university of bristol · 2017-12-12 · movement, an attack on psychiatry by psychiatrists...

University of Bristol

Department of Historical Studies

Best undergraduate dissertations of

2016

Clare Ford

Mind the Gap: A history of Mind and the impact of the 1960s Civil Rights Movement on its development

The Department of Historical Studies at the University of Bristol is com-

mitted to the advancement of historical knowledge and understanding, and

to research of the highest order. Our undergraduates are part of that en-

deavour.

Since 2009, the Department has published the best of the annual disserta-

tions produced by our final year undergraduates in recognition of the ex-

cellent research work being undertaken by our students.

This was one of the best of this year’s final year undergraduate disserta-

tions.

Please note: this dissertation is published in the state it was submitted for

examination. Thus the author has not been able to correct errors and/or

departures from departmental guidelines for the presentation of

dissertations (e.g. in the formatting of its footnotes and bibliography).

© The author, 2016

All rights reserved. No part of this publication may be reproduced, stored

in a retrieval system, or transmitted by any means without the prior

permission in writing of the author, or as expressly permitted by law.

All citations of this work must be properly acknowledged.

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MindtheGap:AhistoryofMindandthe

impactofthe1960sCivilRightsMovement

onitsdevelopment

Figure1:CurrentMindmotto:http://www.mind.org.uk/[Accessed10/04/2016]

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CONTENTS

AbbreviationList......................................................................................5

Introduction................................................................................................6

Chapter1:AChangingFace..............................................................12

Chapter2:ACivilRightsBasedApproach..................................21

Chapter3:GivingPatientsaVoice..................................................27

Conclusions...............................................................................................34

Appendices................................................................................................36

Bibliography.............................................................................................39

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ABBREVIATIONLIST

NAMH:TheNationalAssociationforMentalHealth

NCCL:TheNationalCouncilforCivilLiberties

SANE:Schizophrenia,ANationalEmergency

SSO:SurvivorsSpeakOut

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INTRODUCTION

‘Theartofvoluntarywork is tobe in tunewith the timesand to

knowhowtoplaythetuneintherightkey’.1

In 1946, three inter-war voluntary groups, the Central Association for Mental

Welfare,theNationalCouncilforMentalHygiene,andtheChildGuidanceCouncil

merged to form the National Association for Mental Health (NAMH). Their

unificationfollowedarecommendationfromthe1939reportoftheFeversham

Committee, The Voluntary Mental Health Services. NAMH went on to become

Mind,theleadingmentalhealthcharityinEnglandandWales,whichhasplayed

a prominent role in transforming the entire approach tomental health in the

UK.2The charity has been a key agentwithin themental health field, active in

campaigningandlobbyingnationallyonmentalhealthsufferers’behalf,andwith

mentalhealthissuescurrentlyaffectingoneinfour,theworkofMindisrelevant,

important,anddeservingofhistoricalattention.

ThedevelopmentofMindfromNAMHisofparticularinterest.A1969articlein

Hospital World proclaimed it had ‘developed from a polite, reassuring body,

uttering words of comfort to all those involved with mental health, to an

organisation firmly on the side of the patient, not at all scared of speaking its

mind’.3This dissertation seeks to investigateMind’s evolution from a group of

‘polite’philanthropists, intoabottom-up,active,lobbyinggroupandtheimpact

onthisevolutionofthe1960scivilrightsmovement.Thispaper’sopeningquote

comesfromareflectivearticlebyMaryApplebey,NAMH’sDirectorfrom1954-

1971.Itechoesthisdissertation’scentralargument:thattheAssociation,‘intune

with its times’ evolved into Mind as a consequence of changes in the social

context in which it operated and, in particular, changes in that social context

arisingfromtheimpactofthecivilrightsmovement.

1M.Applebey,‘Thirtyyearson’,MINDOUT20(January/February1977),10.2NB-Terminologywill beused appropriate to theperiodbeing referred to:NAMH (1946-72),MIND(1972-90s),andMind(1990s-current).3QuotedinK.Darton,‘AHistoryofMindFactsheet’(2012),6.

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Mind’shistoryandevolutionwillbereadagainstthebackdropofsocialchange

that occurred internationally during the 1960s. The decade saw a number of

scandalsconcerningmentalhospitalsinBritainandtheriseofachargedcritique

ofpsychiatry.PublicallegationsresultedinformalinquiriesofbothElyHospital

(1969) and Farleigh Hospital (1971). A discourse had been building in the

academic sphere highlighting the dehumanising nature of ‘total institutions’ in

which Erving Goffman, Russell Barton, andWing andBrownwere influential.4

Furtherdoubtoverthelegitimacyofpsychiatryarosewiththe ‘anti-psychiatry’

movement,anattackonpsychiatrybypsychiatriststhemselves,includingDavid

Cooper, Ronald Laing andThomas Szasz.5Furthermore, the Scientologistswho

viewed psychiatry as ‘a system of murder, sexual perversion and monstrous

crueltyandNAMHasacriminallymotivated“psychiatricfrontgroup”’attacked

NAMHdirectlywhenattemptingatakeover in1969.6Acourtcaseresolvedthe

matter in the Association’s favour, although Mind’s official history recognised

that this ‘encounter may have contributed to [its] shift in emphasis’ in the

1970s.7TheriseofScientologyandtheanti-psychiatrymovementwereelements

of a wider period of social and intellectual change, described by Mathew

Thomson as ‘a melting pot of movements and ideas... in the closely

interconnectedworld of the counterculture’.8It is this paper’s contention that

the entire period of social evolution, but most specifically the civil rights

movement,influencedMind’sdirectionandapproachinthe1970s.

Thecivilrightsmovementthatcommencedinthelate1950ssawthefirstmajor

challenge to a post-war consensus. Organised by and for black Americans, it

nonethelesssoughttoattainsuchbasicvaluesasrespectandequalrightsforall,

andwas a catalyst for further socialmovements globally as vulnerable groups

4See J. Martin,Hospitals inTrouble (Oxford, 1984); E. Goffman,Asylums (New York, 1961); R.Barton, Institutional Neurosis (London, 1959); J. Wing and G. Brown, Institutionalism andSchizophrenia(Cambridge,1970).5D.Cooper,PsychiatryandAnti-Psychiatry(London,1967);R.Laing,ThePoliticsofExperienceandThe Bird of Paradise (Harmondsworth, 1967); T. Szasz, TheMyth ofMental Illness (New York,1961).6C. Rolph, BelieveWhat You Like:What Happened Between the Scientologists and the NationalAssociationforMentalHealth(London,1973),138.7Darton,‘AHistoryofMindFactsheet’,6.8M.Thomson,PsychologicalSubjects:Identity,Culture,andHealthinTwentieth-CenturyBritain(Oxford,2006),272.

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embraced the newfound culture of fighting for their rights. This dissertation

hopes to fill a historiographical lacuna:whilemuch literature concentrates on

theprofoundeffectofthecivilrightsmovementsuponothersocialmovements

(e.g. women’s movements, gay movements and anti-war movements) little is

written about the influence of the civil rights movement upon psychiatry.9

Scholarship also neglects the historical importance of social movements and

social movement organisations on the field of psychiatry more generally. A

handful of sociological studies including Rogers and Pilgrim’s account of the

Mental Health Users’ Movement and Nick Crossley’s Contesting Psychiatry are

exceptions that have explored social movements in mental health.10However,

whilethesefindingshavehelpedinformthispaper’sdirection,theyconcentrate

on the emergence of such groups as a sociological phenomenon rather than

providinganhistoricalanalysis.

