a float for the 1972 Carnival Procession symbolizing the hospital's emergence on the Toowoomba community scene. By 1976 the Auxiliary had raised enough funds to furnish a chapel. No longer did clergy have to stand on the platform in McDonald Hall while staff kept order among the patients. Chapel services became voluntary and clergy, staff and patients appreciated the attractive quiet setting of the Chapel in the Central Nursing Office building.

The drama which cemented town and hospital relations was the Queensland wide strike in 1973 over staff integration issues. About 1,300 volunteers from all walks of life and from secondary schools helped the remaining staff keep services functioning. The-chronicle printed timetables and the radio and television stations broadcast information for helpers. Men and women helped with patients, cleaned wards, served meals, collected rubbish bins while staff organised and handled necessary treatment for long hours. The strike which lasted nineteen days in other Queensland psychiatric hospitals lasted only nine days at Baillie Henderson Hospital. From that time it could be said that Toowoomba had adopted its psychiatric hospital.

Dr. de Groot resigned on 17th February, 1976 to go into private practice at Tamworth in New South Wales. Acting Medical Superintendents, Doctors Jim Wood, Barry Park and Eddie Tan maintained the impetus of change and community liaison until a Medical Superintendent was appointed.

CHAPTER VI - COMMUNITY SERVICE 1977 - 1987

*Dr. J. M. Ridley pictured with the Director of Psychiatric Services, Dr. G. S. Urquhart.*

DR. RIDLEY

Dr. Joan Metcalf Ridley, M.R.C.S., L.R.C.P., M.B.B.S, D.P.M., D.R.C.O.G., F.R.C. Psych., F.R.A.N.Z.C.P., came from England in April, 1977 with the latest ideas in Psychiatry and the enthusiasm to accelerate the momentum already generated. She was originally from Durham, and then she trained in London and eventually came to Australia from the Oxford Health Region. Dr. Ridley (Mrs. Oliphant) and her husband Mr. W. Oliphant (Bill) and their two children soon became the hub of the greater hospital community family.

The new Medical Superintendent's enthusiasm was demonstrated in her request to be driven through the hospital before going to the official welcome. In no time her competence on the job blotted out any fears staff may have had about working under a woman and an English one at that. It was clear that she understood the changes occurring in psychiatric hospitals and she soon summed up where Baillie Henderson Hospital was in them. The immediate issues were the continued integration of men and women patients, the unlocking of doors and pulling down the remaining fences, and then carrying through the big de¬institutionalization programme with its implications for the community outside.

FUNCTIONAL GROUPS AND REHABILITATION

All staff were drawn into the management of their houses through 'ward' staff meetings. These were attended by everyone involved with the patients whether doctors, nurses or paramedical staff. The biggest upheaval was the moving of patients into "functional groups" so that appropriate treatment and care could be provided efficiently. The main groups which became area units at first were Admission, Rehabilitation, Alcohol, Elderly and Intellectual Handicap. The focus was on rehabilitation with the expectation that programmes would improve the quality of life of those who continued to live in the hospital as well as of those who moved out. Community preparation programmes were stepped up to cater for the numbers ready for them.

Each patient's progress was reviewed regularly and anyone who seemed ready for the community preparation programme was moved to a special area to learn or relearn housekeeping, social skills, town orientation, budgeting and shopping. Social skills included how to behave on various occasions and how to relate to people including dealing with moods and stormy relationships. Town orientation included finding the way around town, coping with transport and using facilities like the Post Office, Department of Social Security, the Public Trust Office, shops and banks.

When patients were ready they moved into a share flat or house where they were supervised until they were ready to move on to private accommodation. Those in the programme who couldn't cope with everything but wanted to live outside went to live in boarding houses. The most used were known as Campbell's or Boulton Street, Schultz's, Grundon's; and later "Ben's Farm", down the Range.

Most settled happily and found interests but there were some who were obviously lonely so the Hospital Auxiliary began a Friendship Club, which met every Thursday morning in St. James' Church Hall. Bingo, dancing, music, cards, morning tea, talk, singing and occasional bus trips enriched the lives of all who attended for many years.

In 1978, the Child Welfare Clinic at Royal Street became the core of the new psycho-geriatric service and in 1984; the community based day hospital was opened in the old Philharmonic Hall in Herries Street - an indication of the support given by the Toowoomba City Council.

ORGANISATION AND EDUCATION

State Government psychiatric hospitals are constrained by Acts of Parliament. In Queensland the Mental Health Act divided responsibilities between the Medical Superintendent and the Manager. Dr. Ridley and Mr. Allan Gibson, Manager, had an Executive Committee to assist them with planning and co-ordination. This Executive generally included the Deputy Medical Superintendent, Principal Nurse and Senior Paramedical Officer.

