The Maudsley Hospital and the Rockefeller Foundation: The Impact of Philanthropy on Research and Training

Abstract

Opened in February 1923 to raise the status of academic psychiatry in the UK, the Maudsley Hospital struggled to secure grant income. Without a track record of published research and lacking internationally recognized clinicians, it failed to impress the British Medical Research Council. To challenge leading U.S. and German departments of neuropsychiatry, Edward Mapother, the medical superintendent, looked overseas for investment in an "institute of psychiatry." Intense lobbying and a modified strategy for research and training designed to meet the Rockefeller Foundation's prioritization of psychiatry and medical specialization ultimately led to a significant endowment. Alan Gregg and Daniel O'Brien at the Foundation played a pivotal role in re-defining the Maudsley's programs of research and teaching. Pressure on Mapother to attract funding was matched by that on administrators required to show that their philanthropy had yielded tangible gains in public health. While wealthy charities, like the Rockefeller, often had a vision of the direction that they wished to pull medical science, and they provided much needed income, the impact of their policy agenda was not without drawbacks. Institutions unwilling to embrace a charity's philosophy were unlikely to secure grants, while those that did might find themselves drawn into less optimal areas. KeywordsMaudsley Hospital; Rockefeller Foundation; psychiatric research; mental illness; grants; training; medical education; philanthropy Medical charities are commonly characterized as bringing much needed financial support to speculative research.1 Indeed, it is relatively easy to chart their grants and the publications or products that followed.2 However, the impact of major donors, such as the Commonwealth Fund or the Rockefeller Foundation, went beyond the sums that they gave to laboratories and hospitals. With agendas of their own, which sometimes reflected the interests of their founders or a desire for tangible improvement to the health of a nation, philanthropic organizations could exercise a disproportionate influence on the medical community and on scientific programs in particular.3 Small-scale or innovative research departments, desperate to secure funding, may have tailored projects to meet the aims of medical charities. A researcher working within an experimental environment or a clinician responsive to patient needs might have been a better judge of what was effective or achievable than the executive of a medical charity responsible for setting broad research parameters. As a result, changes introduced to a research program to make it more appealing to a philanthropic organization may have produced projects that yielded less in terms of clinical gain or patient benefit. Although a process of consultation or peer-review was

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