Although Mind remains under-researched given its status within the mental

health field, historians Ann Claytor and Johnathan Toms have given the

organisation somehistorical attention:Claytor analysesMindwithinher study

on the emergence of anti-psychiatry, and Toms does so whilst exploring the

mentalhygienemovement.11Nevertheless,thisstudyisuniqueforitisdedicated

in its entirety to the history of Mind. It will analyse the historical causes and

implications of its transformation andwill do so by critically examiningMind

againstthebackgroundofsocialchangeofthe1960s.

Literature concerning charitable organisations in Britain has focused on the

influences on voluntary agencies and their changing role over time. Marilyn

Taylor has proposed that the Government, as both a ‘significant funder’ and

‘regulator’, ‘makes a significant contribution to the climate of opinion that

9SeeJ.FreemanandV.Johnson(eds.),WavesofProtest(Lanham,1999)andJ.Clements,‘ParticipatoryDemocracy:TheBridgefromCivilRightstoWomen’sRights’,AmericanPoliticalScienceAssociation(Philadelphia,2003),5-24.10A.RogersandD.Pilgrim,‘Pullingdownchurches:AccountingfortheBritishmentalhealthusersmovement, Sociology of Health and Illness 13:2, (1991) 129-148; N. Crossley, ContestingPsychiatry:SocialMovementsinMentalHealth(2006).11A.Claytor,AChangingFaith?AHistoryofDevelopmentsinRadicalCritiquesofPsychiatrysincethe 1960s (Sheffield, 1993); J. Toms, Mental Hygiene and Psychiatry in Modern Britain(Basingstoke,2013).

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surrounds the work of voluntary agencies’.12The Government has certainly

influencedMind,particularly in theeraofNAMHwhenthe funding itprovided

constituted a far higher proportion of its income than in more recent years.

However,by1978,MINDwascommentingthat‘thoughwereceivemoneyfrom

central government,we reserve the right to criticise itspolicies’.13This change

reflects the impactofpublic opinion in aneraof changingattitudes.AsNaomi

Connellyhashighlighted,andaswillbearguedinthisdissertation,amajorcause

ofchangeinthevoluntarysectorinBritainhasbeen‘agreaterpublicawareness

ofandconcernwith…equalopportunities’.14

Mindisaninterestingcasestudy,particularlywhenconsideredinthecontextof

the studies (by historians including Peter Hall and David Hammack) on the

influence of 1960s radicalism and social movements upon voluntary

organisations. Hall asserts that ‘the logic and methods of [the civil rights

movement]were embraced’ by charities, resulting in ‘advocacy-oriented social

movementactivity’.15Similarly,Hammackcreditsthecivilrightsmovementasa

principal factor accountable for the ‘remarkable expansion of the non-profit

sectorsince1960’.16WhilstcentredonAmericansociety,Hammackarguesthis

of‘bothsidesoftheAtlantic’.17Thesehypotheseswillthusbeappliedtothecase

studyofMind as aBritish charity to argue that the civil rightsmovementwas

instrumentalininstigatingthetransitionfromNAMHtoMind,andininforming

theorganisations’approachestowork.

Charles Murdock questioned in 1972 ‘whether the concept of civil rights is

sufficientlybroadtocovertherightsforwhichtheadvocatesof[thementallyill]

are contending’, and whilst a difference certainly exists between the two

situations, thisdissertationwill argue that thekeyprinciplesof thecivil rights

12M. Taylor, ‘Partnership: Insiders and Outsiders’ in D. Billis and M. Harris (eds.), VoluntaryAgencies:ChallengesofOrganisationandManagement(London,1996),15.13‘MINDAnnualReport1978-79’,4.14 N. Connelly, Between Apathy and Outrage: Voluntary Organisations in Multiracial Britain(Oxford,1990),50.15 P. Hall, ‘A Historical Overview of Philanthropy, Voluntary Associations, and Non-profitOrganisations’ inW.PowellandR.Steinberg(eds.),TheNon-profitSector:AResearchHandbook(NewHaven,2006),53.16D.Hammack,‘Growth,transformation,andquietrevolutioninthenon-profitsector’,Non-profitandVoluntarySectorQuarterly30:2(2001),165-7.17Hammack,‘Growth,transformation,andquietrevolution’,158.

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movementhave clearly influenced themental health field.18Caroline Swift and

GloriaLevinhavewrittenon the importanceofempowermentasan ‘emerging

mental health technology’, an ideology appropriatedmost prominently by the

civil rights movement.19Similarly, Judi Chamberlin, activist in the psychiatric

survivors’ movement and author of the pioneering text On Our Own, has

highlighted the usermovement’s principles of consciousness raising, collective

identity, and self-determination, which were borrowed from the civil rights

movement.20The concept of basic legal rights, a fundamental aim of the civil

rightsmovement,wasalsoagoal formentalhealthpatients. It is therefore the

central argumentof this thesis that theprinciplesof the civil rightsmovement

were fundamental in informing the transformation of the moderate ‘do-good’

NAMH into the liberal activist organisation that Mind became. Influenced

somewhat by the hospital scandals, Scientology and anti-psychiatry, butmore

considerablybythesuccessofthecivilrightsmovementanditscallforequality

forall,Mindbecamealobbyinggroupconcernedwithmentalpatients’rights.

Thispaper’sfindingsarebaseduponasystematicandcomprehensiveanalysisof

theMindarchives,which,havingonlyrecentlybeencataloguedattheWellcome

Collection,comprisepreviouslyunseenmaterial.Attentionhasbeenpaidtothe

charity’s Annual Reports, from its birth as NAMH, through to the early-1990s,

whenMind’s new personawas established. These provide an overview of the

charity’sworkandshedlightontheorganisation’s ‘official’voice.Nevertheless,

therearelimitationsinrelyingonAnnualReports.Firstly,awholeyear’sworkis

condensed into a small booklet, which, while providing a valuable overview,

lacks in-depth detail. Furthermore, as the organisation’s official Report,

controversial issues may not be explicitly acknowledged. To overcome these

limitations,theReportshavebeenreadalongsideMind’sjournals:MentalHealth

(1946-1971),MindandMentalHealth(1972-1973),MindOut(1973-1983),and

finally Open Mind (1983-1999). Published more frequently than the Reports,

18C.Murdock,‘CivilRightsoftheMentallyRetarded:SomeCriticalIssues’,NotreDameLawyer48:1(October1972),134.19C.SwiftandG.Levin,‘Empowerment:AnEmergingMentalHealthTechnology’,JournalofPrimaryPrevention8:1(September1987),72.20J.Chamberlin,OnOurOwn:PatientControlledAlternativestotheMentalHealthSystem(NYC,1978).

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theseprovidegreaterdetail, andwithcontributions fromcommitteemembers,

thepublic, andother interestedpersons, they shed light onboth acceptedand

controversialviewsoftheorganisation.

ThisanalysiswilllookexclusivelyattheworkofMindonanationalscale.Itwill

bedividedintothreesectionstohighlighttheprincipalwaysinwhichMindtook

on a civil rights stance and sought to transform the field ofmental health: by

campaigningtoraiseawarenessandchallengestigma,byinterveninginthelegal

field,andbyaligningwith theserviceusermovement.Firstly,Mind’sshift toa

campaigning stance in the 1970s will be analysed to show that there was a

turning point in their approach to raising awareness with a newfound focus

upon challenging stigma. Mind’s intervention in the legal field will then be

addressedtoarguethat,withtheappointmentofanAmericancivilrightslawyer,

therewasaclearshifttoacivilrightsbasedstancewhereMindbegantoactively

lobby for justice, and finally, by focusingonMind’s alignmentwith the service

usermovement,itwillbeshownthatMindembracedandencouragedthesixties

culturethatsawindividualsfightingfortheirownrights.

