Stick with the first couple of minutes, where the protagonist describes his symptoms and fear of admission. The film describes the type of patients and reasons for admission, which resonate today. It is a large psychiatric institution with over three thousand patients living in an enclosed community. The commentary notes a staff shortage—a challenge every psychiatric service faces today. The features of asylum care are described, with the institution as a therapeutic community. Admission lasted at least 14 days—perhaps a useful reminder to us all today of the need for a comprehensive assessment and how long it actually takes. You might think it a luxury for each patient to have a routine assessment by a clinical psychologist in addition to the comprehensive physical tests and psychiatric reviews. How does that compare with current care 70 or more years later?

This film was made before the advent of neuroleptic medication (also known as antipsychotic medication, which reduces the symptoms of psychosis, particularly in Schizophrenia). Insulin shock therapy was thought to help, although it was later found to be no more effective than placebo and had its own dangers. ECT is still used today, although water therapy and sedative packs are no longer used. “But whatever therapy, it is essential the hospital offer a calm and secure environment”. Yes please. “No matter what their problem, there still is hope”. We also hear about the importance of continuity of care and family involvement. Large asylum care has been replaced by—well, what?