Mental Health Emergency Committee
News and Notes.
The Mental Health Emergency Committee has been much encouraged by a generous grant from the Treasury, designed to be used for the continuance and extension of the work of its constituent bodies at a time when their activities were threatened by lack of funds. The money was to be distributed to these bodies but a large proportion has been handed back by them to the Mental Health Emergency Committee, so that it will now be possible to continue to send loan workers to Reception Areas to assist with the solution of problems arising out of evacuation and also to extend this service to other types of work.
The Ministry of Health has sanctioned the appointments of Psychiatric Social Workers at a salary of ?300 per annum at Brighton, Caernarvon, West Riding, Bedford and Flax Bourton. In addition the Berkshire County Mental Hospital has made a Permanent appointment after having had a loan worker for three months.
The whole question of evacuation is at present in some confusion as a result of the movement of East Coast and Channel Islands populations. It is expected, however, that there will be an increased demand for Mental Health Workers and the Committee continues to be in a position to supply these in very special cases?at first on the basis of loan service?if the Local Billeting Authority will make an application to the Ministry of Health for their employment. It is felt that this loan service is fulfilling a very important piece of propaganda work, for nothing can be as effective as an actual demonstration of what can be done by a Mental Health worker and it is hoped that these emergency appointments may lead to a permanent service when peace returns.
The Register of workers qualified to be Superintendents of Hostels for Difficult Children in the Reception Areas is proving to be of value and several vacancies have keen filled through it. The Committee has also been able to arrange for workers With suitable qualifications who are interested in such posts to have a short period of special training, free of cost, in a school which takes difficult children; it is felt that this may be of real value in giving such workers practical experience in the running ?f hostels as well as an opportunity of dealing with children who are emotionally disturbed. The Committee is anxious to keep the Register up to date and would be glad if anyone interested in the work or in the short training scheme will get into touch with the Hon. Secretary. A special worker with psychological qualifications is carrying out a survey of Hostels for Difficult Children in Civil Defence Region 6, at the request of the Senior Regional Officer of the Ministry of Health.
The Committee is in touch with the Advisory Council of the Children’s Overseas Reception Board through its Chairman, Mrs. Montagu Norman, who is a member of this Council. It has been possible to make certain practical suggestions upon such subjects as the selection of children and of escorts.
At a meeting called by Mr. Ernest Bevin, Minister of Labour and National Service, voluntary organizations were asked to co-operate with him in plans for safeguarding the welfare of industrial workers outside working hours. On the Health Group of these organizations the Mental Health Emergency Committee will be represented, and it is felt that it will have a substantial contribution to make in helping to solve some of the problems with which the Minister finds himself confronted.
Psychological Problems of the War
The National Council for Mental Hygiene has recently given a number of lectures in various parts of the country, including Sussex, Oldham, Gloucester, Woolwich, Tottenham and Romford, to civil defence workers with a view to equipping them with knowledge on how to deal with psychological casualties. The meetings were arranged in collaboration with the local Medical Officers of Health and the heads of the A.R.P. services, and there were large attendances on every occasion, from 400 to 1,000 persons being present. Meetings are also being arranged in other areas. The Council is prepared to supply speakers to address meetings on this and kindred subjects and further information will be given upon request.
There has been a large demand for the Notes for those in charge of Air Raid Shelters and for First Aid Workers, prepared on behalf of the Council by Dr Doris Odium, and copies have been circulated to all County and County Borough Councils. Dr Millais Culpin gave a lecture on June 15th on the Prevention and First Aid Treatment of Nervous Instability at a special week-end course arranged by the Royal College of Nursing for trained nurses employed in factories and business houses. Arrangements had been made by the Council to hold a one-day Conference at B.M.A. House on Psychological problems of the war as they affect the Teacher, but owing to the present situation this has been postponed. It is hoped, however, that it will be possible to hold the Conference later in the year.
Mental Hygiene Film
A film, entitled Fear and Peter Brown, produced by Spectator Short Films Limited, from a scenario prepared by a special Sub-Committee of the National Council for Mental Hygiene, was presented at a trade show on June 26th, and is now available for general release. It is expected that the film will be shown this month at certain West End cinemas. A grant for its production was made by the Ministry of Health.
Directed by Dr Richard Massingham, with Nicholas Hannen and Stephen Haggard in the leading roles, the film deals with the prevention and treatment of fear, showing how childhood fears unsympathetically handled by parents and others affect the individual’s reactions in later life. The story stresses the need for admitting fears in oneself and of recognizing that they are nothing of which we should feel ashamed. By making friends with fear we are able to meet with true courage the trials and vicissitudes of life, especially at the present time when fear has become capitalized by our enemies for the purpose of lessening our morale.
