An essay written as part of a Business Studies course in 1979 has revealed what life as a patient was like at Leavesden Hospital.

The hospital was officially opened on Tuesday, September 27, 1870, and its first patients were admitted on October 9.

It was built on 76 acres of land in College Road, Abbots Langley, but eventually closed in 1995.

Through her work, Patricia Allen hoped to discover more about hospitals for the "mentally subnormal" and "throw some light on the vast complex of Leavesden and what exactly goes on within its forbidding exterior".

Here are some extracts from her essay: "Leavesden Hospital was opened as part of the Metropolitan Poor Act 1867, which aimed to establish asylums for the 'sick, insane and other classes of the poor'.

"Prior to 1867, there has been no refuge for the mentally defective in the London area apart from work-houses and like institutions.

"The foundation stone of the asylum was laid on Saturday, October 31, 1868. There were several minor setbacks during construction; on March 17, 1869, there were apparently only 18 bricklayers, which was less than the week before. During that week only 159 men were employed instead of the usual 258, due to the lack in supply of bricks. However, building progressed fairly well.

"The original Leavesden Hospital comprised four blocks for males and five for females. They were erected so that on either side, at a distance of more than 100 feet, there were long corridors extending north and south, giving access to the blocks.

"In exactly the same way, the infirmaries were constructed comprising three storeys for 160 inmates each. The ground floors had a large day-room 105 feet long, 36 feet wide and 14 feet high.

"The single rooms were artificially heated, but the bathrooms and washing places were extremely cold in winter. Both male and female inmates used general bath houses in which there were ten copper baths, but these proved to be too small. A weekly dance for about 160 mixed inmates was held on one of the female wards.

"Each block had a good sized courtyard, neatly laid out, and there was a Chapel where Sunday services were attended by 200 men and 250 women. A special weekday service was held for epileptic patients in order to prevent interruption and disturbance during the other service, which might be caused by fits.

"The first inmates at Leavesden comprised a large proportion of imbeciles or those demented from birth, 325 epileptics and 75 idiot children. The law stated that accommodation be provided for the most harmless and quiet cases, which meant that an examination was conducted to decide on the particular people to be detained.

"This accommodation was therefore unsuitable for dangerous, violent and troublesome patients, and no proper security or care could be ensured to either staff or patients in the ward, where the ration of staff was one to forty patients."

"At one time Leavesden was run as a self-contained village, with its own blacksmith, a tin-smith who made pots and pans, a cobbler and all other trades, which were, at one time, so popular and essential to the running of such a large organisation. There was also a horse-drawn hearse which travelled to the cemetery.

"It is the hospital's policy to enable as many patients as possible to go out into community care, but those who have been resident for over 50 years will almost certainly end their lives at Leavesden.

"The age range of the patients is from a few months old to one in her mid-nineties. One third are over sixty years old. Wards are mixed, and there are those specifically designed for children, although some children are housed in family units.

"The general illnesses of patients at Leavesden include all conditions in the category 'mental sub-normality': mongolism, autism, schizophrenia, hydrocephalic, brain damage, are just a few. Some patients are violent, although they are in the minority, and for various reasons they are locked in wards under supervision. However, nowadays, great efforts are made for their recreation.

"Leavesden has 1,000 ancillary staff and 700 nursing staff; a sick ward of approximately 30 patients would have about six staff and other wards may have less. Children's wards have a maximum of 20 patients.

"In 1977-78, it costs £80 per week to keep a patient at Leavesden Hospital. The annual expenditure is £6million. There are just over 5,000 in-patients days, which is the number of days representing the number of patients attending the hospital each year.

"Patients are expected to pay for certain personal items themselves, such as cigarettes, tobacco, sweets, and to contribute a little for holiday spending money. In order to be able to do this, they receive reasonable amounts of pocket money.

"The treatment provided by the Psychology Department is usually a form of behaviour modification. It comprises a written 'programme' which shows the way in which basic skills have to be taught or developed, mainly in areas such as feeding, toilet training, washing and dressing, one step at a time.

"Plenty of praise and encouragement, together with other rewards, is given to the teaching of each step. Such other rewards could be chocolate or sweets.

"Social skills also have to be taught, such as the way to converse with people, especially the opposite sex, which can be very difficult for those who have been in the hospital for many years.

"The Recreation Department aims to help patients by providing evening classes, discos, live entertainment and visits to theatres and cinemas, and assists them in buying a meal in a restaurant.

"There is an additional problem of providing entertainment for those patients confined in locked Security Wards: because of the very reason these patients are at Leavesden Hospital, they need to be prevented from boredom and have their excess energy channelled in other ways. A gymnasium is provided for their use, and for the use of the hyper-active patients and facilities for cross-country running and more physical activity are hoped to be provided.

"Each year the hospital takes the patients on outside holidays to places such as Weston Super Mare, the Kent coast, the Miners' Holiday Camp at Skegness, but the public has to be educated to accept them in order to make the holidays a success.

"The Occupational Therapy department was established in approximately 1950. Originally the male and female departments were separate but since 1968 they have been mixed, although there is still one all-female department, but this is only because of the lack of toilet facilities to enable men to share.

"Tasks undertaken are simple cooking, shopping, cleaning, personal hygiene, use of the telephone and public transport. The idea is to enable these patients to eventually live in a supervised hostel. Other therapy includes hairdressing, beauty culture and meke-up, craft work and use of the library for elementary reading or just looking at books.

"We can see the way patients could progress through the various stages of work and perhaps eventually be discharged from Leavesden into the community, where they can live in a hostel and go to work each day to earn a wage. It is probably a long and slow process but if results are achieved successfully then surely it is all worthwhile.

"Springfield School provides education for the school-age patients of Leavesden Hospital. The classrooms are like those in any infants' school, with paintings around the wall and tables set around the room. There are eight pupils to a class, together with one teacher and one welfare worker. The main aims are to encourage self-help skills. The pupils are helped to cook and carry out daily household duties, mainly to enable them to be able to live in a hostel later on, where they can look after themselves with the minimum of supervision.

"The aim of the hospital is to maximise the potential of each patient, thus enabling them to lead as near normal lives as they can, with the minimum of supervision. By providing facilities like the patients' clubhouse, whereby they can move away from the hospital and ward-like environment for a time, their needs are being considered.

"It appears that, within financial limitations, as much as possible is being done for the encouragement and achievement of the patients at Leavesden Hospital."