Over the years as area units were established they developed their own internal management structures, large units with house staff meetings, smaller units with the one meeting to cover clinical and organisational matters. For most of Dr. Ridley's time there were various Thursday midday staff activities - a clinical staff meeting, a case presentation or lecture by a visitor, and a journal club. Most professions also held their own meetings for information sharing and education.

The School of Nursing under Mrs. Chris Cantly and her staff provided the academic education for nurses and the hospital staff trained them in on the job practical experience. Attempts were made to enrol equal numbers of men and women for training. The academic entry standard rose progressively over the years and students' results in the State examinations reflected the quality of education provided. The professional status of Psychiatric Nursing could no longer be queried. Mr. Ron Broad died in 1978 and he was succeeded by Mr. Robert Rosenthal as Principal Nurse until he left for more senior responsibilities in the Department in Brisbane. Mr. Jim Torkington, R.G.N., R.P.N., Dip. Admin, F.C.N.A., became Principal Nurse from 10th December, 1984, to 30th June, 1986, during which time management by objectives and a quality assurance programme were introduced through all levels of the nursing service.

Over the years, courses and seminars were presented by the hospital to various groups. A week's course for Community Nurses needing to understand ex-patients or people with chronic psychiatric disabilities was held. The nurses taking the training to specialise in geriatric nursing through Princess Alexandra Hospital came for a week each year. In the International Year for Disabled Persons and during special weeks, like Handicapped Person's Week and Mental Health Week, there were lectures for professional staff and seminars for interested people. The setting aside of an accommodation area made it possible to provide accommodation for the longer courses as well as for University students on placement.

The staff library became more and more important as the hospital was involved in the training of psychiatrists, psychiatric nurses and paramedical staff, so a qualified librarian, who had also been a psychiatric nurse, Mrs. Kate Haley was appointed on 19th March 1984. By 1985 she had reorganised and enlarged the library "to provide a speedy and useful information service to all staff."

Some staff were sent on courses run by the Division of Management Services, and whenever possible staff were encouraged to go to professional conferences. For some months in 1980-1981 Dr. J. M. Sutherland, the eminent neurologist examined selected cases for discussion with medical officers and the trainee psychiatrists. The first psychiatrist to complete his training at Baillie Henderson Hospital was Dr. John Flanagan.

REHABILITATION AND DEINSTITUTIONALISATION

The whole scene was reoriented when thinking and planning was done from a community needs view point. The hospital came to be seen as only part of a comprehensive integrated psychiatric service. One aim then was to assess and treat people in their own environment and only admit those who needed special care to hospital. Another aim was to habilitate or rehabilitate as many inpatients as possible. The other aim was to help the community accept those moving out.

A psychiatric ward was established at Toowoomba General Hospital in 1979, staffed by Baillie Henderson paramedical and medical staff and by Toowoomba General nurses. Clinics at Baillie Henderson Hospital and Toowoomba General Hospital as well as the Day Hospital became the entry points for most people needing psychiatric treatment. The elderly could go to the Royal Street centre and country people had access to the Rural Services Clinics which were conducted by a multidisciplinary team of Baillie Henderson Hospital staff who visited several country centres. Inside the hospital, once the areas were set up, the people with actual psychiatric problems became the core of the hospital. There were still numbers of others like those with intellectual handicap or serious damage from alcoholism. In all cases life and programmes were planned towards life outside. In some ways the changes which meant freedom for many patients disrupted the inside community life that was so safe for patients. Programmes and therapy took priority over work activities, like kitchen, laundry, sewing, cleaning and grounds work. Eventually even ward cleaning was transferred to contract cleaners. Nurses and patients adjusted to programmes designed for individual needs rather than for ward survival, with the assumption that therapy should be related to ordinary outside life. Each house developed its way of life appropriate to its residents, using some outside resources such as basic school education, craft, sheltered workshop employment, recreational music, sport, swimming and walking. Town outings in small groups for shopping, hair dressing and movies, and visits in larger groups to plays and special functions like the Carnival Procession and Fun in the Park days, all added varied experiences. Excursions further afield to places of interest like Sea WorId and Dream WorId, and whole house holidays enlivened life. Home leave and family holidays were encouraged. Some went on Crossroads tours in Australia or overseas.
..

*A patient's room at the hospital.*

Those in the rehabilitation programme were encouraged to be as independent as possible, and when they were ready they took the bus to town by themselves, did their own shopping and tried social activities like the Thursday Club. Anyone capable of employment went as a sheltered workshop trainee to K.B.H. Enterprises or Endeavour. The final step was to go on leave and, if that was successful, participants were discharged.

A great deal of preparatory work preceded the rehabilitation programme. The granting of pensions to individuals by the Department of Social Security made independent living a possibility. Part of this was that patients could buy their own clothes, choose their own outings and give themselves treats. Then the general public and families needed to understand what was going on - why people they thought were being looked after for life were being encouraged to live in the community again. Attempts were made to allay fears and misunderstanding by preparing and supervising patients well, by personal interpretation to families and relevant people, and by general publicity.