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CHAPTER1:AChangingFace-Campaigningtoraiseawarenessandchallengestigma

‘The mentally ill are not… divorced from our world and our

experience:theyare“we”andweare“they”’.21

ThelaunchoftheMINDcampaignin1971signalledaturningpointinthework

ofNAMHasaneweraofcampaigningtoraiseawarenessandchallengestigma

began.Thisdissertationcontendsthatthisisareflectionoftheinfluenceofthe

1960s, as an era of social change and consciousness raising, upon the

Association’soutlookandapproach.

Since itsbirth in1946,NAMHstressed the importanceofpubliceducationand

awareness, arranging educational lecture tours. In 1952, the Association

proposed that ‘themost encouraging sign’ of the year had ‘been the increased

awareness of mental health problems in the national press’, indicating that

awarenessraisinghadbeenimportantsincetheearlyyears.22Furthermore,the

first Mental Health Flag Day in 1954 was acknowledged by Chairman Lord

Feversham ‘as a remarkable trend in the increasing public recognition of the

magnitude of the problem’, stressing the ‘vital importance of informed public

opinion’.23Followingradioandtelevisionappeals,1954alsosawtheAssociation

establish a new Public Information Service. However, the purpose of this, as

statedbyFeversham,was‘tohelpthepublictoappreciatethedifficultiesunder

which the under-developed mental health services [were] labouring’.24This

intent to educate on the difficulties of the services stands in stark contrast to

MIND’s later aim,highlighted in theAnnualReportof1970/71, to educate the

public ‘so as to create an atmosphere of greater understanding and tolerance

towardsmentaldisorder inall itsforms’.25Whilstonthesurface, itappearsthat

in its early years NAMH was, like the later MIND, concerned with raising

awarenessandeducatingthepublic,uponcloseranalysis,thereisevidenceofa

shiftinintentandmethodofthiseducation.MINDbecameconcernedwithboth

21‘MINDManifesto1971’,1.22‘NAMHAnnualReport1951-52’,23.23‘NAMHAnnualReport1954-55’,4.24‘NAMHAnnualReport1954-55’,5.25‘NAMHAnnualReport1970-71’,9.

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raisingawarenessoftheoccurrenceofmentalillness,‘thegreatestsocialevilin

Britain’, and challenging the stigma attached to the label ‘mentally ill’.26The

campaigning style that MIND adopted also differed strikingly from their

paternalistic,educationalapproachofthepreviousdecades.

Chamberlin has suggested that a guiding principle of the psychiatric-user

movement, previously used by movements of the 1960s, was consciousness-

raising. 27 MIND’s inaugural ‘MIND campaign’ clearly demonstrated its

transformation into a campaigning group. Launched in 1971 to celebrate the

Association’stwenty-fifthanniversary, thecampaignhadsevenmainobjectives

including improving services, fundraising, and sponsoring research. The most

important aims, ‘to create concern... challenge apathy and neglect’ and ‘to

overcomeignorance’,centreduponraisingawarenessandchallengingstigma.28

In this sense, MIND was subscribing to the consciousness-raising principle

typical of the socialmovements of the1960s.Thepoignantquote that opened

this chapter encapsulates MIND’s alignment with the ethos of equality that

epitomisedthesocialmovementsofthe1960s;‘theyare“we”andweare“they”’

echoes the fight for equal-rights that spanned nations and social groups

throughoutthesixties.

The success of the MIND campaign resulted in a permanent change in the

organisation,with theadoptionofMINDasNAMH’snewname, representinga

wider change for the organisation. Under the name MIND, NAMH became

engagedinprotestingforchangeasanenergeticallychargedpoliticalcampaign

group. This change can be seen in the Association’s journal: what used to be

MentalHealthbecameMINDOUTin1973.TheopeningissuedescribedNAMH’s

transition into MIND as the organisation ‘became an on-going campaign’, and

remarked that MIND OUT would be covering subjects ‘like controversial

treatment methods’ and ‘patients’ rights’. 29 NAMH also employed different

languagetospeakofthementallyill.AnalysingtheAssociation’sterminologyin

26‘NAMHAnnualReport1970-71’,3.27J. Chamberlin, ‘TheEx-Patients’Movement:WhereWe’veBeen andWhereWe’reGoing’TheJournalofMindandBehaviour11:3-4(1990),326.28‘NAMHAnnualReport1970-71’,1.29MINDOUT1(Spring1973),2.

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the ‘Aims and Objectives’ sections within Annual Reports reveals a shift over

time. The table in Appendix 1 shows that MIND gradually replaced NAMH’s

favouredterms‘mentallysubnormalanddefective’with‘mentallyill’and‘users’.

ThischangewasinlinewithMIND’snewpersonaandalliancewiththementally

ill; the derogatory terms that branded mental patients as ‘subnormal’ and

‘defective’ were gradually replacedwith themore normative categorisation of

being‘ill’.

Public opinionwas a key factor in the transformation of NAMH. Although the

Associationwas reliant upon the Government for funds (which, as Taylor has

highlighted, is typical of British charities), the organisation also depended on

public donations to continue its work. As Figure 2 demonstrates, a large

proportionofMIND’stotal incomehasbeenvoluntaryinrecentdecades.While

voluntaryincomefiguresareonlyavailablefrom1976onwards,reportsconfirm

thatdonationswereaconstantfeaturesincetheAssociation’sbirth.However,in

its early years, NAMH relied far more heavily on the state for funding. The

Account Sheet for 1961/2 (seeAppendix 2) reveals that publicmoney (grants

fromtheMinistryofHealthandsubscriptionsfromlocalauthoritiesandhospital

boards) totalled £26,408whereas public donations andmember subscriptions

came to just £5,157. It is thus unsurprising, given its reliance upon the

Government,thatatthattimeinitshistory,theAssociationwasinclinedtoside

withtheestablishment.

A shortage of funds in the 1960s, which saw NAMH in ‘dire financial straits’

according to the Annual Report of 1969-70, was the result of broader social

change.30The Association sought to increase voluntary income. Following a

decadeofgreatchange, thepaternalisticstanceof traditionalcharities, suchas

NAMH, clashed with modern democratic ideologies. Tom Buchanan has

highlightedhowtheNationalCouncilforCivilLiberties(NCCL)hadslumpedinto

‘a “slow decline”, both in terms ofmembership and financial resources,which

reacheda“nadir”intheearly1960s’,butitsuccessfullyrevivedbyrespondingto

30‘NAMHAnnualReport1969-70’,1.

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‘thechangedclimateofthelater1960s’.31Crossleycorroboratesthis,suggesting

thatNCCLsuccessfully‘frameditscritiquewithinthenewlyemergingdiscourse

ofcivilrights’.32Likewise,NAMHrespondedtotheirowndeclineintheformof

theMINDcampaignandtheirsubsequentreinventionasMINDasareactionto

shifting public opinion and the new campaigning environment of the 1960s.

While, as Figure2 demonstrates, incomeonly truly began to soar towards the

endofthetwentiethcentury,MIND’sprofilegrewsignificantlyduringthe1970s,

asmembershipnumbersinFigure7(p25)demonstrate.

Figure2:VoluntaryandtotalincomeofMind,1948-2008(adjustedforinflation,2009)

N.B:Voluntaryincomefiguresareonlyavailablefrom1976onwards33

AprominentfeatureoftheMINDcampaignwasitsattempttoremovethestigma

associatedwithmentalillness.Byusingpicturesof‘normal’lookingpeople,and

informing the public that ‘your familymay be the next in need’, the campaign

engagedwithsocietyonapersonallevel,framingmentalillnessasaconcernfor

thewholenation.34ThefirstissueofMINDOUTwarnedthatmentalhealth‘does

concernyouwhetheryouwantittoornot’.35Figure3,aposterusedduringthe

MINDcampaign,illustratesMIND’saimtohighlighthowmentalhealthcanaffect

anybodywithinsociety.Ayoung,seeminglyhappyboyisthefaceoftheposter.31T.BuchananinN.Crowsonetal.,NGOsinContemporaryBritain(Basingstoke,2009),120.32Crossley,ContestingPsychiatry,83.33M.Hiltonetal.,AHistoricalGuidetoNGOsinBritain,(Basingstoke,2012),166.34‘MINDManifesto1971’,4.35MINDOUT1(Spring1973),2.

