Further thoughts on the process of restraint

The physical restraint of a disturbed person is a subject constant of psychiatry and is a challenge that particularly faces nurses working in acute inpatient settings. While other approaches to psychiatric treatment have been discarded (e.g. punishment, blood letting, trepanation, deep insulin therapy and so on) or evolved into new treatments (the use of medication), the act of physical restraint has remained largely unmodified. Given the ubiquity of physical restraint in psychiatry, particularly as a nursing procedure, the absence of a sustained body of research is notable. This essay examines some of the historical underpinnings of the use of restraint in psychiatry brought into sharp focus by the David Bennett Inquiry Report (2003) and the National Institute of Clinical Effective (NICE) guidelines (2005) on the management of violence

'Without decontextualisation': the Stanley Royd Museum and the progressive history of mental health care

This paper builds on recent scholarship exploring museum exhibitions and the heritage of mental health care. Using the development of the Stanley Royd Museum in the mid-1970s as a case study, the paper will examine the rationale for the opening of the museum and its link to changing perceptions of mental hospitals in both historical study and what was then ‘current’ practice. It will then provide an overview of the proposed audience for the new museum and briefly analyse its success in communicating its history to its visitors. Ultimately, it will question how successful mental health professionals were in presenting the progressive nature of institutional care at a time when the system was being radically overhauled and reoriente

A Psychosocial Understanding of Personality Disorder: the historical problem of Moral Insanity

Various terms such as ‘psychopath’ and ‘antisocial personality disorder’ have been used at different times to describe individuals who act, with no apparent remorse, with great callousness causing disruption and distress around them. Despite being formally described within medical texts for many years the status of these diagnoses remains highly contested both within and outside of psychiatry. It will be argued that a psychosocial perspective can firstly help us to understand why this and related categories of mental disorder have been so contentious and secondly may also point us towards more useful ways of understanding the phenomena. Two points about a psychosocial perspective are raised in this chapter. Firstly, consistent with the premise this book there is the engagement with the social and cultural significance of emotion. Secondly there is the need to cross disciplinary fissures; not only trying to bridge the most obvious gaps between the psychological and the sociological, between the individual and the cultural, but also most notably in this case the analysis benefits from historical context