News and Notes
Memorandum on the Care of the Homeless Child Because it is assured of the importance of understanding the mental and emotional needs of normal homeless children, and in the light of its experience of training in Nurseries, wartime Hostels and Homes, the Provisional Council, in response to many requests, has been considering the publication of a simple Memorandum on the subject. This should embody the principles on which to base provision for the child who has to be brought up away from his own family.
From many angles, work in the mental health field shows that the child has the same fundamental needs” whatever his environment. It is necessary for all those in charge of children to understand these aspects of child development, and especially important when children have been removed from a family setting. The same principles hold good whatever the age of the child, and it seems important to stress this when there are apt to be artificial divisions such as ” under-fives ” and ” school-ageThe fact that there are not final divisions can be seen from the suggestion to raise the nursery phase to ” under-sevens ” and the proposal to extend the school age.
In laying down the principles, it became evident that these should be followed by suggestions as to how staff could be enabled to carry these out. The suggestions had not been confined to one fixed syllabus, for the conditions of the times as well as the present wide variety of practice would prohibit the establishment at this moment of a unified national system. A more general standard may be desirable as an aim, but different types and sizes of Homes will be required for many years, and already exist, many with long and honourable histories.
The Memorandum which is being prepared will outline the minimum proportion of teaching in the mental health aspects of child care, which should be embodied in every course of training for staffs of Children’s Homes. It advocates a national certificate for a course of adequate length, but also makes suggestions for a short-term plan to cover the period before staff can be equipped for training.
It is hoped that such a general statement of princip’e will be of use to those concerned with training in many fields?Residential Nurseries, Voluntary and Pubhc Assistance Homes, Hostels, and Residential SchoolsFrom requests made to the Provisional Council, there is evidence that the staffs of many such places which care for children are eager for a fuller understanding 01 child development. It is hoped that this Memorandum will further the acceptance of the importance of knowing something of the emotional life of the child.
After-Care of Men and Women discharged from the Services During the past six months the Provisional Council has tackled one of the biggest mental health problems of the war?the social needs of the man or woman discharged from the Services on psychiatric groundsUnder a scheme, the execution of which has been entrusted to the Provisional Council, and which has been planned in conjunction with the three Services and also the Ministries of Pensions, Labour and Health, with the Board of Control as co-ordinating body, some 1,500 such men and women in England and Wales alone h^ve already availed themselves of special after-care services from experienced psychiatric social workers following their discharge to civilian life. This is a part only ?l the total number to whom such help might be given> but it is a noteworthy beginning. ,
These men and women were discharged from a selected list of some thirty Naval, Military and R.A.F. psychiatry hospitals and E.M.S. Neuroses Centres. If, before then discharge, their medical officer feels they would benen from after-care, they are asked if they would like to see a social worker and discuss their problems and The Services After-Care Officer makes a report on this interview, including the recommendations of the medico officer. This report is sent to the Board of Control an<j is forwarded to the Provisional Council for transmission to their After-Care Officer in the patient’s home area* who visits him on his return and helps him in every vva^ she can to settle down happily and civilian life. . Prnvisional Council’s The work is carried out by the P hiatric social Regional After-Care Officers, who are p ^ responworkers appointed for each defence g ^ patjents in sible for the visiting of hospitals a conVersant with hat area. These officers are thoroughy ^ they work the local treatment and social la Pdical Services of closely with the Commissioners ot Me f ReSettlethe Ministry of Pensions, Ministry organizations. ment Officers, Local Authorities and socia.^^j as Jhey have done great work, n?to”y . j^ing together fnend and adviser to the patient, but 1 -ble underthese services and so ensuring th eedy solution, standing of his problems and their speeuy Guy’s New Clinic?a Modern Psychological A. pioneer venture, and an important adva ^ York rnedicine, is marked by the recent P ,s hospital. Clinic for psychological illnesses _ try t0 be built ; It is the first clinic of its kind in th ^ patients, men at a general hospital, and it has bed frQm tbe York and women. A donation of ?43,, made the Trust and Lord Nuffield’s gift of half th ^ put up building of the clinic possible. Ahhoug ^ ^ *n the first year of the war, it has damage inflicted Guy’s for other purposes as a result of damag on the main structure through enemy but it is A charge is made for all Pa Ilprorne established it hoped that when the clinic has beds. An agreemay be possible to provide some *r provides that ment under which the clinic will1 ?P -j’ to reduce the any surplus income shall be used p circumstances, costs of maintenance to patients 1 P becjs to be at t?’ jternatively, for the ProvJ.sl?” vch0logical medicine the disposal of the physician for psycho at Guy’s Hospital. , . . i units of this type The establishment of psycholog j. ^oCtors and meets a long-felt want both on th P’ ourage persons paUents. it should do much to enco ^ overcome suffering from nervous and menta bmit themselves the reluctance which is so often fel pi;nic will make ^ treatment. Access to the y?.rnk.pScation of the Possible a great expansion and 1 - psychological teaching to Guy’s Hospital students o J.{lhealth in Medicine and the psychological asp benefits. general, which should have far-re^ueSbeginning of the It is hoped that this venture mark kind, and that establishment of further clinics of sabie units of they wiibecome recognized as in P general hospitals.
