News and Notes
Professor Mapother
By the early death of Professor Edward Mapother both psychological medicine and the large circle of his friends have suffered an irretrievable loss. As Head of the Maudsley Hospital from its beginnings soon after the World War, he had a unique opportunity to build up a great psychiatric hospital and to develop not only the clinical but the teaching and research aspects. All these opportunities he grasped fully,
so that the Maudsley has come to be regarded as equal, if not superior, to any similar institution in the world. There is no doubt that Professor Mapother’s work has done much to establish psychiatry as one of the most important branches of Modern medicine.
Professor Mapother was closely associated with the work of the National Council for Mental Hygiene, of which he became a member in 1924, and served for some time ?n one of its Standing Committees. He also gave valuable help as a member of the Special Sub-Committee appointed by the Council to consider amendments and ^commendations in connection with the Mental Treatment Act of 1930. His wisdom and knowledge were always at the Council’s service, and in spite of the many demands ?n his time he was never too busy to give help and advice whenever it was needed. Our deepest sympathy goes out to Mrs. Mapother in the great loss which we share with her.
The Passing of a Pioneer
The death of Mrs. Elizabeth Miriam Burgwin on February 1st, at the age of 89, has revived memories of the beginnings of compulsory education for handicapped children.
When, in 1891, the London School Board instructed the School Management Committee to prepare a scheme for the establishment of Special Schools, they appointed Mrs. Burgwin?then Head Mistress of the Orange Street School, Southwark?to be Superintendent of such schools, and sent her on a six months’ tour to Germany and other countries to study their methods of teaching handi- capped children. On her return, the first Special Classes were organized in London, and in 1892 two Special Schools were opened.
From this time onwards, Mrs. Burgwin worked unceasingly to further the education of physically and mentally defective children and to develop educational method and technique designed to help them, and on her retirement in 1916, a testimonial of ?1,000 subscribed by teachers in Special Schools throughout the country (members of the National Special Schools Union of which she was President) marked the high regard in which she was held.
Mental Welfare Work and the War
Enquiries made from various types of areas in which active Mental Welfare work is being carried on, have revealed the fact that up to now the war has not, in the majority of instances, had any very appreciable effect on either the type or the volume of this work, except in reception areas where the closing of Occupation Centres and the development of Home Teaching in their place, has been necessitated. The following points from replies received may, however, be of interest:
The Cambridgeshire Voluntary Association is providing facilities in practical Mental Deficiency training for students attending the Mental Health Course (trans- ferred to Cambridge with the London School of Economics), and the opportunity of enabling them to see something of rural social conditions is felt to be a valuable one. The Cumberland and Westmorland Voluntary Association and the Suffolk Voluntary Association specially stress the increasingly acute shortage of institutional accommodation. In the former area this has been intensified by reason of the fact that one institution (Dovenby Hall) has received some 75 defectives evacuated from Shotley Bridge Colony, and in Suffolk the holding up of plans for an extension of institutional accommodation has meant that vacancies only now become available through the discharge of a larger number of patients on licence.
The chief effect of war conditions noted by the West Lancashire Association is the extra work arising out of the collective evacuation of Liverpool’s Occupation Centre children to North Wales.
The Kent Association reports some increase of visiting?usually in the more remote parts of the county?occasioned by unsuitable billeting of “problem” children. The Portsmouth Mental Treatment Department has noted a slight increase of work carried out for the Juvenile Court, due not to a heavier incidence of juvenile delinquency but to the fact that there is now a slightly larger proportion of subnormal children amongst juvenile delinquents. At the Mental Treatment Clinic there has been a definite falling off in attendances.
In Staffordshire all the ten Occupation Centres were closed on the outbreak of war and a temporary scheme of Home Teaching was substituted. Within three months, however, nine of the Centres were re-opened, and the tenth re-opened in February. The Lichfield Centre gave shelter to 30 defectives from West Bromwich for a fortnight at the beginning of the war. As Great Barr Colony has been required to evacuate 200 beds for other purposes, the pressure on institutional accommodation in the county is acute.
The Essex Mental Welfare Department has had a considerable increase of work both in evacuation and in reception areas, and has been able to offer useful service in connection with mentally subnormal evacuees, some of whom had?unclassified and unprovided for?found their way into evacuation parties at the last moment and quickly presented serious billeting problems. An increase in the number of Licence cases, and of applications for advice in dealing with difficult relatives, for whom the special arrangements hitherto made had broken down under stress of war conditions, is also noted.
