Mental health policy and practice in the NHS: 1948-79

Abstract

The management of mental disorder by the state was linked from the beginning with the response to poverty. Publicly financed mental hospitals were established mainly for paupers and workhouse infirmaries included units for the mentally disordered. The NHS took over these institutions and they were slow to change after 1948. Nevertheless, a view that mental hospitals were no longer appropriate to modern conditions became influential within the Ministry of Health, and a substantial reduction of mental hospital beds was proposed. This became absorbed into a national Hospital Plan, within which psychiatry was to be one of the main specialties of the district general hospital. development of plans for the reorganisation of mental health services, the hospital unit was seen as the base for a comprehensive service for each district. National policy was adumbrated in a White Paper of 1975, but a fiscal crisis had already occurred, making progress towards its targets very slow. 'Community care' emerged as an influential concept in the 1950s, but the financial resources never existed in this period to make it a reality, apart from some local initiatives. the further