James Leatham Tennant Birley, known as ‘Jim’, was an eminent psychiatrist who was instrumental in shifting the provision of mental health services away from long-stay psychiatric hospitals towards community-based care. He was born near Harley Street in London, the son of James Leatham Birley [Munk’s Roll, Vol.IV, p.562], a neurologist, and Edith Birley née Tennant. When Birley was six his father died and he moved to his grandparents’ house in Essex. He was educated at Winchester College, where he was head boy, and then studied medicine at University College, Oxford, and St Thomas’ Hospital, London. He qualified BM BCh in 1952.
After junior posts, he carried out his National Service as a junior specialist in the RAMC from 1954 to 1956. It was during this time he first became interested in psychiatry. In 1957 he was a demonstrator in pathology at St Thomas’ and then, from 1958 to 1959, a medical registrar at North Middlesex Hospital. He was subsequently a psychiatry/neurology registrar at St Thomas’. In 1960 he joined the Maudsley Hospital, where he stayed for the rest of his career, becoming a consultant in 1968.
His commitment to what he described as ‘the social revolution in psychiatry’ developed in the early 1960s, when he was working at the Medical Research Council’s social psychiatry research unit at the Maudsley with George Brown and John Wing. In 1960 Birley conducted research which showed that patients who were suffering from psychotic episodes were likely to have experienced some sort of recent life crisis. His article on his findings, co-written with George Brown, was rejected by the British Journal of Psychiatry, but was published in the United States in the Journal of Health and Social Behavior and became a classic (‘Crises and life changes and the onset of schizophrenia’ J Health Soc Behav. 1968 Sep;9[3]:203-14).
Birley established the Windsor Walk Housing Association, which provided loosely-supervised accommodation in the community for patients. He also founded the Camberwell Rehab Association, a company that trained and employed patients, and the Southwark Association for Mental Health, which raised funds for local community services. He was also the chief organiser behind the Thorn Nurse Training Initiative, a curriculum for community psychiatric nurses, with the aim of including family and patients in deciding best care. The Maudsley’s 18-bed facility for acutely ill women has been named the ‘Jim Birley unit’ in his honour.
Despite a huge clinical load, he was dean of the Institute of Psychiatry (from 1971 to 1982) and later dean of the Royal College of Psychiatrists (from 1982 to 1987). He then became president of the Royal College of Psychiatrists, a post he held until 1990. From 1993 to 1994 he was president of the British Medical Association.
In the latter part of his career, Birley was involved with psychiatric reforms in the Soviet Union and the Eastern bloc. He represented the Royal College of Psychiatrists at the World Psychiatric Association meeting in 1989, when the Soviet Union was readmitted under strict conditions. He was a leading member of what is now the Global Initiative on Psychiatry, which campaigns against poor psychiatric practices abroad. He was an actively involved in the Network of Reformers in Psychiatry until 2000.
In 1991 he retired from clinical practice and he and his wife Julia (née Davies), whom he had married in 1954, went to live on the Welsh-Herefordshire borders. There he tended a large garden. Jim Birley died from Alzheimer’s disease and was survived by his widow Julia, their four children, Rosalind, Margaret, Humphrey and Ellen, and ten grandchildren.
RCP editor
[The Guardian 24 October 2013 http://www.theguardian.com/society/2013/oct/24/jim-birley – accessed 28 November 2015; The Telegraph 3 November 2013 www.telegraph.co.uk/news/obituaries/10423704/Jim-Birley.html – accessed 28 November 2015; The Independent 7 November 2013 www.independent.co.uk/news/obituaries/doctor-jim-birley-pioneer-of-local-care-who-also-changed-the-way-we-view-schizophrenia-8927945.html – accessed 28 November 2015; BMJ 201 347 6612 www.bmj.com/content/347/bmj.f6612?hwoasp=authn%3A1448817965%3A1019339%3A1454434226%3A0%3A0%3AvvGLddJsDNpDtEEGBkiKGw%3D%3D – accessed 28 November 2015; University College Oxford www.univ.ox.ac.uk/univ-news/james-leatham-tennant-birley-1946 – accessed 28 November 2015; Bethlem and Maudsley Hospital Gazette, Spring 1969, 10 (3) p.5-6; Institute of Psychiatry Annual Report 1991, p.20]