1. Introduction: civilians, lunacy and the First World War -- 2. Infrastructure: rules, walls, obstacles and opportunities -- 3. Certified insane: concepts and practices -- 4. Personnel: staffing the asylums and serving the Colours -- 5. Food, farm and fuel: an inequitable supply chain -- 6. Patients and their daily life -- 7. Difficult diseases: tuberculosis and other infections -- 8. Accidents, injuries, escapes and suicides -- 9. Shackles and chains: some concluding thoughts.
This book is open access under a CC BY 4.0 license. This book tells the story of Barbara Robb and her pressure group, Aid for the Elderly in Government Institutions (AEGIS). In 1965, Barbara visited 73-year-old Amy Gibbs in a dilapidated and overcrowded National Health Service psychiatric hospital back-ward. She was so appalled by the low standards that she set out to make improvements. Barbara's book Sans Everything: A case to answer was publicly discredited by a complacent and self-righteous Ministry of Health. However, inspired by her work, staff in other hospitals 'whistle-blew' about events they witnessed, which corroborated her allegations. Barbara influenced government policy, to improve psychiatric care and health service complaints procedures, and to establish a hospitals' inspectorate and ombudsman. The book will appeal to campaigners, health and social care staff and others working with older people, and those with an interest in policy development in England, the 1960s, women's history and the history of psychiatry and nursing. ; Explores the influence of AEGIS as a pressure group in improving care for older people in psychiatric hospitals, unlike other histories that attribute these improvements to the government Offers a much-needed account of the experiences of older women, and other vulnerable people, on psychiatric wards Highlights the ongoing relevance of AEGIS's campaign today and how this history can inform current debate on chronic care for older people
AbstractThe government acknowledged scandalously poor care of long‐stay patients in National Health Service (NHS) hospitals in 1969. This followed the Ely Hospital inquiry, which emerged in the aftermath of revelations of abuse at seven hospitals described in Barbara Robb's book Sans Everything: A Case to Answer (1967). Allegations in Sans Everything and at Ely were similar. However, the inquiry committees which investigated, 'disproved' those in Sans Everything and upheld those at Ely. The Ely inquiry became pivotal to NHS policy reform for long‐stay mental illness and mental handicap hospitals, and for giving patients and their families a greater voice if they had concerns about inadequacies. This paper explains the relationship between Sans Everything and 'Ely' and analyses the impact of Robb's work—her high‐profile press campaign, networking, and determination to achieve improvement—which triggered revelations at Ely and elsewhere, and helped shape the course and constructive outcome of the Ely inquiry.
Demographic trends, and older people over 65 years disproportionately occupying beds in psychiatric hospitals, pointed to their increasing clinical needs. Clinical work with older people often required different skills from work with younger people. 'General psychiatrists', nominally working with adults of all ages, usually had little interest in working with older people. By 1977, it was clear to clinical leaders in the field of psychogeriatrics that official recognition of their specialty by the government was essential to ensure service development. Official recognition would provide the means to collect data to identify gaps in services, to obtain information on the implementation of government guidance and to advocate for resources, including ensuring high quality training posts for doctors wanting to specialise in the field. Doctors have traditionally taken the lead in creating new medical specialties, and psychogeriatrics was no exception. However, support fluctuated towards the specialty from the leadership of the Royal College of Psychiatrists. Health service leaders who did not undertake work with older people, were incredulous that others wished to do so. Negotiations between the Royal College of Psychiatrists and the Department of Health and Social Security about recognising psychogeriatrics were convoluted and prolonged. Recognition was achieved in 1989, following intervention by the Royal College of Physicians of London.
Introduction Much research into psychiatric disorder in Jamaica has investigated psychotic illness but studies of neurotic disorders are lacking. This study investi gated psychiatric disorder in a group of mainly urban, lower social class, young adults who had been regular clinic attenders as a physically healthy control group in a cohort study of sickle cell disease. Method The study was cross-sectional in design. Subjects, 44 male and 45 female, were aged 18 to 20 years at the time of the study. The Psychiatric Assessment Schedule was used to determine psychiatric disorder at Index of Definition level 5. Results All subjects approached participated. Rates of psychiatric disorder were 6 (14%) in the male group and 16 (36%) in the female group. There were no psychotic disorders. In the group as a whole, psychiatric disorder was associated with female gender, unemployment, difficulties with social adjustment and number of episodes of physical illness in the 6 months prior to interview. Variables associated with psychiatric distress amongst males included not having a steady relationship, unemployment, criminal activity and difficulties with social adjustment. Variables associated with psychiatric distress amongst females included lack of domestic amenities, not having a mother at home, lack of education, unemployment and social adjustment difficulties. Conclusion Rates of psychiatric disorder were higher than expected, especially for women. Larger studies are indicated to investigate the prevalence of neurotic disorders amongst young people in Jamaica, compared to similar groups in other countries.
