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Title: The development of psychogeriatric services in England from circa 1940 until 1989
Author: Hilton, Claire Fiona
ISNI:       0000 0004 5361 679X
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2014
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The clinical specialty of psychogeriatrics developed to provide dedicated mental health services for people over age 65, often treating people with complex combinations of mental, physical and social difficulties. Clinical reports in 1943/4 showed that physically and mentally unwell older people could benefit from active treatment, but the old age health specialties -geriatrics and psychogeriatrics - followed different paths of development. By 1970 there were about 200 consultants in geriatrics, but merely a handful of psychogeriatricians. Psychogeriatric services did not fit conveniently into policies and plans categorised as either psychiatric or geriatric, and suffered from lack of defined responsibility at all levels of health service management. Political, economic, demographic, legal, social, epidemiological, clinical and scientific factors influenced service development. Negative attitudes towards older people and unwillingness of society, including the medical profession, to provide actively for them were repeated obstacles. Tensions existed between doctors advocating better mental health services for older people and various influential committees nationally and locally. Debates over responsibilities and allocation of resources, and professionals’ attitudes towards the new psychogeriatricians and their specialty, contributed to its tortuous development. Leaders in the specialty showed determination, dedication, clinical acumen, organisational and research skills, and the ability to motivate and inspire others. In 1989, the Department of Health recognised psychogeriatrics as a medical specialty. By that time, specialist psychogeriatric services had increased substantially and were available to over 70% of the UK population. Until recognition, there were obstacles to providing appropriate specialist training for psychiatrists and the government did not collect relevant and specific data to assist with developing and monitoring services. Lack of data was associated with difficulty obtaining an equitable allocation of resources, despite clinical and epidemiological research indicating that dedicated, specialist-led services were needed and effective.
Supervisor: Thane, Patricia Mary Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available