HST2512: Shell-Shock to Prozac: Mental Health in Britain

20 credits (semester 2)

Module Leader: Dr Chris Millard

Module Summary

The history of psychiatry and mental health in Britain is full of scandal and science, compassion and brutality. The sweep of the twentieth century shows both remarkable progress and lengthy stagnation. We will approach themes such as mental health stigma, the fraught relationship between psychiatry and science, and how different ideas of body and mind circulate in medical and social science. Central to the course will be analysis of the ways in which diagnoses, treatments and restrictions impact differently on men and women: from the enduring legacy of hysteria, to the damaging gender difference in diagnosis of ‘personality disorders’, though ides of mental wellbeing that blame mothers and mothering for widespread social problems and mental disorders. We shall also see how government and the legal system is intimately involved with mental health, alongside the changing roles of psychiatrists, general practitioners, nurses and social workers.

At the beginning of the century, the majority of formal mental healthcare was still based in the imposing and isolated Victorian asylums. The First World War thrust psychiatry headlong into the theatre of modern technological warfare, as some units became overwhelmed with ‘war neurosis’, ‘battle fatigue’ or ‘shell-shock’. From here, we take in the rise and fall of Freud and the spread of his scandalous ideas on infants’ sexual drives, penis envy and castration anxiety. We shall analyse two important Royal Commission reports on mental healthcare (The Macmillan Commission (1926) and the Percy Commission (1957)), both of which formed the basis for wide-ranging legislation.

We shall analyse the closure of the asylums and the rise of ‘community care’. A number of exposés about the terrible conditions in mental healthcare in the 1970s (especially geriatric mental health) prompt further discussions about change. We will also examine the ideas of the ‘anti-psychiatry’ movement (including those of RD Laing), as well as a number of moves to root mental healthcare in general hospitals and local clinics. The important issue of patient/survivor activism (including personal testimonies of mental ill-health and treatment), along with the patients’ rights movement of the 1980s will be considered also. Finally we look at the increasing use of psychoactive medication, culminating in the fervour around Prozac in the 1990s, the roots of the current the epidemics of depression and self-harm, and contemporary discussions arguing for ‘parity of esteem’ between mental and physical health.

Recommended Reading:

Roy Porter, Madness: A Brief History (Oxford, 2002)

Lisa Appignanesi, Mad, Bad and Sad: A History of Women and the Mind Doctors from 1800 to the Present (London, 2008)

Edward Shorter, From the Age of the Asylum to the Age of Prozac (London, 1996)

Elaine Showalter, The Female Malady: Women, Madness and English Culture: 1830-1980 (New York, 1985)

Tom Burns, Our Necessary Shadow: The Nature and Meaning of Psychiatry (London, 2014)

Elizabeth Lunbeck, The Psychiatric Persuasion: Knowledge, Gender and Power in Modern America (Princeton, NJ 1996)

Ian Dowbiggin, The Quest for Mental Health: A Tale of Science, Medicine, Scandal, Sorrow, and Mass Society (Cambridge, 2011)

Vicky Long, Destigmatizing Mental Illness? Professional Politics and Public Education in Britain 1870-1970 (Manchester, 2014)

Roberta Bivins & John Pickstone (eds), Medicine, Madness and Social History Essays in Honour of Roy Porter (Basingstoke, 2007)


The module has five broad aims:

  • To help students to analyse, historicise and (where necessary) challenge ideas around mental healthcare and mental health issues.
  • To promote awareness of the value of historical insight for contemporary issues.
  • To build the confidence of students in analysing and criticising scholarly literature.
  • To develop the capacity of students to express their opinions.
  • To develop the capacity of students to provide historical evidence for their arguments.

Teaching and Assessment

The module will be taught through eleven lectures and eleven seminars. Lectures will examine particular events and developments in the history of psychiatry in Britain in the twentieth century, while seminars will focus on historians’ and students’ interpretations of those events. Formative feedback on both written work and oral participation will help prepare students for the summative assessment.

The module will be assessed in part by one formative essay, which will allow students to advance their understanding of aspects of the module in more detail, to develop skills of analysis and argument, and to improve their writing. Formative feedback will offer advice on how to improve for the forthcoming summative assessment. A written examination will require students to demonstrate that they have absorbed and understood the material and that they can express this in clear prose and a structured argument.

Information on assessment can be found at: http://www.sheffield.ac.uk/history/current_students/undergraduate/assessment/level2

Intended Learning Outcomes
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