In Oxford, the Mental Health Department has found itself called upon to deal with numerous problems connected with evacuees and with the local Hostel for Difficult Children, and the Child Guidance Clinic has had a great extension of work. This has led to the appointment of a Psychiatric Social Worker, part of whose time is allocated to the Mental Hospital.
Reference is made below to the work involved in connection with the exemption from military service of defectives under Statutory Supervision; one worker draws attention, in addition, to the problem of the feeble-minded ex-Special School boy (who, as such, is not exempted) accepted for military service and finding himself heavily handicapped by his inability to understand the technical instruction with which every recruit is now confronted. One of these willing but troubled lads, telling her ?f his fears of the time ahead in which he would be required to put into practice what he was supposed to have learnt, said to her: ” I can’t understand that Bren gun and will be the ‘ cells ‘ for me On the other hand, another worker reports that several high-grade boys known to her, who have found their way into the army, are doing well and are thoroughly happy.
Exemptions from Military Service
Amongst the categories who have been exempted from the provisions of the National Service (Armed Forces) Act, 1939, are the following: Men who are the subject of an order or inquisition under the Lunacy and Mental Treatment Acts, 1890 to 1930, or are being detained in pursuance of section twenty-five of the Lunacy Act, 1890, or as criminal lunatics or in pursuance of an order made under the Criminal Lunatics Act, 1884, or are undergoing treatment as temporary patients under section five of the Mental Treatment Act, 1930, or are persons placed in an institution or a certified house, or under guardianship, under section three of the Mental Deficiency Act, 1913, or are the subject of an order under section six, eight or nine of that Act, or are under supervision provided under paragraph (b) of section thirty of that Act, or are inmates of a home approved under section fifty of that Act, or are the subject of a notification under sub-section (2) of section fifty-one of that Act.
The completion of the necessary Forms claiming such exemption for defectives under Statutory Supervision is proving to be, in the more thickly populated areas, a somewhat formidable task involving much time spent in clerical work, visits of enquiry, and correspondence. Thus, in Birmingham, as noted above, the Special Schools After-Care Department is dealing with 1,000 such cases, and proportionately large numbers are being dealt with in London and Essex, and in every large urban area where a vigilant school Medical Service and an efficient administration of the Mental Deficiency Act have resulted in the extensive use of statutory supervision.
Mental Deficiency Institutions and the War
We are indebted to the Board of Control for the following information: Two Certified Institutions?Shotley Bridge Colony, Durham and Westwood, Bradford?have been completely vacated for the period of the war.
In twenty-one Institutions, a portion of the accommodation has been set aside to serve as a Casualty Section, and the displaced patients have been “overcrowded ” in the remainder of the buildings. These Institutions are:
Brandesburton Hall, Hull ; St. Catherine’s, Doncaster; Oulton Hall, Yorks; Cranage Hall, Cheshire; Brockhall, Lanes; Calderstones, Lanes; Leicester Frith; Aston Hall, Derbyshire; Coleshill, Birmingham; Great Barr Park, Birmingham; Cell Barnes, Herts; Bromham House, Beds; Borocourt, Oxon; Coldeast, Hampshire; Botley’s Park, Surrey; Hortham, Bristol; Hensol Castle, Glam; The Manor, Epsom; Leavesden, Herts; Caterham, Surrey; Darenth Park, Kent.
C.A.M.W. Annual Report, 1938-9 The Annual Report of the Central Association for Mental Welfare for 1938-9 is now available, and a copy will gladly be sent to any reader of this Journal who cares to apply to 24 Buckingham Palace Road.
The Report records the diverse activities of the Association amongst which may be noted its work for individual cases, its Guardianship scheme, its educational courses for teachers, doctors, workers in Occupation Centres, etc., its Holiday Homes, its after-care of epileptics, its organization of Occupation Centres and Home Teaching carried on for the Middlesex County Council, and its share in the maintenance (with the Child Guidance Council) of the Joint Register of Foster Homes for Nervous, Retarded and Difficult Children, and in the formation of the Mental Health Emergency Committee. A summary of the work of the North Eastern Council for Mental Welfare is appended, and a note is given of the work done in connection with the two Mental Hospitals in South Wales to which the Association has seconded a member of its staff.
The Report does not cover any part of the war period, but points out that if at first sight the difficulties of the present time seem overwhelming it should be remembered that they are no greater than those which threatened to submerge the Association at the outset of its career in August 1914.
The National Council for Mental Hygiene
Since the outbreak of war the Council has been directing special attention to the question of preventing the incidence of neurotic manifestations which would reduce our national efficiency, and of maintaining the morale of the civilian population in times of special danger. A large number of lectures have been given in many parts of the country to A.R.P. and First Aid Workers, nurses, teachers, etc., and also to the various units of the Port of London River Emergency Service. Syllabuses of special lectures have been prepared and widely circulated, and the Council is dealing with a great many applications for speakers.
