Democratizing mental health: Motherhood, therapeutic community and the emergence of the psychiatric family at the Cassel Hospital in post-Second World War Britain

Shortly following the Second World War, and under the medical direction of ex-army psychiatrist T. F. Main, the Cassel Hospital for Functional Nervous Disorders emerged as a pioneering democratic ‘therapeutic community’ in the treatment of mental illness. This definitive movement away from conventional ‘custodial’ assumptions about the function of the psychiatric hospital initially grew out of a commitment to sharing therapeutic responsibility between patients and staff and to preserving patients’ pre-admission responsibilities and social identities. However, by the mid-1950s, hospital practices had come to focus pre-eminently on patients’ relationships with family members, and staff had developed a social model of mental health that focused on the family as the irreducible unit of mental treatment. By the late 1950s, this culminated in the in-patient admission of entire families for mental treatment, even when only one family member was exhibiting symptoms. At the heart of this growing post-war social-psychiatric preoccupation with the family was a new emphasis on the close relationship between mental health and individuals’ successful development toward mature responsible adulthood. The family came to be conceived as the quintessential space where both were forged. This article examines the process through which the Cassel’s social-psychiatric commitment to ‘therapeutic community’ became focused on the family as a key therapeutic site. While the family had become a central point of focus in social, political and psychological discussions of the foundation for stable democratic culture and political peace in post-war Britain, the Cassel Hospital actively experimented with these connections in therapeutic practice. This article thus illuminates the important, but frequently overlooked, role of psychiatric practices in the development of a post-war psychopolitics that established important links between the nuclear family, mental health and democratic social life.