Care in the Community

World war one brought proof of mental health being affected by the environment.  Shell-shock was identified which led to Freudianism gaining popularity and neurosis becoming a focus for study and research.  Unfortunately, although there was a general concern for patients with mental ill health, the Mental Treatment Act of 1930 focussed on detainment and compulsory treatment.  Outpatient services were available but mental hospitals were still the main point of contact for mental health issues.In 1948 the infant NHS got something of a shock on realising it was responsible for 100 asylums, each with its own rules, regulations and treatment practices.

 The Percy Commission, 1957 report called for mental illness to be regarded in the same way as a physical illness or disability and that psychiatric hospitals should be run as nearly as possible on the lines of “normal” hospitals and which set the course for a move by mental health services into the community. It was followed by the 1959 Mental Health Act, which enshrined the commission’s principles and excluded “promiscuity alone” as grounds for incarceration.

Maybe the biggest milestone on the road to the therapeutic revolution occurred in Brighton in 1961 at the National Association for Mental Health (now Mind) annual conference. It was there that then health minister Enoch Powell signalled the end of the old asylums with his historic “water-tower” speech. He described the institutions thus: “There they stand, isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside.”

1983 Mental Health Act.

2007 Mental Health Act includes powers for compulsory treatment in the community.

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