COMMUNITY - VOLUNTEER SERVICES AND SUPPORT

The co-ordinator of the Auxiliary Services committee, Mrs. Mavis Jones, built bridges between the hospital and the community by helping patients who were being rehabilitated and living in the community and by bringing the community into the hospital.

Volunteers meet hospital staff during an orientation course run by the Hospital's Community Liaison Unit in May /983. From the left: Miss Mary Starky, a visitor; Medical Superintendent Dr. loan Ridley; Hospital Manager Mr. AI/an Gibson; Mrs. Anne Stanfield and Mrs. Iris Starkey, both visitors; the Principal Nurse. Mr. Bob Rosenthal; Deputy Medical Superintendent, Dr. Eddie Tan; and Mr. Stephen Boyle, a visitor.

The strike had opened the hospital doors to Toowoomba so when Dr. Ridley, within three weeks of arrival, appealed for volunteers, townspeople responded readily and some wonderful people came forward. Dr. Ridley explained in 'The Chronicle', "There is no suggestion of their replacing or taking over the role of trained nursing staff. Some of the many jobs the volunteers could do are: taking patients shopping, playing money games with them, feeding some of the severely handicapped children, or even simply walking around the hospital grounds with them."

Mrs. Jones and the Hospital Auxiliary were very active working for the good of the patients by working among them and by raising money for extra comforts. Other groups made contributions. The Sports' Club ran an Art Show which was opened by Sir James and Lady Ramsay. It also sponsored a Double Wicket Cricket Match featuring the English and Australian captains as well as other international and local talent. A Country Women's Association sub-branch supported by the Oakey C.W.A. was started in the hospital. Over the years many volunteers and sponsors responded to appeals for help from the hospital Community Liaison Unit. Mrs. Jones retired at the end of 1978 and was succeeded by Mrs. lan McSweeney. The Community Liaison Unit was formally launched by the Hon. Brian Austin, Minister for Health, in 1983. The report of that year illustrated the effectiveness of the unit. That year 1,000 visitors were welcomed. The number of volunteers increased and courses and support were provided for them. The public was educated through talks to community groups, charitable organisations and schools. A successful Mental Health Week that year was made possible thanks to many sponsoring business people. The Fete plus $2,500 from the Hospital Auxiliary enabled the purchase of "Search and Rescue" equipment.

Many residents passed through the Hume Street and Windmill Street flats which were managed by the voluntary organisation, Karakan. Some inpatients and some discharged patients worked in K.B.H. Enterprises. This latter was a joint project between Karakan and Baillie Henderson Hospital. As a sheltered workshop from 1980 it received some funding from the Department of Social Security and later from the Department of Community Services. Karakan employed management and skilled staff and controlled finance and marketing. To supervise the trainees, the hospital provided nursing staff who understood the problems of trainees. In this way any inpatients or outpatients of the hospital who were preparing to return to the workforce, could work in a caring environment and also earn some extra money.

In 1977 a liaison nurses’ service was set up to cover patient placement and two Social Workers were appointed. Social Workers and Liaison Nurses worked together co¬ordinating the rehabilitation programme, although all staff and many volunteers contributed to the programme.

For a while it was hoped that once people were settled outside and discharged they would be independent and use ordinary community services, but it soon became clear that there were some who could not cope and yet were not sick enough for hospitalisation. In 1982 Dr. Jeff Thompson set up the Whishaw Day Centre. At first it was hoped that a refresher course in rehabilitation would suffice to re-establish those who attended into community life, but it was soon apparent that an informal day centre for long term voluntary attendance was needed. This coincided with changes which led to the closing of the Thursday Club at St. James'.

The Whishaw Day Centre finally came to be located in one of the oldest wards, old Ward One or Ray House. The voluntary coming and going of those who attended and the sharing in the planning of programmes between staff and members was a far cry from the life of locked doors, rattling keys, drab clothes, shuffling and shouting. Whishaw soon had music and quiet chatter by smartly dressed people straight off the bus or from their own cars. These men and women could meet in an environment where they were understood and where they had help to organize group activities like games, outings and information sessions. They arranged talks by people from services like Social Security, the Public Trust Office and the Police Department. Dances organized by Whishaw will be remembered as much for the decorations and disco lights as for the dancing. This Day Centre became an integral part of the after-care service and the base for the psychiatry follow up team.

