Maleria treatment was one of the first of the so called shock therapy, The introduction of the first effective forms of treatment brought about a shift in the treatment of metal illness across the country. The Mental Treatment Act of 1930 adapted the terminology surrounding mental health, the word asylum was dropped in favor of term mental hospital. Which led to a change of name for Moulsford Asylum, It became Berkshire County Mental Hospital. Likewise the residents of the hospital would now longer be caled a lunatic, a word which had lost much of its original scientific meaning to become a common insult, from then on they were to be called patients. The act would also lead to more fundamental change to the lives of one group of patients in particular. Those who now fell under the category of "Mental Defective" which included patients with Down's syndrome, Hydrocephalus and Epilepsy and for whom treatment within the mental hospital system was now deemed inappropriate. The county council found itself responsible for providing a separate more appropriate hospital for its mental defectives and in a joint venture with Oxfordshire it opened the Borocourt Certified Institution for Mental Defectives.

The hospital's patient population continued to grow through the 1920's and was approaching 1000, leading to further extensions to the hospital. In 1929 a new detached superintendents residence designed by C.B Willcox of Reading was constructed leaving the old residence free for conversion into patient wards. Followed in 1934 by a detached female villa for an additional 100 patients along with a nurses residence, designed by Willcox and Greenway Partners of Reading. Even after the completion of the buildings the hospital's population continued to grow reaching a peek of 1,400 in 1940 when two additional brick emergency medical service huts were added.

The years following the end of world war two brought about one of the most significant changes in the hospital's history when the birth of the National Health Service was announced. On the 5 July 1948 the hospital was transferred from the care of the county council to a hospital management committee under the direction of the regional health board of the National Health Service. One of the first decisions taken by the new committee was to rename the hospital. One of the goals of the newly formed NHS was to erase the distinctions between mental and physical health care the term mental hospital was dropped in favor of plain hospital, The new name the management committee selected was Fair Mile Hospital which would remain unchanged until it's closure.

Properly the most famous of all the shock therapies, Electro Convulsive Therapy was introduced at Fair Mile during the 1940's to treat patients suffering with depression, schizophrenia and Mania. ECT originated form the observation that the symptoms of depressive patients who also had epilepsy demonstrated a remarkable improvement following an epileptic fit. ECT sought to achieve a similar effect by artificially enduing a convulsive fit by the application of short electrical pulses to a patients head. ECT was and still is a highly controversial treatment but its benefits were noted in many clinical trials and it would remain a widely used treatment at Fair Mile until the 1970's when effective long lasting anti depressants were introduced.

The revolution in mental health treatment which lead to these new drugs began in 1954 when the Largactil was licensed in the UK. Largactil had been proven to significantly ease the symptoms of hallucinations, delusions and agitation within schizophrenic patients and was hailed as a wonder drug in the mental health community. Within a few years Lithium was in use as an effective treatment for manic patients and Tofranil the first effective anti depressant was being developed into a new family of effective medications. For the first time a range of effective treatments was available which would at the least control patients symptoms, but these first generation drugs were short acting and had to be taken at frequent, regular intervals which could only be guaranteed while the patient remained within the hospital. In 1959 the number of in patients was still almost 1,000 but the 700 new admissions were matched by a similar number of discharges. An admissions or acute unit had been opened in the old isolation hospital, where early treatment could begin away from the main hospital community preventing a new patient from becoming institutionalised and avoiding long term stays. The new Mental Health Act of 1959 gave all patient's the right to appeal against their admission to a Mental Hospital, Treatment at the hospital no longer meant a life sentence.

Two years later the Health secretary Mr Enoch Powell made the first public commitment to the closure of Mental Hospital's, in his 'Water Tower' Speech, in which he outlined his 'Hospital Plan' which was committed to the final and complete closure of the countries large mental hospitals, to be replaced by community care, supported by psychiatric units attached to local and general hospitals all to be achieved within fifteen years. This long term vision had very little immediate effect on Fair Mile, in fact in 1966 the hospital buildings were expanded with brick built extensions to Blewbury and Basildon wards.