Child Guidance Clinics blishment S during this year a marked featurein theest^ opened tl ?f new clinics has been the’increasing: n working on ? ? Greater London and the Home Coii raphically- ei a sessional basis with the staffs gro p onjy resident |n many instances the social worke hologist and member of the team, whilst the n clinics, and psychiatrist share their time between s while this is rn many cases travel daily from t ‘abljsbing Child P obviously not the ideal method o brought to Guidance, it has enabled the ser^hi: .foment of Outer > rural areas and, through the estab ..ng lists jn the London Clinics, is relieving the long ^icfo altogether London clinics. The list of clinics, wn (and will in now number 127, is in the pubhshers h^ Qffice_ of shortly be obtainable at the Child G in Nuffield Foundation Grant for Child Guidance Work ps On the cessation of the grants previously given by the aj Commonwealth Fund for the support of Child Guidance n_ work, the Nuffield Foundation have generously agreed to support this work until complete amalgamation is effected, and have granted the Child Guidance Council the sum of ?2,500 for the current year. This will enable ^ the Council to maintain their Central Office and to increase the staff. The training of Fellows in Psychiatry and Psychology will also be considerably increased.
Advanced Training in Clinical Psychology
r- An Ad Hoc Committee of the Provisional Council’s i. Interclinic Committee has been discussing the establishment of training in Lay Therapy for selected Psychologists and Psychiatric Social Workers, who will work as medical auxiliaries and in conjunction with a [j Psychiatrist. As a temporary and emergency measure, ( a course of half-time training for a period of two years is being planned, which it is hoped, will commence in j September. j As a longer term measure, this Committee is considering . the establishment of training in Lay Therapy to cover a J period of about four years, and to include academic as well as clinical teaching.
After-Care of Special School Children (M.D.) For many years the London County Council has undertaken, on behalf of the Ministry of Labour and National Service, the work of placing in employment children leaving its Special Schools at the age of 16, and figures have been submitted each quarter as to the number of placings. But an attempt has recently been made to find out ” what happens ultimately to ex-special school children “?a question which, in view of its connection with the Education Bill, is now of particular moment.
Accordingly, it was decided to investigate the records of all the children leaving the L.C.C. Special Schools in the specimen year 1935, with results that are described as ” illuminating and reassuring Out of the 493 school leavers, 59 are now in Institutions or under Guardianship under the Mental Deficiency Act, and 13 have died. The remaining 421 have needed no form of public care, and of these only 13 are unemployable; 198 are known to be wholly or partially self-supporting, and 48 joined H.M. Forces. There is a balance of 162 boys and girls who could not be traced owing to evacuation, etc., but there is every reason to believe that they, too, are living successfully in the community, as no applications for institutional care or other help have been received on their behalf.