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This image contrasts with the stereotype, informed by exaggerated cultural

representations, that the nation would have held of the mentally ill. One

portrayal of the insane that starkly contrasts with MIND’s is the character of

NormanBates inAlfredHitchcock’s 1960 film,Psycho. AlthoughAmerican, the

filmwasreleasedinBritaininthesameyearandwaswellreceived,describedas

a ‘masterpiece’ byTheObserver and ‘grisly but exciting’ byTheGuardian.36As

Figure4displays,thepsychopathicmurderouscharacter,asuffererofcatatonic

schizophrenia, is depicted as a chilling menace, with staring-eyes and an

unnervinggrimace.AlthoughthepublicwouldhaveappreciatedthatHitchcock’s

depiction of insanitywas fictitious, it is reasonable to assume that thiswidely

popularisedfilmwouldhaveinfluencedpublicconceptionsofthementallyill.It

was thisstigmatisationthatMINDaimedtocondemn,as theydid inprotesting

against the advertisement for Schizo, the 1976 film which is reminiscent of

Pscyho in its depiction of schizophrenia. They criticised the negative ‘publicity

which gives an entirely false definition of a very common illness’.37In tackling

suchstigmatisationthroughtheMINDcampaign,NAMHchangedtheirownface,

andthatofthementalpatient.

Figure3:MINDCampaignposter38

36K.Tynan, ‘ASeaofColdSweat’TheObserver (London,18/12/1960),18; ‘At theCinema’,TheGuardian(London,1/09/1960),15.37MINDOUT21(March/April1977),19.38MINDCampaignPoster(1971).

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Figure4:AlfredHitchcock’sNormanBatesinPsycho(1960)39

A further,moreexplicitdemonstrationofMINDchallengingstigmaoccurred in

1988-9, when the organisation clashed with another voluntary group,

Schizophrenia:ANationalEmergency(SANE).Inthe1980sMINDwasconcerned

bythe‘hostilestereotypedimagesof“schizophrenics”’usedbySANEtogenerate

concern about the ‘national emergency’.40SANE’s publicity campaign of 1988,

produced various poster advertisements depicting schizophrenia as ‘the

delusions of a disturbed mind’.41Figure 5 is one example. Forgiving the poor

quality, one can identify the close-up image of a woman’s face with a vacant

expression. Superimposed over the photograph read the words: ‘SHE THINKS

YOUWANTTOKILLHER.YOUTHINKSHEWANTSTOKILLYOU.THEYTHINK

SHE’LL GO AWAY.’ Another poster featured a similarly expressionless man,

reminiscent somewhat of Hitchcock’s Bates, overlaid with the words: ‘HE

THINKSHE’SJESUS.YOUTHINKHE’SAKILLER.THEYTHINKHE’SFINE’.

39A.Hitchcock,Psycho(1960),Author’sscreenshot.40‘MINDAnnualReport1988/89’,10.41M.Davidson,TheConsumeristManifesto:AdvertisinginPost-ModernTimes(London,2013),86.

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Figure5:PosterfromSANE’scampaign,‘StoptheMadness’42

The posters were displayed at railway, tube, and bus stations, much to the

frustration of MIND who complained to the Advertising Standards Authority

(ASA)andBritishRail.WhileBritishRailremovedtheposters,theASA,despite

acknowledging their potential to cause offence, maintained that some

schizophrenics exhibit ‘behaviour of the kind depicted’ so a distorted picture

wasnotbeingpresented.43MIND’sownoutlookonthematterwasreiteratedin

OpenMind:

Are we teetering on the edge of a new authoritarian age of

incarceration – particularly for people with serious mental

health problems?... If [public transport travellers] half closed

42FromA.Roberts,‘MentalHealthHistoryTimeline’(MiddlesexUniversity,1981-),http://studymore.org.uk/mhhtim.htm [Accessed 18/04/16] 43OpenMind38(April/May1989),8.

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their eyes, what key words stood out? Killer. Voices. Lies.

Nothing. Jesus. Madness. Their conclusionmight well be that

not only did ‘those people’ inhabit some completely different

world but also that ‘those people’ pose a particularly awful

menace,thetruedimensionsofwhichcanonlybealludedtoin

public.44

Not onlywasMIND opposed to the stereotyped images used by SANE, SANE’s

belief in the medical model of schizophrenia and the hospitalisation of the

mentally illalsocontradictedMIND’srights-basedapproachandpropagationof

the benefits of care in the community. This can be seen in MIND’s counter-

campaign of 1989. Different wording was applied to the same staring-eyed,

hollowlookingmanwho‘thoughthewasJesus’.Figure6depictsMIND’sposter,

with the text reading ‘THEY SAY I SHOULD BE SHUT AWAY. THEY SAY THEY

KNOW WHAT’S GOOD FOR ME. I HAVE NO SAY!’ This emphasised MIND’s

antagonismtowardsSANE’spromotionofhospital care, suggesting thisneed to

‘beshutaway’wasevidenceofoppressionofthementallyill,who‘havenosay’.

While the content of MIND’s interactionwith SANE highlights their defence of

patients’ rights, MIND’s reaction also demonstrates the organisation’s charged

character,whichstoodinstarkcontrasttotheactivitiesoftheearlierNAMH.Asa

contemporary remarked on the eve of NAMH’s transition, the Association

‘decidedtoalteritsapproachfromrelativelyunobtrusivesocialworktoabrasive

stirring up of public opinion’.45MIND’s conflict with SANE demonstrates this

newfound energy and commitment to raise awareness and rouse opinion that

theyinheritedfromtheprecedingsocialmovementsofthe1960s.

44OpenMind38(April/May1989),3.45D.Wilson,‘Thetroubledminds’,TheObserver(London,14/2/1971),9.

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Figure6:PosterfromMIND’scounter-campaign,‘StoptheNeglect’46

Duetothechangingclimateofpublicopinioninthe1960s,andinanattemptto

garner support and financial backing from the public, NAMH underwent a

comprehensive transformation, evolving from a polite ‘do-good’ organisation

intoanactivecampaigninggroup.Centraltothistransformationwasthedesire

to raise awareness and challenge stigma, two values inherited from the social

movements that prevailed in the 1960s. Through the MIND campaign, NAMH

soughttochangethefaceofthementalhealthpatient,whohadbeenstereotyped

andpubliclyoutcastby societyas sociallydeviant. Indoing so, theAssociation

alsochangeditsown‘face’.

46‘MINDAnnualReport1988/9’,10.

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CHAPTER2:ACivilRightsbasedapproach–Interventioninthelegalfield

‘MIND has developed a lusty appetite for legal reform and the

issueofpatients’civilrights…’47

NAMH’sadoptionofacivilrightsbasedapproachfollowingitsrebirthasMIND

canbeseenintheorganisation’sinterventioninthelegalfield.Ashighlightedin

thechapter’sopeningquotebyAnthonyClare(thenMedicalAdviserofMIND),

the Association developed a ‘lusty appetite for legal reform’ in the years

following its rebrand. This newfound outlookwasmotivated by the successful

assertionoflegalrightsbythecivilrightsmovement:TheAmericanCivilRights

Actof1964,whichoutlaweddiscriminationbasedonrace,colour,religion,sex,

or national origin, was one of the crowning legislative achievements of the

movement,andencouragedsimilartriumphsinthementalhealthfield.

