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By Pamela Michael.
University of Wales Press
£14.99
ISBN 0 7083 1740 5   

This book shows the development of care and treatment of mentally ill people over two centuries at one institution in North Wales.

Denbigh Hospital was the first to invest in staff training to provide high care, strict discipline and careful financial management, and to understand the importance of staff being able to speak to patients in Welsh and to make this a requirement of appointment. Continuity of care from outpatient to aftercare resulted in the first psychiatric social worker being employed in 1945.

Detailed observations from many sources illustrate the social and cultural context in which care was provided and how it changed over time.

An example of tension between treatment and containment for patients is illustrated by staff (or attendants) being at one time completely responsible for the actions of the patients, and, if they escaped through negligence, had to pay for their recapture from their wages.

This book, though, is more than a historical account of the hospital. It explores social and political life outside and how it affected the numbers of patients receiving care, from its height in 1956 with 1,523 residents to the falling numbers in the 1960s following reform, and closure.

Susan Ashworth is an approved social worker and practice assessor, Wiltshire County Council.