Maudsley Hospital Research Articles

Hidden from history? A brief modern history of the psychiatric “treatment” of lesbian and bisexual women in England

It is well documented that homosexuality was classified as a mental illness in the DSM until 1973, when it was replaced with the diagnosis of “sexual orientation disturbance”. While it is widely known that homosexual men were criminalised and risked a spell in prison or aversion therapy in a psychiatric hospital (Dickenson, 2013), the class dimension is probably less well known. According to the Queer historian, Chris Waters (2017), it was the more privileged middle class men who were offered aversion therapy, as a “softer” option than jail (Alan Turing being the most prominent example). In contrast, the majority of mostly working class men who were discovered engaging in same-sex relations were more likely to end up in prison, without the offer of “treatment” as an alternative. However, there are aspects of this history we know even less about. Because it is well documented, gay men’s experiences of psychiatric treatment for same-sex attraction have become a dominant historical discourse. But what happened to same-sex attracted women in England (1950–70s) who were not subject to direct court referral routes into psychiatric treatment like their male counterparts? Although female homosexuality was not criminalised in England, it was still, like male homosexuality, officially classified as a mental disorder (“sexual deviation”). As part of a cohort of studies around the theme of sexualities and health funded by the Wellcome Trust, we conducted a bottom-up archival study of women’s and lesbian, gay, bisexual, and transgender (LGB&T) archives in England to investigate this question. Documentation proved to be sparse and fragmented, and what little material we found presented us with numerous challenges to interpretation. A small number of psychiatrists and psychologists had various, often competing, theories about homosexuality and published papers promoting examples of experimental or purportedly successful “treatments”, which they often used to test out their theories. However, it is not clear how much these theories actually influenced practice (Oram and Turnbull, 2001).

Mary Barkas: An Early Antipodean Psychiatrist and Analyst

Mary Barkas, a forgotten pioneer in psychiatry and psychoanalysis, was a prodigy from New Zealand who studied medicine in London and went into psychiatry. The restrictions on women doctors prompted her to become an analyst, having a training analysis with Otto Rank in Vienna in 1922, meeting Freud and other figures. In 1924 she was the only woman appointed at the new Maudsley Hospital that was to have such influence on British psychiatry. Mary Barkas’ achievements as a woman in psychiatry and psychoanalysis are substantial. Her Vienna summer is a valuable contribution to our record of a period that is getting lost in time.

PTSD: A Short History by Allan V. Horwitz

Reviewed by: PTSD: A Short History by Allan V. Horwitz Edgar Jones Allan V. Horwitz. PTSD: A Short History. Johns Hopkins Biographies of Disease. Baltimore: Johns Hopkins University Press, 2018. xviii + 238 pp. Ill. $28.95 (978–1–4214–2639–6). Post-traumatic stress disorder (PTSD) was formally recognized by the American Psychiatric Association in 1980 with the publication of DSM-III. It followed a sustained campaign by critics of the Vietnam War who sought to highlight the injurious psychological effects of the conflict, but the diagnosis was included only when the committee on reactive disorders concluded that PTSD had a general applicability and could be observed after any form of traumatic event. In this study, Allan Horwitz, author of Anxiety, a Short History, has applied his sociological insight to PTSD. He adopts a thematic approach with chapters devoted to the history of post-traumatic illness, the conceptual antecedents of PTSD, psychological casualties created by war and the campaign to persuade psychiatrists that this was a legitimate diagnosis. Horwitz also explores how the recovered memory movement offered an implicit challenge to PTSD by suggesting that some severe traumatic experiences are repressed to an extent that they leave no conscious trace. [End Page 144] Vivid and intrusive memories, by contrast, are key symptoms of PTSD beyond the ability of sufferers to suppress. The author vividly documents the rise in the incidence of PTSD and analyzes the culture of vulnerability and compensation with which it is associated. As Horwitz acknowledges, PTSD is but one position in the enduring debate about where to locate causality for post-traumatic illness between the poles of environmental stressor and individual vulnerability. In the late nineteenth and early twentieth centuries, people themselves, their personality and inherited characteristics, were held primarily responsible for their breakdown. To explain why only a subgroup succumbed to the psychological effects of battle, combat stress was relegated to a secondary role or that of a trigger. With evidence from casualty statistics collected after World War II and during the Vietnam conflict, psychiatrists increasingly attributed causality to the traumatic event. This reversal eroded much of the stigma associated with post-traumatic illness, though it failed to address the shame and guilt commonly experienced by those with a diagnosis of PTSD. Shell shock is explored as part of the intellectual and clinical heritage of PTSD, though the role of Frederick Mott is overlooked. As a neuropathologist with an international reputation, he was appointed by the War Office to lead research into its causality and treatment. Based at the Maudsley Hospital with a regular influx of patients, Mott was arguably the first clinician in the UK to identify the fundamentals of the PTSD model. He observed that most cases arose from a pre-existing vulnerability and some the result of concussion or toxic exposure. However, Mott identified a third group who were healthy individuals subjected to “terrifying or horrifying conditions,” soldiers whose record demonstrated that they are “neither of a timid disposition” or possessed of “any neuropathic tendency” and for whom the event was the primary cause.1 Although Horwitz describes the momentum behind research into the limbic system designed to identify the neuro-biology of PTSD, more detail could have been given on the hypotheses and findings in the search for an organic explanation. This research, if successful, could result in the disorder being reframed as a neurological illness with specific therapeutic targets. In sum, Horwitz draws together an impressive array of work to produce a balanced and concise analysis of PTSD that will serve as an insightful guide to the nature and evolution of the disorder. Whilst the fourth iteration of PTSD, published in DSM-5 (2013), incorporated much additional research, a new critique of the disorder has gathered momentum. The growing interest in moral injury is, in part, driven by the idea that PTSD fails to capture the full range of emotions and cognitions that follow exposure to traumatic events. A high percentage of those with mild traumatic brain injury also report the symptoms of PTSD, prompting the hypothesis that microscopic brain lesions may account for both disorders. Horwitz’s measured history of PTSD may have come at a time when the disorder...

