Edward HareDonald McLartyPhilip Edmund Clinton Manson-BahrMichael O'SullivanRobert William Trainer MasonDesmond Richard Levinge NewtonIan Rea SmithKenneth Arthur TomlinsonJune Rosalind Wilkie (neé Hill)BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7080.609 (Published 22 February 1997) Cite this as: BMJ 1997;314:609
- Edward Hare, consultant psychiatrist
The son of a clergyman, Edward Hare first read biochemistry at Cambridge before deciding to switch to medicine. Found to be unfit for military service in the war because of partial deafness, he soon entered psychiatry at Cardiff City Mental Hospital and later at Bristol. Here he wrote an MD thesis on the ecology of mental hospitals, with its effects on patients. He then turned to studying why the rates of schizophrenia are higher in the centre of cities than elsewhere. His findings supported the “drift” hypothesis-that those who are developing serious mental illness become detached from their families and move into areas of anomie. This work impressed (Sir) Aubrey Lewis, who subsequently invited him to apply for a vacant consultant post at the Bethlem-Maudsley Hospitals. Here he remained a committed clinician (though his time included a spell as chairman of the medical committee) and a detached and critical commentator of the passing fashions within and outside the joint hospitals.
In 1983 Hare electrified the research community with his elegant Maudsley lecture asking in its title whether insanity was on the increase. In the 19th century in Britain and the United States there had been a progressive increase in demand: both the numbers of asylums and of their inmates had increased. The “nosocomialists” believed that this was a result of demographic and social changes; the “alarmists” argued for an increase in incidence. In this debate Hare allied himself with the alarmists, concluding that “this increase was principally the type of insanity which in the 1890s Kraepelin called dementia praecox and which we now call schizophrenia.” This thesis challenged the complacent but ill documented established view that the incidence is constant across variations in time and place. Hare concluded that the historical evidence was compatible with a somatic cause and himself …