The film is excellently produced and makes an interesting story. It is hoped that it will be widely shown and achieve its purpose of instilling the right attitude to fear and of helping people to overcome their anxieties.
The C.A.M.W.’s Holiday Homes
On the outbreak of war, the Central Association for Mental Welfare had five seaside Holiday Homes available for patients from Mental Hospitals and Mental Deficiency Institutions, and for children from Occupation Centres. Under war conditions the continuance of these Homes for the use of holiday guests was obviously no longer possible, but they were quickly diverted to other purposes. With the exception of the one at Redcar, every Home was at once reserved for defectives evacuated from Occupation Centres or others for whom no instutitional accommoda- tion was available, and whilst the administration continues in the hands of the Association, the whole of the accommodation is allocated to three Local Authorities ?Middlesex, Hampshire and Lancashire.
In addition to its pre-war Homes, new premises at Basingstoke were acquired, to provide the additional vacancies needed, through the kindness of the Sisters of the Transfiguration who are responsible for Mount Tabor Certified Institution. A house in the country in Somerset has also been recently rented to take the place ?f the Seaford Home from which it became necessary to evacuate. Negotiations are at present taking place for still another house, as further emergency vacancies are found to be urgently required.
All the Homes are staffed by experienced workers and the type of training the children were previously receiving at Occupation Centres is being successfully carried on.
Should there be a still further demand for accommodation for defectives evacuated from dangerous areas, the Holiday Homes Committee would be glad to hear of it.
Child Guidance Council
Bradford Education Committee opened its child guidance clinic in April at 28a Manor Row, Bradford, with the following staff: Dr H. Edelston (psychiatrist), ^rs. E. M. Henshaw (educational psychologist) and Miss M. E. Cullen (psychiatric social worker).
Clinics in connection with the Emergency Medical Service are now being held at Stanboroughs, St. Albans Road, Watford, and at the Emergency Medical Service
Hospital at Bishop’s Stortford. Both of these are under the general supervision of Dr W. J. T. Kimber who has been appointed consulting psychiatrist to Hertfordshire County Council?the second Local Authority to make an appointment of this kind. In Sheffield, the clinic under Dr Alice White’s direction in the Neurological Department at the Royal Infirmary has been fortunate in securing the voluntary services of Mrs. Sarmienti (formerly Mrs. Newell) as psychiatric social worker. The London Hospital clinic has qualified as a Group I clinic in the Council’s “recognized ” list by instituting separate sessions for children. This Clinic already possessed a full team of adequately qualified personnel.
At Newcastle-on-Tyne a representative Committee is working towards the establishment of a clinic, and at York public concern over the question of the increase in juvenile delinquency has led several sections of the community to interest them- selves in child guidance. A well-attended meeting was addressed by Mr. A. H. Mann, formerly Hon. Psychologist to the Cheltenham and County Child Guidance Clinic. Blackpool, Bolton and Hull are three other towns in which interest has been aroused. There is every prospect that a ” pooled ” clinic will be set up in North-East Lancashire before the end of the year.
Under the auspices of the London Police Court Mission a much appreciated lecture was given to Probation Officers on behalf of the Council by Mrs. D. H. Hardcastle, who has lectured also at the Maria Grey Training College. Mrs. Henshaw has lectured to Bradford Education Society, to the Bradford branch of the National Council of Women and to students at Ripon Training College.
It is gratifying to note that the National Union of Women Teachers passed the following resolutions at their Conference in May, an indication of increased general interest in the work of the Council:
” That hostels opened in Reception Areas for the care of difficult children should be adequately staffed by people experienced in the treatment of such children.”
“That this Conference draws attention to the urgent problem of the increase of juvenile delinquency and calls on the Government and Local Education Authorities throughout the country to set up Child Guidance Clinics so that expert advice may be available (a) to parents and teachers, (b) to the Juvenile Courts.”
National Council for Mental Hygiene Annual Report, 1939 The Annual Report of the National Council for Mental Hygiene for 1939 has recently been published and copies may be obtained on application at 76-77 Chandos House, Palmer Street, S.W.I.
The Report is a record of activity in a great many directions and gives information on the work of the Council’s Standing Committees, notably in relation to the Criminal Justice Bill, the teaching profession and the psychologically unfit student, and also investigations carried out with a view to promoting a Bill to repeal the existing anomalies in regard to the law on suicide. Particulars are also given of the wartime activities of the Council, among these being special training lectures for civil defence workers on psychological problems of the war, and the preparation of memoranda for the use of those in charge of First Aid posts and A.R.P. personnel, and for teachers in reception areas.
