The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
December 1995 (Volume 73)
Quarterly Article
Hugh L. Freeman
September 2026
Sep 25, 2026
Sep 23, 2026
Back to The Milbank Quarterly
For over a century, the specialist mental hospital was the basis of psychiatric care in all industrialized countries. Britain was among the first to establish national requirements for asylum care, although these institutions were financed and managed locally. Psychiatric treatment in general hospitals began in the later eighteenth century, but, except for some outpatient clinics, this practice ended prematurely in the mid-nineteenth century, not to resume until after World War II. The National Health Service (NHS) provided the framework within which general hospital psychiatry was re-created, forming the nucleus for district services. Although the intent of NHS reform in the 1980s was to establish a reduced market hospital system that would continue to offer long-term care, this service seems likely to continue for only a few more years. “Reforms” in the NHS and social services have placed the whole of British mental health care in a situation of uncertainty.
Author(s): Hugh L. Freeman
Download the article
Read on JSTOR
Volume 73, Issue 4 (pages 653–676) Published in 1995