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Mental health services are in a state of flux. We struggle with the most basic concepts - can we distinguish between the need for "health" as opposed to "social" care? Mental distress is instantly recognizable, but less clear is what causes such distress or how we should respond to it. We have become so involved with current challenges that we assume that these are new- that we are living in a world beyond the end of psychiatric history.
This article focuses on the Bethlem Hospital, 750 years old this year. An overview may help us to appreciate that our contemporary problems are the result of history and that the concept of care is a vital part of that.
Nurses are trying to improve the response to the special needs of mothers with a mental illness. Such developments are the latest in a history of innovation and change. We too are part of that process and hopefully, our efforts will be seen as a meaningful contribution to the care of those with mental illness.
Phil Barker
Professor of Psychiatric Nursing
Newcastle University
Bedlam 9S past
The 750th anniversary of the Bethlem Royal Hospital this year is particularly poignant at a time when debates over the United Kingdom's mental health policies and the merits of closing many old mental hospitals from the Victorian era are hotly contested.
An historical overview, however, often places contemporary issues in context, and Russell's (1996) book Scenes From Bedlam shows that many themes that dominate the U.K.'s current mental health policy agenda have recurred regularly throughout many centuries.
Russell (1996), a former director of nursing services at the Bethlem Royal and Maudsley Hospitals, notes that relationships between caring staff and patients have "varied from brutality to the essence of kindness and consideration" since St. Mary Bethlem Priory, the forerunner of today's Bethlem Royal Hospital, opened in London's Bishopsgate in 1247.
The only other example of a 13th century institution for people with mental disorders was at Gheel in Belgium. Other such institutions opened at Florence, Italy in 1389; and at Valencia, Spain, in 1409.
The original Bethlem
The original Bethlem Priory did not care for the sick, but was a venue for celebrating divine services. Hospitality was offered to the Bishop of...