The Department of Psychiatry approaches 50
written by Professor John Geddes, MD FRCPsych. Head of the Department of Psychiatry, Professor of Epidemiological Psychiatry and Director of NIHR Oxford Health Biomedical Research Centre and NIHR Oxford Cognitive Health Clinical Research Facility.
The Department of Psychiatry at University of Oxford was founded in January 1969. A donation from the WA Handley Trust endowed the first Chair of Psychiatry, to which Michael Gelder was appointed and the University funded a senior lecturer, initially John Bancroft. Michael Gelder retired in 1995, replaced in 1996 as WA Handley Professor and Head of Department by Guy Goodwin. Two years later, writing in 1997 on the first 28 years of the Department, Michael Gelder and Richard Mayou could reflect on a Department with approaching 100 staff with annual research funding of approximately £2 million (Gelder and Mayou 1997). As we approach the 50th anniversary of the Department in January 2019 (we are planning a major party!), the Department has almost 200 staff, with over £60 million external grant funding from 37 funding bodies, 21 Professors, 9 Associate Professors, 52 postgraduate students and generating 360 publications in 2016-17. This places us as one of the medium sized clinical departments in Oxford – but perhaps the largest department of psychiatry outside the Institute of Psychiatry, Psychology and Neurology in London.
However, in several ways the University of Oxford’s contribution to psychiatry and mental healthcare began much earlier. Robert Burton, Student of Christchurch, published The Anatomy of Melancholy in 1621. Unlike many University Departments of Psychiatry in the UK, the Oxford Dept has always been blessed with collocated clinical service at the Warneford Hospital – much closer to the University than a typical county asylum. The Warneford Hospital was founded as the Radcliffe Lunatic Asylum in August 1821 - it was always conceived as s a sister institution to the Radcliffe Infirmary. Initially funded by the University, the Colleges and the City of Oxford, it was renamed the Warneford Lunatic Aslyum in 1843 in recognition of the major donations from Revd. Samuel W. Warneford. It was renamed the current Warneford Hospital in 1920. In 2021, we will therefore have the 400th anniversary of the publication of Burton’s Anatomy coinciding with the 200th anniversary of the founding of the Warneford Hospital.
Since 2010, we have capitalised on the strong academic base developed since the founding of the Department, to renew our infrastructure and build relationships across the University. From the founding of the Department in 1969, we have built an international reputation in the investigation of treatment mechanisms and the development of new treatments (psychological, pharmacological, physical and – increasingly – digital). We have a strong track record of innovative early (and later) phase clinical trials, having led over 100 clinical trials of psychological and pharmacological treatments. We have developed a dedicated trials infrastructure including the Oxford Cognitive Health and Neuroscience Clinical Trials Unit, the first fully UKCRC-registered CTU specialising in CNS trials in the UK, the NIHR Oxford cognitive health Clinical Research Facility, and internationally leading imaging facilities (Oxford Centre for Human Brain Activity which now houses both magnetoencephalography and 3T magnetic resonance imaging).
With our colleagues in the Nuffield Department of Clinical Neuroscience and Experimental Psychology, we were rated 1st overall and top for research quality in Psychology, Psychiatry and Neuroscience in the Research Excellence Framework 2014 (THE analysis of REF 2014). The close partnership with Oxford Health NHS FT and, more recently, Oxford university hospitals is especially productive, enabling Oxford Health NHS FT to produce more highly cited publications than any other mental health Trust (RAND 2015).
This strong relationship with the NHS, and track record of translational research, led to a successful application for a mental health and dementia-specific NIHR Biomedical Research Centre in 2016. The NIHR Oxford Health BRC is only the second mental health-focused BRC in the UK – the other being the well established BRC at the Kings College/South London and Maudsley NHS FT.
Scientifically, the Department is blessed by a wonderfully diverse range of scientists – both clinical and non-clinical. We have had substantial recent success by working as teams, across research groups and more broadly across the University and beyond, while at the same time continuing to therapies and developing new ways of implementing. We have substantially increased our activity in dementia research with the recruitment of Prof Sir Simon Lovestone, Prof John Gallacher and their teams.
Oxford can be very proud of its contribution to medical student teaching. The course is currently the highest rated in the clinical school and this translates into the highest proportion of graduates entering psychiatry from any medical school in the UK (joint top with Keele University). Historically, although Oxford has not (yet) had a psychiatrist Regius, several Regius Professors have been incredibly important in ensuring that psychiatry is at the heart of the curriculum. The renowned Regius Professor Sir William Osler latterly became very interested in Psychiatry – writing papers on Burton, the Anatomy and Burton’s library (now housed in Christchurch and the Bodleian). Prof Sir George Pickering, the first clinically active Regius Professor since Osler, was a major proponent of creating the Department in the 1960s. The current Regius, Professor Sir John Bell, has been enormously supportive of our expansion plans - including the successful application for a second Oxford Biomedical Research Centre.
Even more than other areas of academic medicine, Psychiatry has found it difficult to attract bright young clinical scientists although we have done much better in developing non-clinical, “translational” academics. For the future, attracting and developing the next generation of clinical academics is a key priority for the Department and there are signs that we are now beginning to improve the situation. There can be little doubt that the Athena Swan process has been a major contributor to the recent improvement in the Departmental age and gender balance.
Public engagement and outreach is crucial in Psychiatry – mental disorders and their management are still poorly understood by the general population and prone to stigma. Members of the Department are very active both locally and across the international published and broadcast media to ensure that the scientific evidence is well represented.
Apart from teaching, the fundamental goal of a research active clinical department of psychiatry must be to deliver advances in the prevention and care of mental disorders. To do this effectively requires the brightest and most energetic clinical and nonclinical scientists, the best, up-to-date scientific facilities and platforms and strong partnerships and collaborations across the University, with other academic, funding, commercial organisations and with patients groups. This collaborative infrastructure is now in place and is growing all the time. Of fundamental importance, however, for a Department focusing on translational research is a strong partnership with the clinical service. We are fortunate to have strong relationships with both Oxford NHS Trusts. The partnership with Oxford Health NHS Foundation Trust, formalised via the Biomedical Research Centre, is particularly important. The University and Trust have agreed to develop the Warneford site as a centre for translational neuroscience, housing the Department of Psychiatry, expanded research facilities and new clinical facilities with integrated research capability. As we approach the 200th anniversary of the founding of the Warneford Hospital (and the 400th anniversary of the publication of Burton’s Anatomy) in 2021, the shared plan is to create a unique campus on the Warneford site, integrated with the rest of the Headington clinical academic campus and with strong links to the local community.
References Gelder MGG, Mayou R The Oxford University Department of Psychiatry 1969−1996 Psychiatric Bulletin 1997, 21:328330build on our long proven strengths – innovations in all modalities of treatment for mental disorders, clarifying the evidence-base for existing