Naomi Shirley Richman

Naomi Shirley Richman was born and brought up in Leeds. Her parents were second generation Jewish immigrants from eastern Europe. She won a place at the local grammar school, Roundhay...

Restraint in mental health settings: is it time to declare a position?

The emergence of a drive to reduce restrictive interventions has been accompanied particularly in the UK by a debate focussing on restraint positions. Any restraint intervention delivered poorly can potentially lead to serious negative outcomes. More research is required to reliably state the risk attached to a particular position in a particular clinical circumstance.Declaration of interestF.S. is a consultant psychiatrist in Psychiatric Intensive Care at the Maudsley Hospital, London. He is on the Executive Committee of the National Association of Psychiatric Intensive Care and Low Secure Units, and was a member of the National Institute for Health and Care Excellence Guideline Development Group for the Short-Term Management of Aggression and Violence (2015). J.P. is a senior lecturer at the Faculty of Health and Life Sciences, Coventry University. E.B. is a consultant and expert witness in violence reduction and the use of physical interventions, independent expert to the High Secure Hospitals Violence Reduction Manual Steering Group and a member of the College of Policing Guideline Committee Steering Group and Mental Health Restraint Expert Reference Group. B.P. is the clinical director for Crisis and Aggression Limitation and Management (CALM) Training and formerly a senior lecturer for the Faculty of Health, University of Stirling. He is a nurse and psychotherapist and presently chairs the European Network for Training in the Management of Aggression. A.O'B. is a consultant psychiatrist, the Director of Educational Programmes for the National Association of Psychiatric Intensive Care and Low Secure Units, and the Dean for Students at St George's University of London.

Evaluating the long-term impact of the Fostering Changes training programme for foster carers in Wales, the Confidence in Care trial: study protocol for a randomised controlled trial

BackgroundThe Fostering Changes programme was developed by the Adoption and Fostering National Team at the Maudsley Hospital, South London, in conjunction with King’s College London. It is a 12-week group-based training programme for foster and kin carers, which aims to build positive relationships between carers and children, encourage positive child behaviour and set appropriate limits, through a practical skills-based approach. The programme also aims to improve foster carers’ understanding of the causes of children’s social and emotional difficulties and their confidence in applying this knowledge in various situations.MethodsThis is a pragmatic open-label individually randomised controlled trial, with embedded process evaluation. A total of 237 participants will be recruited from Welsh Local Authorities and Independent Fostering Providers; those allocated to the intervention group will be offered enrolment in the next Fostering Changes programme group at their site. Participants in the control group will be offered the Fostering Changes programme at the end of the follow-up period. Data will be collected at baseline, immediately following the 12 week Fostering Changes intervention, and 12 months from the start of the Fostering Changes programme. The primary outcome measure assesses the extent to which carers feel able to cope with and make positive changes to the lives of their foster children and is measured by the Carer Efficacy Questionnaire at 12 months.DiscussionThe trial will determine whether the Fostering Changes programme, in the long term, can deliver important, significant differences to the way foster carers build positive relationships with their foster children, encourage positive child behaviour and set appropriate limits, compared with usual care.Trial registrationInternational Standard Randomised Controlled Trial Number, ISRCTN19090228. Registered on 11 January 2017.