The report states that, on the basis of these figures, it would appear that only 10 per cent, of its Special School leavers are likely to need institution care, and that the other 90 per cent, may be expected to ” float ” successfully in the community. It is true that the employment situation since 1940 has been abnormally favourable for defectives, but, on the other hand, attention is called to the “imponderable factor ” of the Disabled Persons (Employment) Act, under which those mental defectives who become registered as disabled persons may hold an advantage in obtaining work.
Testimony is paid to the value of the after-care given by social workers in the L.C.C. Supervision Section to these boys and girls, whose successful launching in the industrial world depends very largely on the understanding help and guidance given to them, both at the time of placement and afterwards.
The National Council for Mental Hygiene
The Duchess of Kent, who recently took office as President of the National Council for Mental Hygiene, honoured the Council by her gracious presence at a special meeting and reception held at Manson House, Portland Place, W.l, on April 26th. In expressing her pleasure at attending the meeting and her keen interest in the Council’s work, Her Royal Highness spoke of the important part which it had to play in relation to the mental health of the nation, especially in view of the accumulated strains of war, and of the help which the study of mental health could bring to parents in the upbringing of children. Dr Helen Boyle, Vice-Chairman, gave a most interesting address, which is printed in full on pages 7-10 of this issue, on the Mental Hygiene Movement, and recalled the little-known history of its beginnings.
The meeting ended with a showing of the psychological film ” Fear and Peter Brown in the production of which the Council had helped, and was followed by tea.
” Lord ” Memorial Essay Competition A first prize of ?3 3s. and a medal, and a second prize of ?1 Is. are offered to all certificated mental nurses, male and female, of the rank of staff, charge or chief charge, in Mental Hospitals in the United Kingdom and Northern Ireland in the ” Lord” Memorial Essay Competition, founded by the Society of the Crown of Our Lord and administered by the National Council for Mental Hygiene. The competition, which is an annual one, takes the form of an essay of approximately 2,000 words. The subject chosen by the Selection Committee for this year is ” The Nurse’s part in helping the newly admitted Patient to settle down The latest date for the reception of essays is September 1st, 1944, and these should be addressed to The Secretary, The National Council for Mental Hygiene, 39 Queen Anne Street, London, W.l, from whom full details regarding the conditions of entry may be obtained.
The Diagnosis and Treatment of Delinquency
The Institute for the Scientific Treatment of Delinquency has recently issued under this title an extremely interesting and informative clinical report by Dr Edward Glover on the work of the Institute during the five years 1937 to 1941. The report comprises Chapter IV of Mental Abnormality and Crime, Vol. II of the series ” English Studies in Criminal Science published by Macmillan. It contains a brief introductory note On the history of the Institute, and also sections dealing with clinical material, diagnosis and disposal of cases, treatment and results, with comparative tables for the five years.
In view of the public interest in the increase in juvenile delinquency, a comment on this point, contained in the report, is worthy of special note. Official records, it is stated, go to show that there was a pre-war as well as a wartime increase in juvenile delinquency, and suggest also that the basic causal factors are not due to ” war conditions “, but that the latter act as a precipitating factor. Some confusion, it is felt, has arisen owing to the fact that the authorities have lost sight of the pre-war increase and have taken the view that the increase is only a wartime phenomenon. Pending a reasonably scientific investigation of the problem, the necessity for suspending conclusions as to the nature of wartime ” waves ” of delinquency is stressed.
The report ends with suggestions for future developments, among which may be cited the provision of Hostels for patients under the control of the Institute, of an Observation Centre outside the London area, and the organization of seminars for Magistrates and Clerks of the Court.
Workshop for Epileptics
The Provisional National Council for Mental Health opened in South-East London on April 18th last an experimental workshop for the employment of epilep*lCS’ whose fits were too frequent for them to be suitable ft” work under normal conditions. Eight men wer*j enrolled to begin with, all of whom had been unemploye for a considerable time, and of these, two were discharge0 from a Colony for the purpose, as their families weJ.e willing to have them at home if work could be providedThe screw sorting first obtained for them (after severa months spent in searching) has proved to be monotonou and financially unprofitable, but it is hoped that something more suitable may be found shortly.