From the earliest days the Churches of Toowoomba visited the hospital for services, to give entertainments, and they encouraged parishioners to respond to calls for volunteers. St. lames' Anglican Church people formed the nucleus of the Auxiliary and ran the Thursday Club in their hall. The Lutheran Church's most visible contributions were Pastor Kahler's visits year after year and the annual luncheon for patients at Nobby. The Salvation Army band, especially at the carol services, was an institution. The contributions of clergy and laity of all denominations were appreciated over the years. One of the most touching gifts was the confirmation of some of the Tredgold patients who were so physically and mentally incapacitated that their only way of communication was through their eyes. A Catholic Chaplain felt the Church should extend its benefit to them. In 1981 Sister Margaret Murphy, seconded by the Catholic Bishop of Toowoomba, assumed the duties of Hospital Chaplain. A token of the value patients and families were putting on the hospital as a community were the number of funerals held in the chapel. One patient’s ashes were interred in the lawn. A couple was married in the chapel before their discharge from hospital.

The disabled riding programme, established and run by volunteers, became a most valued service.

The voluntary services function became an annual event as a tribute to the voluntary organizations, individuals and sponsors associated with the hospital. Many staff worked to make these occasions a special thank you but no one more than the housekeeper, Mrs. Ollie Zeller, with her different floral decorations and Mr. Jim McLoughlin who prepared the delicious food. An extra dinner party called the "500" Dinner Party was given to the hospital by the Division of Psychiatric Services to celebrate and publicise "the community acceptance of the service provided by Baillie Henderson Hospital, in its dramatically successful deinstitutionalisation programme."

COMPREHENSIVE SERVICE

The eighties were years when Baillie Henderson Hospital reviewed its future after the dramatic deinstitutionalisation years. The numbers dropped to about 500 and appeared to stabilize. Hundreds of patients settled outside and many never needed treatment again, though, after the initial hope of cures, it was realized that many people had chronic disabilities for which they would need help. It was also hoped to reduce admissions by preventive work and early diagnosis. These ideas led to an expansion of community services.
The Clinics held at Toowoomba General Hospital saw most people who needed assessment and treatment, and each year the demand for more and better inpatient services there became stronger. Baillie Henderson Hospital generally provided the specialist psychiatric staffing personnel.

One of the problems Dr. Ridley set herself to address was the inappropriate admission of elderly people. Many of these and their relatives just needed help along the way. She established the Royal Street Assessment and Day Care Centre in town. Anyone could refer an elderly person for assessment by a multi-disciplinary team. It was found that many could remain in their homes with support and treatment. Some were diverted to a hostel or nursing home rather than to a psychiatric hospital. After a while it became apparent that more observation of some of these people was needed before advice could be given, so Hill House was set up for patients to come for further assessment. Only those who needed psychiatric hospital treatment were then admitted to the psycho-geriatric wards.
From time to time clinics had been held in some rural centres. In Dr. Ridley's time the travelling rural service was extended to provide a regular service to major centres in south west Queensland. A team with a Psychiatric Registrar, Social Worker, Psychologist and Nurse drove to Warwick, Stanthorpe, Gatton and Dalby and flew to Roma and Charleville. For a while Goondiwindi was visited. This meant that patients could be seen for assessment; treatment and support in their own areas and patients discharged from city hospitals could be followed up. Some people travelled a couple of hours often on dusty or muddy roads to their appointments. Sometimes too the team gave talks to schools or other groups in the towns visited to improve the understanding of psychiatric illness and caring for people with psychiatric disabilities.

*The Rural Services Team moves out from Baillie Henderson Hospital in October 1982.*

In June 1984 the Downs Day Hospital was opened in the old Philharmonic Hall in Herries Street by the Hon. Brian Austin, Minister for Health, to encourage people to seek help before major illness occurred and to help people deal with restricting psychiatric disabilities. As the Minister stated in his speech the aim was "to provide a psychiatric service for those in the community who might otherwise require hospitalisation and those psychiatric clients who are not being treated by any other service".

A particularly specialised clinic attended by a psychiatrist with experience in forensic work was set up to meet with a hospital team to prepare reports for the courts.

Any changes within Baillie Henderson Hospital itself were outward looking. A strong community inside was encouraged only so that it and its members could relate better to the wider community outside. As a psychiatric hospital its central core was the patients with psychiatric illnesses, but there were a number of other groups who benefitted from the psychiatrically trained staff available to manage their care.

In 1980 there was a thorough assessment of all patients to regroup them to achieve the most satisfactory way of life despite their disabilities. The large number of intellectually handicapped did not need psychiatric treatment so they were housed separately and life for them was made as normal as possible. This unit did not need a primary medical focus so its team was led by a psychologist and medical treatment was made available through a clinic. The main goal of the team was to provide an appropriate quality of life. This was done by widening residents' experiences through outings, holidays and community contacts. Some who did not have relatives who kept in touch were enrolled in the' Adopt a Patient' scheme of the Community Liaison Unit. Quite a number were placed in appropriate accommodation away from the hospital.

At the beginning of 1982 the hospital took over a complex on the hill above Bedford Street for the Alcohol Rehabilitation Unit and for K.B.H. Enterprises. This was a few kilometres away from the main base and was an attractive, new building around which staff and patients soon built a prize winning garden.