The new Acute units at general hospitals had proven to be effective through the 1960's, and admissions to Fair Mile were dropping, by the beginning of the 1970's it's patient population had fallen to 800. However although the hospital plan had made some headway towards community care it had focused resources on the treatment of Short Term mental illness to avoid the need of committing a patient to the care of a Mental Hospital. Little attention had been given to the hospitals long stay patients with the Mental Hospitals low on the list of priorities conditions within them began to worsen. The late 60's and early 70's was a period of "Scandal" as case after case of mistreatment was exposed. Fair Mile itself was not implicated directly within any particular scandal but those exposed at other hospitals had an effect on Fair Mile as policies were introduced to rehabilitate an de institutionalise long term patients with the aim of moving them into community based care. Two pre fabricated buildings alongside the farm were used for industrial and art therapy, where patients were taught how to make craft items like bird tables and dolls houses and more importantly spent time away from their wards in preparation for an eventual departure from the Hospital.

Many patients were still tied to the hospital by their reliance on by the need to administer their medication frequently and regularly, These ties were cut in the mid 70's with the introduction of Modecate the first long acting anti-psycotic drug meant that patients could remain medicated out side of the hospital by the administration of a single injection every few weeks.

The election of the conservative government in 1979 was to mark a turning point in mental health care. A confidential report prepared by Cecil Parkinson MP endorsed community care and recommended a determined program of hospital closures, linked to a statutory duty of care and financial incentives for local councils to make provisions within their community. The report found that although successive governments had made a commitment to community care, in reality it had not been implemented. Although patients were leaving the psychiatric hospitals government money and professional skills were still invested within the hospital system leaving the released patient in the community without the full network of support they needed. The findings of the report were finally made public in the "Care in the Community" green paper of 1981 which introduced a number of measures to transfer funds for mental health provision away from the NHS to local authorities and voluntary associations, for the provision of community based programs and hostels, backed up with acute units and psychiatric wards at general hospitals for those requiring inpatient treatment. The program allowed the NHS boards a period of seven years later extended to thirteen, to develop and implement a program to transfer their patients to the community.

Fair Mile avoided immediate closure although as the years passed and its long term population moved on the number of patients decreased, in 1995 there were 212 patients still resident at the hospital, and Large parts of the building were closed off. Although as late as 1997 Fair Mile's name was still missing from lists of hospitals proposed for closure, it was becoming clear that the old victorian buildings were far too large for the reduced number of patients and unsuited to modern mental health care. As the new millennium began, work commenced on a constructing a replacement for Fair Mile, Completed as Prospect Park hospital in Reading in 2003. Fair Mile's final patients were transferred to the new hospital shortly after it was opened leaving the old asylum empty for the first time in 133 years. After the hospital closed the land was declared surplus to requirements and transferred to English Partnerships a government agency responsible for promoting the redevelopment of former government land, Currently the former hospital is the subject of a proposed mixed use development which will ensure the Victorian buildings survival as residential accommodation.

Since the hospital closed the hospital had been rarely visited, and it still sits almost abandoned awaiting development. My visit to the hospital began in one of C.H Howell's 1878 extension wards on what would have been originally on the male side of the hospital. The ward would have been know by a simple number for most of its working life, but during the early 1970's all of the hospital's wards and pavilions had been named for towns and villages within it's catchment area to make them more friendly and inspire a sense of community within the residents. This ward on the ground floor of the most northerly pavilion had been named after the village of Frilsham.