The Medical Doctrine of Informed Consent: How the Commonwealth & United States Helped Form Current UK Medico-legal Practice

Finding a working law of informed consent between doctors and patients has been a long haul in the United Kingdom. This article addresses where the UK currently stands on the medico-legal doctrine of informed consent and how the Commonwealth and the United States of America have influenced medical information disclosure laws into the UK. I identify and interpret seven significant UK cases from Sidaway v Governors of the Bethlem Royal Hospital and Maudsley Hospital in 1995 to Montgomery v Lanarkshire Health Board in 2015 and apply the role informed consent case law from Australia, Canada, and the USA has had in our legal jurisdiction. I argue that the common underlying struggle between patient autonomy and medical paternalism in the legal sphere ties all this case law together. I further postulate on how feminist approaches have helped build a stronger legal position for patient autonomy. As Montgomery has been a pivotal departure from previous judicial decisions, there will be inherent issues for doctor-patient information disclosure in both the therapeutic privilege exception and the possibility of over-informing patients. This article also looks at the case study of assisted dying as one possible area for more legal anomalies arising from informed consent.

Mary Barkas at the Maudsley: 1923-1927.

The Maudsley Hospital, reopened in January 1923, became the centre of British psychiatric research and achieved a world-wide reputation. At a time when women were rare in psychiatry, New Zealand-born Mary Barkas was the only woman (and psychoanalyst) among the first four psychiatrists appointed. This paper looks at her role in the early years at the Maudsley. The letters she wrote to her father, often on a daily basis, provide a unique insight to the earliest years of the hospital that was to have such an influence on British psychiatry. It is the only insider record we have of this crucial time. Barkas demonstrated her versatility in psychiatry and child psychiatry. She used psychoanalysis to treat her patients, receiving recognition from her colleagues. Her work in this field proved to be an exception as analysis was not practiced after she left the Maudsley. Her problem was the institutionalised prejudice against women in psychiatry, which caused her to leave. Her career was terminated at an early stage and her life took a puzzling turn after she returned to New Zealand in 1933. We can remember Mary Barkas as a forgotten psychiatric pioneer whose life and work deserves to be more widely known and recognised.

1 Origins of neuropsychiatry/bnpa

As we leave the “Decade of the Brain” neuropsychiatry has emerged as one of the most exciting and challenging fields in which to work. The BNPA was founded in December 1987 at the suggestion of Dr Jonathan Bird. Professor W A Lishman, the founding Chairman, describes its formation as follows: “The Association was created to provide a forum for cross-disciplinary discussion of matters of common interest among psychiatrists, neurologists, neuropsychologists and workers in the related neurosciences. All suitably qualified persons with an interest in brain function in relation to behaviour would be welcome to join. For this reason, we did not seek formal affiliation with other bodies, such as the Royal College of Psychiatrists, but decided to stand as an independent association. Young members bringing fresh ideas would be particularly encouraged to join, by keeping fees to a minimum and the establishment of appropriate prizes”. At the 2015 AGM Dr Jonathan Bird was awarded an honorary fellowship of the BNPA. Jonathan’s fellowship was proposed by Professor Alwyn Lishman (Honorary Life President) who hoped the BNPA would recognise Jonathan’s “sustained work and service over many years in the promotion of present day neuropsychiatry”. In his commendation, he revealed that it was in fact Jonathan who first to suggested, to a group of like-minded colleagues, including Alwyn himself, the formation of the BNPA. Jonathan went on to serve as the secretary throughout its early years. The ability to bring people together towards common goals has continued and Jonathan was instrumental in forming the Section of Neuropsychiatry at The Royal College of Psychiatrists, and then serving as its first chair. He helped, although ably assisted by Dr Rafey Faruqui who succeeded him as chair, in guiding the nascent section through to the establishment of the status of Faculty, which is a major step forward as a mechanism for improving services and the development of recognised training. Jonathan originally read medicine at the University of Bristol, where he achieved the Prize for Physiology and did his junior training in the region. He went on to the Maudsley Hospital for his higher training, winning the prestigious Gaskell medal of the Royal College of Psychiatrists. He then worked as Clinical fellow at McMaster and was exposed to many of their revolutionary teaching approaches before returning to the Maudsley and then completing the circle with a return to Bristol to take up a consultant post at Burden Centre for Neuropsychiatry, Neuropsychology and Epileptology, Frenchay Hospital, Bristol. He has been active throughout his consultant career in Epilepsy Action and served as Chairman of their Professional Advisory Panel.

