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Integration in a Divided World: Salford Community Mental Health Services 1948–1974

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Deinstitutionalisation and After

Part of the book series: Mental Health in Historical Perspective ((MHHP))

Abstract

Harrington offers a rare insight into how the vision of community mental healthcare contained within the 1959 Mental Health Act translated into ground-level service provision. Drawing on archival sources and oral history interviews, her case study of a local authority mental health department in the north-west of England focuses on the processes of, and obstacles to, change within community mental health services during the first 25 years of the NHS. Harrington sets this in the context of the wider historiographical debates about the relationship between the national and the local within the change process, and the value of small-scale case studies within the broader history of deinstitutionalisation.

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Notes

  1. 1.

    Interview 1: Tom Fryers, Medical Officer in Salford from 1962, and Medical Officer of Mental Health (MOMH) 1965–1969.

  2. 2.

    Royal Commission on the Law Relating to Mental Illness and Mental Deficiency 1954–1957 (1957) Report, Cmnd 169 (London: HMSO), pp. 100–247.

  3. 3.

    K. Jones (1993) Asylums and After: A Revised History of the Mental Health Services (London: Athlone Press), pp. 150–58; J. Busfield (1986) Managing Madness: Changing Ideas and Practice (London: Unwin Hyman), pp. 326–46; A. Scull (1984) Decarceration: Community Treatment and the Deviant. A Radical View, 2nd edn (Cambridge: Polity Press); S. Goodwin (1997) Comparative Mental Health Policy: From Institutional to Community Care (London: Sage Publications), pp. 26–112.

  4. 4.

    J. Welshman (1999) ‘Rhetoric and Reality: Community Care in England and Wales, 1948–74’ in P. Bartlett and D. Wright (eds) Outside the Walls of the Asylum: History of Care in the Community 1750–2000 (London: Athlone Press), pp. 217–20; S. Rolph, J. Walmsley and D. Atkinson (2003) ‘“A Pair of Stout Shoes and an Umbrella”: The Role of the Mental Welfare Officer in Delivering Community Care in East Anglia: 1946–1970’, British Journal of Social Work, 33:3, 339–59.

  5. 5.

    H. Freeman (1984) ‘Mental Health Services in an English County Borough before 1974’, Medical History, 28:2, 111–28.

  6. 6.

    The chapter draws on the findings of a Wellcome-funded research study into the post-war history of mental health services in Manchester and Salford. More information about methodology and sources appears in V. Harrington (2008) Voices Beyond The Asylum: A Post-War History of Mental Health Services in Manchester and Salford (PhD dissertation: University of Manchester).

  7. 7.

    Rolph, Walmsley and Atkinson, ‘“A Pair of Stout Shoes”’; D. Gittens (1998) Madness in its Place: Narratives of Severalls Hospital 1913–1997 (London: Routledge).

  8. 8.

    Interview 2: Mervyn Susser, MOMH in Salford, 1957–1965. Joint interview with Susser and his wife, Zena Stein, who worked closely with him in the mental health department, primarily as a researcher.

  9. 9.

    City of Salford (1948) Annual Report of the Medical Officer of Health [hereafter Salford MOH Reports], p. 108.

  10. 10.

    Royal Commission, Report, p. 242.

  11. 11.

    Busfield, Managing Madness, p. 346.

  12. 12.

    Welshman, ‘Rhetoric and Reality’, p. 208. Total LA expenditure on health and welfare around this period ranged from approximately £42 million (1949–1950) to approximately £57 million (1953–1954) (Ministry of Health (1963) Health and Welfare: The Development of Community Care, Cmnd 1973 (London: Ministry of Health), p. 1).

  13. 13.

    K. Jones (1954) ‘Problems of Mental After-Care in Lancashire’, Sociological Review, 2:1, 34–56, p. 40.

  14. 14.

    Ibid., pp. 40–41.

  15. 15.

    Freeman, ‘Mental Health Services in an English County Borough’, p. 116. These figures are echoed in a 1959 survey of 32 MWOs in three county councils. Ten were former relieving officers, nine came from a clerical background and seven had been nurses in a mental hospital (H. Miles, J. Loudon and K. Rawnsley (1960) ‘Attitudes and Practices of Mental Welfare Officers’, Public Health, 76:1, 32–47).

  16. 16.

    Miles, Loudon and Rawnsley, ‘Attitudes and Practices of Mental Welfare Officers’, p. 33.

  17. 17.

    S. Rolph, J. Walmsley and D. Atkinson (2002) ‘“A Man’s Job”?: Gender Issues and the Role of Mental Welfare Officers, 1948–1970’, Oral History, 30:1, 28–41; Rolph, Walmsley and Atkinson, ‘“A Pair of Stout Shoes”’. The recollections of their informants were echoed in a number of my interviews.

  18. 18.

    E. Younghusband (1978) Social Work in Britain: 1950–1975: A Follow-up Study. Vol. 1 (London: George Allen & Unwin), p. 165.

  19. 19.

    Salford MOH Reports (1950), p. 107.

  20. 20.

    Ibid., p. 4.

  21. 21.

    Interview 3: George Mountney, MWO in Salford from 1955 and Chief MWO 1964–1970.

  22. 22.

    Interview 2: Stein.

  23. 23.

    Salford MOH Reports (1957), pp. 92–93.

  24. 24.

    Salford MOH Reports (1951), pp. 99–100.

  25. 25.

    Salford MOH Reports (1952), pp. 127 and 86.

  26. 26.

    Interview 4: Joyce Leeson, Medical Officer and researcher in Salford 1954–1965.

  27. 27.

    Interview 1: Fryers. Everyone I interviewed who had known Lance Burn shared Fryers’ opinion.

  28. 28.