The ward block was typical of all the wards within Fair Mile and other asylums across the country and divided into several rooms, Located at the end of hospital's range of buildings the pavilion was T shaped entered from the bottom of the T a long wide corridor lead past several doors which opened into a series of seclusion bedrooms where disruptive and disturbed patients could be isolated from the remainder of the wards residents The doors to theses cells had been faced in chip board to make them look "modern" at some point during the hospitals later life, but where some of this board had been peeled away around the locks it was easy to see the original heavy oak doors beneath. The Horizontal stroke of the T was made up of the wards main rooms to the right of the main corridor was the day room, where the wards resident would have spent most of their time, The day room would have been a present environment with several wide bay windows letting in plenty of sunlight even on the cold winters day on which i visited. On the left hand side was the dormitory, which would have been lined with the patients beds when the ward was open but it now lay empty but for a few browning leaves which had somehow found there way inside.

Leaving Frilsham ward the tour of Fair Mile next took me into one of the original parts of the building and on to Blewbury ward. It had the same sequence of rooms as the previous ward but at its fullest extent Blewbury consisted of two parts, one located in the oldest part of the building and the other in the most modern. A brick built extension added on to the rear range of the hospital during the 1960's. The original part of the ward had the same character as the other older wards but entering the extension the atmosphere became much more institutional, The corridor painted in a sterile shade of green each of the rooms lining the corridor seemed soulless and bland, this part of the building is slated for demolition and is really no loss.

After leaving Blewbury I was at the intersection of two of the hospitals main corridors, To my right one of the spine corridors lead off through an arch and set of double hospital doors straight out of "Only When I Laugh", towards administration past the modern kitchen and restraunt. The Second corridor lead straight ahead along the bottom floor of the hospital's rear three story range of buildings. Moving along this corridor i passed through the former dentists and hairdressers, halfway along the corridor opened up in to a wider hallway where the stairways up to the wards on the first floor meet. just off this hallway an unassuming door way lead into a open space with a bar and serving hatch along one wall, but the rooms dominating feature was a huge yellow and red double door which opened with a gentle push onto the recreation hall. The hall was not an original feature of the hospital buildings, but from the 1890's a recreation hall had become a standard feature of asylum design Fair Mile's hall was added by GT Hine as part of extensions made in 1894. The hall still retained some of its character but has been scared by a "modern" suspended ceiling. Where has most of the hospital i has seen so far had been stripped since closure, The hall was still full of artifacts though these came from the days since the hospital closed, the remains of a public meeting to discuss the buildings future.

From the hall I headed to the other side of the hospital and the former Female side, where I found Basildon ward the mirror image of Blewbury on the other side and just as sterile. Then upwards into the first and second story wards heading through, Catterham, Ipsden, Ilsley past an endless procession of different dated wall paper ad paint effects which dated the times the wards were last used and followed the path of ward closures which rippled through the hospital from the 1970's onwards. Eventually I found myself at the far south end of the hospital and the opposite side of the building from where my tour began. On the hallway between the two final wards Henley and Ilsley a small cupboard contained the tell tale brown glazed brick tiles that are GT Hine's signature, used on the corridors of his giant asylums like Hellingly, West Park and Long Grove. Pushing open the door to Henley ward I was greeted by the fantastic sight of an beautifully unmodernised ward, with its wood paneling and oak doors un touched by chip board Despite its original appearance Henley was one of the last wards to be used, One one of its walls the wipe down wall board was still marked with the names of the final duty staff. Henley was the same T shape as Frilsham ward where my tour began but was far more welcoming the long entrance corridor was decorated as an extension to the day room with the bay windows along its length fitted with built in seating offering a pleasant view down towards the river.

From Henley ward I headed back in towards the heart of the hospital and some of the original asylum wards. Moreton and Goring wards were both quite small when compared the others but they had a striking resemblance to some of the ward pavilions CH Howell would go onto use on his most famous Asylum Cane Hill. With a large square dormitory ending in a row of seclusion cells. One further surprise to be found in Goring was the thick oak door to one of the seclusion cells who's inner surface was scared with finger nail scratches which were quite disturbing. Leaving the wards behind the final stop of the tour was the Administration block where the main remaining feature was a modern reception desk. On the way out of the main building there was time for a quick look at the hospital mortuary and industrial therapy units in the their outbuildings before it was time to leave the hospital to await its future, hopefully development will be kind to Fair Mile.