Before its transformation into MIND, patients’ rights were not a priority of

NAMH; the Association was inclined to ally with psychiatrists over patients,

particularly in the years preceding the 1959 Mental Health Act. When the

formationofthePercyCommission(whosepurposewastoassesstheextentto

whichpeoplewithmentaldisorderscouldbetreatedasvoluntarypatients)was

discussedbyNAMH inMentalHealth, itwasargued thatpatientsdidnotneed

protecting from doctors and psychiatrists. While the old legislation was

‘designedtopreventvictimisationbyunscrupulousdoctors’,NAMHmaintained

that this ‘is surelyunnecessary today’.48Furthermore,whengivingevidence to

thePercyCommission,theAssociationemphasisedtheneedtoensuretherights

ofthepublictobefreeofanypossibledangersposedbythementallyillrather

thanpatients’ rights.Thiswas reiterated in theParliamentary contributionsof

the Association’s Chairman, Lord Feversham, who stressed the importance of

‘protectionofthecommunity’.49

47A.Clare,MINDOUT48(April1981),17.48MentalHealth13:2(1954)50.49C.Feversham,‘TheLawRelatingtoMentalIllness’,HouseofLordsDebates207(19/02/1958),817.

22

The1950ssawNCCLlaunchapubliccampaignhighlightingconcernsaboutthe

treatmentandrightsofmentalhealthpatients.Thiswasuniqueforitstimeand

somewhatsurprisingly,givenMIND’s latercivilrightsbasedapproach,NAMH’s

response was negative. Minutes taken at an AGM document the Association’s

beliefthatNCCL‘whollyignorestheimmensebenefitsconferredondefectives’by

mentalinstitutions.50TotheAssociationatthistime,therightsofmentalhealth

patientswerenotaprimeconcern.Yet,withintwentyyears,theAssociationhad

fullyembracedacivilrightsbasedapproach.Itisthispaper’scontentionthatthis

isaresultof theAssociationembracingthechange inpublicopinion instigated

bythewidercivilrightsmovementsofthe1960s.

Althoughthesocialmovementsof the1960sweretheprincipal influenceupon

MIND’snewpersona,thetransformationreliedonkeyindividualstospearhead

thischange.Theappointmentin1974ofNCCL’sTonySmytheasMIND’sDirector

markedaturningpointintheorganisation’sattitudetothecivilrightsofmental

health patients. A tribute to Smythe in MIND OUT following his resignation

commended his ‘commitment to securing the rights and dignity of patients’.51

The mental health field progressed tremendously while Smythe was MIND’s

Director: the era witnessed both the radical transformation of MIND’s own

outlook and approach, and Government paying greater attention to mental

health issues: reforming legislation and granting patients the right to vote.

Smythe established a multi-disciplinary working party to review the 1959

MentalHealthAct, resulting in agreement that apermanentLegal andWelfare

Rights Officerwas required. American civil-liberties lawyer, Larry Gostin, was

employedinthiscapacityandwasalsoakeyproponentofchange.Gostinwasat

the forefront of MIND’s campaign to highlight the shortcomings of the 1959

Mental Health Act and in 1975,MIND’s publication ofAHumanCondition, the

firstofGostin’stwo-volumecritiqueoftheAct,laidoutcomprehensivedemands

forreform.

AHuman Condition called to re-embrace legalism. However, as Gostin himself

asserted, this was a ‘new legalism’ differing from that based on segregation

50‘NAMHMinutesoftheFifthAGM’,(09/01/1952).51MINDOUT55(November1981),2.

23

embodied in the 1890 Lunacy Act.52Two key principles underpinned it: the

‘ideology of entitlement’, (that patients should have enforceable rights to

requiredhealthservices);andthe‘leastrestrictivealternative’,(thattheyhavea

righttoexpecttobecaredforintheleastrestrictivealternativesetting).53Gostin

challenged the assumption that compulsory detention allowed for compulsory

treatment, proposing that in cases lacking consent, a multidisciplinary

committee should reviewavailable options before decidingwhether treatment

would be given. 54 He stressed that treatment involving ‘surgery, electro-

convulsivetherapyorexperimentaldrugsshallnotbegivenwithoutapproval’.55

Gostin’sproposalswereacteduponinthe1982MentalHealth(Amendment)Act

(consolidated in the1983MentalHealthAct),whichmadenotableadvances in

thementalhealthfield.Theseincluded:significantlyincreasingopportunitiesfor

tribunal review; providing patients appearing before Mental Health Review

Tribunals with an entitlement to public funding for legal representation;

establishing detailed regulation of consent, treatment and second opinions;

launchingaspecialhealthauthority(theMentalHealthActCommission)which

held a protective function over detained patients, and ensuring no voluntary

patient lost the right to vote. A Human Condition was highly influential in

achievingthesetriumphs.AsCliveUnsworthhasargued,thereformsinthe1983

MentalHealthAct are ‘in considerablepart attributable toproposals advanced

by Gostin’. Gostin too has acknowledged that approximately two-thirds of the

provisionsoftheActderivedfromproposalsheadvancedonbehalfofMIND.56

MIND’s role in shaping this legislation was only one way in which the

organisationintervenedinthelegalfield.MINDorganisedtrainingconferences,

publishedamanualforrepresentatives,andtheLegalandWelfareRightsService

defended patients and ex-patients in numerous cases. MIND won multiple

52L.Gostin,‘ContemporarySocialHistoricalPerspectivesonMentalHealthReform’,JournalofLawandSociety10:1(1983),47.53L.Gostin,‘Theideologyofentitlement’inP.Bean(ed.),MentalIllness:ChangesandTrends(NewYork,1983),49-50.54L.Gostin,AHumanCondition,Vol.1(London,1975),123-130.55Gostin,AHumanCondition1,152.56C.Unsworth,ThePoliticsofMentalHealthLegislation(Oxford,1987),317;Gostin,‘ContemporarySocialHistoricalPerspectives’,67.

24

ground-breakingrulingsontherightsofthementallyillincourt.Thisincludeda

victoryatWarringtonCountyCourtin1976,whichgave‘potentiallythousands’

of patients in mental hospitals the right to vote.57The ruling set a strong

precedent that MIND sought to consolidate by encouraging local health

authorities tosubmit ‘resident’patients’names to theelectoral register.Gostin

also brought cases before the European Court of Human Rights. One of the

organisation’s greatest legal achievements was a test case brought to the

European Court of Human Rights in 1981. The Court came to two unanimous

conclusions in its decision on the case of X vs. the United Kingdom [(1981) 4

EHRR]: that the Government was in breach of Article 5(2) of the European

ConventiononHumanRightsfornotprovidingthepatientwithreasonsforhis

detention,andArticle5(4)fornotprovidingarighttoaperiodicreviewincourt.

The rulinghad far-reaching implications that changed the landscapeofmental

health in Britain; it prevented the Home Secretary from making decisions

relating to thedetentionand recall of restrictedpatients, andentitledpatients

accesstocourtonaperiodicbasis.58

ThroughMIND’sinterventioninthelegalfield,itisclearthatbyprioritisingthe

rights of patients, they embraced the key principles of the 1960s civil rights

movement. Kathleen Jones has argued that, with their new civil rights based

approach and legal stance, MIND ‘rejected the duchesses-and-twin-set image,

alienatedsomeofitsprofessionalsupporters,andintroducednewtechniquesof

lobbyingandmediapublicity’.59ItisunquestionablethatMINDradicalisedtheir

image and assumed a new lobbying stance, and that theydid so at the cost of

professionalsupportistestamenttotheirdedicationtotheirnewoutlook,driven

by patients’ rights. Certainly, some psychiatrists opposed MIND’s change of

direction,particularlytheirnewlegalapproach,whichwasconsideredanattack

on psychiatrists’ professional authority. Martin Roth and Denis Hill are two

psychiatristswhowerevice-presidentsofMIND,andresignedinprotestin1980.

