Geoffrey Baruch

Originally published in 1978, with the reform of the 1959 Mental Health Act under consideration, it was time to re-examine the recent policy of desegregating the mentally ill and treating them within general hospital psychiatric units rather than in mental hospitals. This shift in policy reflected a number of significant trends in contemporary British psychiatry. It signified the acceptance of the idea that mental disorder is like a physical illness and should be treated as such, within the same buildings. It had also brought the psychiatric profession closer to the mainstream of medicine and had conferred on it a status similar to that enjoyed by other branches of the medical profession.In this study, however, the authors question much of British psychiatric practice at the time. Part of the book is devoted to explaining how the psychiatric profession had been able to establish a hegemony over the mental health field, and consequently subordinate the other mental health professions to minor roles. The main emphasis of the book is on the controversial policy of desegregation of the mentally ill. The historical development of general psychiatric units is discussed, then a case study documenting the ‘careers’ of three patients who passed through one such unit is presented, providing a fascinating insight into the way in which the unit operated as a diagnostic and therapeutic centre. Finally, an analysis is made of some of the issues raised by the study. In particular, the staff structure of psychiatric centres and the processes of assessment and treatment are considered in detail.

Originally published in 1978, with the reform of the 1959 Mental Health Act under consideration, it was time to re-examine the recent policy of desegregating the mentally ill and treating them within general hospital psychiatric units rather than in mental hospitals. This shift in policy reflected a number of significant trends in contemporary British psychiatry. It signified the acceptance of the idea that mental disorder is like a physical illness and should be treated as such, within the same buildings. It had also brought the psychiatric profession closer to the mainstream of medicine and had conferred on it a status similar to that enjoyed by other branches of the medical profession.In this study, however, the authors question much of British psychiatric practice at the time. Part of the book is devoted to explaining how the psychiatric profession had been able to establish a hegemony over the mental health field, and consequently subordinate the other mental health professions to minor roles. The main emphasis of the book is on the controversial policy of desegregation of the mentally ill. The historical development of general psychiatric units is discussed, then a case study documenting the ‘careers’ of three patients who passed through one such unit is presented, providing a fascinating insight into the way in which the unit operated as a diagnostic and therapeutic centre. Finally, an analysis is made of some of the issues raised by the study. In particular, the staff structure of psychiatric centres and the processes of assessment and treatment are considered in detail.

Social inequality and social disadvantage provide an all too fertile soil that sustains the majority of the serious mental health problems suffered by children in our society. The complexity of the issues clinicians routinely encounter in working with children with mental health problems is widely acknowledged. However, few books concern themselves with how such difficult populations can be effectively approached and the strategies that are likely to deliver effective treatment to them. This book, based on a highly successful seminar for grant-giving children's charities held at the Anna Freud Centre and sponsored by John Lyon's Charity, provides pragmatic solutions to this major therapeutic challenge of our age. The chapters bridge statutory and voluntary initiatives and are held firmly together by the commitment to evidence-based, systematically offered, programmatic and innovative approaches that can help those who, although hard to reach, are in greatest need of our efforts: the socially excluded children and families in our society. As such, this book will be invaluable to psychologists, psychotherapists, counselors and family therapists.