Swanbourne Hospital

In 1901, the newly appointed Surgeon Superintendent of the Fremantle Lunatic Asylum and the Whitby Falls Asylum Farm, Dr Sydney Hamilton Rowan Montgomery, declared Whitby Falls an unsuitable site for a new large asylum. Montgomery and Grainger travelled to the eastern states of Australia to examine the design of various asylums and relevant legislation. In 1901 Dr Montgomery chaired a committee formed to select a site for a new asylum, and in early 1903 the committee chose a site at Claremont, accessible from both Perth and Fremantle, to be staffed largely by experienced personnel, including a resident medical officer.[8] The advantages of this location were "ease of visiting", "lower construction and operating costs", "ease of providing entertainment", "proximity to medical help" and "ease of obtaining staff". Government Reserve H8636 at Claremont was set aside for the new asylum on 27 February 1903, consisting of 394.5 acres (159.6 ha) of land, including an artesian water supply.[8]

The hospital was to be administered under the new Lunacy Act of 1903, managed by a state government Lunacy Department headed by the new Inspector General of the Insane, Sydney Montgomery. Temporary buildings were subsequently set up and on 18 August 1903 twenty "quiet and chronic" patients were moved there from Whitby Falls Hospital to help clear the scrub and prepare the site for building and farming. The layout of the site is almost identical to that of George Temple-Poole's 1896 designs for the Point Walter Lunatic Asylum, which may indicate that Grainger reused Poole's plans. The Claremont buildings, however, were almost exact copies of those designed by Hillson Beasley for the original Whitby Falls Asylum project.

In 1903, the Public Works Department, under Grainger's supervision, prepared plans for the development of the site. The central area contained the administration block, main store, kitchen, attendants' quarters, and the dining and recreation hall. To the north were the female patients' wards, with those for male patients located to the south. There were separate wards for different categories of patients, which included "quiet and chronic", "recent and acute", "sick and infirm", "epileptic" and "violent and noisy", which were located furthest from the centre. Covered walkways on the eastern side of the blocks connected the wards to the central buildings. The main administrative buildings were located on the highest point of the site, at its eastern end, and included a portico constructed from Donnybrook stone.[8] Grainger also designed the heritage-listed Inspector General's residence, which still stands at 1 Grainger Close, Mount Claremont.

By 1904 all the male wards were under construction, but the female wards were constructed over a more extended period, with the fifth female ward ('violent and noisy') not being constructed until 1934. To the north east of the central core buildings were the hospital's service buildings including the boiler house and laundry. Transfer of patients from Fremantle began in 1904, but it was not until 1909 that all patients had been moved and the Fremantle asylum closed.

From 1910 to 1912, four new wards were designed and built by the Public Works Department under the direction of then Principal Architect, Hillson Beasley, and Acting Principal Architect William Hardwick. X Block, as it was known then (now Fortescue House), was constructed at the site that eventually became Graylands Hospital. The block was placed in an isolated position, adjacent to the dairy farm, and approximately 800m to the east of the main Claremont Hospital for the Insane site. Similar in plan to the main hospital, this block had a central core incorporating a kitchen, a dining hall, a doctor's residence and small rooms for the head attendant, with two wards located on either side of the core area. Two rotundas that provided shelter for patients were constructed in the outdoor area on either side of the kitchen. The four separate free-standing wards and the core buildings were connected by means of timber framed covered walkways. Each ward had a separate single-storey bathroom and latrines building located on the eastern elevation. X Block was completed by 1910–11 at a cost of £24,789 and accommodated 150 patients, who worked in the adjoining farm, associated gardens and orchards located on the hospital site. The X Block wards were originally open wards, with patients on an honour system to be inside by 10 pm.

The hospital was renamed Claremont Mental Hospital in 1933.[1] In 1939 a new physical treatment block was planned and built at Claremont Mental Hospital by the Public Works Department under the direction of the Principal Architect, Albert Ernest (Paddy) Clare. This building, known originally as the "Treatment Block" (now known as Gascoyne House), comprised two wings of wards at right angles with associated bathroom, lavatory, treatment and recreation areas with a central administration area constructed to bisect the two wings on the diagonal. The building was constructed at an estimated cost of £26,500.

