The rise of psychological physicians: The certification of insanity and the teaching of medical psychology

Int J Law Psychiatry. 2021 Jan-Feb:74:101667. doi: 10.1016/j.ijlp.2020.101667. Epub 2020 Dec 17.

Abstract

This paper investigates the nexus between the legal provisions for the certification of insanity and the introduction of psychological medicine into British medical education. Considering legal and published sources, it shows that the 1853 Lunatic Asylums Act proved fundamental for the promotion of medical psychology as part of medical training. By giving doctors the authority to report "facts of insanity", this law created the need for "psychological physicians" capable of certifying lunacy. I explore this connection in three sections. First, I introduce the emergence of medical certificates in the context of asylum committal. Second, I focus on the certification procedure introduced in 1853 which required "facts of insanity personally observed". Third, I consider how British asylum doctors advocated for the diffusion of psychological medicine as an essential university subject for certifying practitioners. This paper emphasizes the relevance of confinement legislation in the development of psychiatry as a medical specialty.

Keywords: Asylum; Certification; Confinement; Education; Expertise; Law.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Certification
  • Hospitals, Psychiatric
  • Humans
  • Physicians*
  • Psychology, Medical*
  • Psychotic Disorders*