News and Notes
The Nuffield Provincial Hospitals Trust have generously made a grant to the Provisional National Council
for Mental Health for an enquiry to be carried out,
under the direction of Dr Frank Bodman, into the
social adaptation of children and young persons brought
up in institutions. The original scheme of research
was presented to the Trust for consideration in April,
1943.
The war has brought out very strongly the necessity
for making provision in this country and in Europe for
homeless, abandoned and unwanted children. Many
of these children, because of the size of the problem,
will have to be placed in institutions, and it seems of the
utmost importance to ascertain whether the institution
child suffers from disadvantages in his development as
a person in comparison with the child brought up in a
normal home.
The object of the research, for which a grant has been
made, is to ascertain as far as possible what are the
results of bringing up a child in an institution. Are
there differences between a child brought up in an
ordinary home or an institution so far as educational
attainments are concerned ? Does the child brought
up in an institution show any difference in emotional
maturity as compared with the child from a normal
home? Does he have difficulty in adapting himself to
society when he leaves the shelter of the institution?
Does he make friends easily? Or does he make the
wrong friends? Can he settle down comfortably in a
normal home circle? Is the institution child particularly
liable to sex difficulties, either because of the long period
of segregation in an institution with children and staff
of one sex, or by reason of inadequate sex instruction?
Does he find it easy to adapt himself to conditions of
work?
In beginning such a research, it is necessary to start
with a simple survey, where the variable factors are
reduced to a minimum so that a well defined homogeneous group can be assessed and compared with the
controls. This will throw light on the practical difficulties of such a research, and give indications of the
lines on which further surveys should be conducted.
The plan of the research will be, therefore, to commence work inside the institution. The first part of
the survey will be the investigation of 100 children,
due to leave the institution. The psychologist will
test the children’s intelligence and assess their educational attainments. The psychiatrist will interview
each child, and assess his adaptation to institution life,
and his emotional maturity. The psychiatric social
worker will contact the authorities, and obtain reports
from the staff of the Institution. This contact with the
child in the institution will make easier a subsequent
interview six months to a year after the child has left
the home. The young person will again be interviewed,
and this follow-up will provide information about how
the child is settling down away from the Home, how
he is fitting in at work, what friends he is making, etc.
In this way, it is hoped to get a picture of the average
institution child.
The controls will be a group of fifty children who
have been boarded out from infancy in foster homes,
and fifty children who have been brought up in the
normal way in their own families. It will then be
possible to make a comparison between these groups
of children, and to discover whether there is any real
difference between the institution child and the child
with a normal home.
Children in Homes?Training of Staffs
The Memorandum on the Care of Children Brought
Up Away from their Own Homes, referred to in our
last issue, has since been published as a Provisional
Council pamphlet, and has been widely circulated.
The question it raises in connection with the training
of staffs has been further considered by the Council
who are drawing up a Memorandum on the subject.
The background of such training, it is maintained,
must be a thorough study of the child and of children’s
needs at all stages of their development. This does not
imply a course of lectures in academic psychology but
the giving of thoroughly practical tuition and experience
designed to promote an understanding of children’s
daily behaviour in all its many variations. This aspect
of staff training has, in the past, been too little stressed
if not entirely ignored. It is therefore suggested that
the first people to whom training should be given are
senior workers in Homes, with the right personality,
experience and educational background and capable of
becoming Heads and of training younger staff. For
these reasons, it is recommended that training courses
for the next few years should be concentrated.
It is considered that the training must occupy a full
year?possibly longer?and that it must be given in
connection with one or more Children’s Homes to
ensure the linking of practical and theoretical work.
The content of the Course (in relation to its Mental
Health aspects) should, it is suggested, consist roughly
of five sections:?
(i) Lectures, studies, observations and reading on
Child Development.
(ii) Lectures and observation on the practical application of this material to organizing and running
Homes.
(iii) Lectures on the relation of physical to mental
development.
(iv) Visits of observation.
(v) Consideration of methods by which the material
given, could best be imparted to staffs.
After completing the Course, students should be capable
of giving to the junior members of their staffs, instruction on (i) The child’s normal development in the
family;, (ii) The difficulties in development facing the
homeless child; (iii) Methods and attitudes which
help to meet the loss of family life; (iv) The study of
individual difficulties met with amongst children. It is
hoped that students who have given satisfaction during
their training will thereafter proceed to appointments
as Matrons of large Homes or as Senior Matrons of a
group of small Homes, and that they will be able not
only to train their own probationers but also juniors
sent to them from other Homes for the purpose. In
this way, knowledge would be disseminated and soon
there would exist a body of people convinced of the
value and need of training, and enthusiastic in sharing
their experience. Such a development would inevitably
bring about a recognition of the necessity of including
training of this type in any more general provision that
is, or may in the future be, made. But the establishment of a National Certificate for workers in Homes
to be instituted by a co-ordinating body with recognition from the Government Departments concerned,
ls? in the Council’s opinion, the only really satisfactory
solution of the problem of securing properly trained
and qualified people for this essential national service.
