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DEVELOPMENT of OLD AGE PSYCHIATRY from the 1960S UNTIL 1989

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DEVELOPMENT of OLD AGE PSYCHIATRY from the 1960S UNTIL 1989 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE, University of Glasgow 9 th May 2008 THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE University of Glasgow THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 9th May 2008 Seminar team: Dr Claire Hilton, consultant old age psychiatrist, CNWL NHS Foundation Trust, London Professor Tom Arie, professor emeritus, University of Nottingham Dr Malcolm Nicolson, director, Centre for the History of Medicine, University of Glasgow Editor: Claire Hilton Contents Introduction .............................................................................................................. 2 Seminar programme ................................................................................................ 4 Transcript of proceedings ....................................................................................... 5 Reflections .............................................................................................................. 67 Acknowledgements ................................................................................................ 68 Appendix 1: Biographies of witnesses ................................................................. 69 Appendix 2: Additional biographical information ............................................... 97 Appendix 3: Archival sources used to compile footnotes ............................... 106 1 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE, University of Glasgow 9 th May 2008 THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 Introduction The specialty of old age psychiatry 1 has been developing in Britain since the 1940s. We decided that a project was needed to capture the oral history memories of some of the early pioneers of the specialty, and that we would do this in the format of a witness seminar. Witness seminars are features of academic contemporary history research, and have for several years been used in the exploration of medical history by the Wellcome Trust at University College London.2 Our seminar was hosted by the Centre for the History of Medicine at the University of Glasgow in May 2008. They have a special interest in social aspects of medicine. Generous financial support was given by the Guthrie Trust, to whom we are most grateful. ‘Witnesses’ were invited who could recount their own experiences of the history of old age psychiatry and introduce topics for discussion. The seminar was advertised in the Newsletter of the Faculty of the Psychiatry of Old Age at the Royal College of Psychiatrists, through the Centre for the History of Medicine, University of Glasgow, and by word of mouth. More details of the format of the seminar are given in the main transcript in the introduction given at the seminar. The sound recording of the meeting has been transcribed and footnotes added. Of note amongst the participants were several leading members - chairmen and secretaries - of the Group, the Section then the Faculty of the Psychiatry of Old Age at the Royal College of Psychiatrists,3 each of whom had a huge role in shaping and developing the specialty in Britain, a model which has been adopted in many countries around the world.4 The transcript should be of particular interest to old age psychiatrists, as well as others interested in the history of psychiatry, older people’s health and medicine more generally. 1 The terms ‘old age psychiatry’ and ‘psychogeriatrics’ have been used interchangeably, and this reflects their usage both historically and by seminar participants. The hyphenated term ‘psycho- geriatrics’ may be used at times to denote collaborative working between geriatricians and psychiatrists, and reflects its use in official documents. 2 Wellcome Trust Centre for the History of Medicine at UCL http://www.ucl.ac.uk/histmed/publications/wellcome_witnesses accessed 9.9.08 3 Chairmen: Dr Felix Post (73-78), Dr Sam Robinson (78-81), Prof Tom Arie (81-86), Prof Brice Pitt (86-90), Prof Dave Jolley (90 -94) Secretaries: Prof Brice Pitt (73-78), Dr Peter Jefferys (78-82), Prof Dave Jolley (82-85), Prof John Wattis (85-89) 4 For example, Snowdon J, Draper B. ‘The Faculty of Psychiatry of Old Age’ Australasian Psychiatry (1999) 7: 30-32; Shulman K. ‘The future of geriatric psychiatry’ Canadian Journal of Psychiatry (1994) 39: no 8 supplement 1 s1-s8 2 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE, University of Glasgow 9 th May 2008 THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 (Left to right: Sam Robinson, Tom Arie, Bill Boyd, Gordon Langley: Glasgow 2008) 3 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE, University of Glasgow 9 th May 2008 THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 Seminar programme List of speakers introducing topics for discussion Dr RA (Sam) Robinson The earliest days - before 1970 Prof Brice Pitt Early collaboration with