The History of Mental Health Services in Modern England: Practitioner Memories and the Direction of Future Research.

Writing the recent history of mental health services requires a conscious departure from the historiographical tropes of the nineteenth and twentieth centuries which have emphasised the experience of those identified (and legally defined) as lunatics and the social, cultural, political, medical and institutional context of their treatment. A historical narrative structured around rights (to health and liberty) is now complicated by the rise of new organising categories such as 'costs', 'risks', 'needs' and 'values'. This paper, drawing on insights from a series of witness seminars attended by historians, clinicians and policymakers, proposes a programme of research to place modern mental health services in England and Wales in a richer historical context. Historians should recognise the fragmentation of the concepts of mental illness and mental health need, acknowledge the relationship between critiques of psychiatry and developments in other intellectual spheres, place the experience of the service user in the context of wider socio-economic and political change, understand the impacts of the social perception of 'risk' and of moral panic on mental health policy, relate the politics of mental health policy and resources to the general determinants of institutional change in British central and local government, and explore the sociological and institutional complexity of the evolving mental health professions and their relationships with each other and with their clients. While this is no small challenge, it is perhaps the only way to avoid the perpetuation of 'single-issue mythologies' in describing and accounting for change.

Contested psychiatric ontology and feminist critique: 'Female Sexual Dysfunction' and the Diagnostic and Statistical Manual.

In this article I discuss the emergence of Female Sexual Dysfunction (FSD) within American psychiatry and beyond in the postwar period, setting out what I believe to be important and suggestive questions neglected in existing scholarship. Tracing the nomenclature within successive editions of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), I consider the reification of the term 'FSD', and the activism and scholarship that the rise of the category has occasioned. I suggest that analysis of FSD benefits from scrutiny of a wider range of sources (especially since the popular and scientific cross-pollinate). I explore the multiplicity of FSD that emerges when one examines this wider range, but I also underscore a reinscribing of anxieties about psychogenic aetiologies. I then argue that what makes the FSD case additionally interesting, over and above other conditions with a contested status, is the historically complex relationship between psychiatry and feminism that is at work in contemporary debates. I suggest that existing literature on FSD has not yet posed some of the most important and salient questions at stake in writing about women's sexual problems in this period, and can only do this when the relationship between 'second-wave' feminism, 'post-feminism', psychiatry and psychoanalysis becomes part of the terrain to be analysed, rather than the medium through which analysis is conducted.

The history of 'Female Sexual Dysfunction' as a mental disorder in the 20th century.

PURPOSE OF REVIEW: To provide an overview of conceptualizations of female sexual problems, and 'Female Sexual Dysfunction' in particular, throughout the 20th century, especially in relation to psychiatry and mental illness. RECENT FINDINGS: In the past 15 years, there has been an increase in both medical and public discourse about 'Female Sexual Dysfunction'. I discuss a variety of literature sources dealing with female sexual problems, where these are understood variously as problems of developmental psychopathology, as technical phenomena to be resolved through education, or as medical problems to be addressed pharmaceutically. SUMMARY: The stigma of mental illness shapes much recent discussion of female sexual problems, as does the legacy of the postwar critique of psychodynamic psychiatry.