The Report also contains references to the Council’s participation in the inter- national mental hygiene movement, and reports are appended on the work of the Council’s affiliated societies, the Oldham Council for Mental Health and the Bath and Bristol Mental Health Society.
The Scottish Association for Mental Hygiene
The Annual Meeting of the Scottish Association for Mental Hygiene was held in the Technical College, George Street, Glasgow, on Saturday, June 1st. The meeting was well attended and was representative of wide and varied interests. Sir William M’Kechnie, President of the Association, who was in the chair, explained that at the outbreak of war it was suggested that the work of the Association should be carried on by an Emergency Committee composed of the President and the Chairman of each of the three Sections of the Association. This Committee had met at regular two-monthly intervals and the attendance had been 100 per cent, on all occasions. The Committee were of the opinion that the supervision of mental defectives was work of national importance and as such should be continued as far as possible. A brief resume of its activities was then given to the meeting. Dr Clarkson, Chairman of the Mental Deficiency Section, opened a discussion on the problem presented by the mentally defective lad who found himself called up for military service. Reference was made to the special risks involved and to the difficulties of ascertainment. Dr Kate Fraser, Commissioner of the General Board of Control for Scotland, informed the meeting that for the past six months the names of defectives known to the Local Care Committees who had joined the Army had been forwarded by the Board of Control to the War Office, for their information and consideration. She suggested that (1) defectives might be drafted to a Labour Corps where their services could be utilized; (2) that some form of group testing be organized for recruits which would assist in ascertainment and would be of value in grading for special types of work, etc.; (3) that Special School teachers might be asked to prepare a short report of their pupils likely to be called up in the next age group, and that this ^formation should be available for Local Recruiting Offices and for the Scottish Command. It was agreed that the Emergency Committee should request an inter- view with the Scottish Command with the object of laying these and other proposals before them.
Professor Drever, Chairman of the Child Guidance Section, stated that the question of the establishment of Child Guidance Clinics in Evacuation Areas had been discussed. It had been decided that no action should be taken in this connection Meantime. A list of available Clinics had been sent to Directors of Education in Evacuation Areas, pointing out that the services of the Clinics already in existence were available for advice and guidance in cases of difficulty. Articles in the Press had already been published and it was hoped to continue these.
It was agreed that the Emergency Committee should meet with the Educational Institute of Scotland and the Women’s Voluntary Service with a view to suggesting that the services of teachers should be organized to assist with Child Guidance problems arising in evacuation areas.
Dr Harrowes, Chairman of the Mental Health Section, dealt with the importance of education of the public in matters of mental health and of the symptoms to be expected in the event of Air Raids. Arrangements were being made for groups of voluntary workers to receive special instructive lectures along these lines. The Secretary submitted a short report on the work of Local Case Committees, explaining that in some districts the work had been curtailed, but that every effort was being made to retain supervision as far as possible. The special difficulties were (1) lack of finance, (2) transport, and (3) the securing of premises with suitable Air Raid Shelters. A Scottish Federation of Case Committees had been formed, with representation on the Executive Council of the Association.
It was agreed that the Scottish Association should co-operate with the Editorial Board of Mental Health in endeavouring to increase the circulation of the magazine. The Emergency Committee was empowered to continue in office for the purpose of carrying on the Association’s work under wartime conditions.
The Use of “Licence A National Economy
The Royal Eastern Counties Institution was the first Mental Deficiency Colony in England to adopt the practice of licensing defectives, after a period of training, for work in the outside world, and Dr Turner, its well-known Medical Superintendent, has always strongly championed the use of this particular provision of the Mental Deficiency Acts.
In his recently published Report he refers specially to the economic value of the system, and estimates that the annual saving it represents to the community, in respect of patients in his own Institution alone, has been ?11,000. In 1940, more- over, this figure is likely to be higher still. In addition the Local Authorities using the Institution have been saved the capital cost of building accommodation for some 200 more patients which would otherwise have been necessary.
On January 1st, 1940, there were 192 patients on Licence from the Institution. Of these, 168 were in some form of employment, 33 being in ” living-in ” domestic service. During the year under review, 35 cases were discharged from Licence. Of these 16 were transferred to another form of care, but 19 were discharged because they had been proved to be capable of earning their own living and successfully adapting to life in the community. It is significantly pointed out by Dr Turner, that every one of these had failed ” very badly ” before admission to the Institution and that their stabilization was due entirely to the training they had received there.