However, the new treatment block was taken over by the military at the outset of World War II pending the construction of the military's own hospital facility at AGH 110 (today Hollywood Private Hospital). During this period, the building was known as "Davies Road Service Block", "Davies Road Annexe", or "Military Block". Mental Health Services regained control of the block by 1945 and used it to accommodate ex-servicemen with psychiatric disorders, and by the 1950s the block became known as "Montrose House". Incoming Inspector General of the Insane Dr Digby Moynagh then had Montrose House renovated, and on 17 April 1959 the building was re-opened as Australia's first psychiatric day hospital. The Graylands Day Hospital continued to operate on the site until it moved to Shenton Park in the 1960s, and the building was resumed for ward purposes and renamed "Riverton House" in 1967.

In 1954 the Commonwealth government funded the construction of a Tuberculosis Block on the Claremont Mental Hospital site, which lay across the southern end of the Hospital sports ground. This was later renovated for use as an early treatment and admissions centre, outpatients clinic and infirmary, which became part of the original Graylands Hospital complex in 1972 and was called "Victoria House".

In 1961 a sheltered workshop (Industrial Rehabilitation Unit) was constructed at Claremont Mental Hospital, and by November that year activities were established involving patients in simple production and manufacturing tasks, including the maintenance of hospital equipment and the production of concrete slabs for hospital pathways. The first building constructed for this purpose was Forrest House.

By 1966, Claremont was home to nearly 1700 long-term psychiatric patients. However, improved medication regimes and personal determination by some medical and nursing staff to foster a "discharge culture" (notably Drs Gerry Milner, Trevor Adams and John Milne) led to increases in the number of patients being discharged in the early 1960s. Following the appointment of Dr Harry Blackmore in 1967 as the hospital's psychiatrist superintendent, a major reorganisation and increased discharges of patients took place, and wards were redecorated and named after Perth suburbs (Ardross, Belmont, etc.), rather than the previous sex-numerical system (M1, F1, etc.).

By 1966–67, a number of projects had been completed at Claremont Hospital, including the construction of a cafeteria and additional workshops (De Grey House) at the Industrial Rehabilitation Unit at a cost of $70,000, the opening of two new 48-bed rehabilitation wards (Swanbourne/Shenton House and Tuart House; today Shaw and Moore Houses, Graylands Hospital) in November 1966, costing approximately $380,000, and the remodelling of X Block. In 1968 the former dining hall (Anderson Hall) at X Block was also converted for reuse as a recreational hall for patients.

Under Blackmore's regime there was a significant reduction in patient numbers; by the early 1970s the patient load was under 1000 for the first time in nearly sixty years. The hospital also reorganised internally into three divisions: a "deficiency" division, a "dementia" division and a "psychiatric" division. The mental and dementia divisions formed the basis of Swanbourne Hospital, while the psychiatric division became Graylands Hospital. On 3 September 1972, Claremont Hospital was closed and divided into two separate hospitals: Swanbourne Hospital, encompassing the original 1904 buildings, which cared for psychogeriatric patients, and adults with developmental disabilities, while Graylands Hospital treated acute psychiatric patients.[1]

Dr Peter Reed became Swanbourne's first psychiatrist superintendent. It took time for the new hospital to settle into its patient load, as patients could be transferred there from the new Graylands Hospital, and also from Swanbourne to Graylands if they were considered more likely to recover. Swanbourne provided art therapy and occupational therapy for the less severely disabled "mentally handicapped" patients in Jolimont ward. Other support services included physiotherapy, chiropody, social work and occupational therapy, but these were hindered by constant loss of staff across all areas including psychiatry, particularly in 1975–76, so that newly set-up programs had to be modified or withdrawn.

As early as 1974 Reed warned that Swanbourne could not accommodate the rapidly increasing numbers of elderly patients diagnosed with dementia, so Manning House became Swanbourne's admissions and assessment centre. Pre-admission assessments reduced the numbers of admissions to Swanbourne by up to half. However, medical and nursing understaffing was also chronic.

Public criticism of Swanbourne came early and from an unexpected source: Dr Fred Bell, the new Director of Mental Health Services, who succeeded Dr Arch Ellis in 1977 and described Swanbourne as "an affront to the dignity of man" to Perth's Daily News, 2 November 1977. Then some time in late June or early July 1980, Swanbourne nurse Alan Bradbrook had a conflict with two adult patients with developmental disabilities in the dining room at Swanbourne Hospital. This resulted in disciplinary action, Bradbrook's sacking, and a psychiatric nurses' strike which lasted eight days and polarised the nursing staff. During the dispute Dr Fred Bell also threatened to resign, but Bradbrook was eventually reinstated.