‘BelievingthatMINDcannolongerbesupportedasaninstrumentofitsoriginal

aim,Ihaveresigned’Rothstated,andsimilarly,thechangefromthe‘previously,

57MINDOUT21(March/April1977),5.58‘MINDAnnualReport1980-81’,10.59K.Jones,AsylumsandAfter,(London,1993)200.

25

muchrespectedNAMH’intothemoreconfrontationalMINDledHillto‘resignin

protest’. 60 Even Christopher Mayhew, MIND’s presidential figurehead,

endeavouredtodistanceMINDfromtherecommendationsofAHumanCondition

in1975andsubsequentlyresigned.61

Nevertheless,MIND’schangewasinresponsetoawidershift inpublicopinion

thatoccurredasaresultoftheclimateofthe1960s,andmembershipnumbers

suggest that the transformation was overall a welcome one. Figure 7

demonstratesthattotalmembershipofMINDsteadilyincreaseduntil1970when

there was a rapid expansion that saw members almost double from 1970 to

1973(thedurationoftheMINDcampaign).Althoughimmediatelyfollowingthis,

membership fell, one can assume that this was caused by the resignation of

disgruntled psychiatrists, for numbers rose rapidly again. Though not all of

MIND’smembersagreedwithitsadoptionofacivilrightsbasedstance,MIND’s

outlook was in line with the general publics’ attitudes, which is evident as

membershipclimaxedinthe1970s,whenMIND’snew‘face’wasfullyformed.

Figure7:NumberofmembersbelongingtoMind,1948-200762

60M.Roth,‘MINDanditspolicies’,TheTimes(London,13/09/1980),13;D.Hill,‘AttackonMINDofficial’TheTimes(London,27/05/1980),15.61C.Mayhew,‘MentalHealth’TheTimes(London,7/11/75),15.62Hiltonetal.,HistoricalGuidetoNGOs,166.

26

Thischapterhashighlightedhow,withitstransitiontoMIND,NAMH’sapproach

shifted to one akin to the civil rightsmovement of the 1960s, concernedwith

solidifying civil rights for mental health patients in law. Larry Gostin, who

brought his American civil rights stance to Britain, spearheaded MIND’s legal

venture,and,inachievingrevolutionaryrulings,successfullychangedthefieldof

mental health. By intervening in the legal arena, MIND demonstrated their

commitmenttopatients’rightsaboveallelse.NAMH’sinitialpriorityhadbeento

align with the psychiatrist, whereasMINDwas not afraid to lose professional

support in favour of achieving civil rights andpublic approval. Intervention in

the legal field allowed them to do this, and subsequently allowed them to

transformthelandscapeofmentalhealthinBritain.

27

CHAPTER 3: Giving patients a voice - Mind and the Service User

Movement

‘MINDexists togivea voiceanda forum to theneglectedand the

under-privileged...’63

This finalchapter tracesMIND’salignmentwith thementalhealthserviceuser

movement. Referred to simply as the ‘service user/survivormovement’, it is a

group of individuals who either access mental health services (users), or

accessedmentalhealthservices(survivors)andwhofightforimprovedservices

andequalrightsformentalhealthpatients.ThroughMIND’salignmentwiththe

movement,theorganisationbegantopresentacritiqueofpsychiatry.

Thereiscontentionovertheusermovement’sorigin:a2006articlebyDavidand

JoshuaRissmillerwascontroversially received.64TheRissmiller’sproposal that

the movement grew out of anti-psychiatry was severely rejected by internal

membersofthemovement.DavidOaks,DirectorofMindFreedomInternational,

criticisedthearticleforimposing‘falselabelsandaskewedhistoryonactivists

forhumanrightsinmentalhealth’,arguinginsteadthat‘wecreditthecivilrights

movementandourownexperiencesofpsychiatricabuseastheoriginalsources

ofourinspiration’.65PeterCampbell,afoundingmemberandthefirstsecretary

ofSurvivorsSpeakOut(SSO)likewisearguesthattheinfluenceofthecivilrights

movement upon psychiatric patients was natural: ‘the movement... towards

increasingcivilrightsfordisadvantagedgroupshadtotoucheventuallyonthose

diagnosedashavingamentalillness’,andbythe1980s,therewere‘substantial

numbersofpeoplewhohadbeenbroughtupinacivilrightsclimate’toinstigate

suchamovement.66Inasimilarvein,Chamberlinhasproposedthat,‘influenced

bytheblack,women’sandgayliberationmovements’,theex-patientmovement

63MINDOUT5(April1974),3.64D.Rissmillerand J.Rissmiller, ‘Evolutionof theAntipsychiatryMovement intoMentalHealthConsumerism’PsychiatricServices57:6(2006),863-866.65D.Oaks,‘TheEvolutionoftheConsumerMovement’,PsychiatricServices57:8(2006),1212.66P.Campbell,‘ThehistoryoftheusermovementintheUnitedKingdom’inT.Helleretal(eds.)MentalHealthMatters:AReader(London,1996),219.

28

was driven by ‘self-definition and self-determination’. 67 Alongside

consciousness-raisingandlegal-rights,anotherguidingprincipleborrowedfrom

the civil rights movement was the exclusion of non-patients. One current

network ofmental health patients that has certainly been influenced by these

principles is Mad Pride. Its ‘direct action’ approach, with ‘defiant displays of

ostentatiousmadness; riots; sabotage; andmedication strikes’ has undeniable

similarities with the action that characterised 1960smovements.68Links have

been drawn by the network, as they have exclaimed, ‘we themad community

demandequality,simple!Aswomen,gayandblackcommunitieshadtofightfor

thatrightsowillwe!’69

MIND’s role was influential in stimulating this service user movement. Most

simply,byconfrontingthestigmaassociatedwithmental illness,MINDcreated

anenvironment thatencouragedgrowingnumbersofpeople to ‘comeout’and

discuss their mental illness freely. A more direct link has been proposed,

however.Campbell,whileacknowledgingearlyprotestagainstthementalhealth

system, locates the ‘real flowering of service user action’ in the 1980s,

emphasising MIND’s joint conference with the World Federation for Mental

Health.70The1985conferencehosteddelegatesfromtheDutchusers’movement

who influenced British service users. MIND’s own annual conference of 1985

was also significant. Advertisements for the event highlighted that ‘for many

people…usingmentalhealthservicesbringsachangeinstatus.Peoplebecome

“patients” or “clients”, surrendering control of decisions and determination of

their dailyway of life’.71The conference, titled ‘From patients to people’, gave

serviceusersachancetobeheard.TheofficialhistoryofSSO,asoneofthefirst

userorganisations,evencreditstheMINDconferenceforitsfoundation,stating

that the annual conference ‘made possible’ its establishment by providing a

67Chamberlin,‘TheEx-Patients’Movement’,325.68T.Curtisetal.(eds.),MadPride:ACelebrationofMadCulture(2004),7.69‘AboutMadPride’http://www.madprideireland.ie/about/[Accessed23/03/2016]70P.Campbell, ‘FromLittleAcorns:Thementalhealthserviceusermovement’, inA.BellandP.Lindley(eds.)BeyondtheWaterTowers(London,2005),74.71‘AdvertisementforMINDAnnualConference1985’.

29

platformfor likemindedserviceusers tomeetand interact.72However, there is

evidenceofMINDgivingavoicetotheserviceuserthatpredatesthe1980s.