Offline: The message of mental health

One entirely avoidable and indefensible tragedy of the global response to non-communicable diseases has been its extraordinary failure to embrace mental health. Instead, advocates and international institutions, such as WHO, have preferred to emphasise the simple (and simplistic) message of “four-by-four”—four key diseases (heart disease, cancer, diabetes, and chronic respiratory diseases) and four key risk factors (tobacco use, alcohol, unhealthy diets, and physical inactivity). It is not that those who preside over global health today have been ignorant of the mental health crisis befalling our world. The importance of anxiety and depression, for example, as major causes of disability has been understood ever since the first efforts to measure the global burden of disease in the 1990s. But the wise eminences of global health thought that death mattered more than disability, and so they chose to exclude mental health from their manifestos and strategies. To be fair, WHO has recently been trying to remedy its original error. World Health Day this year was dedicated to the ravages of depressive illness: over 300 million people worldwide living with depression, a number that continues to rise. But the frequently cited idea of parity of esteem between mental and physical health remains just that—an idea, yet to be realised through serious investment and political commitment. A symbolically important step to take the study of mental health more seriously was celebrated this past week. One of the quaint traditions of British medicine is the existence of Regius Professors. The first ever Regius Professor of Psychiatry has been awarded to King's College London, where Simon Wessely was justly praised for being its founding Chair. 26 Regius Professors have been granted since the time of Queen Victoria. The honour goes to the institution, not the individual. King's is the home of the Maudsley Hospital and the Institute of Psychiatry, Psychology and Neuroscience, two of the world's leading centres for the care and study of those with mental ill-health. Simon's inaugural lecture was typically unconventional. His subject was monarchs, mental health, and medical students. He reminded his audience that King George III is famous for two reasons—he lost America and went mad. But one of his particular achievements was to have appointed 11 Regius Professors. The very first Regius was created by James IV in 1497. It was awarded to Aberdeen University, and for medicine. The goal of this royal patronage was to bring the benefits of the Renaissance to Scotland. In other words, the bestowal of a Regius Chair was supposed to send an important political and social signal. In 1540, Henry VIII added a further six Regius Professors to Oxford and Cambridge. It wasn't a wholly welcome gift. One recipient was John Story, who became Regius Professor of Civil Law at Oxford. He was hung, drawn, and quartered in 1571 during the reign of Queen Elizabeth I. Perhaps falling into disrepute, the last Regius Chair to be established was in 1870. Then along came Queen Elizabeth II. For her Diamond Jubilee and 90th birthday, more Regius Professors were bestowed beyond Oxbridge. King's College London won a Regius in Psychiatry. The Maudsley has a well deserved reputation for a string of firsts—understanding the neuropathology of epilepsy, the birth of psychiatric epidemiology and genetics, the advent of cognitive behavioural therapy, and the development of global mental health. The Maudsley also stood for a new model of care: combining compassion with research, education, and a mission to reintegrate patients back into society. But now the contours of mental health in our communities are changing. The rates of mental disease have remained remarkably stable over time. But recently a worrying signal has been detected—rising numbers of women aged 18–24 years with mental health problems. Why? Nobody is quite sure. Online bullying? Constant societal scrutiny? The disappearance of places for peace, solitude, and personal reflection? There is a further concern. At a time when psychiatry has never possessed more knowledge, recruiting young doctors into psychiatry seems to be getting more and more difficult. The message being sent by the creation of this Regius Chair at King's is therefore important—mental health matters, the discipline has never been more significant, and it's time to encourage a new generation of young health professionals to reinvigorate its work.

The London Contribution to Neurology and Psychiatry: The second British Symposium on the History of Neurology and Psychiatry

Following the first British Symposium on the History of Neurology and Psychiatry on 9 July 2014 at the Institute of Psychiatry, Psychology and Neuroscience/King's College London1 a second Symposium was...

