Refugee doctors and the development of psychiatry

Cohn et al (2006) were perfectly correct to point out the potential of refugee psychiatrists in reducing the recruitment crisis in psychiatry. However, on the basis of the contribution to psychiatry of previous generations of refugees, they also have the potential to contribute significantly to the development of the discipline.

In considering the careers of our refugee colleagues today, we need also to look back to the influx of refugees during the Nazi era, many of whom were hugely influential in the development of psychiatry in Britain from the 1930s onwards. As refugees, they had hurdles to overcome similar to those faced by today's refugees; a new language, the loss of their homelands and, for many, the traumatic deaths of their families. Some are known to have escaped the Nazis at the very last minute, such as Max Glatt (a pioneer in the treatment of alcoholism), Erwin Stengel (remembered for his later work on suicide and attempted suicide and as a professor of psychiatry in Sheffield) and Sigmund Freud. Even in the 1930s, well-qualified doctors from abroad were required to obtain a British medical qualification in order to continue in medical practice.

During the Second World War, some refugees had the further indignity of internment in the Isle of Man as ‘enemy aliens’. They included Erwin Stengel, Felix Post (pioneer in old age psychiatry) and the psychiatrist and psychotherapist Adam Limentani. Some, such as Frederick Kräupl Taylor and Felix Post, went into psychiatry aware that their foreign backgrounds would not permit them entry to more popular medical specialties.

Among the refugees was Willi Mayer-Gross, previously a professor of psychiatry in Heidelberg, who also had a distinguished career in Britain; his Clinical Psychiatry with Eliot Slater and Martin Roth became a standard textbook. Alfred Meyer became a professor of neuropathology, Joshua Bierer founded the first day hospital in Britain and Michael Balint became widely known for his work on psychological aspects of general practice.

There were women psychiatrists too, such as Liselotte Frankl, Stefanie Felsenberg and Ida Macalpine (psychiatrist and medical historian), as well as others who came to this country as children and after a lifetime of psychiatric practice continue to contribute in retirement to British psychiatry.

This list is by no means exhaustive, but in essence, the best summary is probably that in Ida Macalpine's obituary (C.J.E., 1974): ‘she was one of that number of medical men and women who sought and found refuge in Britain from Nazi persecution… and lived to enrich by her achievements the country of her adoption’.