The University Department
The Glasgow Lunatic Asylum, in Cowcaddens, opened in 1814, funded by a public appeal led by Robert McNair, a sugar refiner. In 1843, the Glasgow Royal Asylum for Lunatics, popularly known as “Gartnavel”, opened in the West end of Glasgow, and was associated with the University.
The first formal teaching post was created in 1880 when Dr David Yellowlees, the Physician Superintendent of The Glasgow Royal Asylum was appointed Lecturer in Insanity. Medical students had been taught there previously by Dr Alexander Mackintosh, the previous Superintendent, after whom the Mackintosh Prize for medical students was named.
The Regius Professor of Medicine at that time, Professor William Tennant Gairdner, supported teaching of mental illness and advocated the establishment of psychiatry as a major undergraduate subject.
Women were admitted to classes for the first time in the late nineteenth century.
Sir David Kennedy Henderson, then Dr David Henderson, was appointed as Physician Superintendent and Lecturer in 1921. As a result of his influence, the title of the Lectureship was changed to Lecturer in Psychological Medicine. The change reflected his period of training with Alzheimer and Kraepelin and the psychosocial model of mental illness he took from his training with Adolf Myer in the United States. Henderson gives a vivid description of the hospital and its patients (1915-1932) in his book, The Evolution of Psychiatry in Scotland (E & S Livingstone, 1964). With his colleague Dr Robert Dick Gillespie, he co-authored a standard textbook in Scotland which ran to ten editions. Henderson became Professor of Psychiatry at Edinburgh University in 1932.
The Department 1948-1973
The Chair of Psychological Medicine was founded in 1948, further emphasising the importance of psychiatry in the medical curriculum. Thomas Ferguson Rodger (1907-1978) was the first Professor (1949-1973). He had been a specialist psychiatrist during the Second World War and that experience, together with the influence of his mentor Sir David Henderson, led him to an eclectic approach to psychiatry. His department was based at the Southern General Hospital and he was instrumental (with the surgeon J Sloan Robertson) in establishing that hospital’s reputation as a pioneer in combining Psychological Medicine and Neurological Sciences. In fact, Professor Rodger worked in an era when balancing physical, psychological and social approaches to the treatment of psychiatric patients covered a range of theoretical and practical ideas and practices including psychotherapies, an expanding range of pharmaceutical treatments and physical methods such as electroconvulsive therapy (ECT), insulin therapy and lobotomy/leucotomy. Aspects of these approaches were to be found in the proceedings of The Glasgow Psychosomatic Society.
Professor Rodger together with Dr Bob Mowbray, a Clinical Psychologist, established a two year Diploma course in Clinical Psychology at The Crichton Royal Hospital in Dumfries in 1960 (now the University of Glasgow Dumfries Campus).
At a later date, it was transferred to the department at the Southern General Hospital and was converted to an MSc Degree and in 1995 to a Doctorate in Clinical Psychology.
Professor Rodger was Vice-President of the Royal College of Psychiatry, served on Government and World Health Organisation Committees. He was appointed CBE in 1967.
Ronald David Laing was a Glasgow graduate who trained at Gartnavel in the 1950s, and introduced experimental treatment of schizophrenia there in 1953.
He became famous as author of The Divided Self, which encouraged a new appreciation of the condition. He rejected conventional psychiatric diagnoses and with others established a community based approach at Kingsley Hall, where patients and therapists lived together. The papers of this cult figure of the 1960s, innovator, author and playwright are kept in the archives of Glasgow University.
The Department 1973-1998
Sir Michael Bond was Professor of Psychological Medicine (1973-1998); He continued the broad –based eclectic approach of his predecessor having been fully trained both as a psychiatrist and a neurosurgeon. His psychiatric training was in Sheffield with Professor Erwin Stengel who had interests in various aspects of psychiatry and neurology including a training analysis with Sigmund Freud. His surgical training was with Professor Bryan Jennett in the School of Medicine, Dentistry, and Nursing at the University of Glasgow.
Professor Bond contributed to the administrative activities of the university. He was a Vice Principal, (1986-97) and Administrative Dean of The Faculty of Medicine (1991-97). He was awarded an Honorary Doctorate of The University (2001).
Professor Bond also contributed to medical and general undergraduate education developments at a national level. He was a member of The University Grants committee and was Chairman of its medical sub-committee, The University Funding Council and The Scottish Higher Education Funding Council. He became Chairman of the Joint Funding Council’s Medical Committee. In 1992/3 Professor Bond was a member of a committee which produced The Tomlinson report – ‘Report of The Inquiry In to London’s Health Service, Medical Education and Research’.
He was knighted for services to medicine in 1995.
Teaching and Research
In addition to a heavy undergraduate and postgraduate teaching programme, the Department of Psychological Medicine had three main research interests with Professor Bond as Head. They were first, the investigation of the psychosocial consequences of severe traumatic brain injuries and second, the investigation and management of chronic pain heavily influenced by psychological and social factors and third, disorders of sleep.
Head Injury Research
Professor Neil Brooks succeeded Dr Gordon Claridge as Head of Clinical Psychology in the Department. He was a world authority on the cognitive and behavioural consequences of severe brain injury and led a small group which published papers, book chapters and books on these topics. Professor Bond, in collaboration with Professor Bryan Jennet who with Professor Graham Teasdale had developed the Glasgow Coma Scale (GCS), produced a second major contribution to the assessment of head injured patients with the publication of The Glasgow Outcome Scale in 1975 (GOS). Both the GCS and the GOS have been in use world-wide since their appearance in the 1970s and both have been further developed – the latter primarily by Professor Tom McMillan, a neuropsychologist in the department.
