Emergency Hostels for Difficult Children
- Author:
Evelyn Fox, C.B.E.
The Editorial Board does not hold itself responsible for the opinions of contributors Vol. I. No. 4 OCTOBER 1940 Price lOd. (1/- Post Free)
In the original evacuation scheme, drawn up to meet a contingency that was still theoretical and hopefully remote, attention was largely concentrated on the Process of getting children out of London and other vulnerable areas and on the task ?f ensuring that a billet of some kind was available for every child who needed it. On the whole, the schemes worked amazingly well and there was no lack of co-opera- tion on the part of householders who willingly received into their homes, for an indefinite period, unknown children accustomed for the most part to an entirely different environment.
But there was one aspect of the problem to which sufficient attention was not ?iven by those in authority and the nature and extent of which it has taken time to reveal. In making its evacuation plans, it is true the Ministry of Health realized that there would be blind children, deaf children, crippled children and mentally defective children for whom special provision would be needed, and the Board of Education in its Circular 1469 issued in May 1939, referred to a small proportion ?f children who would not be acceptable in ordinary billets on account of ” behaviour difficulties ” and who would need accommodation of hostel type. Experience, however, quickly showed that the number of such children was far greater than was Anticipated and that the upheaval involved in being sent away from a familiar home to live with strangers precipitated in many cases trouble of a serious nature. More- ?Ver, the discovery of these children was left to chance, for no provision had been made in the official plans for the visiting of the schools to be evacuated and for the Ascertaining of cases likely to present special difficulties. Had this been arranged, during the twelve months September 1938-9, much unnecessary suffering both to the children and hostesses could have been avoided.
In October 1939, in its Circular 1882, the Ministry of Health drew attention to the Board of Education’s suggestions as to hostels for ” problem children, but it Was not until February 1940 that the subject of Hostels was fully dealt with in an official communication (Evac. Memo. 8) and the various types of children for whom they were required enumerated in detail. From its formation in January 1939, the Cental Health Emergency Committee has been alive to the need for recognizing the Urgency of making provision for children who could not be fitted into ordinary blllets, and in September 1939 it instituted a system of loaning Mental Health workers to receiving areas for the purpose of helping to deal with evacuation problems of the kind.
From every area to which these workers were sent, overwhelming evidence was received as to the peculiar needs of these ” difficult ” children. Where Billeting Officers were people of understanding and where the help of trained social workers was available, it was found that much could be done by discussion and advice to clear up problems which were disturbing the child or his foster-parent, or by transfer to a more appropriate type of billet to help a child whose disordered behaviour had its roots in unhappiness and insecurity. Nevertheless, it was proved beyond doubt that when everything possible along these lines had been done, there still remained a residue of children unable to adjust to any billet, however carefully chosen, without a preliminary period of skilled observation and understanding treatment, and that for this group, provision for Hostel placement was essential.
Billeting Authorities had early discovered that Hostels of some sort were going to be necessary for children who were ” misfits ” through minor illnesses or dirty habits, as well as through temperamental difficulties, and that there were others for whom emergency provision must be made either because foster-parents could no longer put up with them or because illness or domestic crisis in the household necessitated their removal. By the spring of this year such Hostels or ” sick bays ” had sprung up in every Civil Defence Region under the auspices of Billeting Com- mittees, or voluntary organizations with little understanding of the needs of the various and often very different groups for which they catered. Such a Hostel often served only a small area, and any kind of classification or specialization was therefore impossible. To add to the difficulties, the problem of staffing was acute, for, although the Ministry of Health was prepared to meet administrative expenses, the responsibility of the actual running of the Hostel devolved entirely on the local Committee. Many workers with knowledge and experience of difficult children were discovered by the Mental Health Emergency Committee by means of its special Register, but the demand nevertheless continued to exceed the supply.
Confronted by these acute problems, the Committee, in November 1939, suggested to the Ministry of Health that a useful purpose could be served if a Survey of existing Hostels were instituted, and in May 1940 it was asked by a responsible authority, through the Child Guidance Council, to conduct a Survey in one region. This Survey was accordingly carried out by an Educational Psychologist with special experience of the problems involved, and her report on the twenty-two Hostels visited was recently before the Committee.
The data collected, not only through the Survey and by Mental Health workers all over the country but from various other sources of information also, indicate that the main problems connected with the Hostels as at present constituted are as follows:
Classification of Hostels.
Selection of Children.
Provision of Skilled Advice.