The experience of the C.A.M.W.’s Case and Guardianship Department largely bears out the experiences recorded above, and shows that in the national ” war effort ” high-grade defectives are by no means merely a liability. Of the girls placed out in service by the Association ” On Licence ” or under Guardianship, a number are employing their leisure in knitting “comforts ” for the troops, one is helping her mistress in canteen work, another has successfully passed an A.R.P. test in first aid. Two girls are working as machinists in a factory for the making of uniforms for the Royal Air Force, one of whom is able to earn as much as ?2 10s. a week.
Many of the male defectives under the care of the Association are also playing a really useful part in the present emergency. A number of them are employed in factories producing various kinds of war equipment ; others are in rubber factories, chain-making works, printing works, etc. In almost every instance these defectives are found to be capable of holding their own with normal workers, working at equal pressure and for equally long hours. In some cases, earnings amount to as much as ?4 to ?5 a week. One lad employed as a shoe repairer claims that he can repair three pairs of army boots in half a day; another engaged in assembling chains used for tanks was told by his foreman that in one week his output was greater than that of his fellow-workers. Moreover, many of the lads are engaged in some form of voluntary service, e.g. there are two who, with other men from their factory, help ambulance workers at the local hospital to move wounded patients.
All this achievement proves to any who may remain as yet unconvinced, that, after a period of training in an institution, and if he is carefully placed in an environ- ment which will give him the special supervision he needs, the high-grade stabilized defective, far from being a life-long burden on the community, may constitute an actual asset.
In Memoriam. Elfrida Rathbone
On April 22nd there passed away another pioneer worker to whom it is fitting that tribute should be paid in a journal concerned with the needs of those who are Mentally handicapped.
By two achievements will Elfrida Rathbone be remembered when the story of voluntary work for defectives in the twentieth century comes to be recorded. First, by her founding in 1919, in a poverty-stricken district of London near King’s Cross, the Lilian Greg Occupation Centre (dedicated to the memory of a defective child |n whose training she had taken an absorbing personal interest)?the first Centre of Jts kind designed specifically for low-grade children placed under statutory super- vision under the Mental Deficiency Act, and the one which demonstrated to sceptical enquirers the practical possibilities of such a venture.
Out of this work grew her multifarious activities for the pupils and ex-pupils attending the four Islington M.D. Special Schools, carried on in co-operation with the local London County Council District Organizer of Children’s Care, and with the help of a Committee known first as the Lilian Greg Welfare Committee and afterwards as the Elfrida Rathbone Committee. By Clubs and Classes, Camps and Parties, by countless acts of service in response to innumerable individual needs, by eyer accessible personal counsel and advice, she and those working under her leader- ship sought to guide and protect boys and girls struggling with dim intelligence and weak wills to deal with the problems inherent in life in a crowded industrial district. They accepted her as their best friend, and will ever remember her with love and gratitude.
After her retirement from active work in 1936 she suffered from an illness which brought with it increasing infirmity and ultimately deprived her of freedom of move- ment, but she accepted her condition without bitterness or complaint and in a spirit which made the task of serving her a deeply enriching experience.
The Committee which bears her name will perpetuate her memory by carrying on the work she loved, and she would desire no other memorial.
” Lord ” Memorial Essay Prize Competition
This competition was instituted some years ago by the Society of the Crown of Our Lord in memory of the late Lt.-Col. J. R. Lord, C.B.E., M.D., F.R.C.P., of Horton Mental Hospital, who was also Joint Honorary Secretary of the National Council for Mental Hygiene.
The subject chosen for the essay this year is ” How can the Nurse help the Refractory Patient? ” The competition, which is held under the auspices of the National Council for Mental Hygiene, is open to certificated mental nurses, male and female, of the rank of staff, charge or chief charge, in the Mental Hospitals of England and Wales, and a medal and a money prize of ?4 are offered.
Essays are limited to approximately 2,000 words, and the latest date for the reception of these is October 31st, 1940. They should be written legibly on one side of foolscap numbered sheets. Names of competitors must not be placed on the paper, but a motto should be selected to identify candidates and written at the head of the essay. A sealed envelope containing the name and address and the motto of the candidate should be sent with the essay to: The Secretary, The National Council for Mental Hygiene, 76-77 Chandos House, Palmer Street, London, S.W.I.
Neurotic Symptoms Among Evacuated Children
In an article in the British Journal of Educational Psychology (February, 1940), Dr Cyril Burt gives some interesting statistics as to the frequency of neurotic symptoms and delinquency among school children, before and after evacuation. He points out that the figures should be regarded only as an epitomization of first impressions rather than as the results of a systematic enquiry, but that they may be of value as a provisional starting point for more intensive work.