Meanwhile, by way of experiment and demonstration,
the Council is making provision for a Six Months’
Training Course for workers who already have some
experience of Homes. Particulars will gladly be sent
to any interested enquirer.
The appointment of a Joint Committee, by the
Ministry of Health, the Minister of Education and the
Home Office:?
“To inquire into existing methods of providing
for children who, from loss of parents or from any
other cause whatever, are deprived of a normal
home life with their own parents or relatives: and
to consider what further measures should be taken
to ensure that these children are brought up under
conditions best calculated to compensate them for
the lack of parental care “
ls welcomed by the Provisional Council, who have for
some time been considering questions connected with
the mental health of the homeless child and the training
of those who care for him.
Some of our readers may have seen a letter from the
Council published in The Times of 27th July, 1944 in
which attention was drawn to the infinitely complex
Problem involved in the attempt to provide an adequate
substitute for normal home life and parental care,
for, as was stated: “to supply the affection, personal
‘nterest and essential stimulus for healthy emotional
development for the motherless child within an institution is one of the hardest tasks with which anyone can
be confronted.”
A suggestion in the letter as to the need for careful
selection and training of Institution staffs has since been
further considered by the Council jmd the result of its
deliberations are outlined above.
The Minister of Health in a recent circular, invites
all local authorities, with experience in the Government
evacuation scheme, to make a list of householders
who have successfully looked after evacuated children
and who may be willing to act as foster-parents to
other children. The Ministry are of the opinion that
many of these householders have been found to have
^ vocation in the care of children, and it is suggested
that this valuable information should be turned to
turther good by providing orphans and other children,
who become the responsibility of local authorities or
yoluntary organizations, with the care and affection of
tamily life.
A point made by the Minister, which is particularly
^elcomed by the Provisional National Council for
Cental Health, who have made strong representations
tif subject, is that Public Assistance Authorities in
j.he “return home” areas, who will shortly resume
,uU responsibility for children in their care who havs
een evacuated, should do their best to avoid bringing
?n evacuated child back to an institution or children’s
j}?rne, if he has settled down in a good billet and the
oster-parents are willing to continue to look after him.
11 the view of the Provisional Council such an uprooting
could but have a deleterious effect on the mental health
,?t the child, which no statutory requirements could
JUStify.
Encouraging evidence of the progress being achieved
in the field of the medical care of children is provided
by the recent establishment of Chairs of Child Health at
several Universities, including Durham (established in
1943), Liverpool, and London. In this, the example
of Edinburgh, where a University Department in Child
Life and Health dates from 1931, has been followed.
To the many other public benefactions made by Lord
Nuffield is added yet another munificent gift, since
these important developments have been made possible
through substantial grants received through the Trustees
of the Nuffield Foundation and of the Nuffield Provincial Hospitals Trust.
The establishment of these University Departments
give practical expression to the recognized importance
of child health in the welfare of the nation, and, in this
connection, to the essential need for close collaboration
between the university, city Council and the voluntary
hospitals in order to ensure the fullest measure of
benefit to the child, both from the curative and preventive aspect. The departments will be concerned not
only with the investigation of the diseases of childhood,
but also with the preservation of good physical and
mental health during the early years of life. Linked
up as they will be with the children’s hospitals, w)iich
will provide wards for teaching and research purposes,
the latter should now be in a position of having their
medical and nursing staff actively participating in the
study and care of the healthy child.
A further development, which will be welcomed by
all those engaged in the field of mental health who have
for long advocated measures of this kind, is the decision
of’Leeds University, as a result of a grant of ?15,000
from the Nuffield Provincial Hospitals Trust, to establish
a whole-time Chair in Psychiatry, with which will be
associated a complete psychiatric unit. Facilities will
be provided for both undergraduate and post-graduate
instruction, and for research in the various branches of
psychological medicine as well as for treatment. It is
suggested that the functions of the unit shall include
the establishment of close contact between general
medicine and psychiatry and the clinical integration of
the various mental health services in the area.
The chief concern of the Child Guidance Council has
been with training. There will undoubtedly be a great
demand for all workers in child guidance after the war,
as the local education authorities are obliged to make
provision for problem children under the new Education
Act, but it has been agreed that it is undesirable to
attempt to meet the demand by lowering the standards
of training. At the same time, the Provisional Council
have decided, so far as Child Psychiatrists are concerned,
to try the experiment, for a limited period, of concentrating the training into six months whole time. The
possibility of organizing theoretical instruction in
various centres is also under consideration, and in this
way some of the demands may be met.
