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This investigation was generously supported by the Wellcome Trust [grant number 093390Z/10/Z].
The history of psychiatry in post-war Britain has largely been told through two interlinked narratives: the rise of psychopharmacology and the process of 'decarceration'. As Hess and Majerus noted in 2011,1such narratives share with manifold histories of nineteenth-century psychiatry a concern with the issues of rights, confinement, treatments and the level of the asylum population. While these tropes have illuminated many aspects of the history of psychiatry, there is a striking divergence between the 'single-issue mythologies'2developed in these works and the sheer diversity of approaches to understanding and managing mental distress and disorder that characterises the British mental health services at the beginning of the twenty-first century. The scope and rapidity of change has left many developments in social policy, legislation, medico-legal practice, service design, service delivery and clinical practice without systematic historical analysis. New emphases in service provision, such as person-centred care, well-being, recovery, the involvement of service users and increased access to psychological therapies, lack a historical context. Indeed, the language of mental health has changed. A historical narrative structured around rights (the right to health and the right to liberty) is now complicated by the rise of new organising categories such as 'costs', 'risks', 'needs', 'inclusion' and 'equality', which contemporary actors use to define competing visions of mental health services. As a first step in tracing out the new language and landscape of mental health care, this paper sets out a research prospectus in the form of a report on a series of witness seminars and interviews concerning the history of mental health services since the Mental Health Act of 1959, which replaced the legislation under which services had been provided since the 1890 Lunacy Act. Seminars were held at the Wellcome Unit for the History of Medicine in London in 2010 and 2011, and were supported by the Wellcome Trust.3
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Method
The explicit purpose of the seminars was to develop historical questions rather than to generate replicable answers. This had implications for the selection of speakers, the conduct of the meetings and the construction of the report which follows. The principal contributors were fifteen speakers: practitioners,...