MINDusedMINDOUTasaforumforthosewhoseviews,theyacknowledged,‘are

so rarely heard’.73In June 1974, MIND announced its intention to devote the

October edition solely to the views of the service users. The newly appointed

TonySmythesuggestedthat,whileMINDeffectivelyrepresentedtheinterestsof

professionalgroupswithinmentalhealth,theorganisationcouldevolvetoactas

abridge ‘betweenusersandprofessionals’.74TheOctoberpublicationaimed to

dojustthat.Therewasanunprecedentedresponse,withhundredsofletterssent

infrompatients, ex-patients, and relativesalike.MINDOUT acknowledged that

whilstoneindividualexperiencecannotbegeneralised, it is imperativetohear

differentexperiencesofpatients,andalthough‘psychiatristswill[not]likebeing

criticisedby their patients… criticism is a necessary function of this particular

relationship’.75In the editorial,MINDOUT stated that despite asking ‘for both

good and bad experiences of the mental health services’, somewhat

unsurprisingly, ‘thebadexperienceswerebyfar inthemajority’.76Theedition

was divided into topics raised by the contributions, including compulsory

treatment, drugs, and psychotherapy, and the consensus amongst patients

tendedtobe that the ‘wholeprocess’of thementalhealthserviceswas,asone

ex-patient vocalised, ‘a humiliating experience stripping one of identity rather

thanequippingoneforliving’.77

Theartworkaccompanying the text isof interestas itwasalso thecreationof

service users. All images are of a similar ilk and differ starkly, in their

monochromestate,tothecharacteristicallybrightpagesofastandardMINDOUT

edition.Theillustrationscorroboratetheoppressivenatureofpsychiatrythatis

presented in the users’ views throughout the edition. As Figures 8 and 9

72 A. Roberts, ‘History of Survivors Speak Out’, (2010),https://www.studymore.org.uk/ssohist.doc[Accessed18/04/2106]73MINDOUT3(Autumn1973),3.74‘MINDCouncilofManagementMinutes’,04/10/1974.75MINDOUT7,(October1974),2.76MINDOUT7,(October1974),2.77MINDOUT7,(October1974),12.

30

demonstrate, the depictions portrayed psychiatric individuals reaching out for

help whilst simultaneously being shut away by society and oppressed by

psychiatry.AlthoughtheseimageswerenotcreatedbyMINDandthuscannotbe

saidtodirectlyreflectMIND’soutlook,theywerechosenbyMIND,andthisalone

tells us that MIND was, in line with the service user’s view, presenting a

controversialcritiqueofpsychiatry.

Figures8and9:TwoimagesfeaturedinMINDOUT’s1974useredition78

The mixed response in the following edition confirms that this was a

controversial venture. One psychiatrist expressed his ‘concern at the paltry

standardsof theOctoberedition’,whichhedismissedas consistingof ‘nothing

morethananecdotalalarmistaccountsfromdisgruntledandquerulentpeople’.79

A woman of similar opinion warned that the issue was ‘dangerously slanted’,

publishing complaints belonging to ‘a sickmind anyway’.80Nevertheless, there

were individuals who wrote in supporting the publication. One individual

commented ‘it is refreshing to hear the views and thoughts of those who do

know what mental illness is really about’.81Though MIND did not choose to

explicitly side with either camp, the October edition ofMINDOUTprovided a

platformpurelyforserviceuserstoexpresstheirviews:serviceuserswere,for78ImagesfromMINDOUT7(October1974),11-12.79J.Slater,‘Letters:Paltrystandards’,MINDOUT8(December1974),4.80E.Ellis,‘Letters:Slanted’MINDOUT8(December1974),4.81C.Cheeseman,‘Letters:Congratulations’,MINDOUT8(December1974),5.

31

the first time, given individual agency to speakoutandbeheard.Thismarked

thebeginningofMIND’sinteractionwithserviceusersonapersonallevel;rather

than simply representing them, MIND incorporated the mental patients into

theirowndiscourse,givingthemavoice,asthischapter’sopeningquote(taken

froma1974MINDOUT)claims.

Notwithstanding this, it was not until 1987 that MIND launched its own user

group,MINDLINK.FirstknownastheConsumerAdvisoryPanel,thegroupwas

formedunder theumbrellaofMIND,butexisted independently.AsClaytorhas

argued, although oneway to ensure patients’ rights are valued is to ‘enshrine

those rights in law’, another is ‘to ensure that usershavedirect input into the

processofplanningandrunningservices,andthattheirvoiceswillbeheard’.82

TheestablishmentofMINDLINKprovidedapermanentforumforusermembers

of MIND, ensuring that the user’s voice was able to influence policies and

servicesofferedby theorganisation. Furthermore, therewasa commitment to

representusersandinstilthemwiththeabilitytoexerciserealpower.1988saw

a service user appointed asMIND’sVice Chair for the first time:Mike Lawson

heldthepositionforsixyearsandusershavebeenpresentwithinmanagement

teams ever since. The recent decision to terminate MINDLINK in 2011 was

becauseMind believed that service users should be integrated throughout the

wholeassociation,ratherthancongregatedwithinonesolenetwork.

At present, by becomingmembers, service users are able to influenceMind in

multiple areas,with individual campaigns andprojects often having their own

advisers. The central governing of Mind also remains heavily influenced by

service users: the organisation is currently managed by a board of sixteen

trustees,theCouncilofManagement,andastheMindwebsitestates,‘halfof[the

Council] must have direct experience of mental distress’. 83 This newfound

involvementoftheserviceuserintherunningofMind,whichcameinthe1980s,

differs starkly from the original governing of the National Association. As a

female psychologist employed by NAMH during the 1950s recollected, the82Claytor,AChangingFaith?,282.83Mind, ‘Our Trustees’, http://www.mind.org.uk/about-us/what-we-do/minds-annual-review-and-governance/our-trustees/[Accessed11/04/2016]

32

Associationwasoriginallystaffedbyacircleofmiddle-classwomen‘ofacertain

age’, the kind who would have tea ‘served with some formality by the “tea

lady”’.84Crossley convincingly suggests that in its early state, ‘the organisation

embodiedthestatusandrespectability(the“goodmanners”andgeneralbodily

hexis)ofthemiddleclasswoman’.85Thepersonalrecollectionreflectsthisimage

oftheorganisationinitsinitialyears,whereagroupofconservative‘do-gooders’

gathered tomake a difference. The civil rightsmovements of the 1960swere

influential in instigating its change inpersona.Mentalhealthpatients, inspired

by other vulnerable individuals fighting for their rights, followed suit, actively

participating in the mental health field. Mind, too, responded to the

countercultural movements and ensuing intellectual change of the sixties, in

allowing the serviceuser tobeheard.Whatbeganas a ‘polite’ group trying to

make a difference became a charged organisation of service users working

alongsidenon-serviceusers,prioritisingmentalhealthpatients’rights.

Aswell as aligningwith service users, therewas cross-fertilisationwith those

whohadbeenfightingfortheirrightsinthe1960s,asMINDdevotedattentionto

thosealreadyvulnerablewithinsociety.OneexampleisMIND’salignmentwith

women.With the rise of feminist critiques of psychiatryMIND began to raise

awareness of the gendered nature of the field, andWomen in MIND, a policy

working party devoted to women’s needs, was formed in 1984.86The group

created publications for distribution and stressed the importance of mental

health as ‘a crucial issue’ for theWomen’sMovement.87Such publications also

highlighted thebias inherent in the treatment of lesbianismwithinpsychiatry,

which, the group maintained ‘although not illegal… is still treated as a

psychological sickness’.88As well as sexism and heterosexism they stressed

‘racismandeconomicdeprivation’asfactorsthatpreventedwomenfromtaking

controloftheirlives,explainingthat‘theproportionofblackandworking-class

84R.Husain,‘Castyourmindback’,OpenMind56(1992),15.85N.Crossley,‘Transformingthementalhealthfield:TheearlyhistoryoftheNationalAssociationforMentalHealth’,SociologyofHealthandIllness20:4(Oxford,1998),472.86SeeN.Tomes,‘FeministHistoriesofPsychiatry’inM.MicaleandR.Porter(eds.)DiscoveringtheHistoryofPsychiatry(Oxford,1994),352-376.87SeeMIND,FindingOurOwnSolutions:Women’sexperienceofmentalhealthcare(London,1986);MINDPamphlet‘WomeninMIND’(1985).88FindingOurOwnSolutions,51.

