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Up Top tells how the mentally ill were treated in the 20th century, focussing on the Mid Wales Mental Hospital, which began as a lunatic asylum and closed when community-care took over 100 years later. It was the only UK hospital for psychotic POW's in World War II, including, briefly, the Deputy Fuhrer Rudolf Hess. This account is based on original archives and oral testimony from staff and patients, and is copiously illustrated.
The Mid Wales Mental Hospital was representative of most mental institutions. The book places in a wide context life in a lunatic asylum, the treatment of shell shock in two world wars, the short lived fashion for brain surgery, heavy ECT and deep sleep treatment; then the increasing reliance on drugs and various therapies before the gradual taking over of community care.