Notes and articles of special value to civil defence workers of all kinds and for teachers in reception areas have also been prepared, and a series of articles ?n ” Psychological Problems of the War as they affect the Nurse” was recently contributed to the Nursing Mirror. It was felt that this series would achieve a valuable purpose in giving the general nurse some insight into the Psychological implications of illnesses with which they have to deal, especially war- time casualties.
The scenario for a mental hygiene film entitled ” Make Friends with Fear ” has been prepared by a special Committee of the Council. This is being produced under the auspices of the Central Council for Health Education and will, it is hoped, shortly be available for general release.
Regular monthly meetings of the Council’s Executive Committee have taken Place since hostilities began, and a joint Sub-Committee has now been formed, consisting of the members of the Council’s Standing Committees, who will consider in detail psychological problems arising out of the present situation. Meetings of this Sub-Committee will take place on the same day as the Executive meets.
Arrangements are being made to hold the Council’s Annual Meeting in June next, and this will be followed, as in former years, by a Public Meeting, at which an address on a mental hygiene subject will be given. The Council is also actively co-operating in the work of the Joint Mental Wealth Emergency Committee, to which reference is made elsewhere, and has contributed grants towards their expenses.
Cental Nursing as a Career
The essay on this subject, published in the present number of the journal, should help to stimulate the recruitment of mental nurses, for the writer has clearly expounded the great improvements in conditions of service which have taken place since the days when mental hospitals were popularly regarded as asylums for the irrecoverable, and where no great degree of skill in nursing was either expected or indeed considered necessary. The result was that this branch ?f the nursing profession tended to be regarded with some disfavour, as being lnferior and offering no great scope either for advancement or for the display of special ability.
The writer has rightly shown that far from this being the case candidates for mental nursing should not only be equipped with very high nursing qualifications, but should also possess in an exceptional degree attributes of sympathy and tact as well as patience and forbearance. These will enable him or her to understand the delicate mechanism of the human mind and so help to bring about the recovery of the patients in their charge. Mental nursing should be regarded as a highly skilled profession which demands of the best, since here we have to deal with patients who by the very nature of their illness require nurses with exceptional qualities both as regards training and personality. When this has become more generally recognized we may look for a considerable increase in recovery rates among mental patients, as upon the nurse depends to a great extent the chances of improvement and of ultimate cure.
Nurse Liddell, who contributed this essay, was awarded the “Lord” Memorial Prize for 1939, and successfully competed for a similar prize in 1938. The competi- tion, which was instituted by the Society of the Crown of Our Lord in memory of the late Dr J. R. Lord, C.B.E., Medical Superintendent of Horton Mental Hospital, is held annually under the auspices of the National Council for Mental Hygiene whose Selection Committee awards the prizes.
Mental Health Emergency Committee
This Committee continues to meet regularly and is working in close touch with the Board of Education and the Ministry of Health.
It is satisfactory to record that the Ministry has shown its appreciation of the value of mental health work amongst evacuated children by agreeing to make grants to two Local Authorities (Northampton and Reigate) to allow of the services of the trained workers loaned by the Committee being retained, and it is hoped that applications for such grants will be followed up by other Authorities.
The Ministry has also agreed to meet as an evacuation expense the cost of maintaining Homes for Difficult Children, including the salaries of trained workers and, where necessary, the cost of psychiatric treatment at a recognized Centre.
In Bradford, Brighton, Northampton and Reigate, the workers loaned by the Committee for work amongst evacuated children have continued to carry on, and workers have been sent, in addition, to Bedford, Caernarvon and Chester and to the Berkshire Mental Hospital. The Committee has also been able to give considerable assistance in connection with the Cambridge Survey of Evacuated Children.
Other matters considered by the Committee include the provision of treatment for children suffering from the effects of air raids (in conjunction with the Invalid Children’s Aid Association and the Women’s Voluntary Services), camps for evacuated children, the need for the provision of psychiatric teams for cases suffering from mental breakdown under stress of war conditions.
The Committee is seeking to keep an up-to-date record of Mental Treatment Clinics for children and adults, and has noted with satisfaction that a number of the former in London closed down at the beginning of the war, have now been re-opened.
Child Guidance Council
The Annual Report of the Child Guidance Council, published in February, contains a list of 48 clinics in England and Wales “recognized” by the Council, and of 13 clinics in Scotland represented on the Scottish Association for Mental Hygiene.