Rehabilitation and Pain
In 1981, the department was relocated at Gartnavel Royal Hospital. A ward unit was set aside for the rehabilitation of individuals with chronic pain driven primarily by psychological and social factors. It was the first such unit in Scotland and the second in the UK. Over a period of ten years, many patients with pain as part of a mental disorder, pain due to known physical problems but of excessive severity, and those for whom pain was an aspect of a personality which brought secondary gain. Working with their families they were, in many cases, relieved of pain or helped to cope better with any pain which persisted. The rehabilitation regime included drug withdrawal from powerful opiate analgesics.
Professor Bond was President of The British Pain Society (1999-2001 and 2009-2010) and of The International Association for The Study of Pain, (2002-2005). He published steadily on psychosocial aspects of pain including the visual analogue measure for pain, VAS, which he devised with I Pilowsky. He was the co- author of several books on pain injury and published an undergraduate book on pain – ‘Pain and its Treatment’.
Professor Colin Espie succeeded Professor Brooks as Head of Clinical Psychology in 1993. He was, and remains, a widely recognised authority on disorders of sleep and has written many scientific papers and several books on this subject. He was the founding Director of the Glasgow Sleep Clinic (1995- 2012). His areas of research are in the management of insomnia using cognitive behavioural therapy, and the aetiology and pathophysiology of insomnia. Currently he is a Professor of Sleep Medicine in the Nuffield Department of Clinical Neuroscience at the University of Oxford.
The Department 1998-present
The Chair of Psychiatry was founded in 1999 with funds from the Khan Educational Fund for Psychiatric Medicine. The first post holder was Janine Scott (1999-2006). Her expertise was in the psychological treatment of mood disorder and, in particular, Bipolar Disorder.
Peter McKenna (2006-2007) succeeded Professor Scott briefly as Professor. He was involved in clinical research in schizophrenia.
At the present time, there are two holders of Personal Chairs in Psychiatry in the Department. Professor Jonathan Cavanagh (2014- present), a neuropsychiatrist, is the Director in Glasgow of The Sackler Centre for Psychobiological Research which was established jointly with the Department of Psychiatry in Edinburgh in 2004. The centre uses molecular biology, neuroimaging and data science to examine the underpinnings of psychiatric disorders. His research is focused on the molecular neurobiology of the relationship between the immune system and the central nervous system.
Professor Daniel Smith’s research involved another aspect of the neurobiology of mood disorders, the overlap between mood disorders and cardio-metabolic disease using ’big data’ science methods, for example from the UK Biobank. Professor Smith is developing precision medicine projects in mental health exploring the re-purposing of cardiovascular medicines for psychiatric disorders.
A third personal Chair was held by Christopher Williams (2009-2017). His major interest was the use of self-help interventions for psychiatric disorders.
The Clinical Psychology course remains a significant aspect of the work of the department with 78 doctoral postgraduates. The staff involved are
- Professor Tom Macmillan, with a research programme in the study of traumatic brain injury
- Professor Rory O’Connor who investigates aspects of suicide
- Professor Andrew Gumley working on complex interventions in psychosis
- Professor Jon Evans with research into cognitive rehabilitation.
Glasgow Psychiatry since 1948
At the inception of the National Health Service, the era of institutional psychiatry in Glasgow, as elsewhere in the United Kingdom, was reaching its height. The peak number of psychiatric inpatients was reached in the mid-1950s, and since that point there has been sustained de-institutionalization.
Of the large institutions that existed at that time in Glasgow, several have subsequently closed completely: Gartloch, Woodilee and Lennox Castle (for Mental Handicap); and others such as Gartnavel Royal and Leverndale Hospitals have reduced markedly in size and reconfigured into more modern buildings on the same sites.
- Read more on the history of psychiatry in Scotland
Although the process of deinstitutionalization had already begun, the advent of antipsychotic, antidepressant and mood stabilizing drugs in the 1950s and 1960s helped to accelerate this process: chlorpromazine, imipramine and lithium were the prototypes in each of these categories. These drugs, and those that have followed, have been a great advance in the treatment of severe mental illness. For example, in the 1950s most individuals diagnosed with schizophrenia were cared for in institutions, while today it is only a minority of sufferers who require such care.
The system operating now in Glasgow, as elsewhere, is that of community care for the majority, and each part of the city now has its own arrangements.
During this recent era, there was also the establishment of psychiatric care in general hospitals in Glasgow. This was an attempt to remove the stigma of mental illness and give its treatment an equal status with physical illness.
However, the only general hospital site that continues to have inpatient psychiatric provision in Glasgow, is Stobhill Hospital. The campus at Stobhill has a forensic medium secure unit (the Rowanbank Clinic), an adolescent unit (Skye House), as well as general psychiatry, old age psychiatry and, for the moment, provision for addiction psychiatry. The psychiatric wards at Gartnavel General Hospital and at the Southern General Hospital (now Queen Elizabeth University Hospital) have all closed, with the provision transferring back to the campuses at Gartnavel Royal and Leverndale Hospitals, respectively.
The only new psychiatric hospital opened during this time was Parkhead Hospital, which opened in 1988. It is currently scheduled for closure, with provision due to transfer to the Stobhill Hospital campus. Old age psychiatry has become a major discipline within psychiatry, given our longer lifespans and the prevalence of dementia in later life.
Alongside the revolution in psychopharmacology, there have been important innovations in social care and in psychotherapies, delivered by specialist nurses, occupational therapists and clinical psychologists in multidisciplinary teams alongside the psychiatrists. Psychotherapies derived from cognitive and behavioral psychology have now become the mainstay, though sometimes in combination with elements from the longer established psychodynamic tradition.
Certainly Glasgow psychiatry has moved out from the asylums and closer to the population that it serves.
Professors Sir Michael Bond, Jonathon Cavanagh and Dr Iain Smith
Images unless otherwise noted provided by the authors