Summary of the impact

University of Huddersfield research into the history of mental health care has encouraged a broad range of stakeholders and individuals to challenge their values and beliefs about people who live with mental health issues and the services they use. The work has contributed to modern-day policy, practice and perceptions through a series of collaborations with health officials and practitioners, third-sector organisations, service users and the wider public, including museum exhibitions, online engagement and bespoke teaching and learning materials. Beneficiaries have credited the research with helping to "break down the barriers and stigmas" that surround mental health and with developing positive attitudes towards the issue.

Underpinning research

Cost, equality, diversity and stigma are central to the modern-day provision of mental health care. Research by the University of Huddersfield's Dr Rob Ellis has shown how the lessons of the past can enhance understanding of such concerns with a view to informing current thinking in this field.

This work can be traced back to 1998 and the development of original research carried out by Ellis as part of his PhD, completed at the University of Huddersfield in 2002. He returned to Huddersfield as a Research Fellow in the School of Applied Sciences in 2006, moving to History in August 2009. Publications in 2006 and 2008 built on Ellis's PhD research and led to two significant grant applications that allowed innovative collaborations with partners in the heritage and archives sector. These activities form a central pillar in the strategy of the department and especially the work of the Centre for the History of Public Health and Medicine.

A consistent theme of Ellis's studies has been consideration of orthodox views of the physical and social separation of the insane in 19th-century lunatic asylums. The initial research, which focused on patients and their families, argued for a more nuanced understanding of asylums as both therapeutic institutions and places of custody. Ellis showed that the idea of therapy was an important driver behind the committal of many individuals. He demonstrated that, though issues of stigma relating to "madness" and pauperism were important, the relatively short stays of many asylum patients are noteworthy while the role of non-"heroic" treatments such as rest cures have been under-valued. Specific research on the role of the Poor Laws, Poor Law finance and the general cost of caring for the mentally ill challenged the conventional view that subsidised asylum care led families to pass over the responsibility of their kin to the medical profession and that patients, once committed, were left to rot and never seen again. Using qualitative and quantitative archival research, Ellis argued that the asylum system would not have grown at the rate it did if this was its only function. [1]

Ellis's 2006 paper developed this further with case studies of 19th-century committals [2], while his later research showed that, in spite of a national legislative framework, regional differences in the development of facilities and treatments remained [3]. Subsequent work has expanded on these themes to address the issue of stigma in relation to both the institutions and the people who used them [4, 5].

Overall, the research has consistently demonstrated that the process of getting into and out of an asylum was guided by a number of factors, of which custody might have been only one. Similarly, while treatment could be invasive for some and barbaric for others, the absence of medical intervention in certain cases showed asylums could act as a refuge. In addition, the focus on finance and its relation to committal and discharges illustrated how families played a significant role in decisions about the care of their kin. These themes have proved to be particularly appealing to current practitioners and those in the heritage sector anxious to explore issues of equality and diversity with hard-to-reach groups.

References to the research

(The following 3 pieces are in REF 2)

Grants:

Ellis R, Collaborative Doctoral Award, with the Thackray Medical Museum, AHRC (Sept 2010 — Aug 2013) — circa £50,000

Ellis R, Research Award, South West Yorkshire Mental Health Trust, Jan 2013 — Jun 2013 — £1,500

Ellis R, Research Award, South West Yorkshire Mental Health Trust, Mar 2013 — Oct 2013 — £3,240

Ellis R, Connected Communities: Research for Community Heritage funding, Mental Health and Learning Disability, Heritage and Stigma, AHRC, Feb 2013 — Jan 2014 — £32,099

Details of the impact

Ellis's research into mental health history has informed current practice by challenging longstanding notions of cost, stigma, equality and related concerns. Exemplifying the unit's key strategic aim of partnership working, this influence has been achieved through collaborations with a wide range of stakeholders, including the NHS and the third sector, and via extensive outreach that has successfully engaged both specialists and the public.

