Psychological Illness and General Practice

Abstract

At a meeting of the Royal Society of Medicine in November 1958, the psychiatrist Michael Shepherd and a group of colleagues observed that most of the previous work on the epidemiological aspects of mental disorder had been focused on institutionalised patients where the population had been ‘conveniently circumscribed for the purposes of investigation’. Research, therefore, had been concerned predominantly with major psychiatric disorder. In order to obtain further knowledge about mental illness, Shepherd argued that there was a need for systematic study of the minor psychiatric disorders and their prevalence in the community.1 Shepherd, a well-respected Professor of Psychiatry, established the General Practice Research Unit at the Institute of Psychiatry in London during the late 1950s. The aim of this unit was to study, by epidemiological methods, ‘the causes, nature, extent and distribution of extra-mural mental disorder in the setting of general practice, where, under the conditions of the British National Health Service, information is obtainable about the health of the bulk of the population’.2 In stating this aim, Shepherd and his colleagues were articulating a view widely expressed by those working in general practice during the post-war period: that family doctors fulfilled a unique role in medicine and should be more widely involved in epidemiological research.