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Integration and specialism: complementary not contradictory

Published online by Cambridge University Press:  19 January 2007

Stephen Pereira
Affiliation:
Consultant Psychiatrist, Pathways Psychiatric Intensive Care Unit; Honorary Senior Lecturer, Guy's, King's & St Thomas' School of Medicine; Chairman, NAPICU
Daniel Dalton
Affiliation:
Consultant Psychiatrist, Pathways Psychiatric Intensive Care Unit; Honorary Senior Lecturer, Guy's, King's & St Thomas' School of Medicine; Chairman, NAPICU

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Psychiatry, behavioural disturbance and risk management have conceptually coexisted for hundreds of years, however, prior to the 1800 Criminal Lunatics Act, drafted exigently following an attempt on the life of the then King by the “insane” Hadfield, the only means of care was custodial, under arcane vagrancy legislation, such as the 1714 Vagrancy Act, or on the basis of the poor laws. Mentally disordered individuals were either incarcerated as criminals or paupers (Select Committee, 1807) falling under the responsibility of local parish councils. At this point, incarceration was just that, with prisons hosting most detained mentally disordered individuals, under the indefinite see of the monarch. The first vision for caring, secure, environments for mentally disordered individuals was in the development of asylums following the 1808 County Asylums Act, which recognised that detaining, “lunatics and other insane persons…in Gaols, Houses of Correction, Poor Houses and Houses of Industry, is highly dangerous and inconvenient.”

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Type
Editorial
Copyright
© 2006 NAPICU