Professor Hugh Lionel Freeman

Formerly Editor of the British Journal of Psychiatry (1983-1993)

The simplest people are often the most complex. Hugh Freeman, who died aged 81 in May, 2011, was one of them. On the surface, he was a local boy from Salford made good by steady advancement from Altrincham Grammar School to a scholarship at Oxford University, and from there to become a Captain at the Royal Army Medical Corps, then completing his psychiatric training at the Maudsley Hospital to return to Salford in triumph as a consultant psychiatrist heading up a vibrant service. But Hugh had hardly started his career at this point. Salford was the launching pad for a multifaceted future involving consultancy to the World Health Organization, the initiation of one of the first comprehensive data registers in the UK (at Salford), editorship of the British Journal of Psychiatry, acting as the founding editor of Current Opinion in Psychiatry, Honorary Visiting Fellowship of Green College, Oxford, being awarded the Anniversary Medal of Merit at Charles University, Prague, Honorary Professorship at the University of Salford (which became a full university in 1967), and Honorary Fellowship of the Royal College of Psychiatrists.

But this does not explain Hugh adequately. With these accolades he was clearly a figure of worth and a member of the establishment, the curious concept of respectability that shows you have made it in society. He did not seem that way to me. At academic meetings it was Hugh who bluntly asked the questions that the ordinary hard-working psychiatrist might ask: ‘What evidence have you that this would work in practice outside a teaching hospital?’, ‘Do you really expect that a busy psychiatrist would have the resources to do what you are recommending?’, and, more simply - in despair - ‘Are you in the real world?’ He might have appeared a curmudgeon in such settings, but he was not. Hugh had a very good knowledge of history - his Oxford scholarship was in this subject - and this not only made him a natural editor of books about the history of psychiatry but also helped him to take the long view when it came to the current practice. He was fully aware of the implications of the concept of community psychiatry and the need for any advances to be made across the range of service settings. As he wrote more than 40 years ago, ‘Community psychiatry is not just extramural work or a means of avoiding hospitalisation. A community mental health service is a comprehensive psychiatric service of care and treatment for a defined population, including full hospital facilities’. It was this abiding interest of a comprehensive service that led him to establish the Salford Psychiatric Case Register, a magnificent exemplar of the value of the genre, and to show, for example, that when the closing of mental institutions was in full swing, the care of the most severely ill was still predominantly based with hospital services, not with community ones.

Hugh was Editor of the British Journal of Psychiatry from 1983 to 1993. During that time he made many changes that have ensured the stability and long-term success of the Journal. These included the appointment of a fully professional staff, stimulating the Gaskell book series, with 40 volumes published during his editorship, the development of an accurate audit of all aspects of publications, and the establishment of the Publications Management Board, which has secured the financial stability of this part of the College's activities. Some of the changes have not been attained easily; Hugh introduced supplements to the Journal and some of these have been a valuable source of income to the College, but this was only achieved against a certain amount of opposition. On occasions such as these Hugh always stuck to his guns. If his mind was set on an aim he would see it not as an aspiration but as a clear destination that not only could, but definitely would be achieved, and he was seldom proved wrong. His strong sense of purpose was accompanied by his quiet demeanour. I never heard him raise his voice even when faced with vociferous antipathy. He could also be remarkably kind and thoughtful towards colleagues and staff, and this surprised many as superficially he often appeared to be detached.

My personal explanation of Hugh's complexity, at least in professional terms, is Salford. Salford does not have a good reputation. For many years its main association was with the popular song, Dirty Old Town. The tightly packed houses (8 square miles were covered by the Salford Register) were not noted for elegance or splendour, and when reading accounts of the Register's findings I often seemed to hear in the background the words of the song dragging me down the narrow alleys:

Found my love by the gaswork croft,

Dreamed a dream by the old canal,

Kissed my girl by the factory wall,

Dirty old town, dirty old town.

I feel for Salford personally. We Tyrers all come from Wigan, like Salford a dormitory town for Greater Manchester, and for years it too, ever since Orwell's The Road to Wigan Pier was published in 1938, has tried to escape the epithet of ‘dirty old town’. But it has been more successful than Salford in getting some semblance of national respectability, probably helped a little by the performance of its very upright football team. Salford, even its sound hinting at disillusion, has struggled less effectively to create a new image. So in many ways I saw Hugh as standing up for all the lost and forgotten Salfords of this world. If you satisfied the requirement, ‘Do unto Salford what you would do unto others’ he would approve, but not until you had firmly convinced him it was not just flannel. And it was when you approached him on this level that you saw the real Hugh Freeman. I first encountered this when I was trying to get hold of a book I first read as a medical student, Trends in Mental Health Service by Freeman & Farndale. I managed to find a copy, quite by chance, in a second-hand bookshop in Paris, and when I next saw Hugh I waved it in front of him and explained its background. The rest of his face became secondary to a broad smile. ‘And were you at all disappointed on reading it again?’, he asked merrily. ‘Not at all, the message is still right, 40 years later’, I responded. And it was.

Hugh was blessed with a happy marriage to Joan Casket (Freeman), well known as a professor of psychology who has recently received a Lifetime Achievement Award from the British Psychological Society for her work with gifted children. In their 54 years together they constantly encouraged and supported each other's work. She and their three sons, Stephen, Justin and Felix, a daughter, Rachel, and two grandsons, survive him.