Mental Welfare: Voluntary Mental Health and Learning Disability Organizations in Britain, c. 1946–1959 Kevin Burris A dissertation submitted to the Faculty of Graduate Studies in partial fulfillment of the requirements for the degree of Doctor of Philosophy Graduate Program in History York University Toronto, Ontario June 2020 © Kevin Burris, 2020 ii Abstract This dissertation traces the trajectories of four British voluntary organizations working in the fields of mental health and learning disability in the late 1940s and 1950s: the National Association for Mental Health; the Mental After Care Association; the Ex-Services Welfare Society; and the National Association for Parents of Backward Children. As the British welfare state was established in these years, voluntary organizations were forced to adjust to a new political landscape, carrying on operations despite increased state responsibility for mental health and learning disability care. First, the dissertation is an institutional history of four distinct organizations, concerned with operations, administration, leadership, and publicity, among a host of other day-to-day affairs. Second, it examines varying responses among voluntarists to the establishment and permeation of the welfare state in British life, asking how these organizations maintained their vitality (and importantly, their sources of support and funding) within a landscape of expanding statutory service provision. That they did survive, and thrive, into the present suggests that the interventionist, “cradle-to-grave” welfare state was not as all-encompassing as originally envisioned—at least in the field of mental health care. Rather than challenge increasing statutory dominance, their persistence confirmed and reinforced several elements of the nascent welfare state. Though voluntarist leaders tended toward political conservatism, and often criticized specific policy directives or statutory services, their organizations generally bolstered three major welfare goals: the regulation of disorder, the maintenance of non-working populations, and the reproduction of labour. iii For Sarah, who sees me through. iv Acknowledgments First, I would like to thank my supervisor, Dr. Stephen Brooke, for his unwavering guidance—I’d like to think my work has been vastly improved through his help. More than once— through comprehensive exams, teaching assistant strikes, and now, as I write this, a global pandemic—his kind words of support have kept me from giving up on this whole venture. Thank you as well to the other members of my supervisory committee, Dr. Marlene Shore and Dr. Kenton Kroker, both for the insights and inspirations I gleaned in their graduate courses, and for their incisive comments on the draft of this dissertation. Thanks to the external members of my examining committee, Dr. Mathew Thomson and Dr. Michael Pettit, as well as committee chair Dr. Molly Ladd-Taylor, for their rigorous yet encouraging interrogation of the project during my defense. Thank you to Karen Dancy and the History Department staff for their constant help navigating the bureaucratic peculiarities of a modern university, and for always doing their best to make the Department a warm and inviting space. Thank you to the members of my union, CUPE 3903, who were always ready to stand up for our collective rights, and who were the best picketers a picket captain could ask for. Thanks are due to the librarians and archivists at several institutions. These include the staff at the Wellcome Library, the National Archives, the London Metropolitan Archives, the East Sussex Record Office, the Bedfordshire Archives, the Norfolk Record Office, and the Lambeth Archives. Special thanks to Combat Stress Records Manager Clare Flanagan, who provided access to a trove of documents—not to mention desk space, a computer, and car rides back to the Leatherhead train station. Clare also welcomed me with a tour of Tyrwhitt House, for which I am very grateful—we are not always able to literally follow the steps of our subjects. Thanks as well to Dr. Lesley Hall, who alerted me to the Wellcome’s Mind and MACA collections, Dr. Jan v Walmsley and Dr. Liz Tilley, who pointed me in the right directions to find material on the NAPBC, and Dr. Sheena Rolph, who kindly lent me several of her own books on that organization’s regional branches. This research would not have been possible without generous funding from several sources: the Social Sciences and Humanities Research Council of Canada, the Ontario Graduate Scholarship, the Faculty of Graduate Studies at York University, and the St. George’s Society of Toronto. To all my friends (some might as well be family) in Toronto, thank you for your encouragement, both personally and professionally. I am an introvert by nature, and when I moved here from Vancouver in 2013, I couldn’t have imagined I would become part of such a supportive and loving community. Thanks to (in no particular order) Erica McCloskey and Madison Sieloff, Alex Bien and Nava Dabby, Annie Selzler, Sara Howdle, Max Smith, Jason Chartrand, and Chelsea Bauer. Special thanks to my study buddies Marlee Couling, Brianna Goldberg, and Harrison Forsyth—there is hardly a word in this dissertation that was not written while sitting in a coffee shop across from at least one of you. To all my fellow editors at Left History, thank you for indulging my frankly embarrassing love of copyediting minutiae. To my friend, Kal Tamm: thank you for your unflagging optimism—it’s more inspiring than you know. To my parents, Kathy, Michael, and Anita: thank you for your constant support, and for instilling in me the desire to keep learning. To my wife, Sarah: thank you for loving me, believing in me, and knowing I could do this, even when I didn’t. Kevin Burris June 2020 vi Table of Contents Abstract ............................................................................................................................... ii Dedication .......................................................................................................................... iii Acknowledgments .............................................................................................................. iv Table of Contents ............................................................................................................... vi List of Illustrations ........................................................................................................... viii List of Abbreviations ......................................................................................................... ix Chapter One: Introduction .................................................................................................. 1 Argument and Scope ............................................................................................... 1 Medical Care in the Welfare State .......................................................................... 7 Mental Health, Learning Disability, and State Medicine ...................................... 11 The Development of Voluntarism ......................................................................... 19 Voluntarists as Professionals ................................................................................ 21 Theoretical Influences ........................................................................................... 24 Chapter Outline ..................................................................................................... 31 Chapter Two: The National Association for Mental Health ............................................. 36 Introduction ........................................................................................................... 36 Residential Services .............................................................................................. 42 Public and Professional Education ........................................................................ 62 Contending with the State ..................................................................................... 72 Conclusion ............................................................................................................ 81 Chapter Three: The Mental After Care Association ......................................................... 84 Introduction ........................................................................................................... 84 After Care Homes ................................................................................................. 91 Cooperating with the State .................................................................................. 110 Publicity and Donors ........................................................................................... 119 Conclusion .......................................................................................................... 128 Chapter Four: The Ex-Services Welfare Society ............................................................ 131 Introduction ......................................................................................................... 131 Rehabilitation and Sheltered Employment ......................................................... 140 Advocacy Work .................................................................................................. 151 Prestige and Funding ........................................................................................... 165 Conclusion .........................................................................................................