Israel Kolvin, psychiatrist: born Johannesburg 5 May 1929; Professor of Child Psychiatry, Newcastle University 1977-90; John Bowlby Foundation Professor of Child and Adolescent Mental Health, Royal Free Hospital Medical School, London 1990-94, Emeritus Professor of Child Psychiatry 1994-2002; married 1954 Rona Idelson (one son, one daughter); died London 12 March 2002.
Child and adolescent psychiatry entered a new phase of its short existence in the early and mid-1960s.
The subject, previously dominated by psychoanalytic theories, especially those formulated by Sigmund and Anna Freud as well as by Melanie Klein and Donald Winnicott, then became open to empirical research studies aiming to investigate the nature, extent and causes of emotional and behavioural disorders in the general child population. The findings of these epidemiological and clinical studies have had an important impact on policies for children and for the development of services. For at least two decades, the UK led the world in this approach and still plays a major role. For four decades, Israel Kolvin was right in the forefront among those who pioneered such work.
Kolvin's early life was not easy. He was born in Johannesburg in 1929; his father died when he was six years old and subsequently his family suffered significant financial hardship. He went early to the University of Witwatersrand, but had to take some years out of his medical studies to earn enough money to continue. During those years out, he successfully completed a BA degree in Psychology and Philosophy before he returned and qualified in medicine.
As a young doctor in the mid- and late 1950s, he worked on the wards and in the admitting room of Baragwanath Hospital in Soweto. The malnutrition on the children's wards and the severe psychiatric conditions presenting in the emergency room both made a profound impression on him. As an undergraduate, he had read much Freudian psychology, so it was natural that he should consider a career in psychiatry. With few training opportunities open to him in South Africa, Kolvin obtained a place on a psychiatric training scheme in Edinburgh. Attracted by the approach of one of the consultant child psychiatrists there, Margaret Methven, he decided to specialise in this subject and went to Oxford to work with the brilliantly original Kit Ounsted.
Kolvin was highly productive in research in Oxford, carrying out a particularly important study comparing children with autism and those with psychotic disorders such as schizophrenia. Prior to this work there had been considerable confusion about the status of autism as a psychotic or a developmental disorder, and Kolvin's work, still quoted, clarified the issue considerably and, with other studies, firmly established autism as a developmental condition.
He was appointed consultant in charge of the Nuffield Psychology and Psychiatry Unit in Newcastle upon Tyne in the mid-1960s. Child psychiatry was a Cinderella speciality throughout the whole of the north of England at that time, but Kolvin's leadership enabled him to establish a strong academic department, carrying out excellent research.
He seized the opportunity of the existence of a cohort of children born in the city in 1947, the so-called Thousand Family Study, to study the effects of social deprivation and disadvantage from one generation to the next. He was able to show significant movement over time towards improved social conditions in a number of individuals, demonstrating that children living in deprivation could overcome their disadvantages, but that there was also significant inter-generational continuity.
Another of his achievements in Newcastle was an evaluation of the effectiveness of different forms of psychotherapy delivered in schools. This was groundbreaking work, published in an influential book, Help Starts Here (1981). Many believed psychotherapy was not capable of evaluation, but this study demonstrated not only that it was possible, but that meaningful results with significant implications for practice could be obtained.
Kolvin had been appointed to a personal chair in Newcastle in 1977 to become one of the first chair holders in child psychiatry. In 1990 he made a bold late career move when he was appointed to the John Bowlby Chair of Child and Family Mental Health jointly held at the Royal Free Hospital and the Tavistock Clinic in London.
This was quite a challenge. The Tavistock Clinic, though productive in theory and in the development of psychotherapeutic approaches, had not previously shown itself to be particularly sympathetic to empirical, hypothesis-testing research. Kolvin's combination of modest persuasiveness, doggedly applied over time, produced highly positive results and a significant number of empirical studies were launched under his guidance. A multi-centre (London, Athens and Helsinki) study of the effectiveness of psychotherapy in depressed children, and a comparative study, published only a fortnight before Kolvin's death, of two types of psychotherapy applied to sexually abused girls, are particularly notable.
Throughout his career Kolvin was supportive to young researchers. A number of his staff, including Rory Nicol, Ian Goodyer, Marnie van der Spuy and Stuart Fine went on to work productively in senior posts in the UK and abroad. He shouldered major responsibilities in his field, holding senior positions, including the Treasurership, in the Royal College of Psychiatrists and acting as Chair of the Second Opinion Panel of the Cleveland Inquiry in which accusations of sexual abuse were rigorously tested.
Issy Kolvin was a serious workaholic who always had difficulty leaving his desk. He was dictating research papers until a couple of days before his death. But he was, in addition, a warm, compassionate man, immensely concerned about the children and families under his clinical care. With Rona, a greatly supportive wife for over 40 years, he built a wonderfully happy family life. His close family helped him to face, with bravery and stoicism, the test of a dreadful, prolonged final illness.
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