Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-25T10:09:50.047Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatry in the National Health Service 1948–1998

Published online by Cambridge University Press:  03 January 2018

Hugh Freeman
Hugh Freeman*
Affiliation:
21 Montagu Square, London WIH IRE
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The 50th anniversary of the inauguration of the NHS provided the occasion to review the evolution of mental health services and of psychiatry itself in Britain during that period.

Aims

The principal themes to be followed were the decline of a mental hospital system that had existed for over a century, the development of an alternative policy of ‘community care’, the emergence of a numerous and well-trained psychiatric profession, and the interaction between political and legal processes and mental health care.

Method

An examination of Ministry of Health and Department of Health and Social Security files in the Public Record Office, interviews with influential figures, examination of the secondary literature, and personal experience of events described.

Results

The material has been analysed, in the light of the expressed aims, and important trends have been described. The current situation is assessed.

Conclusions

The replacement of one system of care and treatment in Britain by another has been a process fraught with overwhelming difficulties. While adhering to the aim of ‘community care’, governments have been reluctant to provide the means for achieving this. The psychiatric profession is now faced with very large but ill-defined responsibilities.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 175 , Issue 1 , July 1999 , pp. 3 - 11
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baker, A. A. (1993) Interview with Hugh Freeman. In Talking about Psychiatry (ed Wilkinson, G.), pp. 192–206. London: Gaskell.Google Scholar
Bosanquet, N. (1998) Managers and schizophrenia care: the missing dimension of strategy. British Journal of Health Care Management, 4, 16–19.Google Scholar
Busfield, J. (1986) Managing Madness: Changing Ideas and Practice. London: Hutchinson.Google Scholar
Butler, T. (1985) Mental Health, Social Policy and the Law. London: Macmillan.CrossRefGoogle Scholar
Crammer, J. C. (1990) Asylum History. London: Gaskell.Google Scholar
Department of Health (1998) Modernising Mental Health Services. London: Department of Health.Google Scholar
Department of Health and Social Security (1971) Hospital Services for the Mentally Ill London: HMSO.Google Scholar
Department of Health and Social Security (1975) Better Services for the Mentally Ill (cmnd. 6233). London: HMSO.Google Scholar
Ferguson, J. J. (1998) Primary care. Journal of the Royal Society of Medicine, 91 (suppl. 36), 11–13.Google Scholar
Freeman, H. L. (1960) Oldham & District Psychiatric Service. Lancet, i, 218–221.Google Scholar
Freeman, H. L. (1963) Community mental health services: some general and practical considerations. Comprehensive Psychiatry, 4, 417–425.Google Scholar
Freeman, H. L. (1996) The general hospital and mental health care: a British perspective. Millbank Quarterly, 73, 653–676.Google Scholar
Freeman, H. L. (1998) Mental health policy making in the NHS. 1948–1979. Journal of Mental Health, 7, 225–240.CrossRefGoogle Scholar
Gittins, D. (1988) Madness in its Place. London: Routledge.Google Scholar
Godber, G. E. (1988) Interview with Hugh Freeman. Psychiatric Bulletin, 12, 513–519.Google Scholar
Hall, P. & Brockington, I. (1991) The Closure of Mental Hospitals. London: Gaskell.Google Scholar
Howells, J. G. (1991) The establishment of the Royal College of Psychiatrists. In 150 Years of British Psychiatry, Volume I (ed. Berrios, G. E. & Freeman, H. L.), pp. 117–134. London: Gaskell.Google Scholar
Jones, K. (1979) Integration or disintegration in the mental health services. Journal of the Royal Society of Medicine, 72, 640–648 Google Scholar
Jones, K. (1988) Experience in Mental Health: Community Care and Social Policy. London: Sage.Google Scholar
Kendell, R. E. (1988) The National Health Service celebrates its 50th birthday. British Journal of Psychiatry, 173, 1–3.Google Scholar
Leff, J. P., Thornicroft, G., Coxhead, N., et al (1994) The TAPS Projects: a five-year follow-up of long-stay psychiatric patients discharged to the community. British Journal of Psychiatry, 165 (suppl. 25). 13–17.Google Scholar
Leyberg, J. (1959) A district psychiatric service – the Bolton pattern, Lancet, ii, 282–284.Google Scholar
Marshall, M. (1999) Modernising mental health services. British Medical Journal, 318, 3–4.Google Scholar
Martin, F. M. (1984) Between the Acts. London: Nuffield Provincial Hospitals Trust.Google Scholar
Merskey, H. (1991) Shell-shock. In 150 years of British Psychiatry, Volume I. (eds Berrios, G. E. & Freeman, H. L.), pp. 245–267. London: Gaskell.Google Scholar
Pickstone, J. V. (1986) Psychiatry in district general hospitals. In Medical Innovations in Historical Perspectives (ed. Pickstone, J. V.). London: Macmillan.Google Scholar
Pines, M. (1991) The development of the psychodynamic movement. In 150 Years of British Psychiatry, Volume I (eds Berrios, G. E. & Freeman, H. L.), pp. 206–231. London: Gaskell.Google Scholar
Powell, J. E. (1961) Opening address. In Services and the Public. London: National Association for Mental Health.Google Scholar
Robb, B. (1967) Sans Everything – a Case to Answer. London: Nelson.Google Scholar
Sainsbury Centre (1998) Acute problems: a survey of the quality of care in acute psychiatric wards. London: Sainsbury Centre for Mental Health.Google Scholar
Seebohm, F. (1989) In conversation with Hugh Freeman. Psychiatric Bulletin, 13, 465–470.Google Scholar
Shorter, E. (1997) A History of Psychiatry. New York: Wiley.Google Scholar
Taylor, P. J. & Gunn, J. (1999) Homicides by people with mental illness: myth and reality. British Journal of Psychiatry, 174, 9–14.Google Scholar
Titmuss, R. (1961) Community care, fact or fiction? In Emerging Patterns for Mental Health Services and the Public. London: National Association for Mental Health.Google Scholar
Tooth, G. & Brooke, E. M. (1961) Needs and beds: Trends in the mental hospital population and their future planning. Lancet, i, 710–713.Google Scholar
Trieman, N., Hughes, J. & Leff, J. (1998) The TAPS Project 42: the last to leave hospital. Acta Psychiatrica Scandinavica, 98, 354–359.Google Scholar
Webster, C. (1988) The Health Services Since the War, Volume I. London: HMSO.Google Scholar
Webster, C. (1996) The Health Services Since the War, Volume 2. London: HMSO.Google Scholar
Williams, P. & Clare, A. (1981) Changing patterns of psychiatric care. British Medical Journal, 282, 375–377.Google Scholar
Wooff, K., Golderg, D. P. & Fryers, T. (1988) The practice of community psychiatric nursing and mental health social work in Salford: some implications for community care. British Journal of Psychiatry, 152, 783–792.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.