When I began what was then called psychiatric nurse training in 1974, the medical model was unquestionably the dominant model in the UK. With this tradition, powerfully in the ascendant, the consultant psychiatrist was king, and his (they were usually men) kingdom was the traditional mental hospital. Built under the terms of the 1845 Lunacy and County Asylums Acts, these huge mostly isolated Victorian buildings dotted the countryside of England and Wales.