The 1996 Conference of the Team for the Assessment of Psychiatric Services attracted a larger audience than ever, including many from overseas. Dr Douglas Bennett looked at the historical evolution of community services over a 50-year period, in which no grand plan can be found. It has been a step-by-step process in which each step has followed either a successful innovation by pioneering psychiatrists, some advance in medical treatment, or a political or social change in our society. In his own experience of working with Dr Maxwell Jones at Belmont Hospital, he had not realised at first how revolutionary it was then for the staff to meet in groups. Wartime experience, when some of the traditional restrictions had to be given up, influenced some medical superintendents to open the doors of their hospitals in the 1950s. When industrial therapy introduced paid work, it provided an adult social role to those from whom nothing had been expected up to then. For chronic patients, social changes were the most important ones; in the 1950s, these started to release both patients and staff from the separate world they had inhabited up to then. The mental hospital ceased to be seen as the centre of psychiatric care; it was replaced by the comprehensive mental health service for a district.
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