It would appear that child guidance work has divided
itself to some extent into definite psychological treatment which naturally should be carried out by fully
staffed child guidance clinics (which may subsequently
operate under the Ministry of Health). There is a large
amount of work, however, partly diagnostic and partly #
social, and also educational adjustments, which will have
to be carried out under the local education authorities,
and which will deal with very much larger numbers of
children. All members of the team will be concerned in
this, but it may be carried out rather more loosely in
what it is suggested should be called child guidance
centres. It is impossible to make definite prognostications as to the exact nature which child guidance work
will take in the future until the policy for health services
for the nation is finally determined.
Training Course for Staffs. In view of the serious
shortage of trained workers and of the need for re-opening Centres closed during the War, the Provisional
Council consider that the time has come when some
effort must be made to deal with the increasingly difficult
situation.
The possibility of reviving the Training Course for
Occupations Centre Workers initiated by the C.A.M.W.
in 1939-?which had to be cut short on the outbreak
of war?is therefore being explored and plans are now
in hand.
The Course projected will consist of three terms’
work, theoretical and practical. The theoretical instruction will be given in London, at the beginning and end
of the period, and, for their practical experience, students
will be allocated to various Occupation Centres, and
Training Departments of Certified Institutions.
Arrangements must be provisional, until it has been
ascertained whether an adequate supply of candidates
for training is likely to be forthcoming. Anyone
interested is invited to apply for further particulars to
the Education Secretary, 39 Queen Anne Street, London,
W.l.
Cambridgeshire Occupation Centre. An interesting
scheme for the training of mentally defective older
girls who attend this Centre, started a year ago and
has been found to work very satisfactorily.
For the past six years?since the Centre was opened
on a full-time basis necessitating the provision of a
mid-day dinner?the Senior Girls have helped in the
kitchen. It was then decided, in order to maintain a
high standard of proficiency, to institute a Domestic
Certificate, awarded on the result of practical tests
judged by an outside Domestic Science teacher. There
are three Certificates?for Kitchen Workers, Cooks,
and Laundry Workers respectively, all on prescribed
lines.
More detailed information as to the working of the
scheme will be gladly supplied by the Centre Organizer,
Miss Isobel Simon, Fitzroy Hall, Wellington Street,
Cambridge.
In the Summary Report of the Ministry of Health
for the year ended 31st March, 1944 (published by
H.M. Stationery Office, price Is. net), it is stated that
the number of residential nurseries maintained under
the Government Evacuation Scheme for the reception
of babies and children under five is around 400 with
about 13,000 places. The great majority are long-stay
nurseries, and a small minority cater for short-stay
cases, usually the young children of women who are
themselves evacuated to an emergency maternity home
for confinement and who can find no one to care for
the child in their absence. It is stated that there has
been an increased demand for this kind of provision,
and steps have been taken to increase the number of
short-stay nurseries.
Between 30,000 and 40,000 children have spent some
time at an evacuation residential nursery during the
course of the War.
Although many children benefit physically from the
healthy surroundings, good food and regular routine
of a residential nursery, the Ministry stress that they
do not advocate this as desirable for children, whose
essential need and right is the love and individual
attention of a mother.
It is of interest to record here that a step towards
meeting the need for special provision for children
between the ages of two and five, who have been found
unmanageable in ordinary large nurseries, was taken
in 1942 when Haybrook House, Pewsey (Wiltshire)
was opened at the request of the Ministry of Health,
and on behalf of the Church of England Waifs and
Strays Society, as a Residential Nursery for 20 to 25
such children. The Nursery is a pioneer undertaking
to determine the best method of dealing with problem
children of this age-group. The Chief Educational
Psychologist of the Provisional Council visits each
week, and Dr D. H. H. Thomas, Medical Superintendent
of Pewsey Colony, is the Visiting Psychiatrist.
Some of the children have been parted from their
parents in infancy, and others have been in and out of
one Nursery after another. They are referred for a
variety of specific problems, but all alike are violently
aggressive and destructive, demanding adult attention,
and lacking in ordinary affection. In order that this
veneer of hardness may be broken through, and that the
expert individual attention which will foster a sense of
security may be ensured, the children are divided into
groups of five, each placed under the care of a Group
Mother. In this way, every child definitely ” belongs ”
to a particular member of the staff.
It is not possible to estimate with any accuracy the
result of this experiment after so short a period as two
years, but it may be definitely stated that some six or
eight of the children dealt with have now become practically normal in their relationship to adults and to other
children.
