18 February 2010

John Henderson obituary







Psychiatrist, reformer and adviser to Greece on mental health







Henderson was an early pioneer of social psychiatry

John Henderson, who has died aged 80, was an influential figure in psychiatry, mental health and human rights around the world. Long after official retirement, he continued his work with startling energy through a vast array of voluntary and non-governmental organisations right across Europe – especially Mental Health Europe, which he helped to found in the late 1990s.

In particular, he supported colleagues and activists working for the reform of the Greek mental health system. The appalling institutions for mentally ill people and those with learning disabilities on the Greek island of Leros, in the south-east Aegean, became more widely known from the early 1980s. When full, the institutions had housed around 3,000 people. During John's tenure at the World Health Organisation (WHO) in Europe, and as part of its accession to the European Union, Greece made a request for special assistance to reform and modernise its mental health system away from institutional care.

Controversially, a special programme was agreed in 1984. However, by 1987 nothing had happened to change conditions in Leros, very little money had been spent and there were moves in the European parliament to end the programme. Then an Observer journalist, John Merritt, and an independent film- maker, Jane Gabriel, decided simultaneously to draw the world's attention to Leros with dramatic press coverage swiftly followed by two powerful documentaries broadcast on Channel 4.

Such was the public outrage that a compromise was agreed by the European commission for the assistance programme to be renewed and extended for five years from 1990. John was asked, as part of this deal, to lead an independent team of experts working for the European commission to monitor and evaluate the progress of the reforms. For five years the European Commission Independent Team of Experts (ECITE) spent six to eight weeks a year in Greece reviewing progress in Leros and – just as importantly – reviewing the changes to the mental health system that would make the institutions on Leros and elsewhere in Greece redundant. It was a challenging assignment.

The outside experts were not always welcome or popular, and it required all of John's diplomatic skills and firmness to win the trust and co-operation of politicians, bureaucrats, officials, the medical profession, the staff and the patients of the institutions. The work that led to the eventual closure of the worst parts of the institutions in Leros and at other sites involved many people from Greece and elsewhere who came to change the terrible conditions. The contribution of ECITE under John's leadership was to keep the show on the road when it seemed that the political and administrative blockages would bring the reforms grinding to a halt.

The work of ECITE ended in 1995, with the worst abuses, at least, on the way to being dealt with. However, John and other team members were regularly invited back by the Greek government and by the organisations running the new services to monitor progress – especially when momentum was in danger of being lost. As recently as last June, John spoke at a memorable meeting in Brussels in front of EC commissioners, MEPs and officials as, once again, the reform programme was brought back from the brink of collapse.

Gabriel summed up John's contribution in Greece and more generally: "I remember some remarkable times with him and how he managed to maintain a cheerful equilibrium when all around was either as grim as it gets – or worse.

"He was a man who inspired a quiet optimism, and more than once kept me going in the Leros days, by insisting that improvement would come, and in that case, of course, he was right."

Born in the town of Galashiels, Borders, John attended Central secondary school in Aberdeen and Melville College, Edinburgh. He studied medicine at Aberdeen University, graduating in 1954, and undertook national service with the Royal Army Medical Corps, in Kenya (1955-57). He then trained as a psychiatrist at Kingseat and Cornhill hospitals in Aberdeen.

After becoming a consultant in 1963, John took up the post of physician superintendent, first at Bilbohall hospital, in Elgin, and then at Bangour, in West Lothian. In 1976, after two years at the Scottish Office, he took up his first international posting as a regional adviser in mental health for WHO in south-east Asia, and then moved to the European regional office in 1980.

The thread that ran through John's life's work was his belief that psychiatry should be about helping people with mental heath problems to have the possibility of a better life. That meant caring about the whole person and the circumstances in which they lived. He was one of the early pioneers of social psychiatry, a firm believer in the abilities and capacities of people living with and recovering from mental illness, and always a fierce critic of the discrimination and human rights abuses that were – and unfortunately still are – rife across many parts of Europe and the rest of the world.

John was kind, supportive and encouraging to those who were trying to do the right thing in challenging circumstances. It was this combination of stern authority, compassion and an in-depth knowledge of psychiatry and mental health as practised throughout the world that made him such a potent force for change.

He is survived by Toshie, his wife of 52 years, four sons – two of whom work in mental health – and 10 grandchildren.

Two weeks before his death John finally agreed to the wishes of his sons and colleagues to establish a foundation in his name to help continue the mental health work he so passionately believed in across Europe.

• John Henderson, psychiatrist and reformer, born 29 November 1929; died 4 January 2010