The figures (based on an estimated percentage of sample population) show an increase in anxiety states from 4*2 to 6-3, reports from reception areas showing that this condition is occurring most frequently amongst the girls and the younger and only children. The other notable increase is for incontinence, rising from 3 ? 4 to 7 ? 2, but in many cases Dr Burt maintains that the trouble is not a ” habit ” but a new manifestation, and in several instances it ceased immediately the child returned home. These two conditions are the primary cause of a rise in the estimated frequency of the various types of neurotic symptoms amongst children, from 17-1 before evacuation, to 25*3 after evacuation, and of this percentage only 5 per cent, represents cases of ” serious ” nervous disorder, urgently needing special treatment.
Vocational Training for the Mental Patient
An interesting account of an experiment in the ” rehabilitation and resocialization of mental hospital patients ” is given in a recent issue of the Journal of Mental Science (January, 1940), by Dr L. H. Wooton, Medical Superintendent of St. Ebba’s Hospital, Epsom, and Dr L. Minski, Deputy Medical Superintendent.
It was noted that a number of voluntary patients treated since the passing of the Mental Treatment Act in 1930, sought readmission to Hospital and that inability to obtain employment was frequently a deciding factor in their relapse. Merely to give help in finding work in a former occupation, was often inadequate, as such work was found to be in a trade which was dying or overcrowded. What, therefore, appeared to be needed, in addition to such help, was a scheme by which special training in a new occupation could be provided for selected patients, and in 1935 a grant of ?100 from the Mental Hospitals Committee of the London County Council made it possible to begin the experiment. From the outset, it had the enthusiastic support of the Council’s Education Department, and each patient chosen for training ls seen by a representative of this Department in conference with the Hospital’s Medical staff, to ensure that the best choice of work may be made. The training is given at polytechnics, technical schools, training centres, etc., and if a patient has no home, he either lives in Hospital, going backwards and forwards each day, or is P’aced in some suitable Hostel or in lodgings.
Out of a total of 31 patients placed in employment since the experiment began, o males and 1 female were given special training in some new occupation which deluded: typing, electrical wiring, motor engineering, gardening, and shoemaking. The remainder were placed without preliminary training, the majority returning to their former type of occupation. Of these 31 patients, 25 remained well and in work at the date of writing (September, 1939), 4 had relapsed, 1 had committed suicide, and 1 was in the hands of the police.
The working of the scheme placed a heavy additional burden on the medical staff of the Hospital and on the Social Worker, and the help of the Mental After-Care Association was subsequently enlisted. In a period of some twelve weeks, 10 patients were referred to the Association of whom 7 were successfully placed in employment. The expenditure involved since the inauguration of the scheme, viz. ?259, may aPpear at first sight to be disproportionate to the number of cases dealt with, but it ls pointed out that a large part of this sum has been spent on the maintenance of Patients during training. Moreover, without such special help many of the patients c?ncerned would undoubtedly have reverted or drifted into the Social Problem group and would have become a heavy charge on the community.
Cental Health in the ” Services ” In his report for 1939, Prof. D. K. Henderson, Physician-Superintendent of the H?yal Edinburgh Hospital, draws attention to the need for the service of psychiatrists in Training Camps and on Recruiting Boards. In this way, not only would men who were likely to break down under war strain be quickly eliminated but the mental health of others capable of responding to psychotherapeutic treatment might be preserved.
Dr Henderson points out the shortsightedness of the present policy by which men who have become temporarily incapacitated as the result of nervous breakdown, especially those who have had to be certified as mentally unsound, are thereafter automatically discharged. He considers this a waste of man power owing to the fact that ” the types of nervous and mental illness occurring during war conditions develop at a very much more superficial level than similar disturbances in civil life “. Consequently, quick recoveries may often take place, in many cases jio further break- down need be anticipated and a patient on the completion of treatment may easily be found to be capable of doing useful work in one or other branch of the services. On the other hand, the failure to pay attention to the mental as well as to the physical health of recruits, can only lead, as the same mistake led in the last war, to many serious nervous and mental collapses after months of intensive specialized training given to no purpose.
The National Council for Mental Hygiene has at present under consideration the question of Recruiting Boards and the psychological examination of recruits. A memorandum on the subject is being drafted by a special Sub-Committee of the Council’s Standing Committee for submission to the relevant authorities, and it is hoped that it will be supported by various other mental health and medical organiza- tions. Further reference to this matter will be made in the October number of the journal.
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