As inpatients established themselves in the wider Toowoomba community, wards became smaller in size (a maximum of thirty patients) and the old wards housing over 100 patients each, a thing of the past. Concurrently, staff were also redeployed in community support work and day hospitals and a new need; sadly arising from the increase in motor vehicle accident was able to be met.

*Queensland Director of Rehabilitation, Dr. Paul Hopkins, watches as a patient uses an alphabet board to communicate.*

The patient had lost the use of his vocal chords as the result of a fall from a horse. Dr. Hopkins, pictured during a visit to the hospital in 1982, said the hospital's unit for the young disabled was unique in Queensland. Its objective was to give young people training to see if it were possible for them to live independently and return home.

A specialised unit was established in 1982 for young people with chronic disabilities. This was the new Penrose House. Most of these young people had head injuries from car, motor bike, horse riding accidents or from brain tumours and they were offered an intensive rehabilitation programme for up to two years. A few for whom there was no alternative than life in a nursing home with elderly people stayed for long term care. This unit has become one of the few specialised units of its type in Australia and was fortunate to receive support from Queensland's Director of Rehabilitation, Dr. Paul Hopkins.

The Psycho-geriatric unit was able to contain its expansion due to careful assessment procedures and the availability of alternative accommodation for the elderly. The excellent liaison with nursing homes and the nursing services meant problems could often be resolved "in situ".

The Mental Health Services Act 1974 - 84 became operable in July 1985. It ensured that the basic rights of the mentally ill were protected at all times while access to proper care and treatment was guaranteed.

BEHIND THE SCENES

The Manager and his staff and the Public Works Department were kept active keeping up with the modernising programmes. Mr. Allan Gibson, Manager until 31st October, 1985, somehow stretched the hospital's resources to provide support to the expanding community services. In 1977 the old kitchen and laundry buildings were demolished and the building opposite the main car park was opened as wards for some of the intellectually handicapped, the nurses’ training school and patients' education facilities. A new laundry fence was erected and the staff car park surfaced and lit. On 8th May, 1980 a carefully planned Artisan Workshop was opened. This brought the many maintenance departments together with an internal yard for machinery and equipment needing repair. The Engineer had a range of tradesmen in the area - carpenters, plumbers, fitters, mechanic, electricians and painters. Most of their time was used in maintenance. Big building jobs were done by the Department of Works but the Artisans carried through a number of smaller projects such as the internal renovating for the Day Hospital.

In 1981 a large refrigerated storeroom was built for frozen food. This improved the variety of meals for patients. There was some public controversy on the issue but the menu, which was always supplemented with fresh fruit and vegetables, was approved regularly by a dietician. Meals were transported by small runabout vehicles to the houses where there were patients unable to walk to the cafeteria and to the sites away from the central hospital.

Transport became increasingly important with the expansion of services. There never seemed to be enough cars for all the staff needing to move around the community so some staff were given permission to use their own vehicles and claim mileage costs. The gardeners also used tractors. The Hospital Auxiliary provided the original mini-bus with cassette music for taking patients on outings. One of the joys of even Tredgold patients was to drive into the country and pull up to see horses over fences or cows ogling them. The odd occasion when a lamb or puppy was taken into their ward made them quite ecstatic, in the same way that Hill House patients mooned over visiting babies.

In 1984 the long planned indoor recreation complex was completed.

*Medical Superintendent, Dr. Joan Ridley, and Hospital Manager, Mr. AIlan Gibson, in front of the swimming pool, 1984.*

This included a heated swimming pool with equipment for disabled people, a large gymnasium, dance room with mirrors, a music room and patient library. A physiotherapy unit was added and included a hydrotherapy pool. This meant that physiotherapists, who had been working in temporary rooms since Robyn Brims was appointed in 1977, now had permanent and modern facilities. The ground floor included a modern pharmacy and large bulk store, and space for a future occupational therapy facility.

Staff from all areas became part of the Health Department's regional computer pilot project. Some were fascinated, some frustrated but most came to terms with computers used for recording and communication.

BAILLIE HENDERSON HOSPITAL ACCEPTED BY CITY

The hospital built over the hill from town as a place in which to hide troublesome people behind high fences and locked doors - a place feared by many - was never satisfied to be just a mental hospital that stayed quietly out of sight. Dr. Ridley threw herself into Toowoomba community life through her many personal and work interests becoming known socially in a variety of circles. She attended and encouraged her staff to attend relevant committees, seminars and workshops. Hospital staff and patients soon made their presence felt in town and in return townspeople were made welcome as visitors and as volunteers at the hospital. Dr. Ridley ensured that Baillie Henderson Hospital took a position of prestige in the wider world, not only in Queensland but throughout Australia and the world.