Irving Gottesman

![Figure][1] Irving Gottesman used a register of twins at the Maudsley and Bethlem Royal hospitals in London for his study of schizophrenia. Photograph: Lisa Miller, University of Minnesota/[theguardian.com][2] The research and writings of the clinical psychologist and behaviour geneticist

The science of therapeutic images

The Netherne Hospital in Surrey is perhaps the most prestigious site in the history of British art therapy, associated with the key figures Edward Adamson and Eric Cunningham Dax, whose pioneering work involved the setting-up of a large studio for psychiatric patients to create expressive paintings. What is little-known, however, is the work of the designated scientist for psychiatric research, Hungarian Jewish émigré Francis Reitman, who was charged with an overall scientific analysis of the artistic products of the studio. Schooled in the biological psychiatric tradition of Ladislas J. Meduna in Budapest prior to his exile to the Maudsley Hospital in 1938 – and committed to treatments such as leucotomy and electro-convulsive therapy (ECT) – Reitman was an unusual candidate for research into the unconscious processes behind art and psychosis. Yet he authored two highly popular and widely reviewed books on his analyses of the abundant artistic output created by patients with schizophrenic diagnoses at the Netherne. In his Psychotic Art (1950) and Insanity, Art and Culture (1954), Reitman compared such schizophrenic images with those produced by artists under the influence of mescaline and examined the artistic output of patients having undergone leucotomy. This article draws on archival materials and Reitman’s original research publications in order to reconstruct his theory of schizophrenic art within the complex context of postwar British psychiatry, negotiating as he did between biologically reductive understandings of Freudian and Jungian psychoanalytic categories, and ultimately synthesizing concepts from both. It also analyses Reitman’s implicit theory of the therapeutic mechanism of art in the treatment of psychiatric patients.

The laboratory and the asylum: Francis Walker Mott and the pathological laboratory at London County Council Lunatic Asylum, Claybury, Essex (1895-1916).

London County Council's pathological laboratory in the LCC asylum at Claybury, Essex, was established in 1895 to study the pathology of mental illness. Historians of psychiatry have understood the Claybury laboratory as a predecessor of the Maudsley Hospital in London: not only was this laboratory closed when the Maudsley was opened in 1916, but its director, Frederick Walker Mott, a champion of the 'German' model in psychiatry, was instrumental in the establishment of this institution. Yet, as I argue in this essay, for all the continuities with the Maudsley, the Claybury laboratory should not be seen solely as its predecessor - or as a British answer to continental laboratories such as Theodor Meynert's in Vienna. Rather, as I show using the examples of general paralysis of the insane and 'asylum colitis', the Claybury laboratory is best understood as an attempt to prevent mental illness using a microbiological model.

Irving I. Gottesman (1930-2016): the multifactorial threshold model of complex phenotypes mediated by endophenotype strategies.

Irving I. Gottesman (1930-2016): the multifactorial threshold model of complex phenotypes mediated by endophenotype strategies.

Classical eyelid conditioning, psychopathy, and Hans Eysenck's grand theory

The concept of conditionability, usually assessed in classical preparations such as the eyelid conditioning paradigm, was one of the original cornerstones of Eysenck's goal for a grand theory moving seamlessly from biology (inherited and acquired CNS differences), through basic learning, to personality, and to clinical syndromes, including psychopathy and criminal conduct. From a somewhat personal perspective we trace the beginning of classical conditioning research in Eysenck's research programme at the Institute of Psychiatry (Maudsley Hospital), through various technical developments, which eventually led to questions regarding the adequacy of the construct of conditionability itself. Nevertheless, contemporary research on psychopathy, drawing on new approaches to personality theory and sub-types of psychopathic individuals, is still influenced by Eysenck's interest in crime and personality. While most of the details of the original model have been challenged, there is still a surprising consonance between Eysenck's theory and modern approaches to research on the nature of psychopathy. Conditioning studies of psychopathic individuals could still benefit further from insights developed in Eysenck's laboratories.

Paul Haydon Rogers

Paul Haydon Rogers was a respected psychiatrist, who had a leading role in the development of modern psychiatric services in Northampton and Northamptonshire. He was a son of the manse,...

