The closing decades of the twentieth century brought a rising and sustained critique of the welfare institutions of the modern state – one largely left-wing in origins but increasingly taken over and voiced by the radical right. Professions which professed to be ‘enabling’ were, claimed a rising chorus of critics, ‘disabling’. Social services which presented themselves as benign were, in reality, ‘insidious’, serving the interests of providers not consumers, promoting professional dominance, policing deviance and intensifying the social control required to ensure the smooth running of multinational capitalist corporations – or, in the right-wing version, such institutions were wasting tax-payers' money on scroungers and so encouraging malingering.

Unsurprisingly, such political critiques of ‘welfarism’ (in its widest sense) spawned histories of their own. Replacing various kinds of Fabian, ‘Whig’ or celebratory historical interpretations which had treated the emergence of the ‘caring professions’ and social-security institutions as beneficial and progressive – as shifts from neglect to administrative attention, from cruelty to care, and from ignorance to expertise – a new brand of studies took altogether a more negative or jaundiced view of such social institutions and policies, and sought to blow their benevolent ideological cover.

In no field were the new and critical histories more critical, indeed more indignantly impassioned, than the history of psychiatry. Traditional ‘in-house’ and Whig histories of the care of the insane had never been particularly triumphalist – after all, psychiatry had always been a house divided against itself, uneasy in its stance towards both the public and the medical profession at large, and aware of its embarrassing want of ‘magic bullets’.