Julian was a great communicator and a well loved clinician by all of his patients. He travelled extensively worldwide discussing and demonstrating the importance of family work for recovery in schizophrenia, and later on developed AVATAR to help people deal directly with distressing voicesProfessor Elizabeth Kuipers
19 May 2021
Professor Julian Leff 1938 – 2021
Tribute to Professor Julian Leff, pioneer in social psychiatry, who passed away in February 2021
Julian Leff initially trained and qualified as a doctor at University College London medical school, before turning to psychiatry. The majority of his career - from 1972 to 2002 – was spent at the (then) Institute of Psychiatry at the Maudsley Hospital, where he became Professor of Social & Cultural Psychiatry and director of the Medical Research Council’s Social Psychiatry Unit.
During this period, he developed new approaches in the treatment of schizophrenia (including intensive group and individual work with families), and further developed research on expressed emotion of carers and relapse of schizophrenia. Much of his attention focused on family work with patients in the community. He was an advocate of issues related to migration and the role family plays in the life of an individual whether they have mental illness or not.
Professor Leff was director of the team for assessment of psychiatric services at the Maudsley, and led on a study exploring the emotional and social effects of deinstitutionalisation, following 1500 patients from 1985 to 2005 after the closure of two psychiatric asylums in north London and discharge of patients into the community.
For several years I worked closely with Professor Julian Leff at the Team for the Assessment of Psychiatric Services. This was a research team at Friern Hospital in north London whose task was to assess the impact of discharging over 1000 long term patients from Friern and Claybury hospitals. This was the largest, and in my view it was also the most important, study of deinstitutionalisation ever carried out. The results were clear: that on the large majority of outcomes community care was more effective and more cost-effective than long term care in the asylums. Because of this project, and also because of his other important areas of research, his work has had a positive, lasting international impactProfessor Sir Graham Thornicroft
As Emeritus Professor, he continued to work and created avatar therapy, in which digital avatars are created to represent the internal voices experienced by people with psychosis to help them cope with the distress caused by those voices.
Professor Leff wrote more than 200 papers and nine books on psychiatry. He won the Royal College of Health’s Starkey prize in 1976, and became a fellow of the Royal College of Psychiatrists in 1979. He received the Burgholzli award from the University of Zurich in 1999, the Marsh award for mental health work in 2010, and the Pelicier lifetime achievement award from the World Association of Psychiatry in 2017. He was awarded honorary Fellowship - the highest honour given by the Royal College of Psychiatrists - in 2015.
Few psychiatrists develop any successful new treatments. Julian Leff developed four. Firstly, the value of the prophylactic use of antipsychotics to prevent the return of psychosis; secondly family therapy to reduce the adverse effects of high expressed emotion; thirdly methods of successfully returning patients to the community who had been in psychiatric hospitals for decades; and fourthly, the value of avatar therapy in reducing the voices that torment patientsProfessor Sir Robin Murray
The thoughts and deepest sympathies of the IoPPN community are with Professor Leff’s family, work colleagues, collaborators and friends.