(4) Staffing and Training of Workers. (1) Classification
At present, owing to the mushroom growth of the majority of the Hostels, no systematic attempt is made at classification. Practically all of them contain a mixed group of children sent there for various and diverse reasons?e.g. for minor physical ailments, for delinquency, for enuresis, for mental defect or for some deep-seated Psychological disturbance needing prolonged treatment. Some local Billeting Officers frankly regard the Hostels as ” dumping grounds ” for any children present- lr*g any sort of difficulty, transient or chronic, mild or severe; others send to them children for no other reason than that the parents would take them home if they were left with an ordinary foster-mother. Children suffering from some purely temporary emotional disturbance, who should be drafted back to billets after a short period of observation, continue to remain in the Hostel indefinitely, and generally speaking there is no clear concept in the mind of those responsible as to what exact need the Provision is intended to meet. This failure to classify the children sent to any one Hostel also intensifies the staffing difficulty, for while a Warden may be excellently adapted to deal with one special type of child, he or she may fail entirely in handling a problem of quite another type.
To meet this difficulty, it has been suggested* that the Hostels should be established on a regional basis and that they should be of the following types:
Sick bays for children suffering from minor physical complaints and disorders.
(b) Clearing and Observation Homes where difficult children can be under observation for a period. In connection with these, it is recommended:? (i) That a person with special training in psychological methods should examine the children, and that the time of stay should be limited. (ii) That the Warden in charge should be able to give reliable observation and that the Home should therefore be adequately staffed. (Note.?This Home could also accommodate children temporarily out of billets because of illness or absence of the householder.) (c) Homes for children suffering from temporary emotional disturbances, e.g. spasmodic enuresis, behaviour difficulties due to mishandling, wrong environment, etc. (d) Homes for children with persistent psychological difficulties?persistent enuresis, stealing, truanting, etc., also those of backward intelligence and educational retardation from causes other than lack of intelligence. Note.?The Homes under (c) and (d) should, when at all possible, be placed in an area where psychiatric advice is available, at any rate for the more serious cases.
Selection of Children
The usual procedure for selecting children for admission to a local Hostel ls that a complaint against a child is made by a householder either to a Medical Officer or a Billeting Officer. This is then investigated (with varying thoroughness) and brought before the authority responsible for the Hostel. Whether or not the * This suggestion and others indicated in our article are, at the time of writing, under c?nsideration by the Mental Health Emergency Committee.?Ed.
child is admitted thereafter rests frequently on the opinion of one person only, and there is no guarantee that that person has any special understanding of the implications of psychological disturbance.
Any systematic classification of Hostels such as is suggested above, makes it of primary importance that a more enlightened method of selection and disposal of children should take the place of the present haphazard procedure, and so far as possible it is suggested that it should be placed in the hands of a worker with special training and experience, e.g. a Psychiatric Social Worker or trained Mental Health Worker or an Educational Psychologist working under a Psychiatrist or the Medical Officer supervising the Hostel or group of Hostels (if such exist) and in co-operation with all the Billeting Officers concerned. Such team work would go far to ensure that the right choice of Hostel is made, and that, moreover, a child is not accepted for any Hostel if his need can equally well be met by a change of billet.
Provision of Skilled Advice
In only a few Hostels do there appear to be any facilities for skilled psychological or psychiatric treatment nor are the services of a psychiatric social worker usually available. That such assistance should be forthcoming is considered to be of the utmost importance, and wherever possible the services of a consulting psychiatrist, through a local Child Guidance Clinic or at the Children’s Department of a Clinic for Mental Treatment should be available. If such facilities are quite unobtainable, it is suggested that Wardens should at least have the right to call in the help of a specially trained Social Worker in any case of special difficulty. She should also be used for the purpose of re-billeting, in co-operation with the Billeting Officer, children who are considered to have made a satisfactory adjustment as the result of their treatment in the Hostel, and her close and constant touch with the Hostel should ensure that no child drifts on there simply because it is no one’s concern to see that he is discharged. This worker should, if possible, be employed by the Local Authority in whose area the Hostel is situated?a grant for the purpose can now be obtained from the Ministry of Health and many appointments of the kind have been made?but if for any reason this is not possible, it is suggested that there should be such a worker for each Civil Defence Region under the Regional Medical Officer of the Ministry of Health and that an essential part of her duty should be the work described above in connection with any Hostels in the area.
It should be pointed out, however, that as the number of cases, both adults and children, needing social help because of mental disturbance, is at present so great and ever-increasing with the evacuation of the civilian population from danger zones, she should be used only for this special work and not employed also in social work of a more general nature.