Lasker Award for Mental Hygiene
——————————-
It is announced that the Albert and Mary Lasker
Foundation, Inc., have established the Lasker Award of
$1,000 to be given annually through the National
Committee for Mental Hygiene (New York), for outstanding service in the field of mental hygiene.
The purpose of the award *is to recognize significant
contributions towards the promotion of mental health
and towards making mental hygiene more familiar to
the general public. Each year the award will be made
for a contribution in some special aspect of the field of
mental hygiene which seems to be of immediate and
current significance. The recipient of the award will
be selected by an anonymous jury chosen annually for
its competence to judge accomplishment in a particular
field.
The award for 1944 will be for mental hygiene work
related to the war, and the recipient will be chosen from
among leaders who have done work in the general
enhancement of the mental health of the men and
women of the services, both while in service and during
the period of rehabilitation.
The award is not confined to persons in the United
States, and if some outstanding contribution has been
made abroad in a particular field, the award will be
made jointly with the leading mental hygiene organization of the country concerned. The range of activities
for which the award will be made will include, under psychiatric education, popular adult education (through
books, articles, lectures and plays), popular child
education (in schools, camps, playgrounds, community
centres, churches and other group activities). Professional
Psychiatric education comprises medical school education, nursing school education, psychiatric social work
educate n, clinical psychology, and other professional
groups, such as vocational guidance, occupational
therapy, teaching, theology, etc. The field of psychiatric
organization and administration will include hospital
and clinic organization, child guidance clinics, all
types of community projects for the care of problems
m special groups, penology, and delinquency. The
Psychiatric research field will include etiology, techniques of diagnoses, special screening devices, and
treatment methods, both group and individual. The
held of psychosomatic medicine will also be included in
consideration for the award.
Further particulars may be obtained from the National
Committee for Mental Hygiene, 1790 Broadway, New
York, 19.
The National Committee for Mental Hygiene, U.S.A.
Members of the National Council for Mental Hygiene
will be interested to hear that Mrs. Mary Lasker, who
*s a member of the Board of Trustees of the Institute
lor Psychoanalysis, Chicago, and a Trustee of the
Wenninger Foundation, Topeka, has been appointed
Secretary of the National Committee for Mental Hygiene
(U-S.A.) in succession to the late Mr. Clifford W.
j-*eers, founder of the Mental Hygiene movement.
Mrs. Lasker, who has been keenly interested in Mental
Hygiene for a number of years, is also a member of the
?ooard of Directors of the National Committee in
New York.
At a delegate Conference convened by the Norwich
Class Teachers’ Association and presided over by the
Lord Mayor, the following resolution was passed:?
” That this meeting views with concern the
extent of Juvenile Delinquency, and urges that a
panel be constituted from its members to consider
the position, and make suggestions for its mitigation.”
. The Panel constituted was composed of people
?nterested in the subject from various angles, including
two or three City Councillors, a magistrate, a psychiatrist,
^ educational psychologist, the Head of the Training
College, three teachers, two ministers of religion, a
Probation Officer, and two officers of Youth Organizations. Its method of work was by sub-committees; each
took one particular problem or need for detailed study
and presented its findings to the main body.
The survey thus made of the whole field led to an
interesting final recommendation, viz. the need for the
formation by the City Council of a ” Social Service ”
or ” Social Medicine ” Department which would
co-ordinate the activities of all the Authorities and
Committees responsible for social welfare, whether
concerned with education, health, or housing, with
Juvenile Courts or with Probation. Such a Department would also be in a position to initiate new schemes
for social betterment?with education, research and
propaganda?and it would have as its underlying
purpose the popularizing of a new concept of ” health
mental and physical, and the building up of new standards of social behaviour.
A pamphlet on this subject, which has reached us
from the American Epilepsy League, publishes some
interesting information of a kind which it is difficult
to obtain in this country.
Out of 350,000 epileptic men and women gainfully
employed in the United States, more than 250,000 are
estimated to be physically and mentally normal, apart
from their liability to seizures, and it is contended that
the embargo on the acceptance of epileptics for service
with the United States Army is unjustifiable.
The writers contend further, that the association of
mental deterioration and epilepsy has been grossly
over-estimated. Out of 838 epileptic adults examined
by neurologists, 67 per cent, were judged to be mentally
normal and in only 9-2 per cent, was gross deterioration observed.
The Workshop for Epileptics opened in South London
by the Provisional Council in the spring of 1944, which
had to be temporarily closed owing to the flying bomb
attacks, has now been re-opened and satisfactory
arrangements have been made for the men to work
on a process in connection with the assembling of gas
pokers.
