Deinstitutionalisation and the move to community care: comparing the changing dimensions of mental healthcare after 1922 in the Republic of Ireland and England.

The advent of deinstitutionalisation and the introduction of community care in the latter part of the twentieth century have revolutionised mental-health service provision across Europe, although implementation, timing and services have varied widely in different countries. This article compares the changing dimensions of mental-health provision in post-independence Ireland with that in England, and will shed light on the current state of mental healthcare in both countries. The article calls for more research into the impact of deinstitutionalisation, such as the challenges faced in the community for those in need of continuing care.

Post-mortem in the Victorian asylum: practice, purpose and findings at the Littlemore County Lunatic Asylum, 1886-7.

This article examines the purpose of the post-mortem in the late Victorian asylum and discusses what the findings reveal about contemporary understanding of mental health. By examining the practice at the Littlemore Asylum of Oxford, the definition of the asylum post-mortem will be questioned and issues of consent and ownership of the dead body explored. It will be argued that the purpose of the examination was partly to appease the demands of the Commissioners in Lunacy, to protect the asylum against accusations of malpractice, and to appease the resident assistant medical officer's own morbid curiosity. The examinations would therefore be better defined as dissections. This article will challenge understanding of institutional death, the legal processes required for dissection, and mental healthcare.

The first lady almoner: the appointment, position, and findings of Miss Mary Stewart at the Royal Free Hospital, 1895-99.

This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed "appropriate" received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations.