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Professional politics and public education in Britain, 1870–1970
Author: Vicky Long

Challenging the assumption that the stigma attached to mental illness stems from public ignorance and irresponsible media coverage, this book examines mental healthcare workers’ efforts to educate the public in Britain between 1870 and 1970. It covers a period which saw the polarisation of madness and sanity give way to a belief that mental health and illness formed a continuum, and in which segregative care within the asylum began to be displaced by the policy of community care. The book argues that the representations of mental illness conveyed by psychiatrists, nurses and social workers were by-products of professional aspirations, economic motivations and perceptions of the public, sensitive to shifting social and political currents. Sharing the stigma of their patients, many healthcare workers sought to enhance the prestige of psychiatry by emphasising its ability to cure acute and minor mental disorder. However, this strategy exacerbated the stigma attached to severe and enduring mental health problems. Indeed, healthcare workers occasionally fuelled the stereotype of the violent, chronically-ill male patient in an attempt to protect their own interests. Drawing on service users’ observations, the book contends that current campaigns, which conflate diverse experiences under the label mental illness, risk trivialising the difficulties facing people who live with severe and enduring mental disturbance, and fail to address the political, economic and social factors which fuel discrimination.

Naomi Chambers and Jeremy Taylor

mental disorder among 5- to 15-year-olds has shown a slight increase over time (NHS Digital, 2018 ). Since the 1960s, what we would now see as punitive and stigmatising attitudes to “madness”, with great reliance on institutional care, have given way to a more community-based, human rights-informed approach. These changes were enabled by the development of new generations of anti-psychotic and mood-stabilising drugs, and spurred on by vocal communities of mental health activists. Societal attitudes to mental illness have also changed, aided by

in Organising care around patients
Orla McDonnell

6 Thomas Szasz’s The Myth of Mental Illness Orla McDonnell Introduction Thomas Szasz’s The Myth of Mental Illness: Foundations of a Theory of Personal Conduct, first published in 1961, is a classical radical work that challenges orthodox psychiatry and the core assumptions behind the belief that what we have come to understand as mental illness belongs to the medical realm. My main motivation for rekindling an intellectual and political engagement with Szasz’s original thesis is threefold. First, in the current context of mental health policy and service reform

in Mobilising classics
Treatment, punishment, or preventive confinement?
Lawrence O. Gostin

9780719079740_C03.qxd 3 22/2/10 15:10 Page 49 Lawrence O. Gostin ‘Old’ and ‘new’ institutions for persons with mental illness: treatment, punishment, or preventive confinement?1 In 1972, I covertly entered a brutal, inhumane institution for the criminally insane in eastern North Carolina as a pseudo-patient under a US Department of Justice study. What I experienced during those many weeks would shape how I view what Erving Goffman called ‘total institutions’.2 Since that formative experience as a young law student I have closely observed institutions that

in Incarceration and human rights
Stephen Shute

9780719079740_C03.qxd 3a 22/2/10 15:10 Page 61 Stephen Shute Mental illness, preventive detention, prison, and human rights1 Throughout his long and distinguished career, Larry Gostin has campaigned tirelessly to improve the way modern societies treat those experiencing mental illness. In his essay for the Oxford Amnesty Lectures, Gostin again turns his attention to this topic. Using language that pulls no punches, he catalogues the appalling inhumanities that people with mental illness have had to endure and condemns what he describes as a ‘vicious cycle

in Incarceration and human rights
Vicky Long

3 CHALLENGING THE STIGMA OF MENTAL ILLNESS THROUGH NEW THERAPEUTIC APPROACHES Perceptions of the asylum changed dramatically between 1837, when the alienist W. A. F. Browne painted a compelling picture of the therapeutic powers of the ideal asylum, ‘a spacious building resembling the palace of a peer, airy, and elevated, and elegant’,1 and 1961, when Enoch Powell, then Minister of Health, unveiled plans to close Britain’s psychiatric hospitals.2 Like many other mental health reformers, Powell conjured a history of psychiatry which legitimated his objectives

in Destigmatising mental illness?
Vicky Long

4 MAD, BAD AND DANGEROUS TO KNOW? MEN, WOMEN AND MENTAL ILLNESS A ‘female malady’? In the previous chapter, we saw how some healthcare professionals generated stigmatising images of chronic patients while seeking to improve services for, and reduce the stigma attached to, acute mental disorder. Focusing on the mental nurses’ Union studied in Chapter 2, this chapter builds upon these ideas, exploring how some nurses exploited the image of the dangerous madman to further their own interests. It commences by tracing the historiographical debate on gender and

in Destigmatising mental illness?
Ben Harris

2 Therapeutic work and mental illness in America, c. 1830–1970 Ben Harris This chapter looks at patient labour in the United States from the birth of the asylum to the start of its demise in the 1960s. The focus is on the Northeastern states, where separate psychiatric hospitals originated in the 1840s and multiplied over the next half century. The story told here comes from histories of individual hospitals and histories of psychiatry, supplemented by the medical and popular literature on mental illness, and accounts written by former patients. These show

in Work, psychiatry and society, c. 1750–2015
The working lives of paid carers in the nineteenth and twentieth centuries
Editors: Anne Borsay and Pamela Dale

This book seeks to integrate the history of mental health nursing with the wider history of institutional and community care for people experiencing mental illness and/or living with a learning disability. It develops new research questions by drawing together a concern with exploring the class, gender, skills and working conditions of practitioners with an assessment of the care regimes staff helped create and patients’ experiences of them. Contributors from a range of disciplines use a variety of source material to examine both continuity and change in the history of care over two centuries. The book benefits from a foreword by Mick Carpenter and will appeal to researchers and students interested in all aspects of the history of nursing and the history of care. The book is also designed to be accessible to practitioners and the general reader.

Jane Maxwell

The poor survival rate of primary sources for the history of Irish women in the early modern period is mitigated by the sophistication with which extant sources are now being analysed. When re-examined without reference to the demands of the traditional historical grand narrative, when each text itself is permitted to guide its own interrogation, previously undervalued texts are revealed to be insightful of individual existential experience. The memoir of eighteenth-century Dorothea Herbert, hitherto much ignored due to the authors mental illness, is becoming increasingly respected not just for its historic evidential value but for the revelations it contains of a distressed individuals use of literature to manage her circumstances. The interpretive tools deployed on such a text by different research specialisms necessarily lead to divergent conclusions; this in turn may lead to creative re-imagining of history although they cannot all equally reflect what was likely to have been the lived reality of the original author.

Bulletin of the John Rylands Library