Toowoomba was the ideal town to support a first rate psychiatric service because of its size, its tradition of care, and its position as a base for south-western work. An almost ideal integrated service had been fostered but it needed vision and determination and Dr. Ridley ensured these. Dr. Ridley left in April, 1986 to become Director of Psychiatric Services for the Northern Territory. The whole Oliphant family had endeared itself to patients and staff. They all appeared at functions like fetes and dinners and did a round of visits to all the hospital houses on Christmas morning, and even the family goat trailed in one year. When Dr. Ridley left to become Director of Psychiatric Services in the Northern Territory she spoke of leaving the hospital family. She and staff certainly felt part of a large extended family after nearly ten years of growth together.

CHAPTER VI - PROFESSIONAL PSYCHIATRY

*Dr. J. D. Thompson*

DR. THOMPSON

Dr. Jeffery David Thompson, M.B. B.S. (Univ.of Qld), M.R.C.Psych. (U.K.) came to Baillie Henderson Hospital in 1982 and became Acting Medical Superintendent on 18th April, 1986. He was one in a line of competent psychiatrists the hospital had attracted. He was another in upholding the tradition of learned imaginative leaders.
In the eighties the hospital had to contend with major economic restrictions, a new Mental Health Services Act, public pressures via the legal system and the media, and sophistication in professions and in management structures. These were not necessarily bad and the main functions of the hospital were enhanced by them. The economic restrictions and political issues slowed down the growth of the psychiatric service, and for a while put a damper on staff who wanted to begin innovative projects and research. The Mental Health Services Act (1974 - 84) became operative from 1985 to protect the public from inappropriate admissions to psychiatric hospitals. Soon hospital staff appreciated its provisions but had to explain its working to some members of the public who felt they were being denied immediate admission for problem relatives and neighbours. Psychiatry became news as the general public was affected by changes. People began to show concern about the behaviour of patients who had been discharged and general medicine was forced to become involved with community treatment. Such concern, when matched by education, improved attitudes and should have improved living conditions but the majority living outside was unaffected. The media began showing films of people with mental illnesses and mental hospitals and newspapers reported the occasional tragedy as if it was a common experience. Alongside this there were broadcasters and writers, like Anne Deveson who had personal experience of living with a family member with schizophrenia and provided positive information. Consumer and advocacy organisations became a force amongst relatives and friends. The Queensland Association for Mental Health (QAMH), the Association of Relatives and Friends of the Mentally III (A.R.A.F.M.I.), the Schizophrenia Fellowship and Headway were the main ones which extended help to Toowoomba. They worked with mental health professionals and relatives to improve understanding, research, finance and conditions. The A.R.A.F.M.I. (Toowoomba Branch) met at Baillie Henderson Hospital over many years supporting relatives and sharing together what the general public did not understand. As the public felt more qualified to challenge treatment, patient’s rights and legal scrutiny received more attention, but understanding from knowledge and experience outweighed the difficulties and enabled some positive moves to improve services.

The greatest changes for Baillie Henderson Hospital in the eighties arose from the flowering of professionalism amongst all staff. Each profession was more assertive about its contribution to mental health and when this was added to an appreciation of team dynamics the range of treatment options benefitted the various services. Under the Mental Health Act the Medical Superintendent and Manager were given clearly defined responsibilities. Medical Officers had certain legal responsibilities; but, within that framework, team members from all professions contributed special expertise. Over many years Social Workers, Psychologists, Occupational Therapists, Physiotherapists, Speech Therapists, Recreation Officers and Teachers had been employed when they were available but by the eighties they were considered essential for mental health teams. Dr. Mike Ryan, who had served as a psychologist for some years, was appointed as Senior Paramedical Officer to co-ordinate these services. Over the same period the nursing role was delineated as a profession.

The core of the hospital was always its nursing staff. The combination of vigorous in-service training and reorganisation, resulting from having a nursing hierarchy of authority linked to Brisbane, increased the prestige of nurses and their contribution to team work. Mr. Bob Rosenthal was part of this when he went to Brisbane in 1983. When he left, Miss Dulcie Janetzki carried on as acting Principal Nurse until she retired in December 1984. Mr. Jim Torkington became Principal Nurse on 10th December, 1984 and accelerated change by introducing preceptor courses and quality assurance standards. Mr. Torkington left for the Darwin Psychiatric Service and Mr. Garry Davies became Principal Nurse. Mr. Davies, whose grandfather had worked at the hospital, did his initial nurses training at Baillie Henderson Hospital and Toowoomba General Hospital.

By the mid eighties there were teams covering all areas. Toowoomba and its region had a comprehensive integrated psychiatric treatment programme. It was an integrated hospital based service whose staff had the advantage of belonging to a professional community. The variety of experience offered made employment attractive to people accustomed to the stimulus usually only available in capital cities.