Under Section 15 of the Disabled Persons (Employment) Act, 1944, grants for the purpose of defraying or
contributing towards the expenses of undertakings
employing severely disabled persons may be made
under prescribed conditions. It would appear that
this ” Sheltered Workshop” for Epileptics might
qualify for such a grant, and the whole position of
such Workshops under Section 15 of the Act is being
taken up shortly by the Provisional Council with the
Ministry of Labour.
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Social Adaptation of Institution Children and Young Persons
News and Notes
The Nuffield Provincial Hospitals Trust have generously made a grant to the Provisional National Council for Mental Health for an enquiry to be carried out, under the direction of Dr Frank Bodman, into the social adaptation of children and young persons brought up in institutions. The original scheme of research was presented to the Trust for consideration in April, 1943.
The war has brought out very strongly the necessity for making provision in this country and in Europe for homeless, abandoned and unwanted children. Many of these children, because of the size of the problem, will have to be placed in institutions, and it seems of the utmost importance to ascertain whether the institution child suffers from disadvantages in his development as a person in comparison with the child brought up in a normal home.
The object of the research, for which a grant has been made, is to ascertain as far as possible what are the results of bringing up a child in an institution. Are there differences between a child brought up in an ordinary home or an institution so far as educational attainments are concerned ? Does the child brought up in an institution show any difference in emotional maturity as compared with the child from a normal home? Does he have difficulty in adapting himself to society when he leaves the shelter of the institution? Does he make friends easily? Or does he make the wrong friends? Can he settle down comfortably in a normal home circle? Is the institution child particularly liable to sex difficulties, either because of the long period of segregation in an institution with children and staff of one sex, or by reason of inadequate sex instruction? Does he find it easy to adapt himself to conditions of work?
In beginning such a research, it is necessary to start with a simple survey, where the variable factors are reduced to a minimum so that a well defined homogeneous group can be assessed and compared with the controls. This will throw light on the practical difficulties of such a research, and give indications of the lines on which further surveys should be conducted. The plan of the research will be, therefore, to commence work inside the institution. The first part of the survey will be the investigation of 100 children, due to leave the institution. The psychologist will test the children’s intelligence and assess their educational attainments. The psychiatrist will interview each child, and assess his adaptation to institution life, and his emotional maturity. The psychiatric social worker will contact the authorities, and obtain reports from the staff of the Institution. This contact with the child in the institution will make easier a subsequent interview six months to a year after the child has left the home. The young person will again be interviewed, and this follow-up will provide information about how the child is settling down away from the Home, how he is fitting in at work, what friends he is making, etc. In this way, it is hoped to get a picture of the average institution child.
The controls will be a group of fifty children who have been boarded out from infancy in foster homes, and fifty children who have been brought up in the normal way in their own families. It will then be possible to make a comparison between these groups of children, and to discover whether there is any real difference between the institution child and the child with a normal home.
Children in Homes?Training of Staffs The Memorandum on the Care of Children Brought Up Away from their Own Homes, referred to in our last issue, has since been published as a Provisional Council pamphlet, and has been widely circulated. The question it raises in connection with the training of staffs has been further considered by the Council who are drawing up a Memorandum on the subject. The background of such training, it is maintained, must be a thorough study of the child and of children’s needs at all stages of their development. This does not imply a course of lectures in academic psychology but the giving of thoroughly practical tuition and experience designed to promote an understanding of children’s daily behaviour in all its many variations. This aspect of staff training has, in the past, been too little stressed if not entirely ignored. It is therefore suggested that the first people to whom training should be given are senior workers in Homes, with the right personality, experience and educational background and capable of becoming Heads and of training younger staff. For these reasons, it is recommended that training courses for the next few years should be concentrated.
It is considered that the training must occupy a full year?possibly longer?and that it must be given in connection with one or more Children’s Homes to ensure the linking of practical and theoretical work. The content of the Course (in relation to its Mental Health aspects) should, it is suggested, consist roughly of five sections:?
(i) Lectures, studies, observations and reading on Child Development. (ii) Lectures and observation on the practical application of this material to organizing and running Homes. (iii) Lectures on the relation of physical to mental development. (iv) Visits of observation. (v) Consideration of methods by which the material given, could best be imparted to staffs.
