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A Man Ahead of His Time
Last week I came across an obituary of Dr Jim Birley, a psychiatrist who died last month aged 85. He was regarded as the ‘caring face of psychiatry’. I must confess to never having heard of him before, but certainly when I read the article I had heard of many of the modern day psychiatrists who were influenced by his work. What is so impressive about his life’s work is how many of the ideas that he introduced into working with people with mental illness, and particularly schizophrenia, are now part of mainstream modern ways of working.
He started work at the Maudsley Hospital in London in the 1960s where he became aware of the social and family impact on people’s mental health . He wasn’t just focussed on the biological causes of major mental illness. He conducted research showing the impact of stressful life events on the development of schizophrenia. In the 1960s such thinking was revolutionary. Now it is mainstream thinking that the impact of stressful life events (unemployment, divorce, moving house etc.) can cause relapse.
Jim Birley was at the forefront of developing supported accommodation for people with mental illness, encouraging moves from hospital, not to an uncaring community, but to accommodation which came with staff support. Similarly he was involved in developing industrial therapy units, understanding the importance of useful occupation for us all. He also developed local community and out-patients services and walk-in emergency clinics, perhaps the forefront to the modern day community mental health teams and crisis resolution teams.
He was a major influence in the development of training for mental health nurses to take a psycho-educational approach to working with people with schizophrenia and their families – providing education and information to patients and their families to try and reduce stresses in their lives and improve coping strategies.
BBC Radio 4’s ‘All in the Mind’ programme has just celebrated 25 years of broadcasting by hosting a debate on attitudes to mental health, and how public attitudes are slowly but surely changing. When I first started working in mental health in the 1980s attitudes amongst some professionals was about how a diagnosis of mental illness meant being consigned to a life on medication without any prospect of leading a full life. Thankfully those attitudes have changed. Last week was Stand Up for Schizophrenia week, where people with schizophrenia were sharing their stories about what it means to have the diagnosis, and what helps and what hinders in promoting recovery. I’m sure Dr Birley would have approved.
David Beckingham – QCS Expert Mental Health Contributor