Articles About The Centre

TEN YEARS ago a small group of radical psychiatrists set up a house where people could stay and be supported through an acute mental breakdown without the use of drugs. Fellow professionals dismissed them as the predictable - and passing products of the Sixties counter-culture and the anti-psychiatry movement.
Ten years later the centre still exists and is still the only one of its kind in Britain. But now NHS psychiatrists, GPs, social workers and probation officers all refer people there and count it as a blessing.



American psychiatrists Joseph Berke and Morton Schatzman set up the crisis centre in early 1973 as part of the Arbours Association, a charity to help people in emotional distress. They were already running long-term communities as alternatives to mental hospitals. But the crisis centre was something different. Here people could come at a moment's notice, stay days or weeks and go through even a psychotic breakdown with just the caring support of live-in therapists. Berke and Schatzman were convinced that breakdown could be a 'creative' experience which drugs and hospitals only stifled.
'We were professional people but we were looked at askance because we didn't wear white coats, we used first names, we formed close relationships with the people we were trying to help and lived with them, instead of seeing them for one hour a week across a desk,' says Dr Berke.
The crisis centre has long since moved from its initial somewhat shabby and cramped surroundings to a large bright comfortable house in North London. The three live-in Arbours therapists, backed up by outside, on-call psychiatrists and psychotherapists, deal with several hundred calls by phone, by home visits or by inviting people even whole families plus pets, to stay as guests at the centre.
The original aim at the Arbours communities was to give people a safe place to be where they could do as they liked, unlike in hospital, but with the comfort of knowing that sympathetic people were always around if needed. There were few rules. But it soon became clear that to desperate people, whose own internal boundaries had collapsed, such freedom was often the last and frightening straw.

'We had to have some unspoken rules,' says Andrea Sabbadini, one of the first live in therapists. 'People have their own rooms but someone will knock at the door if they are there too long; people come and go as they please but someone will be making sure they don't get into trouble.'
Therapists will sit day and night with someone who is suffering or scared to be alone. ' Having that kind of time has taught us so much about how people communicate pain,' says Dr Berke. He has found that those who find it hard to articulate feelings in words often induce their own feelings in others. 'They do something to make you feel depressed or angry or anxious or a failure because that is what they are feeling, although they can't face it. When you have picked up on that you can put it into words for them and a dialogue begins.'
One 16-year-old girl referred by a social services department in the north of England had been in over 40 homes and was considered incorrigible. She had repeatedly attacked staff, smashed windows and made suicide attempts. At the crisis centre she established relationships for the first time in her life and felt less and less need to express herself through violence.
The centre has had a diversity of guests over the years, young and old and including labourers, pop stars and politicians. But the therapists' old zealous conviction that they could help anyone has mellowed. 'Some people find it too much agony to go through all the pain of a crisis...They just 'want it stopped and we respect that,' says Dr Berke. He still believes drugs are a palliative, but accepts that they can have a temporary role.


Tempered by time, the method has worked. So why hasn't it been copied? Perhaps because the dedication entailed is outside health service for help scope. The live-in therapists take minimal pay and the centre operates at a third of what it would cost the NHS. It survives by fund-raising, small grants and sliding scale fees from individuals and councils who refer clients. It has even man-aged to expand to run a low- cost psychotherapy clinic to which people can refer them-selves. (In many places outside London no psychotherapy, neither NHS nor private, is available at all.)
'We want more people to know of us, so that we can become a first resort instead of the last.'