other specialties and agencies Prof James (Jimmy) Williamson Psychogeriatrics seen from geriatrics Dr WD (Bill) Boyd The Scottish scene Dr Klaus Bergmann Research Dr Nori Graham Psychogeriatrics from the perspective of a junior doctor in the earliest days, and from the perspective of a part-time woman trainee Prof Tom Arie Educational opportunities and outcomes Prof David (Dave) Jolley The next generation of psychogeriatricians Prof John Wattis Surveying the specialty: the development of psychogeriatrics towards 1989 and recognition by the DHSS Please note : References in the footnotes to The Oxford Dictionary of National Biography, Who’s Who and Oxford English Dictionary can be accessed either via an Athens password, or for most places in England and Wales, via local authority libraries’ online reference scheme. 4 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE, University of Glasgow 9 th May 2008 THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 Transcript of proceedings Dr Malcolm Nicolson, director, Centre for the History of Medicine, University of Glasgow: Open the windows, shut down the radiators if you’re too hot or cold or whatever, just let us know. We are recording this event and it’s important that people really speak into the microphone and also let us know who they are, if you don’t do that I’ll shout to you, OK?! Anyway, any questions about housekeeping speak to me - and I’m looking forward to an interesting and cordial afternoon. And so I’ll hand over to Claire. Dr Claire Hilton, consultant old age psychiatrist, London: 5 Thank you, Malcolm, and thank you all so much for coming. I hope everybody is going to enjoy the afternoon and that we will produce an important historical document in the process. My name’s Claire Hilton. I’m an old age psychiatrist but in my spare time I dabble in history. The scope of the seminar today is to explore the development of mental health services for older people in Britain from 1960 to 1989. I’d just like to remind you of the format of a witness seminar. We have with us some very eminent witnesses to the early years of the specialty of old age psychiatry and some of them will be introducing various topics to encourage reminiscence and discussion. Those of you who weren’t witnesses to the various events also have a very important role - to ask questions and encourage discussion. You are not here just as interested observers, but you’re all essential to help produce as complete a record of events as is possible. To our witnesses, we want to hear your stories and experiences, the things that happened behind the formal events, behind the documents and behind the reports and we want to understand better the significance of the developments in human terms - what changed? How it influenced people’s lives - the patients, the families and the staff? You are welcome to either sit in your seats when you give your presentations or come and sit out here, whichever you would prefer. Perhaps we could have a show of hands. Who are the psychiatrists here? Quite a lot, about 15. What about geriatricians? Only one. What about historians? About 8. And others? A few others. Thank you. Visual aids are not permitted in a witness seminar, but I have two, mainly for the benefit of clinicians rather than historians. Clinicians have the tendency to bring history up to the present time and to view events through 5 For further biographical information on participants see appendix 1. 5 GUTHRIE TRUST WITNESS SEMINAR, CENTRE FOR THE HISTORY OF MEDICINE, University of Glasgow 9 th May 2008 THE DEVELOPMENT OF OLD AGE PSYCHIATRY FROM THE 1960s UNTIL 1989 the retrospectoscope. But today is different, we really want you to time- travel back to the years 1960 to 1989. It’s up there on the poster, and to try and remember what life was like at that time. Of course if you were practising medicine before 1960 you’re very welcome to add in the earlier days. I have another visual aid - a red card. I shall have no qualms about holding it up if anybody is boring me and hogging the microphone for too long - a red card means 20 seconds and no more! But really, seriously, please try and be concise because we want everyone to have the chance to talk and, if you want to contribute a question or a comment you must use the microphone as the proceedings are being recorded. Please introduce yourself briefly, just one sentence and always give your name when you speak otherwise the people transcribing the recording are really going to have a nightmarish job in trying to unscramble the sources of their information. So please be patient in waiting for Leigh, who’s over there, to bring the microphone to you. We also have Steve at the back who’s in charge of the recording. One other point, please define any abbreviations. It’s not just that some of us weren’t in the specialty of old age psychiatry before 1989, but there’s the Scottish versus the South of the Border differences, like the SHHD - Scottish Home and Health Department and the DHSS - Department of Health and Social Security.
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