The areas in which teams worked were Admission and Psychiatric Treatment and Rehabilitation, in-patient care for long-term patients with chronic conditions, Whishaw and Community Care, the Downs Day Hospital and Rural Services. Other areas not primarily psychiatry but benefitting from staff with a training in psychiatry were the units for young chronically disabled persons, for alcoholics and for the intellectually handicapped. Most teams included a Psychiatrist, Medical Officer, Psychologist, Occupational Therapist, Social Worker, Nursing Supervisor and Nurses. Other staff attended as needed. Sometimes an area might have specific education for their task or it might present a seminar to colleagues or the public. The main education thrust took place in Mental Health Week each year. For many years a Baillie Henderson Committee organised the Toowoomba programme with displays in shopping areas, talks, radio and television programmes and Church services. During Mental Health Week the public and schools were invited to tour the hospital.
Some of the professional demands of those years were met by the upgrading of the staff library. The librarian sorted classified and added books, increased the availability of journals, used an on-line computer for literature searches, and became a resource for local health workers, and further afield as far as Mosman Hall and Cairns.

In April 1984, psychiatrist Dr. J. Thompson, and Medical Officer, Dr. Ivan Um, from Baillie Henderson Hospital, flew to North Queensland to offer a consulting psychiatric service to Mosman Hall, Charters Towers.

The staff and patients of the hospital were no longer forced to make their own community because of distance and social isolation neither was the hospital community unduly fragmented by the forces which over the years had battered it within and without. It emerged as a thoroughly modern professional community as proud of its current achievements as it was of its heritage. The Medical Superintendent no longer marched around with a retinue of senior staff inspecting and being saluted. He was more likely-to be found sitting in a team meeting with his two way pager or driving to one of the off campus sites. He was sometimes seen clambering into the little Beechcraft Baron plane with the Rural Services team for a western trip.

Clinical teams are of little use in a hospital unless the management and administration are well done. Just as Or. Hogg and Mr. Burn worked together to establish the hospital so Or. Thompson and Mr. Whitby, Manager at the end of the century shared an understanding of the service they were still shaping. Just as a structure of professional staff had grown on the medical side, so a structure of departments grew on the Manager's side. Senior experts covered several departments under Mr. Keith Simpson, the Engineer - electrical, plumbing, mechanical, carpentry. Administration was divided between the Head Office in Brisbane and Baillie Henderson Hospital. Within the hospital there were departments dealing with clerical work and accounting. The other big areas under the Manager were the Grounds and Kitchen/Housekeeping departments.

The Artisan's Block had the facilities to keep a small island functioning. Its men did everything from making keys and repairing chairs to servicing trucks and tractors, from unblocking drains to planning and building minor structures.

Mechanization and transport kept pace with the speed of life. The fleet of cars, trucks, tractors and runabouts enabled staff to cover the distances their jobs required. The day of the leisurely stroll from Gowrie Hall to the Administration building with typing was over. 'Time was Money'. A courier on a three-wheel motor bike collected and delivered mail. Small runabouts chugged up and down roads and footpaths delivering meals and laundry and collecting rubbish bins. Meals had to be delivered to Bedford Street and the Royal Street Centre; patients, staff, x-rays and pathology parcels to the Toowoomba General Hospital. Staff travelled between the various sites by car and liaison nurses and social workers drove around town to home visits or support agencies. The addition of two way radio to the cars reduced the amount of time in constantly returning to the hospital.

The modern mechanized laundry did the laundry for all the State hospitals in Toowoomba. Keeping the linen and clothes clean was a massive task. The use of plastic over mattresses and kylie sheets helped somewhat.

Two other staff groups moved into new quarters. The gardeners had a new area near their propagating nursery. Each year they timed a brilliant display for the Carnival of Flowers Garden competition and gradually brought the grounds to their present park¬like appearance once their low numbers were compensated for with machinery like the big tractor and slasher. In 1985-1986 over 1,000 trees were propagated and planted out. Fire breaks were also established. The other group was the General Hands. These men, who cheerfully did everything from erecting scaffolding to rescuing cats from drains or collecting bunya nuts, had quite a party when they were able to celebrate moving into quarters of their own.

Staff from all departments benefitted from the various communication systems. Telephones, paging systems, loud speaker, public address system, search and rescue gear and computers all made for efficient co-ordination of services. These all required maintenance as did doctor's, psychologist's and physiotherapist's equipment. Television sets, videos, radios and cassette players had both recreational and therapeutic uses. Clerical staff stayed in the forefront of most of these systems, using electronic equipment like typewriters, word processors, accounting programmes and adding machines and photocopiers. The State Government Department of Works was responsible for the main building and maintenance tasks so the Manager had to have regular contact with its

Manager. From the beginning the local Department of Works had kept up a building programme in collaboration with the Brisbane Departments and the hospital stewards and managers.