Brief Group Psychotherapy for Eating Disorders by Kate Tchanturia (review)

issn 0362-4021 © 2016 Eastern Group Psychotherapy Society group, Vol. 40, No. 2, Summer 2016 177 1 Correspondence should be addressed to Michael McCutcheon, 458 w. 146th Street, Suite 1n, New York, ny 10031. E-mail: michael.mccutcheon@nyu.edu. Book Review Brief Group Psychotherapy for Eating Disorders. Edited by Kate Tchanturia. New York: Routledge, 2015, 225 pp. Reviewed by Michael McCutcheon1 Brief Group Psychotherapy for Eating Disorders is a meticulously detailed book written for group facilitators at all experience levels. The book, which is edited by Dr. Kate Tchanturia, is based on findings from years of inpatient eating disorder (ED) treatment research. It is highly informative and very enjoyable to read. Dr. Tchanturia , an international leader in the field of ED research and promoter of clinical excellence over the past 20 years, is not only the book’s editor; she also authored or coauthored 7 of its 10 chapters. Dr. Tchanturia walks the reader through a brief review of empirical data. Group therapy is more effective than individual treatment with regard to helping anorexic patients gain more weight and have shorter hospital admission times. For the practicing group therapist, this finding might sound counterintuitive. Anorexic patients typically find the interpersonal and relational challenges in the group setting hard to tolerate. To catch the reader up on the current state of ED research, she provides a systematic literature review of extant group treatments. In her review, only 38 publications on anorexia and bulimia treatments met eligibility criteria for inclusion (i.e., studies that focused solely on binge eating disorder, and findings from identical data sets were excluded). The author rightly argues for more systematic research of ED treatments. The existing publications are rife with limitations because they report on a wide range of ED group treatments, often have small sample sizes, and utilize vastly different outcome measures. All of this undermines the universality of findings. There is a great concern about patients with ED, as these conditions carry a higher mortality rate than most psychiatric disorders. Insurance companies and government-funded health programs, saddled with large expenses for lengthy GROUP 40.2 interior.indb 177 8/7/16 3:45 PM 178 mccutcheon inpatient stays, are demanding cost-effective alternatives, such as brief group treatment approaches. In this introductory chapter, Dr. Tchanturia makes a strong case for further research in the field. In the (two-page) second chapter, the author sets the scene for the eight forthcoming sections, which are devoted to various types of ED groups. She offers the reader a brief look into the adult clinical treatment program at the Maudsley Hospital, where these eight ED groups have been tested, and where she holds the position of lead clinical psychologist. Maudsley Hospital, in South London, is one of the largest mental health training facilities in the United Kingdom and is widely known for its family-based treatment for anorexia nervosa. Though the chapter was brief, I found it quite useful to learn what a typical daily routine is like for patients at Maudsley, the goals of the program (and how those goals vary depending on patients’ severity at admission), the four-stage approach employed, and how the numerous psychology groups fit in to the program’s overarching approach to recovery and wellness. The remaining eight chapters all feature a step-by-step, session-by-session description of different types of brief ED groups: cognitive remediation therapy (CRT) in group format for adults; CRT for adolescents; cognitive remediation and emotion skills training (CREST); perfectionism; single session (aka “one-off” or “pop-up”) group themes; compassion-oriented group; body image disturbance (BodyWise) group; and a recovery/discovery group (focused on recovery maintenance). The chief intent of this book is to provide an overview of protocols for ED groups using a brief model; Tchanturia succeeds admirably in this effort. To call the eight chapters that describe each type of group “clear” or “helpful” would be insulting to the painstaking work that went into the stellar organization of what could have easily become a slew of difficult-to-grasp, vague, or even esoteric information. The group descriptions are light on jargon, and when jargon is employed, it is done so with the...

John Mark Hinton

John Mark Hinton was a pivotal figure in psychiatry and palliative care. He attended school at Christ’s Hospital, Horsham, and qualified at King’s College Hospital in 1949. During his houseman...

Mary Barkas: a New Zealand pioneer at the Maudsley

ObjectiveAn account of the life of pioneer New Zealand psychiatrist Mary Barkas.ConclusionAt a time when women were rare in psychiatry, New Zealand-born Mary Barkas excelled. A pioneer in the early years of the Maudsley Hospital, Barkas demonstrated her versatility in organic psychiatry, psychoanalysis and child psychiatry. Her career was terminated at an early stage and her life took a puzzling turn after she returned to New Zealand in 1933. Many questions about this intriguing and accomplished psychiatrist need to be explored.