Child Psychiatry in Britain–the Last 30 Years

Abstract

The development of child and adolescent psychiatry over the last thirty years is described with emphasis on the ideas and concepts which have become a characteristic feature of clinical practice and research. Aspects of training, innovations in practice and the relationship with paediatrics are discussed and the growing participation in international bodies concerned with mental health is outlined. The specialty is now well established and is attracting physicians of high calibre to its ranks. Multidisciplinary collaboration is still a strong feature but has taken a different form in the light of new developments in clinical and developmental child psychology and psychiatric social work.

"The menace of psychiatry": does it still ring a bell?

“…Like a parental couple our alternative perspectives together create a fuller picture than either could alone. Speaking in the 1960s of the relationship between paediatricians and child psychiatrists, the British paediatrician John Apley said “There has been a long and desultory flirtation between them but it is high time they were married – if only for the sake of the children” (cited by Hersov14). …”

The Construction of Emotional and Behavioural Difficulties

“…Turning to the social and/or behavioural sciences raises the question of who is the expert, and sets in motion professional rivalries that unfold in a dialectical relationship with changes in policy and practice (Jones, 2001) and the wider political landscape. In post-war Britain, the expertise was supplied by medical psychology, which was associated with psychiatry and paediatrics, and at the time informed primarily by psychoanalytical thinking (Hersov, 1986). Psycho-analysts attributed antisocial behaviour to developmental deficits: 'most delinquents are to some extent ill [because] the sense of security did not come into the child's life early enough to be incorporated into his belief' (Winnicott, 1964, p. 229).…”

The History of Child and Adolescent Psychiatry: Its Present Day Relevance

“…The period since 1946 encompasses the most significant advances in the care of disturbed children and adolescents and has been well-reviewed by Hersov (1986). It has witnessed the growth of out-patient services, the development of in-patient hospital departments and, from the 1960s, the increasing acceptance of a need for services for adolescents (Parry-Jones, 1984).…”