By Linda Gask
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Extra info for A Short Introduction to Psychiatry (Short Introductions to the Therapy Professions)
The 1950s, as we have seen, were a time of great change and development in psychiatry. Jean Delay, who with Pierre Deniker had discovered chlorpromazine, pioneered the establishment of the WPA with Henry Ey, another distinguished French psychiatrist who served as its first secretary-general. This was an important period for international collaboration because the World Health Organization had just published the sixth revision of the International Classification of Diseases, which for the first time included a section devoted to ‘mental, psychoneurotic and personality disorders’.
Outside these areas referral is easier to obtain. However, guidelines for referral do not necessarily indicate whether or not the patient will actually see a psychiatrist. As in the USA, most care is provided by other mental health professionals and the role of the psychiatrist is perhaps less clear now than in the past. A minority of British psychiatrists spend some time working in the primary care setting,5 usually running an outpatient clinic based in the general practitioner’s surgery, and/or attending primary care team meetings to discuss particular patients about whom the general practitioner would like some advice.
Looking back at these notes now we see that they are often a very limited record, with frequently just the words ‘no change’ written every year for decades. The twentieth century was late to reach the asylum. But a revolution in health care was taking place. 9 Outpatient clinics, day hospitals and hostels began to appear. New therapists were engaged to provide education, occupational therapy, music, art and physical activities. Doors were unlocked, allowing more freedom to patients and enabling graduated discharge.