Self-Harm as a Result of Domestic Distress

  • Chris Millard
Open Access
Part of the Mental Health in Historical Perspective book series (MHHP)


Minister of Health Enoch Powell’s Hospital Plan for England and Wales (1962) is a familiar landmark in twentieth-century psychiatry.1 In 1961 Powell’s ‘water tower’ speech to the National Association of Mental Health eloquently launches the ideas contained within the plan.2 It is an evocative portrayal of asylums as grand, obsolete monuments to Victorian ideas of mental-health care. There is much historiographical focus upon how the plan augurs the scaling back of mental inpatient provision, but much less on how it signals the broader uptake of a new model of integration between psychiatry and general medicine. This model, based upon the establishment of psychiatric units in district general hospitals (DGHs), involves a more intimate connection between general hospitals and psychiatry than do observation wards. The DGH psychiatric units promoted by the plan undercut the progressive status and bridging function of the observation ward.


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© Chris Millard 2015

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Authors and Affiliations

  • Chris Millard
    • 1
  1. 1.Queen MaryUniversity of LondonUK

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