History of Mental Health by Mind

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Article from MIND better mental health

Histort of mental health

factsheets: You are welcome to print and photocopy this page of Mind's website. Organisations are free to distribute copies to service users and colleagues, but must ensure they always use the latest version, as available on the website, at the time of distribution.

1601 The Poor Law was introduced and clearly defined the responsibility of every parish to support those who were incapable of looking after themselves. This responsibility was limited to people born or defined as being 'settled' in a parish. Other people who did not fit these categories could be expelled from the parish.

1808 The County Asylums Act 1808 gave permissive powers to the Justices of each county to build asylums, paid for by local rates, to replace the few psychiatric annexes to voluntary general hospitals. However, this development was very slow.

1834 The Poor Law Amendment Act 1834 required relief to be provided within institutions only. This led to the construction of a huge network of workhouses.

1845 The Lunacy Act 1845 required counties to provide asylums. The majority of Britain's psychiatric hospitals were built during the next 25 years. The growth of asylums was fuelled by funding arrangements that encouraged local parishes to move the parish poor into asylums, as these were funded by the county councils rather than the parishes.

1860s The workhouses were obliged to build 'infirmary' annexes - the first general hospitals (to be set up as a legal requirement).

1863 The Mental After-Care Association (MACA, later renamed Together) was established: a voluntary organisation providing short-stay residential homes for discharged psychiatric patients in the Greater London area.

1875 The Government began to pay a subsidy to Poor Law authorities of up to 25 per cent of the cost of supporting 'pauper lunatics' in asylums. This was the first central government financing of any health or social care service.

1880 The second wave of asylum building began.

1890 The Lunacy Act 1890 brought in laws regulating asylums and compulsory care.

1891 The Lunacy Act 1891 imposed rigid procedures and criteria so that only people with the most severe mental illnesses were likely to be admitted to hospitals.

1909 A report of the Poor Law Commission was published, based around two central principles:

in terms of health care, that prevention is cheaper and more effective than cure in terms of social care, that charitable activity has its proper place in supporting a public service. The report also suggested that the Poor Law should be replaced by specialised social services dealing with separate categories of people. The subsequent development of the National Health Service (NHS) in 1948 and local authority social services can be seen in terms of these principles.

1923 The Maudsley Hospital was opened by London County Council. It was the first psychiatric hospital to operate outside the restrictions of the Lunacy Act.

1923 The Tavistock Clinic was founded as a centre for psychotherapeutic training and treatment.

1926 The Report of the Royal Commission on lunacy and mental disorder suggested that outpatient clinics should be opened and aftercare services developed, as well as voluntary admission to psychiatric hospital. The emphasis was changed from detention to prevention and treatment.

1930 The Poor Law was reformed and terms such as 'pauper lunatic' were abolished. Outpatient work by the medical staff of public mental hospitals was permitted. Legislation brought the workhouse infirmaries under the control of local authorities. More of these progressed towards becoming general hospitals. Many had observation wards where patients were admitted under the Lunacy Act, while others had long-stay wards for non-acute psychiatric patients.

1930 The Mental Treatment Act 1930 allowed for voluntary admission to psychiatric hospitals.

1930s The 1930s saw the...
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