The Maudsley Hospital: Design and Strategic Direction, 1923–1939

The Maudsley Hospital officially opened in January 1923 with the stated aim of finding effective treatments for neuroses, mild forms of psychosis and dependency disorders. Significantly, Edward Mapother, the first medical superintendent, did not lay a claim to address major mental illness or chronic disorders. These objectives stood in contrast to the more ambitious agenda drafted in 1907 by Henry Maudsley, a psychiatrist, and Frederick Mott, a neuropathologist. While Mapother, Maudsley and Mott may have disagreed about the tactics of advancing mental science, they were united in their condemnation of the existing asylum system. The all-embracing Lunacy Act of 1890 had so restricted the design and operation of the county asylums that increasing numbers of reformist doctors sought to circumvent its prescriptions for the treatment of the mentally ill. Although the Maudsley began to treat Londoners suffering from mental illness in 1923, it had an earlier existence first as aWar Office clearing hospital for soldiers diagnosed with shell shock, and from August 1919 to October 1920 when funded by the Ministry of Pensions to treat ex-servicemen suffering from neurasthenia. Both Mott, as director of the Central Pathological Laboratory and the various teaching courses, and Mapother had executive roles during these earlier incarnations. These important clinical experiences informed the aims and management plan that they drafted for the hospital once it had returned to the London County Council’s (LCC) control. On the surface, the Maudsley could not have been further from the traditional asylum. No attempt was made to hide the hospital in the countryside—it was located in a busy London suburb close to a railway station and on a tram route. The red-brick buildings with their Portland stone dressings executed ‘‘in a free treatment of English Renaissance’’ resembled a district general hospital or a town hall rather than a prison or asylum. With beds for only 144 patients, a postgraduate medical school and a dedicated outpatient