Mr. Whitby as Manager co-ordinated the various internal departments and liaised with the outside ones, but he also took initiative and showed he had an eye to needs and for seeing projects carried through. He had a great eye for detail, whether it was laying cement paths where patients walked rather than where he thought they should walk, to finding accurate words for reports.

The test of any institution is the loyalty of its staff members. Many families in the area had a tradition of someone in the family working at Baillie Henderson Hospital. This partly explained the loyalty that was so strong among men and women around the hospital. This spirit showed up on special occasions like fetes, farewells and Christmas parties. Another time it was experienced was at funerals - not just the big ones in Churches for staff but at some of the small graveside ones when a patient was being buried.

No community holds together without responsible reliable leadership. The hospital had lived through some difficult times but it had had a remarkable series of leaders. The Medical Superintendents and Stewards/Managers had tried to make the hospital as bearable and as good a place for patients as they could over the decades, with considerable attention to staff conditions. The influence of a number of outside people supported them. The inspectors and directors maintained good rapport. Dr. Scholes, Dr. Basil Stafford, Dr. Byam Ellerton, Dr. Gordon Urquhart and Dr. Perc Tucker helped with plans, visited regularly and took a sincere interest in both projects and problems. Head Office staff kept in touch with relevant sections whether administrative or clinical. Locally, Official Visitors inspected the hospital and checked to ensure there was no abuse of patients.

Throughout its history the hospital was a lively community reflecting the society of each generation. The first steward had argued for chairs rather than benches because they were more homely. Many a family was comforted by staff when a loved one had to come to hospital. Ward holidays would not have been possible without hours of their own time being donated by staff. There are stories all through of staff feeling compassion and working to improve something, like pretty dresses for women. There was the intellectually handicapped boy with cancer, who was nursed by ward staff because the hospital had been his home for years and his ward staff elected to nurse him as if they had been parents. Then there were the many occasions when staff ministered to staff when work was difficult or when someone needed support because of problems at home.

Two nurses who made special contributions were Mr. Wally Emerson who built the pipe organ as a project for patients; and Mr. Don Featherstone who returned as a volunteer after he retired to help patients paint. Many of the paintings from these classes brighten the hospital walls and the films, "Prelude to Music" and "No Keys" will continue to commemorate practical therapy and the deinstitutionalisation programme.

Each generation worked at living within the constraints of the time. Over the years of the two wars discipline and orderliness provided a framework behind which there was still a great deal of care and understanding. Overworked nurses spent hours with uncontrollable patients. Most really appreciated the easier relationships of the seventies and then, the working together in the eighties. For some, the regime of new structures with more shared responsibility felt uncomfortable at first but it resulted in greater loyalty and willingness in the long run.

Wise leadership and staff loyalty enabled the growth of the hospital community despite tragedies, hardships, frustration and rapid change. Life for most patients over the years was good compared with world standards. When the gates of the hospital were opened the community changed but it was not overwhelmed. Its community life was strong enough to support patients who needed a secure compassionate environment, and it was strong enough to retain its identity while living as part of the outside world. It had the capacity to adapt as the needs of people and society changed.

While its buildings of Baillie Henderson Hospital tower up like "The Lion of Toowoomba", the city and its service area can be assured of a strong, lively psychiatric service. The treatment and care facilities of to-day would gladden the hearts of the early medical superintendents. The spirit of community may have changed but the vitality generated by staff over the years is alive in the present generation and strong enough to carry into the future. The tradition of care built up over the last century must give heart and hope to staff, patients and their families so that the fear of mental illness need no longer haunt our citizens. Professional psychiatry in the hands of those who care for people and their environment is one of the greatest gifts now offered to modern society. May the tradition of Baillie Henderson Hospital continue as long as people need its care.

The following poem was written and recited by Miss Amy Noonan at the Baillie Henderson Hospital Centenary Reunion Dinner Dance held on Saturday, 10th March, 1990. Miss Noonan had been a member of the nursing staff from 1927 until she retired in 1972.

"Today I was asked to write you a rhyme,
Back one hundred years friends is a very long time.
So I'll just pretend I go back to that time,
And hope that you like my effort in rhyme.

With Kit, Gert, Ruth, Marg and Bob,
In my high lace-up boots I feel right for the job;
And my lovely blue frock and apron so white
Will see thru my duty from daytime till night.

So many to care for, no modern day cons,
Cold water for bathing, iron beds and old jons.
No biro to take notes, just old pen and ink,
And it's work by the glow of the old candle wick.

But if I can gladden one heart here each day,
And get them to start their recovery this way.
I won't feel my efforts are wasted my dears,
If a touch of my hand can vanish some fears.

With the help of so many the years they did fly,
I can't name them all but I'd sure like to try.
For to build such a building and staff it for years,
Takes much more than thinking, it's hard work my dears."

Amy Noonan 1990