O.B.E., B.S.C., M.D., F.R.C.S. ED
Obituary, British Medical Journal, 10th January 1970
Duncan Macmillan was born on 20 March 1902, and was educated at the University of Edinburgh, graduating B.Sc with distinction in 1922 and M.B., Ch.B. in 1925. He proceeded M.D. in 1926 and took the M.R.C.P. Ed and the diploma in psychology in 1930. He was elected Fellow of the Royal College of Physicians (Edinburgh) in 1944. From the outset his main interest lay in psychiatry, and having worked for a time in Scotland he was appointed deputy superintendent of Mapperley Hospital in 1930 and later, in 1940, its physician superintendent. Here he remained until his retirement in 1966 and here he fulfilled his life's work. He was appointed O.B.E. in 1960.
The transformation of the traditional mental hospital into a community-
Personal reflections of Duncan Macmillan
Dr Alfred Minto
In the early 1950s, working in another mental hospital I often heard sceptical reference to what was going on at Mapperley in Nottingham. Duncan Macmillan had opened the doors of his hospital and was claiming that being mentally ill did not mean that patients should be locked up forever. Scathing reference to "revolving door" psychiatry paid little heed to his views that several short admissions are preferable to one long spell in hospital which breaks down all the ties with family and job.
If the community in Nottingham did not care about mental health in 1950 Duncan Macmillan made it care by pushing the problem into the full glare of every kind of publicity he could raise. Opening up the hospital, taking psychiatry into the home, the school, even the Industrial Rehabilitation Unit at Long Eaton – all these initiatives were his.
These were the ideas but what about the man? Clearly he must have had great personal courage and integrity to tackle the social pressures against the mentally ill as they existed twenty-
To add to this problem colleagues appeared to stand in awe of him so that he was almost forced to remain a single-
Beneath the reserved lay a very sharp mind, listening, sifting, judging and storing up ideas even when their application might be years away. He had real doggedness of purpose, and ability to bide his time in the working out of a lifelong plan to improve the lives of his patients. And they were "HIS" patients. He had a commitment to the care of mentally ill people that never wavered. If sometimes he seemed reluctant to let go of even small details I never felt that this was the autocrat ruling with a rod of iron – much more his conviction that it was his duty to see through whatever he had initiated. This strength of purpose after made him curiously remote from his staff perhaps because we were thinking of "today" whereas he was way ahead. His "action now" had been worked out in relation to many actions planned for five or six years ahead and sometimes it was difficult for the rest of us to keep up with the long-
My own recollection is of an elusive private man who only let us see inside him when we saw his personal vision in action – to restore mentally ill people to rightful place in society. I could always sends his steely purpose, occasionally see the flash of dry humour and just now and again be given a fascinating glimpse of his hopes for the future. Not, of course, the easiest people to work with because his own output and application were daunting to lesser mortals, but he was also keen to encourage those around him who wanted to try out new ideas. If these went wrong he never condemned but tried to sort out what had happened so that anything good in a scheme might be developed and expanded. At these times he was kindness itself and I have good cause to remember him for that.
Not many people leave a living monument to their drive and integrity and fewer still live to see a vision translated into working reality. Duncan Macmillan did all that. Mentally ill people throughout the world who have never even heard of him and his beloved Mapperley have benefited from his foresight and respect for the rights of the mentally ill. The quiet, reserved Scot was a genuine revolutionary who achieved so much, so quietly that I doubt we will see his like again. That is his true measure – a uniquely gifted psychiatrist who worked out a dream that has improved life immeasurably for mentally ill people and who gave his staff and inspiration that will last all our working lives. It was a great privilege to have known and worked with him.
Personal reflections of Duncan Macmillan
J. D. Smith, Sector Administrator (Psychiatric)
After six years in the Army during the Second World War, I felt the need to settle down in some useful occupation. By pure chance that occupation turned out to be at Mapperley Hospital. I consider myself fortunate in that I was privileged to be involved at Mapperley Hospital during the time that the greatest strides were being made not only in the treatment of mental illness but in the attitude to mental illness.
The one person, of course, who was responsible more than any other for an enlightened approach to mental illness at Mapperley Hospital was Dr Duncan Macmillan who used to ring me up on the 1st January each year and say: "Are the figures ready Mr Smith?" in a dark brown sugar voice followed by a chuckle.
He knew very well that these annual statistics could not possibly ready but it was his way of indicating firstly how much importance he placed on the statistics as a way of proving to the world that his policies were working and secondly emphasising how anxious he was to have them as soon as possible.
In a lecture tour to America in the 1950s he astonished his contemporaries thereby his explanations of 50 per cent reduction in beds, 100 per cent increases in short-
From that point onward everything possible was done to find alternatives to long-
Dr Macmillan was a stern man but a man with a sense of humour, a man whose whole life was dedicated to his work; the fair man but a firm man whose mind once made up, seldom changed. But one thing is certain: he made his mark at Mapperley as, 14 years after his retirement, few weeks pass without the name being heard.
Since the days when the hospital was a close-