History tells us that the broader values of society can be just as important as those of psychiatry itself in shaping the way people with mental illness are treated. Historical scholarship also alerts us to the need to be circumspect about taking society’s self-declared values at face value, an example being the humanitarian reform of the care system for the mentally ill during the Victorian era where harsh and discriminating morality and a growing intolerance of society towards the marginal have also been demonstrated. Historically, in the UK, doctors have repeatedly found themselves limited in their ability to build a person-centred, therapeutic relationship with their patients by circumstances that were beyond their control, for example the overcrowding and strict legalism of the asylum system.

From the twentieth century onwards, there have been periods when society turned to psychiatry for advice about normal life. Anti-psychiatry emerged during a period when the idea that psychiatry could be a tool for social adjustment was under growing criticism; individual freedom began to be prized over conformity; and the service user movement started. One important legacy of the anti-psychiatry criticism is that psychiatry has become much more cautious about taking a public role on values.