Maudsley Hospital

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Maudsley Hospital
South London and Maudsley NHS Foundation Trust
South London and Maudsley NHS Foundation Trust logo.jpg
Maudsley Hospital Main Building.jpg
Geography
Location Denmark Hill, Southwark,, London, England, United Kingdom
Organisation
Care system Public NHS
Hospital type Specialist
Affiliated university King's College London
Services
Emergency department Via hospital A&E
Beds 250
Speciality Psychiatric hospital
History
Founded 1923
Links
Website www.slam.nhs.uk
Lists Hospitals in England

The Maudsley Hospital is a British psychiatric hospital in South London. The Maudsley is the largest mental health training institution in the UK. The hospital's trust describes itself as a world leader in research and also works in partnership with the Institute of Psychiatry, King's College London.[1] The hospital was one of the originating institutions in producing the Maudsley Prescribing Guidelines.

History[edit]

The hospital is part of South London and Maudsley NHS Foundation Trust, provider of an extensive portfolio of mental health services in the United Kingdom, and a research institute working in partnership with the Institute of Psychiatry, King’s College London.

The Maudsley dates from 1907, when Dr Henry Maudsley offered London County Council £30,000 (subsequently increased to £40,000) to help found a new mental hospital that would:

  1. be exclusively for early and acute cases,
  2. have an out-patients' clinic,
  3. provide for teaching and research.

During World War I the hospital was a war hospital, not opening as a mental health resource until 1923. It remains notable that a specific Act of Parliament had to be obtained (1915) to allow the institution to accept voluntary patients.

The Maudsley was returned to the control of London County Council after the First World War, and finally opened in February 1923. Its nursing staff comprised a matron, assistant matron, six sisters and 19 staff nurses with at least three years general hospital training, supported by 23 probationers and 12 male nurses. It had a good reputation for training nurses and some applicants even travelled overseas to train there. A report (held at Bethlem's Archives & Museum) from a nurse who trained at the Maudsley shows some of the work of a new trainee: "Apart from observation and simple treatment, nurses are trained in special investigations and therapy. They carry out many of the routine psychometric tests, help as technicians in the ward laboratories, and are instructors in occupational therapy".

The 1920s and 30s saw a rapid growth in the number of patients treated. Originally, there was no provision for the treatment of children and the rapid growth in this patient population was unforeseen. In 1928, a child guidance clinic was set up under the directorship of Dr William Moodie, the deputy medical superintendent. The Children's Department was promoted as an example of the value of teamwork: 'psychiatrists to diagnose and to prescribe, psychologists for mental testing, social workers to deal with the environmental side and voluntary workers to observe the activities of the children in the play room'. The demand for these services led to the construction of a dedicated building where children were seen as outpatients. In 1947 a dedicated inpatient unit for children was opened.

Research and teaching[edit]

Henry Maudsley was committed to psychiatric research, and the hospital incorporated the Central Pathological Laboratory transferred from Claybury Asylum. Although the hospital initially struggled to secure funding from the Medical Research Council, in 1938 the Rockefeller Foundation made a substantial award to support research and education and the Maudsley has been an internationally renowned centre for research ever since.

The Maudsley Hospital Medical School was established in 1924 and became a well-respected teaching centre. In 1932, Professor Edward Mapother, the first medical superintendent, described the Maudsley as "the main postgraduate school of mental medicine in England." This medical school later became the Institute of Psychiatry which is part of King's College London.

Throughout the 20th century, the Maudsley pioneered the development of new treatments. Breakthroughs included the introduction of clinical neuroscience in the 1950s which was partly led by Denis Hill, a senior lecturer at the Maudsley and the Institute of Psychiatry (IoP), and the use of group talking therapies which is still practiced today.

The growth of the Maudsley led to an on-going building programme. In 1933, a purpose-built outpatient department was added, two years after the completion of a secure unit.

At the outbreak of the Second World War, and the threat of air-raids, the Maudsley closed and staff dispersed to two locations: a temporary hospital at Mill Hill School in North London and Belmont Hospital in Sutton, Surrey. Staff returned to the Maudsley site in 1945 and three years later the Maudsley joined up with the Bethlem Royal Hospital to become partners in the newly established National Health Service (NHS). This partnership saw the introduction of more community-based services and a gradual expansion of the south London catchment area, to become South London and Maudsley NHS Foundation Trust in 2006.

Sharing the Maudsley site is the Institute of Psychiatry, a postgraduate institute of the University of London and, since August 1997, a school of King's College London. It is the only postgraduate institution in the UK that is devoted to the study and practice of psychiatry and related disciplines.

