My friend Julian Leff, who has died aged 82, was a psychiatrist who broke new ground in the treatment of schizophrenia, including through an approach that involved intensive group and individual work with families instead of just the patient alone. He also invented avatar therapy, in which patients create computer avatars of the voices they hear and thus find a way to talk back to their hallucinations. It has proved so effective that it is now being pursued in four centres across Britain.
Julian was born in Kentish Town, north London, to Vera (nee Levy), a writer, and Sam, a doctor. He left Haberdashers’ Aske’s school at the age of 16 and went to University College London medical school, where he qualified as a doctor. He worked as a house officer at University College hospital and the Whittington hospital before turning to psychiatry.
The main part of his career, from 1972 to 2002, was spent at the Institute of Psychiatry at the Maudsley hospital in south London, where he became professor of social and cultural psychiatry and director of the Medical Research Council’s unit. It was during these years that he pioneered his group and individual sessions with schizophrenia patients. The work led him to visit many other institutions around the world that were keen to have him talk about, and run workshops on, his approach.
During the era when large, old-fashioned mental hospitals began to be closed in favour of care in the community, Julian was director of the team for assessment of psychiatric services at the Maudsley, and from 1985 to 2005 conducted a study of the emotional and social effects of the deinstitutionalisation on 1,500 former patients who had lived in various hospitals. Creative even in retirement, it was after he had finished at the Maudsley that he came up with avatar therapy.
Julian wrote more than 200 papers and nine books on psychiatry, with much of his attention focused on family work with patients in the community. He won the Royal College of Health’s Starkey prize in 1976, 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 a popular personality whose remarkable sense of fun stood him in good stead in the last few years of his life, when he faced a degenerative disease with calmness and humour.
He is survived by his second wife, Joan (nee Raphael), a psychoanalyst who is my first cousin, their three children, Jessa, Jonty and Adriel, a son, Alex, from his first marriage, which ended in divorce, Joan’s son Michael from a previous relationship and nine grandchildren.