Clinics which have appeared in the Council’s list for the first time are the Cambridge Child Guidance Training Centre (Group 1) and three in Group 2a; the Portsmouth Clinic organized by the Mental Treatment Department, held in the school clinic, and in charge of Dr Mary Capes, the Royal Manchester Children’s Hospital Clinic (Dr Burbury) and the Barnsley Health Department Clinic (Dr Joyce Marshall). Two temporary ” war ” clinics also appear in the list; one at Guildford (Group 1) and another at Reigate (Group 2a). The new clinics in Scotland are the Royal Infirmary Clinic (Edinburgh) and the Kilmarnock Clinic held at the Child Welfare Centre.
Of the clinics which closed on the outbreak of war, only 7 in London have remained closed, and subsequent to the re-opening of the Maudsley Hospital Clinic, sessions for children were no longer held at the three ” North London ” clinics of the London County Council.
A new clinic is being established at the West London Hospital and some work ls also undertaken at the Elizabeth Garrett Anderson Hospital and at the Prince of Wales Hospital, Tottenham. Of the 46 clinics (i.e. excluding the ” emergency ” clinics) in the Council’s list, 17 are wholly supported by Local Authorities, 5 are Partly so supported and 24 are voluntary.
The Southampton Clinic, which was the only one to close outside London, was re-opened on January 1st. Bradford City Council has approved plans for the establishment of a full team clinic and it is expected that the appointments to the staff will be completed shortly after Easter. In Halifax, a visiting psychiatrist (Or. Montgomery) is seeing problem schoolchildren and delinquent children from the juvenile courts. At Burton-on-Trent, the Director of Education is interested in the establishment of a clinic.
From the Report of the Liverpool Clinic, just received, we note that despite the exigencies of the black-out and wartime travelling, the Midland Group of clinics was enterprising enough to hold a meeting on November 11th which was well attended. Dr Esher spoke on the psychological effects of war conditions, and the Paper was followed by a discussion on the place of Child Guidance in the mental health services of the country.
Earlier in the year, ” Play Therapy ” was the subject of an interesting discussion by the same group of clinics.
Miss I. M. Laird, M.A., B.Ed., a former holder of one of the Council’s Fellow- ships in Psychology at the London Child Guidance Clinic, has been appointed Woman Inspector by the Board of Control (Lunacy and Mental Deficiency).
Child Guidance in London
In the L.C.C. School Medical Officers’ Annual Report for 1938, particulars are given of the number of new cases of London schoolchildren treated at the various Child Guidance Clinics used by the Council. These are as follows: Maudsley Hospital, 397 ; London Child Guidance Clinic, 203 ; East London C.G. Clinic, 125 ; Institute of Child Psychology, 99 ; North Western C.G. Clinic, 25 ; Tavistock Clinic, 77 ; West End Hospital, 75.
A table giving the results obtained shows that 89 children were adjusted, 113 improved, 52 not improved, 198 found to be unsuitable or not co-operative, 25 placed* 12 transferred and 525 were still under treatment. The remaining 233 cases were referred for consultation only.
Cambridge Evacuation Survey
During the past four months, a Survey has been carried on for the purpose of collecting data on the experiences of Cambridge with some 400 children evacuated into that area from Tottenham. The services of teachers, educational experts, psychiatrists and professional social workers, in touch both with the foster-homes and with the children’s own homes have been enlisted, and the first results of the enquiry are now available, and embodied in a ” Memorandum on Practical Recom- mendations ” recently issued.
For dealing with the problems presented by ” misfits ” and difficult children* three types of homes are suggested:
1. A Hostel for the temporary reception of children who are unsuitable for immediate billeting by reason of health, cleanliness or behaviour (estimated at 5 per cent.).
2. A Home, or Homes, for Emergency and Observation providing for children needing immediate removal from billets owing to illness, etc., in the household or to problems created by the children themselves. (Estimated requirement: one home, accommodating 30, for every 4,000 evacuees.)
3. A Home for Difficult Children permanently unsuitable for billets and accommodating not more than 10 to 15 in each. (Estimated number: at least 2 per cent.)
Amongst other recommendations the Committee urge the appointment in every Receiving Area or group of areas of trained Social Workers (one to every 500 children) and of a Psychiatric Social Worker, and suggest that the Evacuating Authority should be required to appoint experienced and responsible School Helpers; one available for each head teacher, to deal with questions concerning the welfare of individual children.
In view of the wide publicity given to the sins and vagaries of evacuees and to the sufferings of foster-mothers, it is encouraging to be informed that, so far as this particular group of children are concerned, 70 per cent, were found to have made a normal adjustment to their new conditions, and to have presented no special difficulties.