Since 2012 Ellis has collaborated with the South West Yorkshire Partnership NHS Foundation Trust as part of its Change Lab programme. One of Change Lab's flagships has been `Breaking Down Barriers to Wellbeing'. Using the volunteer-led Stanley Royd Museum in Wakefield as a focal point, Ellis was invited to devise and deliver teaching and learning activities for a diverse group of visitors. The Trust's Programme Coordinator has described Ellis's contribution as clearly demonstrating "that the museum can play a significant role in fulfilling the Trust's mission and objectives" [a]. This has led to further investment — including refurbishment, the appointment of a professional curator and greatly extended opening hours. As a result, the Trust has been able to convert an under-used and under-resourced museum into a vibrant hub to meet Change Lab's aims of "engaging others in thinking about mental health and breaking down the barriers and stigma that surround it". The Trust has confirmed that the "learning activities that [Ellis] developed had a positive impact on attitudes towards mental health and learning disability" [a].

This collaborative venture built on earlier partnerships developed by the History team, in particular the Out of the Shadows exhibition at the Thackray Medical Museum in 2010. Ellis was invited by the Thackray and Leeds City Museums to act as academic lead. The aim was to enable and encourage debate on mental health provision. Ellis's research led to participation in the project by those who might otherwise be excluded from heritage initiatives, and visitors to the exhibition included current service users. The Community Team Manager at Leeds City Museums has pinpointed Ellis's "passion, enthusiasm and knowledge" as key to not only ensuring the success of the project but also securing additional funding. [b] This has enabled Leeds Museums to follow up Out of the Shadows with other exhibitions, extending the initial reach. The project also led Ellis to act as PI on a joint bid with the Thackray for an AHRC collaborative doctoral award, securing £50,000 to explore further the themes that emerged from the project.

In 2011 the University of Huddersfield Archives Service and the West Yorkshire Archive Service (WYAS) submitted a joint application to JISC, with Ellis invited to be academic lead on HistorytoHerstory, a project to document the lives of Yorkshire women from 1100 to the present day. The aim of the bid was to repurpose an existing database of archival material for an interactive website, with Women and Mental Health among eight key themes. Ellis's role was to coordinate the development of non-HE learning materials. Since its launch in October 2011 the website has averaged 40 new visitors a day and has been featured by BBC History Magazine, The Guardian [c] and various local media, including BBC radio. The Head of Archives at WYAS has noted that it was only through Ellis's expertise in the field of mental health history that it proved possible to open the mental health records to the wider public [d]. Moreover, the demonstrable success of the project played a significant part in a successful initial bid to the HLF for a new archive building for WYAS.

Through Huddersfield's successful Connected Communities project Sound Craft Vision Place, Ellis worked with mental health charities to develop individual projects. St Anne's Our Minds, Our Histories and Mencap's Social History of Learning Disabilities were awarded Heritage Lottery Fund funding of £8,000 and £9,500 respectively following these collaborations. Ellis's supplementary bid in 2013 to the AHRC to enhance these projects has led to wider engagement and dissemination, including further work with Leeds City Museum [e]. Leeds Mencap's Head of Fundraising has remarked that Ellis's "research expertise helped... to both raise [our] profile and disseminate key messages about learning disability and inclusivity" [f], while St Anne's has credited the research with helping the organisation change the way in which mental health and service users are represented [g]. In 2013 Ellis's work on stigma and mental health also led to engagement with the Orleans Gallery, a local-authority-run gallery in Richmond-on-Thames, allowing it to frame an exhibition on `outsider' art within a broader context and so draw on wider funding, raising the profile of both `outsider art' and the gallery itself [h].

Sources to corroborate the impact

a. Change Lab Programme Coordinator, South West Yorkshire Partnership NHS Foundation Trust. Work with Stanley Royd Museum.

b. Community Team Manager, Museums and Galleries Leeds. Out of the Shadows Exhibition.

c. Guardian report on HistorytoHerstory launch — http://www.guardian.co.uk/uk/the- northerner/2011/oct/05/herstory-archive-jill-liddington-anne-lister

d. Head of Archives, West Yorkshire Archive Service. HerstorytoHistory Project

e. Health and Wellbeing: The Contribution of the Arts and Humanities, AHRC — http://www.ahrc.ac.uk/News-and-Events/Watch-and-Listen/Documents/AHRC-Health-and- Wellbeing-accessible-pdf.pdf (see page 12)

f. Head of Fundraising and PR, Leeds Mencap. Social History of Learning Disabilities

g. St Anne's Community Services. Our Minds, Our Histories Project — http://www.ahrc.ac.uk/News-and- Events/News/Documents/AHRC%20Research%20for%20Community%20Heritage%20accessible.pdf (see page 10)

h. Orleans House Gallery — http://www.richmond.gov.uk/literature_festival_2013_brochure.pdf (see page 20)