This open access book explores the history of asylums and their civilian patients during the First World War, focusing on the effects of wartime austerity and deprivation on the provision of care. While a substantial body of literature on ‘shell shock’ exists, this study uncovers the mental wellbeing of civilians during the war. It provides the first comprehensive account of wartime asylums in London, challenging the commonly held view that changes in psychiatric care for civilians post-war were linked mainly to soldiers’ experiences and treatment. Drawing extensively on archival and published sources, this book examines the impact of medical, scientific, political, cultural and social change on civilian asylums. It compares four asylums in London, each distinct in terms of their priorities and the diversity of their patients. Revealing the histories of the 100,000 civilian patients who were institutionalised during the First World War, this book offers new insights into decision-making and prioritisation of healthcare in times of austerity, and the myriad factors which inform this.

This is a poignant, sometimes ribald, history of the rank-and-file servicemen who were psychiatric casualties of World War One.

It’s a troubling phenomenon that many of us think of as a modern psychological epidemic, a symptom of extreme emotional turmoil in young people, especially young women: cutting and self-harm. But few of us know that it was 150 years ago—with the introduction of institutional asylum psychiatry—that self-mutilation was first described as a category of behavior, which psychiatrists, and later psychologists and social workers, attempted to understand. With care and focus, Psyche on the Skin tells the secret but necessary history of self-harm from the 1860s to the present, showing just how deeply entrenched this practice is in human culture. Sarah Chaney looks at many different kinds of self-injurious acts, including sexual self-mutilation and hysterical malingering in the late Victorian period, self-marking religious sects, and self-mutilation and self-destruction in art, music, and popular culture. As she shows, while self-harm is a widespread phenomenon found in many different contexts, it doesn’t necessarily have any kind of universal meaning—it always has to be understood within the historical and cultural context that surrounds it. Bravely sharing her own personal experiences with self-harm and placing them within its wider history, Chaney offers a sensitive but engaging account—supported with powerful images—that challenges the misconceptions and controversies that surround this often misunderstood phenomenon. The result is crucial reading for therapists and other professionals in the field, as well as those affected by this emotive, challenging act.

From the outset of World War I, French doctors faced an apparent epidemic of puzzling neurological and psychiatric illnesses among soldiers. As they attempted to understand the causes of these illnesses, doctors organized specialized centers near the front, where they submitted soldiers to swift, humiliating treatments and then returned them to duty. At home, they interned the scores of civilians who succumbed to the war's strains in decrepit asylums or left them to fend for themselves. In Treating the Trauma of the Great War, Gregory M. Thomas explores the psychological effects of the war on French citizens, showing how doctors' understanding of mental illness produced deep, tangible effects in the lives of the men and women who suffered. Doctors vigorously debated the war's role in the genesis of the neuropsychiatric disturbances observed in soldiers and civilians, but most psychiatrists ultimately concluded that mental illnesses appeared primarily in individuals predisposed to disease. Consequently, doctors granted their patients few favors when making decisions about diagnostic labels, treatment regimes, and pension allocations, leaving many to endure illnesses without adequate care or sufficient financial support. In their quest to understand the psychological impact of war, Thomas argues, doctors focused more on demonstrating the capabilities of their medical specialties and serving a state at war than on treating patients. Those aims significantly affected doctors' scientific conclusions, their medical and legal decisions, and their treatment practices. When the war ended, psychiatric reformers used the trauma of war to their advantage, promoting the perception of France as a traumatized nation in need of new psychiatric institutions that could accommodate a large and growing pool of psychologically wounded citizens. Thomas draws on the vast medical literature produced during and after the war, including veterans' journals, parliamentary debates, newspaper articles, and medical administrative reports, infusing his narrative with a vivid human element. Though psychiatrists ultimately failed to raise the status of their specialty, Thomas reveals how the war helped precipitate lasting changes in psychiatric practice.

This timely book offers a balanced and thoughtful review of the current mental health emergency and its impact upon and among medical professionals, supported by the best available evidence and illustrated through real-life cases. Recognising the increasing stressors in the role including the impact of the environment in which doctors work, the book examines some of the key emotional drivers for this unhappiness among doctors at work – shame, stigma, suffering and sacrifice – and offers practical steps to emotional and physical recovery. Despite the obvious challenges and stresses of the role, with the right support in place the vast majority of doctors can thrive in their jobs. In reading this book, policy makers, politicians, educators, hospital managers will be reminded of the ethical duty to ensure that doctors are cared for and have access to the time, people and spaces to remain psychological healthy, while doctors will learn to recognize and seek actively the help that they need, and to support and guide one another.

Shell shock achieved a very high political profile in the years 1919-1922. Publications ranging from John Bull to the Morning Post insisted that shell-shocked men should be treated with respect, and the Minister for Health announced that the government was committed to protecting shell-shocked men from the stigma of lunacy. Yet at the same time, many mentally-wounded veterans were struggling with a pension system which was failing to give them security. It is this conflict between the political rhetoric and the lived experience of many wounded veterans that explains why the government was unable to dispel the negative wartime assessment of official shell-shock treatment. There was also a real conflict between the government's wish to forget shell shock whilst memorialising the war and remembering the war dead. As a result of these contradictions, shell shock was not forgotten, on the contrary, the shell-shocked soldier quickly grew to symbolise the confusions and inconsistencies of the Great War.

By 2030, the world will be short of approximately 15 million health workers - a fifth of the workforce needed to keep healthcare systems going. Global healthcare leader and award-winning author, Dr Mark Britnell, uses his unique insights from advising governments, executives, and clinicians in more than 70 countries, to present solutions to this impending crisis. Human: Solving the Global Workforce Crisis in Healthcare, calls for a reframing of the global debate about health and national wealth, and invites us to deal with this problem in new and adaptive ways that drive economic and human prosperity. Harnessing technology, it asks us to reimagine new models of care and levels of workforce agility. Drawing on experiences ranging from the world's most advanced hospitals to revolutionary new approaches in India and Africa, Dr Mark Britnell makes it clear what works - and what does not. Short and concise, this book gives a truly global perspective on the fundamental workforce issues facing health systems today.