So frightened are patients and their relatives - and even former patients - that those willing to talk of their experiences are reluctant to allow their names to be used.
But Peter Edwards, a Liverpool solicitor who visits the hospital almost daily, is prepared to put his head above the parapet even though he says he has been threatened by Prison Officers' Association nursing staff in the past.
In his battles on behalf of about 200 patients he has heard, and still hears, gruesome tales of ill-treatment by staff against the 658 patients. The day-to-day regime itself brutalises patients. 'There is little talk about therapy and treatment, the whole ethos is one of containment,' he said. 'The nurses wear uniforms and refer to one another as Mr This and Mr That. Patients are rarely referred to by their Christian names.
'I am also very critical of management. Until the Channel 4 documentary (which revealed the abuse allegations) there was a general malaise. It was much better to go along with the culture than to try to change it.'
The mother of one patient is anxious to point out that little has altered, but her fears that he will be victimised are so grave that she does not even wish to disclose the nature of the attacks on him in the past few weeks.
Her 30-year-old son has spent three years moving from ward to ward and she has seen how the atmosphere and the surroundings have affected his demeanour. 'It's nothing but a delapidated dump. It's absolutely filthy. Even the ward manager said he couldn't believe his office, it's like a dungeon. The place is a drab, dull Victorian building and should be pulled down.'
Staff do little to ease the unremitting gloom and tension. The woman said that her son asked to move recently after being threatened by another patient during a meal, but as a result was forced to eat all his meals for several days in the 'time out' room, a bare cell with just a mattress. 'They just did it to get him going,' she said.
Another patient, Ian, was in confrontation with the nurses almost every day. But since he left Ashworth 18 months ago for another secure unit his behaviour has changed immeasurably, according to his father. 'In my view the quality of the nursing was very, very poor,' he said. 'There was a complete lack of sensitivity among the staff, something that is vital to mentally handicapped patients who are extremely vulnerable. The nurses predominantly perform the job of warders.
'Frankly it was a disgrace that the place is called a hospital. It is 90 per cent security, 10 per cent nursing. Care was minimal. The only way the nurses equated to ordinary nurses was that they could use a hypodermic syringe and they used it with great regularity to reduce the patients to their most docile.'Reuse content