Current hospital[edit]

The Maudsley continues to provide in-patient and community mental health care to local people in Southwark and Lambeth and nationally across the UK. Sharing a site with the Institute of Psychiatry at King's College London it is also a contributor to both psychiatric research and the training of mental health care staff. As part of the South London and Maudsley NHS Foundation Trust (SLaM) it also has close links with Bethlem Royal Hospital - the original "Bedlam". In June 2013 a new learning centre was opened on the hospital site.

Academic Health Sciences Centre[edit]

SLaM is part of King's Health Partners Academic Health Sciences Centre (AHSC) - in partnership with King's College London, Guy's and St Thomas' NHS Foundation Trust and King's College Hospital NHS Foundation Trust. King's Health Partners aims to promote health in mind and body. An AHSC is one of several terms which are used to describe an organisation which delivers both healthcare to patients and health-related science and research, usually with a well-developed teaching and education role as well. This type of organisation is fairly common amongst the leading hospitals and universities around the world. There are currently five AHSCs in the U.K.

Biomedical Research Centre[edit]

The trust manages one of the UK’s only Biomedical Research Centre specialising in mental health.[2] The centre, managed in partnership with the Institute of Psychiatry, King’s College London, is based on the Maudsley Hospital campus and funded by the National Institute for Health Research (NIHR).

The team at the centre are working towards 'personalised medicine' - developing treatments based on individual need. The aim is to diagnose illness more effectively and much earlier, assess which treatments will work best for an individual and then tailor the care they receive accordingly, so that they get better more quickly.

One recent finding to emerge from the BRC is that people suffering serious mental illness can expect to live up to 18 years less than the national average. The research is the first to examine life expectancy for people with specific mental illnesses in the UK and shows that women with schizo-affective disorder and men with schizophrenia are among those most affected, with a reduced life expectancy of 17.5 years and 14.6 years respectively. The study looked at people suffering bipolar disorder, depressive disorders, schizo-affective disorder, schizophrenia and people treated for substance misuse. The findings were published in scientific journal PLoS ONE and demonstrate the need for more assertive interventions and regular physical health assessments to prevent premature death among these vulnerable groups.[3]

The BRC’s development of an advanced computer programme to accurately detect the early signs of Alzheimer's disease from a routine clinical brain scan was reported in the media in 2011. The 'Automated MRI' software automatically compares or benchmarks someone’s brain scan image against 1,200 others, each showing varying stages of Alzheimer’s disease.[4]

On 18 August 2011, the Department of Health announced that the Trust and the Institute of Psychiatry, King’s College London would receive a further £48.8m to continue running the Biomedical Research Centre for Mental Health for a further five years from 1 April 2012. An additional £4.5m was awarded to the trust to launch a new NIHR Biomedical Research Unit for Dementia.[5][6][7]

Media[edit]

In 2013 South London and Maudsley NHS Foundation Trust (SLaM) took part in a Channel 4 observational documentary.

SLaM staff and patients spent two years working with television company The Garden Productions. The four part series started on 31 October.

The first programme, Anxiety, followed patients through Bethlem Royal Hospital’s 18-bed Anxiety and Disorders Residential Unit. This national unit treats the most anxious people in the country - the top one per cent - and claims a success rate of three in four patients. Some are consumed by irrational fears they’ve caused a road accident in their sleep, harmed strangers or have intrusive thoughts.

The next programme was called Crisis; cameras were allowed in to Lambeth Hospital’s Triage ward for the first time. In a postcode with the highest rates of psychosis in Europe, this is the Accident and Emergency of mental health - where patients are at their most unwell.

The third programme, Psychosis, filmed a community mental health team. The lion’s share of our work takes place in a community setting, looking after more than 35,000 people with mental health issues.

The final programme, Breakdown, focused on older adults. The number of older people with mental health problems is estimated to increase by a third over the next 15 years to 4.3 million. Bereavement, stress and loneliness can contribute and some end up on our Older Adults Ward at Maudsley Hospital.

In May 2014 Bethlem was awarded a BAFTA television award in the 'best factual series' category.

References[edit]

  1. ^ "Who we are". www.slam.nhs.uk. Retrieved 2010-01-23. [dead link]
  2. ^ National Institute for Health Research / Biomedical Research Centres
  3. ^ Chang C, Hayes R, Perera G, Broadbent M, Fernandes A, Lee W, Hotopf M, Stewart R (2011) Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London, PLoS ONE
  4. ^ BBC News / health news on-line
  5. ^ Department of Health / research funding announcement
  6. ^ Biomedical Research Centre for Mental Health / new funding
  7. ^ The Guardian / medical research funding

External links[edit]

Coordinates: 51°28′08″N 0°05′28″W / 51.4688°N 0.0912°W / 51.4688; -0.0912