The Chairman of the Research Committee is Dr Susan Isaacs and the Hon. Secretary, Miss S. Clement-Brown.
Mental Deficiency Course for Medical Practitioners
It is satisfactory to be able to record that despite war conditions, the Central Association for Mental Welfare was able to hold as usual the Course on Mental Deficiency and Allied Conditions arranged annually in co-operation with the London University Extension and Tutorial Classes Council, for medical practitioners. The Course, which began on Monday, April 8th, with 65 students, and lasted a fortnight, followed the lines of those held in previous years, and included lectures, clinical instruction and practice in mental testing under the supervision of a psychologist. It is designed specially for School Medical Officers, Certifying Officers to Local Authorities under the Mental Deficiency Acts, and Medical Officers of Institutions.
A Medical Officer of Mental Health
In the recommendations made at the end of her Survey of the Mental Health Services in Oxford City, Oxon and Berkshire, Dame Ellen Pinsent urged the ” immense advantage ” which would be attained ” if each Authority had on its medical staff one man who, both by qualifications and experience”, was an expert in Mental Health matters.
The Feversham Committee arrived at much the same conclusion although its recommendation on the subject takes the form of advocating that every Authority should appoint a mental health staff (psychiatrists, psychologists and social workers) to be shared between the mental health committee and the education committee. Such a development may seem to lie very far in the future but it is encouraging to note that war exigencies have brought about something very much like it in Oxford, where the Medical Superintendent of the Mental Hospital has been appointed to act for the Medical Officer of Health as Director of all Mental Health Services for the duration of the war.
Aconsultingpsychiatristhasbeen appointed by the Hertfordshire County Council.
Mental Welfare Library
The attention of our readers is called to the C.A.M.W.’s Mental Welfare Library, which is able to supply books of interest to Mental Health workers of all types? teachers of retarded children, supervisors of Occupation Centres, workers in Institu- tions, psychiatric social workers, psychologists, students in training, etc. The annual subscription for one volume (excluding postage) is 10s. ; subscriptions for shorter periods (6 months, 5s. 6d. ; 3 months, 3s. 6d.) are also arranged.
Enquiries are invited and should be addressed to the Librarian, 24 Buckingham Palace Road, S.W.l.
Child Guidance Publications
A list of the Council’s publications has been printed and is available on applica- tion to the Medical Director at 23 Queen Square, Bath. The 1939 Supplement to the list of books on child psychology in the English language will shortly be available.
Staffordshire Mental Welfare Study Week
We are asked to announce that the Study Week held annually by the Staffordshire Mental Welfare Association, will again be organized and is to take place from Monday, July 29th to Friday, August 2nd.
Provisional particulars can be obtained from Mrs. Jennie Benson, Organizer of Occupation Centres, Crabbery Chambers, Crabbery Street, Stafford.
Staffordshire Mental Welfare Association
On April 1st, 1940, the staff and functions of this Association were taken over by the Staffordshire County Council with whom, since its foundation 20 years ago, it has worked in close co-operation, resulting in the gradual creation of a scheme for the community care of defectives, including the establishment of a network of Occupa- tion Centres and Industrial Classes covering the county.
The value of the ” voluntary ” side of the work is fully recognized by the Council and provision is made for the continuance of the Association, and for the activities of its Voluntary Visitors and its Local Committees to be left undisturbed. In this way there is ensured the preservation of the ” voluntary spirit “, which has been in the past, and will continue to be in the future, such an essential factor in pioneer achievement.
Scottish Association for Mental Hygiene
On the outbreak of war, the Scottish Association set up an Emergency Committee consisting of the President (Sir William M’Kechnie), with the chairmen of the Sectional Committees, Dr Clarkson (Mental Defect), Professor Drever (Child Guidance) and Dr Harrowes (Mental Health) for the purpose of carrying on the work and of dealing with any new problems that presented themselves.
The Committee meets regularly and has turned its attention particularly to the possibility of helping in the solution of billeting and other problems connected with evacuation, and of securing the re-opening of After-Care, Occupation and Employment Centres which were closed down on the outbreak of war. It is also arranging for lectures on Mental Health subjects to A.R.P. and other war workers, and it is hoping to publish articles in the Scottish press dealing with the psychological effects of air raids and other wartime conditions.
The Secretary of the Association, which, it will be remembered, represents an amalgamation of the Scottish Association for Mental Welfare and the Scottish Child Guidance Council, is Dr Constance Hunter, and its address: 23 Eglinton Crescent, Edinburgh.
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.