33

women’ receiving electro-convulsive therapywas ‘far higher thanmiddle-class

women’.89MINDalsoheldthecampaign‘StressonWomen’toemphasiseissues

unique towomen, such as copingwithmotherhood.Within this too, attention

was given to women from marginalised groups, and the need for equal

opportunities was stressed. 90 Thus, the driving principles of the social

movements of the 1960s: equal rights and societal acceptance for minority

groups (be they women, ethnic minorities, gay, or disabled), were applied by

MINDtothementalhealthfield.

This chapter has shown that, with its transformation into MIND, NAMH

prioritisedandprovidedaplatformforthevoicesofserviceusers.Influencedby

the social movements of the 1960s, where individuals first stood up for their

rights, MIND valued patients’ opinions and played an instrumental role in

instigating theusermovement,whichhas irrefutable linkswith thecivil rights

movement.After initiallyprovidingplatforms for like-mindedusers tomeet at

their annual conferences and (somewhat controversially) giving space for the

service user to express themselves in theirmagazines,MINDdevoted awhole

network for service users to influence the organisation. Although this has

recently been terminated, the service user still plays a prominent role in the

runningofMindonalllevels.

89MIND,FindingOurOwnSolutions,13.90‘StressonWomen:PolicyPaperonWomenandMentalHealth’,1992.

34

CONCLUSIONS

“Wewerecertainlynotcreatedasaprotestmovement...butwehave

becomeone.”91

Historical analysis of theMind archives reveals important conclusions about a

key playerwithin themental health field. This dissertation has shown that, in

response to its social backgroundMind evolved froma paternalistic, ‘do-good’

Association into a civil rights based lobby group. The NAMH that relied on

Government for financial support and sided with the medical profession

developed intoMind, an organisation that fought vociferously for the rights of

thementally ill;engagingwith,reflecting,andrepresentingusers’ interestsand

views. By the late 1960s the genteel NAMH was becoming out of touch with

public opinion, moribund, and in a dismal financial position. Whilst this

highlighted the need for the charity to evolve, the success of the civil rights

movementwasthemost influential factorin informingthedirectionofNAMH’s

evolution.

Theseconclusionsarerelevantbecauseinthewidersphereofcharitywork,they

deepen theunderstandingof theways inwhichapproaches tovoluntarywork

heavilydependontheexternalenvironment inwhich theyareoperating.They

alsohighlighttheinfluenceofthecivilrightsmovementuponthementalhealth

field.Whilsttheinfluenceofthemovementhasbeenexploredinrelationtoother

prominent social movements, its influence upon social movements within

psychiatry (which have themselves been understudied) has, until now, been

overlooked.

The1960swasaneraof immensesocialandpolitical changewhere therights

andlibertiesoftheindividualbecameacausecélèbretobefoughtforagainstthe

perceived oppression of the establishment. The civil rights movement,

championing the rights of the individual against a society which was seen as

demandingconformistbehaviour,achievedgreatsuccessincementingfreedoms

91D.Ennals,MindandMentalHealth(Summer1972),29.

35

for vulnerable and previously un-represented social groups including

homosexuals, ethnic minorities and women. The Association adopted the key

methodsofthemovement:consciousness-raising,empowerment,andcollective

identity, in order to achieve the same fundamental aims: basic legal rights,

acceptance,andanimprovedqualityoflifeforthementallyill.Thisresultedin,

as the quote above highlights, (from David Ennals, MIND Campaign director)

NAMHbecominga‘protestmovement’,inlinewiththesocialmovementsofthe

1960s.

With its new persona, Mind sought to transform the mental health field. By

raisingawarenessandchallengingstigma, theorganisationchangedthe faceof

the mental health patient from a stereotyped ‘loony bag’ to a normal (even

apparentlyhappy)person,andbypublicisingthefrequencyofmentalillhealth,

createdanenvironment inwhichthementally ill feltcomfortableto ‘comeout’

and speak openly about their struggles.Mind’s engagement in the legal arena,

replicatingthetacticsoftheUScivilrightsactivistsinthe1960s,ledtoground-

breakingachievementsencapsulatedinthe1983MentalHealthActthatchanged

the landscape ofmental health, emphasising patients rights. TodayMind is an

organisationwhichisitselffullyengagedwiththeservice-usermovement.Itno

longersimplyrepresentstheinterestsofthementallyillbutgivesthemavoice

andaplatformfromwhichthatvoicecanbeheard.Itishardtorecognisethatit

isthesameorganisationwhichwascreatedin1946.Itisevenhardertoconclude

that it would have become the effective organisation it is today without the

influenceofthe1960scivilrightsmovement.

The influence of the 1960s civil rightsmovement on the Association, and ‘the

Gap’ that canbeseenbetween theNAMHof the1950sandMind todayclearly

demonstratesthetruthofAppleby’sassertionthatvoluntaryorganisationsneed

‘tobeintunewiththetimesandtoknowhowtoplaythetuneintherightkey’.

36

APPENDICES

Appendix1:TabletoshowthechangeinterminologyusedbyMindtodescribethosesufferingfrommentalillnessintheir‘AimsandObjectives’sectionofeachannualreport:

YearofAnnualReport Terminologyusedin‘Aimsand

Objectives’section1946-47(NAMH) Mentallysubnormalordefective1947-48 Mentallysubnormalordefective1948-49 Mentallysubnormalordefective1949-50 Mentallysubnormalordefective1950-51 Mentallysubnormalordefective1951-52 Mentallysubnormalordefective1952-53 Mentallysubnormalordefective1953-54 Mentallysubnormalordefective1954-55 Mentallysubnormalordefective1955-56 Mentallysubnormalordefective1956-57 Mentallysubnormalordefective1957-58 Mentallysubnormalordefective1958-59 Mentallysubnormalordefective1959-60 Mentallysubnormalordefective1960-61 Mentallysubnormalordisordered1961-62 Mentallysubnormalordisordered1962-63 Mentallysubnormalordisordered1963-64 Mentallysubnormalordisordered1964-65 Mentallysubnormalordisordered1965-66 Mentallysubnormalordisordered1966-67 Mentallysubnormalordisordered1967-68 Mentallysubnormalordisordered1968-69 Mentallysubnormalordisordered1969-70 Mentallysubnormalordisordered1970-71(BeginningofMINDCampaign)

Mentallydisordered

1971-72(RebrandedMIND) Mentallydisordered1972-73 Mentallydisordered1973-74 Mentallyillorhandicapped1974-75 Mentallyillorhandicapped1975-76 Mentalpatients1976-77 Mentalpatients1977-78 Mentalpatients1978-79 Mentalpatients1979-80 Mentalpatients1980-81 Mentallyillorhandicapped1981-82 Mentallyillorhandicapped1982-83 Mentallyillorhandicapped1983-84 Mentallyillorhandicapped

37

1984-85 Mentallyillorhandicapped1985-86 Mentallyillorhandicapped1986-87 Mentallyillorconsumers1987-88 Mentallyillorusers1988-89 Mentallyillorusers1989-90 Mentallyillorusers1990-91 Mentallyillorusers1991-92 MentallyillorusersSource:AnnualReportsofNAMH:1946-47–1970-71AnnualReportsofMIND:1971-72–1991-92

38

Appendix2:IncomeandExpenditureAccountofNAMHfromfinancialyear-end31stMarch1962

Governmentfundinghighlightedinyellow,voluntarydonationshighlightedinred.Source:NAMHAnnualReport1961-62

39

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