Elizabeth Casson

Dorset House

In 1926, Casson visited an occupational therapy centre in Bloomingdale Hospital, New York City, whilst on holiday, and decided that the UK needed a similar facility; in the late 1920s, Casson decided to establish one. She borrowed £1000 (equivalent to £38,644 in 2025) from her brother, Lewis, to help set up the occupational therapy centre. Dorset House opened in Clifton, Bristol, in 1929 as a residential centre for women with mental health issues. She expanded Dorset House and on 1 January 1930 the UK's first occupational therapy school, known as Dorset House School of Occupational Therapy opened, and she became medical director herself. Miss Constance Tebbit (Alice Constance Owens) was the first Principal. The school's course would teach not only the medical subjects such as anatomy and physiology, but also occupational treatments such as weaving, bookbinding, and other crafts, as well as how to organise activities such as country dancing and how these activities applied to occupational therapy. Ciné films of these activities can be found at the Dorset House archive held by Oxford Brookes University library.

Casson's vision for Dorset House was that of a 'community where every individual was encouraged to feel that she had a real object'. Having seen the benefit, in the United States and at Octavia Hill, she combined medical interventions with education and recreational approaches. She actively involved herself in the daily therapeutic activities, often inspired by her artistic childhood and build closer relationships between patients and staff, creating a community feel. At one point she even cast herself in Dorset House's drama production, playing Mr. William Collins in their 1934 rendition of Pride and Prejudice.

Days would be structured so that activities would be planned throughout, with occupational therapy carrying on into evenings and at weekends. A typical day would include breakfast then flower arranging until 10:30, followed by an hour in the occupation room for therapy. After their work, the patients would go for a walk or join in community singing until 2pm. Between 2pm and 8pm there would be more time in the occupation room, a period of rest and time in the garden. At 8 pm there would be community games and country dancing. Casson believed it was important to keep the therapy room separate from the rest of the department, as it was specialised knowledge. She also insisted that certain activities, such as knitting, were not used as it was not sufficient distraction from the patient's fantasy system. Some concern existed that patients would not accept being put to work, but of her 100 patients in 1931, only six refused the therapy. A member (and later fellow) of the British Homeopathy Society, Casson also included homeopathic treatments in her programme for the patients.

Dorset House Clinic had space for 800 patients in residence during the 1930s. In 1938 Dr Casson appointed Miss Evelyn Mary Macdonald, a former student, as Principal of Dorset House School, a post she held for 33 years. The School moved to Bromsgrove during World War II. The building was damaged during the war, so in 1946, the School of Occupational Therapy moved to Oxford, whilst the patients moved to Clevedon. To ensure costs were kept down for the patients, Casson subsidised their treatment from her own funds. She began to release control of the projects in 1948, first by passing the school to a nonprofit company with her as vice-president and remaining as medical director. Then, in 1949, Casson created the Elizabeth Casson Trust which focused on occupational therapy treatment and education, with the majority of funds going to Dorset House school. In 1992, the school became part of Oxford Brookes University; the Elizabeth Casson Trust continues to support occupational therapists in professional development activities, service development and leadership.

Societies

Outside of her work, Casson was a member of Bristol societies. She never lost touch with her Welsh roots, discussing the similarities between Wales and Bristol with the Lord Mayor at a meal in 1931 and becoming president of the Bristol Cambrian Society in 1934. She also became the president of the Soroptimist Club of Bristol between 1938 and 1939 and was vice president of the Bristol branch of the British Social Hygiene Council in 1939.

She was an advocate for women working in roles outside offices, suggesting government grants for women who wanted to be nurses or teachers and giving lectures to parents about her work in occupational therapy in 1935. With the Soroptimist club she gave talks to her fellow members, praising the influence of Octavia Hill and explaining that she was interested more in mental health than physical health. She advocated an ordered life and a happy atmosphere for everyone.

As the vice president of the Social Hygiene Council, she worked to ensure that the people of Bristol could give better sex education to their children, without shocking them. She did this in part by hosting a series of lectures called "Sex Education and the Child", investing the profits from the lectures in providing educational materials for those who could not afford them.

Legacy

In 1951, Casson received an OBE for her work establishing Dorset House and was also elected a fellow of the World Federation of Occupational Therapists. She was considered a pioneer in the field of occupational therapy. She died in Bristol on 17 December 1954 after suffering from anaemia. The funeral was held on 22 December 1954 at St Andrew's Church, Backwell.

The Royal College of Occupational Therapists holds an annual memorial lecture in Casson's name and the Callington Road Hospital in Bristol has a psychiatric intensive care unit named after her. In 2005 a pink rose was named in her honour. A Casson rose was planted in the Red Cross Garden, Southwark, where Casson worked for Octavia Hill. To mark International Women's Day in 2022, the Royal College of Psychiatrists published a blog post entitled 'Dr Elizabeth Casson, 100 years on.'