Mental Health Day Services in the United Kingdom from 1946 to 1995: An ‘Untidy Set of Services’

Abstract

Introduction: The evolution of mental health day services in the United Kingdom from the 1940s provides a historical context for the recent modernisation policy. Method: This critical review was conducted to inform local responses to modernisation. A wide range of contemporary and retrospective published accounts was critically analysed. Findings: Since the first reported mental health day hospital opened in 1946, researchers and practitioners have described and evaluated the services, increasingly involving service users. The importance of social contact, structured occupations and community links has been emphasised throughout. Locations and functions of day services have shifted in response to health and social care policies, and occupational therapists have initiated and evaluated services in further response. Service users have consistently valued day services. Criticisms have indicated issues of insufficient resources and too broad a remit, making services difficult to categorise and evaluate systematically. Tensions throughout have been concerned with the location of services and the scope for user involvement in service provision and evaluation. Conclusion: Recognising the origins of these tensions could enhance current approaches to modernisation. Combining social and occupational perspectives would enhance understanding and indicate future directions for day services.