This talk will take a trip though the highs and lows of half a century at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) and the Maudsley Hospital in Denmark Hill.

I arrived at the Maudsley Hospital in 1972, nearly 50 years after it first opened its doors to the public. At the time, the (then) Institute of Psychiatry, though small, was very influential worldwide partly because European psychiatry had not yet recovered fully from the war while psychiatry in America was totally preoccupied with psychoanalysis.

The Institute of Psychiatry’s reputation rested especially on social psychiatry and clinical psychology. Much of the clinical research was carried out by consultants in the Maudsley and Bethlem hospitals where clinical care was much less pressured than now.

There were Neuroscience departments but, surprisingly, they did little research into psychiatric disorders. I was the first psychiatrist to work in the Neurochemistry Department. By chance I inherited the Genetics Unit and, in 1982, I was elected Dean - the only way to get a free parking space near the building! As Dean and subsequently Professor of Psychiatry, I was able to contribute to the huge expansion of the IoPPN, and to The Maudsley taking over psychiatric care for much of South London.

Over the 50 years I have worked with many colleagues more brilliant than I. Some who didn’t initially get much credit have had major influences on the development of psychiatry, while the work of others has faded into obscurity. Psychiatric research become much more competitive both internationally and, in the UK, but the IoPPN has mostly maintained its reputation for quality research, and now the Neuroscience departments do much more work relevant to psychiatric patients.

A major sadness is that a decade of austerity and neglect of inner cities has resulted in more local people becoming ill and put huge strains on our clinical services - consequently we are not able to deliver the quality of care that patients deserve. In my view mental health professionals, both local and national, need to be much better advocates for our patients than we have been.