After completing the Course, students should be capable of giving to the junior members of their staffs, instruction on (i) The child’s normal development in the family;, (ii) The difficulties in development facing the homeless child; (iii) Methods and attitudes which help to meet the loss of family life; (iv) The study of individual difficulties met with amongst children. It is hoped that students who have given satisfaction during their training will thereafter proceed to appointments as Matrons of large Homes or as Senior Matrons of a group of small Homes, and that they will be able not only to train their own probationers but also juniors sent to them from other Homes for the purpose. In this way, knowledge would be disseminated and soon there would exist a body of people convinced of the value and need of training, and enthusiastic in sharing their experience. Such a development would inevitably bring about a recognition of the necessity of including training of this type in any more general provision that is, or may in the future be, made. But the establishment of a National Certificate for workers in Homes to be instituted by a co-ordinating body with recognition from the Government Departments concerned, ls? in the Council’s opinion, the only really satisfactory solution of the problem of securing properly trained and qualified people for this essential national service. Meanwhile, by way of experiment and demonstration, the Council is making provision for a Six Months’ Training Course for workers who already have some experience of Homes. Particulars will gladly be sent to any interested enquirer.
Children’s Homes Enquiry
The appointment of a Joint Committee, by the Ministry of Health, the Minister of Education and the Home Office:?
“To inquire into existing methods of providing for children who, from loss of parents or from any other cause whatever, are deprived of a normal home life with their own parents or relatives: and to consider what further measures should be taken to ensure that these children are brought up under conditions best calculated to compensate them for the lack of parental care “
ls welcomed by the Provisional Council, who have for some time been considering questions connected with the mental health of the homeless child and the training of those who care for him.
Some of our readers may have seen a letter from the Council published in The Times of 27th July, 1944 in which attention was drawn to the infinitely complex Problem involved in the attempt to provide an adequate substitute for normal home life and parental care, for, as was stated: “to supply the affection, personal ‘nterest and essential stimulus for healthy emotional development for the motherless child within an institution is one of the hardest tasks with which anyone can be confronted.”
A suggestion in the letter as to the need for careful selection and training of Institution staffs has since been further considered by the Council jmd the result of its deliberations are outlined above.
Care of Homeless Children
The Minister of Health in a recent circular, invites all local authorities, with experience in the Government evacuation scheme, to make a list of householders who have successfully looked after evacuated children and who may be willing to act as foster-parents to other children. The Ministry are of the opinion that many of these householders have been found to have ^ vocation in the care of children, and it is suggested that this valuable information should be turned to turther good by providing orphans and other children, who become the responsibility of local authorities or yoluntary organizations, with the care and affection of tamily life.
A point made by the Minister, which is particularly ^elcomed by the Provisional National Council for Cental Health, who have made strong representations tif subject, is that Public Assistance Authorities in j.he “return home” areas, who will shortly resume ,uU responsibility for children in their care who havs een evacuated, should do their best to avoid bringing ?n evacuated child back to an institution or children’s j}?rne, if he has settled down in a good billet and the oster-parents are willing to continue to look after him. 11 the view of the Provisional Council such an uprooting could but have a deleterious effect on the mental health ,?t the child, which no statutory requirements could JUStify.
Departments of Child Health and Psychiatry
Encouraging evidence of the progress being achieved in the field of the medical care of children is provided by the recent establishment of Chairs of Child Health at several Universities, including Durham (established in 1943), Liverpool, and London. In this, the example of Edinburgh, where a University Department in Child Life and Health dates from 1931, has been followed. To the many other public benefactions made by Lord Nuffield is added yet another munificent gift, since these important developments have been made possible through substantial grants received through the Trustees of the Nuffield Foundation and of the Nuffield Provincial Hospitals Trust.
The establishment of these University Departments give practical expression to the recognized importance of child health in the welfare of the nation, and, in this connection, to the essential need for close collaboration between the university, city Council and the voluntary hospitals in order to ensure the fullest measure of benefit to the child, both from the curative and preventive aspect. The departments will be concerned not only with the investigation of the diseases of childhood, but also with the preservation of good physical and mental health during the early years of life. Linked up as they will be with the children’s hospitals, w)iich will provide wards for teaching and research purposes, the latter should now be in a position of having their medical and nursing staff actively participating in the study and care of the healthy child.
A further development, which will be welcomed by all those engaged in the field of mental health who have for long advocated measures of this kind, is the decision of’Leeds University, as a result of a grant of ?15,000 from the Nuffield Provincial Hospitals Trust, to establish a whole-time Chair in Psychiatry, with which will be associated a complete psychiatric unit. Facilities will be provided for both undergraduate and post-graduate instruction, and for research in the various branches of psychological medicine as well as for treatment. It is suggested that the functions of the unit shall include the establishment of close contact between general medicine and psychiatry and the clinical integration of the various mental health services in the area.
Training for Child Guidance Work
The chief concern of the Child Guidance Council has been with training. There will undoubtedly be a great demand for all workers in child guidance after the war, as the local education authorities are obliged to make provision for problem children under the new Education Act, but it has been agreed that it is undesirable to attempt to meet the demand by lowering the standards of training. At the same time, the Provisional Council have decided, so far as Child Psychiatrists are concerned, to try the experiment, for a limited period, of concentrating the training into six months whole time. The possibility of organizing theoretical instruction in various centres is also under consideration, and in this way some of the demands may be met.