A further consideration in regard to the provision of skilled advice for Hostel staffs, is that which concerns the needs of children who are mentally dull, educationally retarded for some other reason, or actually mentally defective. In every Hostel such children are to be found, and they attend the local Elementary School where too often there is no provision for ” C ” children as a group or for individual remedial teaching. In view of the scarcity of such provision in the country as a whole even in normal times, and of the present general educational disruption, facilities of the kind can hardly be expected, but their absence tends to add very considerably to a Warden’s difficulties in helping this particular group of children. To find a practicable solution of the problem is not easy, but it might perhaps lie along the lines of arranging for teachers in a reception area, courses of lectures by an Educational Psychologist on methods of dealing with the dull and backward. Such courses can be given through the Mental Health Emergency Committee by the Educational Psychologists on the staff of the Central Association for Mental Welfare.
(4) Staffing, and Training of Workers
Essential as it is that Hostel Wardens should be people specially suited for this difficult work, it may not be desirable at present to prescribe any rigid rules as to qualifications or attainments, for it has been found that the types of workers at present employed are many and diverse. Some of them have had previous experience with ” problem ” children, some have a knowledge of nursing, but more often they are people whose only qualification is ” commonsense ” experience in catering and domestic management. Occasionally a Committee is lucky enough to find someone with a natural gift for handling children, though without any academic qualifications, but such persons are rare. In view of this general lack of adequate training and experience the absence of facilities by means of which Wardens can obtain expert advice on handling cases of special difficulty (referred to above) is all the more deplorable, particularly when?to their credit?most of them are only too aware of their limitations and only too anxious to receive such advice. To this difficulty there is added the all too frequent handicap due to the fact that no informa- tion as to a child’s past history and special difficulty is supplied on admission, and the Warden is left to experiment blindly until he hits on the best method of approach. Nevertheless, in spite of all these adverse factors it is found that Wardens everywhere, with too often no special experience or training and their hands unneces- sarily tied, are carrying on their difficult task with the utmost devotion and the highest tribute is due to them for the great measure of success they have achieved. In reviewing the necessity for the careful selection of Hostel Wardens, the Rental Health Emergency Committee has found itself confronted with the need for Jnstituting some specialized course of training for suitable candidates, possessing the right type of personality and with an innate understanding of children’s difficulties (qualities which are regarded as of greater significance than any academic qualifica- tions). A sum of money has been set aside by the Child Guidance Council for this Purpose from a Treasury Grant allocated to it, and a three months’ Course of Training is now being instituted for older women chosen for their innate suitability to be given in selected Children’s Homes. No fee will be charged, and candidates desiring to make application for it are being invited to send particulars of their previous experience, age, etc., to the Registrar, 24 Buckingham Palace Road, S.W.l.
So impressed is the Committee with the urgent need of arriving at a better understanding of the principles which should be observed in connection with the selection of children for Hostels, their management, staffing, etc., that it is prepared to lend free of charge to a limited number of Regional Medical Officers of the Ministry of Health, workers with special experience of the subject, to carry out a Survey of existing Hostels in areas under their jurisdiction. For this service it is hoped that early application will be made.
The Mental Health Emergency Committee has envisaged the future and not only the present compelling need. For?despite the haste with which they have been set up and their consequent shortcomings and inadequacies, especially the frequent lack of fully equipped psychiatric services?experience of these Homes for Difficult Children has demonstrated beyond all shadow of doubt that they have a permanent part to play in the world after the war. Every Local Education Authority and every Child Guidance Clinic is, under completely normal conditions, frequently called upon to deal with children whose emotional tangles can only be satisfactorily sorted out in a speci- ally organized environment and to whom “wholeness of mind” can only be brought if they are removed for a time from the disturbing conditions under which they are living. Too often it has been found impossible to provide what is so urgently needed. In these Emergency Homes, though they have frequently had to work under insuper- able difficulties, unhappy children have found happiness, insecure children have been made to feel secure, frustrated children have been released and children ostracized because of bad habits making them a burden too intolerable for the ordinary house- holder to accept, have been restored to the company of the socially adapted. It is surely unthinkable that this wartime experiment should be brought to an end when the special circumstances which evoked it are ended, and the Committee is concerned to urge that no effort should be spared to ensure that the Homes should not only be more systematically organized as a war emergency measure but that they should be modelled on a pattern which can readily be fitted into the machinery of a community at peace.
Note.?The Mental Health Emergency Committee referred to above consists of representatives of the Central Association for Mental Welfare, the Child Guidance Council, the National Council for Mental Hygiene, the Association of Mental Health Workers and the Association of Psychiatric Social Workers. Its chairman is Mrs. Montagu Norman. A leaflet describing its work can be obtained from the Hon. Secretary, 24 Buckingham Palace Road, S.W.l.
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