    For a brief biography of Burn see W. Elwood and A. Tuxford (1984) Some Manchester Doctors: A Biographical Collection to mark the 150th Anniversary of the Manchester Medical Society (Manchester: Manchester University Press), pp. 175–80. For his approach to public health see J. Burn (1959) Recent Advances in Public Health, 2nd edn (London: J. & A. Churchill).

  29. 29.

    Salford MOH Reports (1954), p. 7.

  30. 30.

    Interview 4: Leeson.

  31. 31.

    Interview 2: Susser.

  32. 32.

    M. Susser, Z. Stein, M. Cormack and M. Hathorn (1955) ‘Medical Care in a South African Township’, Lancet, 265, 912–15.

  33. 33.

    Interview 2: Susser.

  34. 34.

    Salford MOH Reports (1960), p. 94.

  35. 35.

    Interview 3: Mountney.

  36. 36.

    Ibid.

  37. 37.

    Interview 5: Bill Douglas, Deputy Chief MWO, 1965–1970.

  38. 38.

    Interview 6: Monica Baynes, MWO in Salford, 1967–1970.

  39. 39.

    Interview 3: Mountney.

  40. 40.

    Ibid.

  41. 41.

    Salford MOH Reports (1957), p. 91.

  42. 42.

    Salford MOH Reports (1958), p. 99 and appendix II.

  43. 43.

    Interview 1: Fryers.

  44. 44.

    M. Susser (1962) ‘Changing Roles and Co-ordination in Mental Health Services’, Sociological Review Monographs, 5:S1, 61–90, pp. 80–81.

  45. 45.

    Salford MOH Reports (1960), pp. 93–95.

  46. 46.

    Susser, ‘Changing Roles’, p. 88.

  47. 47.

    D. Macmillan (1956) ‘An Integrated Mental-Health Service: Nottingham’s Experience’, Lancet, 268, 1094–95; H. Freeman (1960) ‘Oldham and District Psychiatric Services’, Lancet, 275, 218–21; A. May and E. Gregory (1963) ‘An Experiment in District Psychiatry’, Public Health, 78, 19–25.

  48. 48.

    Interview 6: Baynes.

  49. 49.

    Interview 7: Hugh Freeman, consultant psychiatrist in Salford 1961–1988.

  50. 50.

    Harrington, ‘Voices Beyond The Asylum’, pp. 102–24.

  51. 51.

    City of Manchester (1969) Annual Report of the Medical Officer of Health, pp. 150, 145.

  52. 52.

    Salford MOH Reports (1969), p. 138.

  53. 53.

    Welshman, ‘Rhetoric and Reality’, p. 214.

  54. 54.

    H. Freeman (1980) Mental Health Services in Salford 1948–74 (M.Sc. Dissertation: University of Salford), p. 123.

  55. 55.

    Salford MOH Reports (1966), pp. 140, 150.

  56. 56.

    ‘The Need for Health Cuts’, Salford Reporter, 28 March 1969.

  57. 57.

    ‘Plan to Close Mental Health Centres’, Guardian, 31 March 1969, p. 4.

  58. 58.

    Interview 2: Mountney.

  59. 59.

    Interview 5: Douglas.

  60. 60.

    K. Wooff (1978) The Use of Social Services by Psychiatric Patients in Salford (M.Sc. Dissertation: University of Manchester); R. Bhaduri (1976) A Study of Mental Health Services in Salford from 1960 to 1974 (MA Dissertation, University of Manchester).

  61. 61.

    J. Smith (1972) ‘Top Jobs in the Social Services’ in K. Jones (ed.) The Year Book of Social Policy in Britain 1971 (London: Routledge & Kegan Paul), pp. 16–30.

  62. 62.

    F. Martin (1984) Between the Acts: Community Mental Health Services 1959–1983 (London: Nuffield Provincial Hospitals Trust).

  63. 63.

    J. Neill, W. Warburton and B. McGuiness (1976) ‘Post Seebohm Social Services: (1) The Social Worker’s Viewpoint’, Social Work Today, 8:5, 9–14.

  64. 64.

    DHSS (1975) Better Services for the Mentally Ill, Cmnd 6233 (London: HMSO), p. ii.

  65. 65.

    J. Pickstone (1992) ‘Psychiatry in District General Hospitals: History, Contingency and Local Innovation in the Early Years of the National Health Service’ in J. Pickstone (ed.) Medical Innovations in Historical Perspective (Basingstoke: Macmillan), p. 199.

  66. 66.

    Ibid., p. 185.

  67. 67.

    N. Henckes (2009) ‘Narratives of Change and Reform Processes: Global and Local Transactions in French Psychiatric Hospital Reform after the Second World War’, Social Science and Medicine, 68:3, 511–18, p. 511.

  68. 68.

    V. Harrington (2010) ‘Learning about Mental Health Services through Local Histories: Case Studies from the Manchester Region’ in A. Anderson, W. Hubbard and T. Ryyman (eds) International and Local Approaches to Health and Health Care (Oslo: Novus Press, 2010), pp. 75–78.

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  1. Macmillan Cancer Care, Manchester, UK

    Valerie Harrington

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  1. Valerie Harrington
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  1. Independent scholar, Athens, Greece

    Despo Kritsotaki

  2. Centre for the Social History of Health, Glasgow Caledonian University, Glasgow, Lanarkshire, United Kingdom

    Vicky Long

  3. History of Psychiatry, University of Strathclyde, Glasgow, United Kingdom

    Matthew Smith

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Harrington, V. (2016). Integration in a Divided World: Salford Community Mental Health Services 1948–1974. In: Kritsotaki, D., Long, V., Smith, M. (eds) Deinstitutionalisation and After. Mental Health in Historical Perspective. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-45360-6_7

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