OBITUARY:Dr Stephen MacKeith

Stephen MacKeith was a consultant psychiatrist with an almost matchless breadth of experience, obtained through taking a new appointment roughly every seven years in a 60-year career that took him all over Britain.

MacKeith was an idealist especially interested in the social aspects of medicine and was for many years an active member of the Keppel Club, with a membership concerned with social issues. He unstintingly sought, by using forward planning and innovation, to improve the spheres of medicine with which he came into contact, both in psychiatry and in health education. He was interested in helping the less popular sub-specialities such as child psychiatry and learning disability, and also encouraged a scheme for the reintroduction to medicine of women who had left practice to bring up a family.

MacKeith was born in 1906 into a medical family with a general practitioner father and three brothers, all of whom became consultants; Stephen took a scholarship at St Mary's Hospital Medical School, in London.

MacKeith's clinical career was in the best tradition of the pre- and post-war mental hospital. A flair for administration led to two successive posts as Deputy Medical Superintendent, at Hatton Hospital, Warwick, and Graylingwell Hospital, Chichester, the latter being interrupted by the Second World War, in which he served with the Royal Army Medical Corps as a War Office adviser and as a command psychiatrist. He saw action in North Africa and Italy and was Psychiatric Adviser to Allied Force HQ under General Eisenhower. For his war service he was appointed OBE. After the war, he returned to the post he had vacated to join the RAMC but was then appointed as Physician Superintendent at Napsbury Hospital, in St Albans, which then had care of over 2,000 patients.

MacKeith next moved to a purely clinical consultant post in Norwich, where he developed a highly successful private practice and during which he was also seconded to the World Health Organisation for two periods, advising on psychiatric services and hospitals in the Far East. This was followed by a further seven years as Medical Superintendent at Warlingham Park Hospital, in Surrey, further enhancing its well-deserved reputation as a standard-bearer of psychiatric innovation.

Perhaps MacKeith's most far-reaching contribution came in 1964, when he moved to Hampshire, this time combining a clinical post at Knowle, outside Southampton, with that of Regional Tutor in psychiatry. He established and developed the Wessex Regional School of Psychiatry and painstakingly organised one of the first comprehensive day-release courses in postgraduate psychiatry, initially for the Diploma of Psychological Medicine and later for the Membership of the newly formed Royal College of Psychiatrists, of which he was a Founder Fellow.

On MacKeith's retirement in 1973, the Regional School and its courses were in a strong position, when taken over by the academic department of psychiatry in the newly formed Medical School at Southampton, where MacKeith's legacy is maintained to this day.

MacKeith started on his retirement from psychiatry a new career in health education in Southampton. This took him to Western Australia, where he was for five months a visiting teaching Fellow at the Perth Institute of Technology. In 1980-81, he spent 10 months in the United States, lecturing at the Stanford University Medical Centre and the Department of Psychiatry of the University of Alabama. Further trips to universities in Australia followed in 1984. Two years earlier, he had given up his work in health education, thereafter working as an Honorary Visiting Fellow to the Department of Psychology at Southampton University.

MacKeith was always interested in the imaginary world of children. In co-operation with Robert Silvey he studied and wrote on the private worlds of children, for which MacKeith coined the word "paracosm", and he co- wrote, with David Cohen, The Development of the Imagination: the private worlds of childhood (1990).

As a colleague he was a rewarding companion, with a fund of stories and a gift for listening which made him always available for advice. As such he was the ideal trainer in an apprenticeship system, teaching by example the wrinkles of clinical psychiatry with as much acumen and enthusiasm as he would the administrative inspection of a long-stay mental hospital ward. He was intensely, but not intrusively, interested in the progress of his junior colleagues and friends. Even after his final retirement, he remained active, studying the history of military psychiatry, and writing poetry. His marriage to Frances, daughter of the eminent psychotherapist Millais Culpin, was exceptionally fortunate and they celebrated their golden wedding in 1988. For many years Stephen MacKeith had attended the meetings of the Society of Friends in Winchester but only became one of their members about three years ago.

John Grimshaw

Stephen Alexander MacKeith, psychiatrist: born Southampton 20 September 1906; Consultant Psychiatrist, Hellesden kHospital, Norwich l950-57; Physician Superintendent, Warlingham Park Hospital, Surrey 1957-64; Consultant Psychiatrist, Knowle & Southampton Group Hospitals 1964-67; married 1938 Frances Culpin (three sons, three daughters); died Winchester 10 September 1995.