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OBITUARY : Professor Michael Shepherd

Anthony Clare
Tuesday 29 August 1995 23:02 BST
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Over the last 40 years in psychiatry much of the attention has focused on the rundown of the psychiatric hospital and the redeployment of psychiatrists and other mental health professionals in the community. However, history may well decide that a more significant shift in thinking has been the realisation that the overwhelming majority of people suffering symptoms of psychological ill-health never make contact with the specialised psychiatric services but are seen, diagnosed and treated for better or worse within the primary health care services by their general practitioners. The recognition of this fact is owed almost entirely to Michael Shepherd whose seminal work Psychiatric Illness in General Practice (1966) served as a catalyst for this whole area of mental health research and policy for the best part of 30 years.

Shepherd's insistence that the mental health services could only be enhanced by better training and better support for GPs rather than a proliferation of psychiatrists did not endear him to many of his psychiatric colleagues but it has since been endorsed by a succession of World Health Organisation declarations and is enshrined in a variety of Government strategy documents, including The Health of the Nation (1992).

Shepherd, one of a cluster of intellectually gifted doctors drawn in the immediate post-war years to the Maudsley Hospital, in London, by his great mentor Sir Aubrey Lewis, founded the General Practice Research Unit at the Institute of Psychiatry in the late 1950s and he continued to direct its activities until his retirement in 1988. In 1967 he had conferred on him a personal chair of epidemiological psychiatry, the first of its kind in the world.

Throughout his remarkably productive career he remained one of the most influential and internationally respected psychiatrists of his time. In common with many of my generation at the Maudsley, I regard Michael Shepherd as the most challenging, provocative and inspiring teacher I ever encountered. His single-minded dedication to the scientific method, his hostility to vague speculation and woolly posturing and his incisive analytical skills made him at times a discomfiting colleague to have around.

He was temperamentally incapable of flattery, could and often would systematically dissect and if necessary destroy an argument and had a merciless eye for the fraudulent. He was unusual, indeed virtually unique, in his lack of ideological bias. Psychoanalysis and drug treatment, behaviour therapy and diagnostic concepts were regularly and rigorously subjected to his sceptical gaze. He was as critical of the contemporary and unbridled enthusiasm for more and more detailed psychiatric classification as he was of the heady assertions and Olympian arrogance of the Freudian movement.

Shepherd was awesomely well read, fluent in several European languages and familiar therefore with the 19th- century German and French origins of today's Anglo- American psychiatry. Throughout his life he maintained a vigorous campaign for the necessity of understanding the social origins and the political context of psychiatry - he edited with William Bynum and Roy Porter the two-volume The Anatomy of Madness (1985) - and no other individual in British psychiatry could move with such felicity and wisdom from an analysis of the racism inherent in the thinking of Emil Kraepelin to an exposition on the Sherlock Holmes-type fantasy at the heart of the great Freudian mythology.

He wrote and co-authored over 30 books and some 200 original articles, established and edited for many years Psychological Medicine, arguably the finest psychiatric journal in the English-speaking world, and masterminded the production of the five volumes of his monumental Handbook of Psychiatry (1982). Among the honours he received was the CBE (he was appointed on his retirement), the Donald Reid Medal for Epidemiology and the Lapousse Award of the American Public Health Association.

Michael Shepherd was the inspiration behind countless psychiatric careers, including my own. He was without equal in his record of selecting, nurturing and encouraging young men and women who would go on to fill senior academic posts in Britain and throughout the world. He was particularly alert in identifying able and committed doctors in Africa, Asia, South America and Eastern Europe on his travels there, and he would make every effort to ensure that they could come and spend some time at the Maudsley which he long argued should remain one of the world's great postgraduate centres for psychiatric teaching and research. In the latter years there he remained an incorrigible opponent of the growing mass-production trends in contemporary university teaching with their emphasis on multiple-choice examination and impersonal teaching methods, and he remained incorrigibly devoted to the tutorial approach of which he was a consummate practitioner.

Few appreciated the extent to which Michael Shepherd was at heart a private and a family man. He suffered greatly following the protracted death of his wife Margaret in 1992, but derived enormous support from his children, Catherine, Simon, Lucy and Daniel.

He was a wonderfully entertaining friend, somewhat shy and formal in manner. He had a multitude of interests from ballet to rugby football, took a great personal interest in the personal lives and backgrounds of those with whom he worked yet he remained an intensely private person who shunned anything approaching sentimentality. As a consequence, he probably had little idea of the intense feelings of affection and respect he generated in those of us privileged to work for him.

Anthony Clare

Michael Shepherd, psychiatrist: born 30 July 1923; Reader in Psychiatry, Institute of Psychiatry, London University 1960-67, Professor of Epidemiological Psychiatry 1967-88 (Emeritus); CBE 1989; books include A Study of the Major Psychoses in an English County 1957, Psychiatric Illness in General Practice 1966, Psychotropic Drugs in Psychiatry 1981, Handbook of Psychiatry 1982, Psychiatrists on Psychiatry 1983, (co-editor with William Bynum and Roy Porter) The Anatomy of Madness 1985, Sherlock Holmes and the Case of Dr Freud 1985, Conceptual Issues in Psychological Medicine 1990; married 1947 Margaret Rock (died 1992); died 21 August 1995.

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