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Ronald Robinson

Psychiatrist

Psychiatrist

Born: April 18, 1924; Died: March 28, 2014

Ronald Arthur Robinson, known as Sam, who has died aged 89, was a pioneer in psychiatry in old age who formulated the idea of specialist assessment and treatment wards for older patients. He was also an important member of the group that developed what would become the Old Age Specialist Section - now Faculty - of the Royal College of Psychiatrists, eventually becoming its chair from 1978 to 1981.

His family roots were in Lancashire, but his parents moved to Northern Ireland and he was born in Holywood, County Down. He attended Sullivan Upper School in Holywood and studied medicine at Queen's University Belfast. His studies were interrupted when he volunteered for training as an RAF pilot, and were not completed till 1949. He later turned towards psychiatry, initially spending six months at Purdysburn Mental Hospital outside Belfast.

He trained at the Crichton Royal Hospital in Dumfries, at the time a centre of excellence that had attracted a group of leading psychiatrists, including Willy Mayer-Gross. Dr Robinson said it was Mayer-Gross in particular who directed his interests towards older patients.

As a trainee, he attended a conference on gerontology in London and was impressed by Wisconsin psychiatrist Raphael Ginzberg who was advocating an eclectic approach to mental illness in old age, incorporating psychological and environmental approaches as well as physical treatment: he called it attitude therapy.

The other stimulus for Dr Robinson came from a trainee research project on the relatively new technique of electroencephalography examination (EEG) to distinguish dementia and other organic disorders in older patients from functional disorders such as depression and psychosis.

At the time, the Crichton was trying out the idea of assessing older patients in the general admission wards, but this had only led to bed-blocking, so other solutions were being sought. Dr Robinson formulated the idea of a specialist assessment and treatment ward for older patients, paralleling developments in geriatric medicine.

He was given the chance to try this out as a new consultant, the ward opening in 1958. It was judged a success and he continued to develop the service, opening a day hospital in 1964 with the hope of maintaining the patient's home base and delaying or preventing admission to hospital.

He also made connections with psychiatrists in England who had been researching mental disorders in old age, such as Felix Post, and those who were beginning to think how specialist assessment services might be developed. The Crichton unit became the place to visit for those who were planning geriatric psychiatric services.

However, Dr Robinson was not a natural self-publicist and the ground-breaking nature of the Crichton unit did not get the recognition it deserved. It was the first comprehensive psychogeriatric service and an inspiration and model for others around the world. Another lasting element in the working of the unit was his Crichton Behaviour Rating Scale, which became widely used worldwide as a measure of the severity of psychiatric disability in older people.

The vision that Dr Robinson developed was that physicians and psychiatrists should be in the same hospital, working side by side and offering regular advice to each other on people with multiple problems, only transferring patients from one side to the other when absolutely necessary.

His contact with the late Dr Jimmy Williamson in Edinburgh presented an opportunity to put this idea into practice. The Royal Victoria tuberculosis hospital was being transformed into a specialist geriatric hospital and Dr Williamson wanted a psychiatric component to the service. Dr Robinson was appointed and moved to Edinburgh in 1971 to work in a hospital still only half built. He was presented with an assessment ward, a day hospital in the old recreation hall and four leaky wards in Bangour Village Hospital, the old asylum for North Edinburgh, 15 miles away.

His 10 years at the Royal Victoria were not all easy going but the Royal Victoria Old Age Psychiatry unit was a major success. Dr Robinson was a respected leader of a dedicated team, a fine trainer and teacher and a first-rate clinician who cared deeply about his patient's welfare.

The joint service worked for the great benefit of patients in Edinburgh and it too was widely admired and envied as a model that other areas found difficult to emulate. It was an idea of coordinated and comprehensive care joining the specialities and the community together for the benefit of the patient. The joint hospital service at the Royal Victoria survived for about 30 years after Dr Robinson retired.

He retired in 1981, but did several locum jobs, including two years at St Brendan's Hospital in Bermuda, where he found problems surrounding sex, drugs and alcohol bewildering at first.

He married Freda McDowell shortly before moving to Dumfries in 1951 and the couple had two daughters, Geraldine and Susan, and one son, Peter. Family holidays involved sailing off the Dumfries coast, and Dr Robinson kept a chalet in Cardoness.

In retirement he also bought a house in the marina of Port Grimaud near Saint-Tropez, two doors from Joan Collins, but was never able to afford the larger boat he dreamed of. He indulged his passions for crosswords and other competitions and for fast driving. He also became deeply involved in his family's genealogy, devoting several years to researching family history.

Always a keen golfer, he won the Lockerbie Senior Open in 1996, and continued to play, mainly at Dalmahoy outside Edinburgh, until declining mobility led him to give up in 2007.

He lived the last twenty years on his own, but he and his wife kept in regular touch and ended their days in the same block of flats in Morningside.

Freda died in 2012. Dr Robinson is survived by his three children and six grandchildren.

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