Abstract
Historical evidence can be useful to inform debate about current dilemmas in health service policy. However, concepts of historical analysis may be problematic for doctors, for whom a model of 'history' is often based on clinical history-taking: a clinical history aims to explain the present, whereas a historical analysis aims to elucidate the past. This article discusses and illustrates these concepts, and highlights potential pitfalls of poor historical methodology. It also provides pointers about researching the history of psychiatry in the UK and how to contribute historical evidence to health service policy debates today.Declaration of interestNone.
Highlights
Historical evidence can be useful to inform debate about current dilemmas in health service policy
Concepts of historical analysis may be problematic for doctors, for whom a model of ‘history’ is often based on clinical history-taking: a clinical history aims to explain the present, whereas a historical analysis aims to elucidate the past
It rarely turns to historical evidence, which might provide a complementary and longerterm perspective, such as about the complex configuration of factors that underpin policy, including politics, economic circumstances, technical innovations, patient expectations and diverse motivations to change or maintain the status quo
Summary
Historical evidence can be useful to inform debate about current dilemmas in health service policy. It rarely turns to historical evidence, which might provide a complementary and longerterm perspective, such as about the complex configuration of factors that underpin policy, including politics, economic circumstances, technical innovations, patient expectations and diverse motivations to change or maintain the status quo For those involved in making health policy decisions at any particular time, it may be difficult to achieve a fully informed ‘helicopter view’, to weigh up how and why a multiplicity of factors come together. History does not repeat itself, as past events are contextualised by the period in which they happened, but behaviours and patterns of response may repeat, and societal beliefs, attitudes and values related to health and social care may change relatively slowly Including these as part of a multifaceted historical analysis can help shed light on past and present policies and practices.
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