It would appear that child guidance work has divided itself to some extent into definite psychological treatment which naturally should be carried out by fully staffed child guidance clinics (which may subsequently operate under the Ministry of Health). There is a large amount of work, however, partly diagnostic and partly # social, and also educational adjustments, which will have to be carried out under the local education authorities, and which will deal with very much larger numbers of children. All members of the team will be concerned in this, but it may be carried out rather more loosely in what it is suggested should be called child guidance centres. It is impossible to make definite prognostications as to the exact nature which child guidance work will take in the future until the policy for health services for the nation is finally determined.
Occupation Centres for M.D. Children
Training Course for Staffs. In view of the serious shortage of trained workers and of the need for re-opening Centres closed during the War, the Provisional Council consider that the time has come when some effort must be made to deal with the increasingly difficult situation.
The possibility of reviving the Training Course for Occupations Centre Workers initiated by the C.A.M.W. in 1939-?which had to be cut short on the outbreak of war?is therefore being explored and plans are now in hand.
The Course projected will consist of three terms’ work, theoretical and practical. The theoretical instruction will be given in London, at the beginning and end of the period, and, for their practical experience, students will be allocated to various Occupation Centres, and Training Departments of Certified Institutions.
Arrangements must be provisional, until it has been ascertained whether an adequate supply of candidates for training is likely to be forthcoming. Anyone interested is invited to apply for further particulars to the Education Secretary, 39 Queen Anne Street, London, W.l.
Cambridgeshire Occupation Centre. An interesting scheme for the training of mentally defective older girls who attend this Centre, started a year ago and has been found to work very satisfactorily.
For the past six years?since the Centre was opened on a full-time basis necessitating the provision of a mid-day dinner?the Senior Girls have helped in the kitchen. It was then decided, in order to maintain a high standard of proficiency, to institute a Domestic Certificate, awarded on the result of practical tests judged by an outside Domestic Science teacher. There are three Certificates?for Kitchen Workers, Cooks, and Laundry Workers respectively, all on prescribed lines.
More detailed information as to the working of the scheme will be gladly supplied by the Centre Organizer, Miss Isobel Simon, Fitzroy Hall, Wellington Street, Cambridge.
Residential Nurseries
In the Summary Report of the Ministry of Health for the year ended 31st March, 1944 (published by H.M. Stationery Office, price Is. net), it is stated that the number of residential nurseries maintained under the Government Evacuation Scheme for the reception of babies and children under five is around 400 with about 13,000 places. The great majority are long-stay nurseries, and a small minority cater for short-stay cases, usually the young children of women who are themselves evacuated to an emergency maternity home for confinement and who can find no one to care for the child in their absence. It is stated that there has been an increased demand for this kind of provision, and steps have been taken to increase the number of short-stay nurseries.
Between 30,000 and 40,000 children have spent some time at an evacuation residential nursery during the course of the War.
Although many children benefit physically from the healthy surroundings, good food and regular routine of a residential nursery, the Ministry stress that they do not advocate this as desirable for children, whose essential need and right is the love and individual attention of a mother.
It is of interest to record here that a step towards meeting the need for special provision for children between the ages of two and five, who have been found unmanageable in ordinary large nurseries, was taken in 1942 when Haybrook House, Pewsey (Wiltshire) was opened at the request of the Ministry of Health, and on behalf of the Church of England Waifs and Strays Society, as a Residential Nursery for 20 to 25 such children. The Nursery is a pioneer undertaking to determine the best method of dealing with problem children of this age-group. The Chief Educational Psychologist of the Provisional Council visits each week, and Dr D. H. H. Thomas, Medical Superintendent of Pewsey Colony, is the Visiting Psychiatrist.
Some of the children have been parted from their parents in infancy, and others have been in and out of one Nursery after another. They are referred for a variety of specific problems, but all alike are violently aggressive and destructive, demanding adult attention, and lacking in ordinary affection. In order that this veneer of hardness may be broken through, and that the expert individual attention which will foster a sense of security may be ensured, the children are divided into groups of five, each placed under the care of a Group Mother. In this way, every child definitely ” belongs ” to a particular member of the staff.
