Mental health policy in Scotland, 1908-1960

Abstract

This thesis traces the evolution of the Scottish mental health service from one which was almost exclusively concerned with 'lunatics', which was rooted in compulsory committal and detention, and which was linked to a deterrent Poor Law to one which incorporated those suffering from a wide range of mental disturbances, which was largely based on treatment willingly undertaken and freely available, and which was associated with a preventive N. H. S. It examines the concepts and intentions which underlay policy, and the impact of policy upon the service and its clients. It describes the ways in which the service was moulded by the changing and sometimes conflicting demands of the needs of the mentally disordered and of society as a whole. It describes the shifting responses of policymakers, psychiatrists, the public and patients to perennial questions like the respective roles of compulsion and voluntaryism,. containment and active treatment, -government and private initiative, hospital and community care, as well as reaction to more dramatic events like wars and major legislative upheavals. The first part of the thesis describes the state of the lunacy service in the early years of the century, the origins and birth of the mental deficiency service, and the impact upon both services of the first total war. The second part deals with the developments of the 1920s and 1930s. It considers the influence of legal and administrative reforms, the increasing emphasis upon the early detection and treatment of deviation from the norm and the growth of a variety of extra-institutional facilities, as well as the therapeutic innovations and disappointments of the inter-war period. The third and final part primarily focuses upon the creation and subsequent development of the N. H. S. mental health service. It describes the changing face, of the hospital service, the further expansion of community care and the post-1945 development of special education for the mentally handicapped, and ends with an analysis of the genesis and significance of the 1960 Act which embodied the new principle of informality.