It is not possible to estimate with any accuracy the result of this experiment after so short a period as two years, but it may be definitely stated that some six or eight of the children dealt with have now become practically normal in their relationship to adults and to other children. Lasker Award for Mental Hygiene ——————————- It is announced that the Albert and Mary Lasker Foundation, Inc., have established the Lasker Award of $1,000 to be given annually through the National Committee for Mental Hygiene (New York), for outstanding service in the field of mental hygiene. The purpose of the award *is to recognize significant contributions towards the promotion of mental health and towards making mental hygiene more familiar to the general public. Each year the award will be made for a contribution in some special aspect of the field of mental hygiene which seems to be of immediate and current significance. The recipient of the award will be selected by an anonymous jury chosen annually for its competence to judge accomplishment in a particular field.
The award for 1944 will be for mental hygiene work related to the war, and the recipient will be chosen from among leaders who have done work in the general enhancement of the mental health of the men and women of the services, both while in service and during the period of rehabilitation.
The award is not confined to persons in the United States, and if some outstanding contribution has been made abroad in a particular field, the award will be made jointly with the leading mental hygiene organization of the country concerned. The range of activities for which the award will be made will include, under psychiatric education, popular adult education (through books, articles, lectures and plays), popular child education (in schools, camps, playgrounds, community centres, churches and other group activities). Professional Psychiatric education comprises medical school education, nursing school education, psychiatric social work educate n, clinical psychology, and other professional groups, such as vocational guidance, occupational therapy, teaching, theology, etc. The field of psychiatric organization and administration will include hospital and clinic organization, child guidance clinics, all types of community projects for the care of problems m special groups, penology, and delinquency. The Psychiatric research field will include etiology, techniques of diagnoses, special screening devices, and treatment methods, both group and individual. The held of psychosomatic medicine will also be included in consideration for the award.
Further particulars may be obtained from the National Committee for Mental Hygiene, 1790 Broadway, New York, 19.
The National Committee for Mental Hygiene, U.S.A. Members of the National Council for Mental Hygiene will be interested to hear that Mrs. Mary Lasker, who *s a member of the Board of Trustees of the Institute lor Psychoanalysis, Chicago, and a Trustee of the Wenninger Foundation, Topeka, has been appointed Secretary of the National Committee for Mental Hygiene (U-S.A.) in succession to the late Mr. Clifford W. j-*eers, founder of the Mental Hygiene movement. Mrs. Lasker, who has been keenly interested in Mental Hygiene for a number of years, is also a member of the ?ooard of Directors of the National Committee in New York.
Norwich and Social Medicine
At a delegate Conference convened by the Norwich Class Teachers’ Association and presided over by the Lord Mayor, the following resolution was passed:? ” That this meeting views with concern the extent of Juvenile Delinquency, and urges that a panel be constituted from its members to consider the position, and make suggestions for its mitigation.”
. The Panel constituted was composed of people ?nterested in the subject from various angles, including two or three City Councillors, a magistrate, a psychiatrist, ^ educational psychologist, the Head of the Training College, three teachers, two ministers of religion, a Probation Officer, and two officers of Youth Organizations. Its method of work was by sub-committees; each took one particular problem or need for detailed study and presented its findings to the main body.
The survey thus made of the whole field led to an interesting final recommendation, viz. the need for the formation by the City Council of a ” Social Service ” or ” Social Medicine ” Department which would co-ordinate the activities of all the Authorities and Committees responsible for social welfare, whether concerned with education, health, or housing, with Juvenile Courts or with Probation. Such a Department would also be in a position to initiate new schemes for social betterment?with education, research and propaganda?and it would have as its underlying purpose the popularizing of a new concept of ” health mental and physical, and the building up of new standards of social behaviour.
Employment of Epileptics
A pamphlet on this subject, which has reached us from the American Epilepsy League, publishes some interesting information of a kind which it is difficult to obtain in this country.
Out of 350,000 epileptic men and women gainfully employed in the United States, more than 250,000 are estimated to be physically and mentally normal, apart from their liability to seizures, and it is contended that the embargo on the acceptance of epileptics for service with the United States Army is unjustifiable. The writers contend further, that the association of mental deterioration and epilepsy has been grossly over-estimated. Out of 838 epileptic adults examined by neurologists, 67 per cent, were judged to be mentally normal and in only 9-2 per cent, was gross deterioration observed.
Workshop for Epileptics
The Workshop for Epileptics opened in South London by the Provisional Council in the spring of 1944, which had to be temporarily closed owing to the flying bomb attacks, has now been re-opened and satisfactory arrangements have been made for the men to work on a process in connection with the assembling of gas pokers.
Under Section 15 of the Disabled Persons (Employment) Act, 1944, grants for the purpose of defraying or contributing towards the expenses of undertakings employing severely disabled persons may be made under prescribed conditions. It would appear that this ” Sheltered Workshop” for Epileptics might qualify for such a grant, and the whole position of such Workshops under Section 15 of the Act is being taken up shortly by the Provisional Council with the Ministry of Labour.
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