Even under present conditions, however, good result have been noted. The men have attended regularly> are happy and contented, and express appreciation a being able to lead a normal working life. In some cases, fits have decreased, and there has been a general improvement in health. Wives and mothers are quite deligWe? with the change, and unanimously express the that the workshop has made a striking difference in tn? men, who are better tempered and easier to manage in every way.
Children’s Painting and Epilepsy
An account of the purpose, progress and development of an experiment carried out at Lingfield Epileptic Colony during the last four years, with painting as an activity to epileptic boys, is described in an interesting article Charles Handley-Read, M.A., with a foreword by 111 Medical Superintendent of the Colony, Dr J. Tylor Fo*> reprinted from The Studio, Vol. 127, No. 614, May 19’4?* As one of many possible activities of real therapeu*1 value, painting is, in a number of respects, ideal. Tfl article attempts to show that a concern for the PT0^e values in art, and an equal concern for therapy can R,, fulfilled through painting organized on ” libertarian lines. Thus the children concerned have had the chanc to expand their personality to the full, and in doing s, have produced work of considerable artistic interest an’ merit, a claim which the specimens of paintings repr?* duced in the article amply support. Exhibitions of wor> done are held from time to time, and paintings w# shown recently at a London art gallery. These exlu^1’ tions have been found to fulfil several valuable purposes* they act as an encouragement and incentive to the children, and are also of propaganda value in that they help to dispel doubts and misconceptions in the layman mind on the subject of epilepsy. The author states tna painting proves to the children themselves their normality’ as well as their ability, and serves to demonstrate tW normality to others.
The Psychology of Tuberculosis
It is announced that the National Association for the Prevention of Tuberculosis are to undertake a comp1?’ hensive investigation into the psychology of tuberculos’si to last, in the first place, for twelve months. All types o patients with pulmonary tuberculosis will be studie0^ and the work will be carried out by a competent psych’a,[ trist, with an assistant psychiatric social worker. Fu-t personality studies will be the basis of the work which, is hoped, will also lay the foundation for more ambitiou sociological studies.
*en,al Health Courses
founH^k” ^hool ?f Economics. The fifth year of the war home ;!e Cental Health Course returned to the London and w h ? Sch?o1 Economics after a period of exile the rectn fu^n8’ return meant the separation from the ser ? School still working in Cambridge. Against ^eieh ‘h ‘OSS cornmon study and social life had to be of do i gains of a far more satisfactory programme area a h [e^ated. theoretical and practical work in one ‘n tr’avn- saving to staff and students of energy spent the ve 8 and settling in three different places during ThfromVw-11111 t^ie Child Guidance Training Centre that fo to Woodside Hospital, Highgate, meant as a / e.^rst time since the war this clinic could work Premis0ni tely independent unit, and with enlarged Child r expand in staff and service. Increased and th Uldance facilities were badly needed in London, student 2Vas therefore added satisfaction to staff and It wS ??11PPortant work to be done.
comminS ^n8 at this stage that the representative Perman ac*visipg the School should have adopted a The MCnt ,constitution after an experimental period. those v7al Health Course Committee now represents and Ce?t ,tary organizations, professional associations eloselv anc* ^oca’ government departments, most Invali,aui0ncerPecl whh the Mental Health Services. ?n man advice has already been offered to the School Contrih?taSpects training and employment. Financial *he Sch 11? ^ave 8enerously been continued, though its Snr:?i?l as now ^ul’y incorporated the Course into GratifJScience Department.
generoi to Commonwealth Fund for their have bpS suPP?rt over a twelve-year period could not Secure LXPressed in a more fitting way than by this No r(f j?tishment of the training.
hilities ?a- r ?f this Journal could doubt the responsiof psvrvrln? a^ead for those concerned with the training shovn natnc soc’al workers. Each year of the war has regional ^ demands for this service, illustrated in the ofex-serP- ning mental health services, the after-care of the P flcf,men and women, and the rapid development throuov, ahhshed child guidance and mental hospitals Much?H- the ?ountry.
methods lfScussi?n is now taking place as to the best end 0r , expanding opportunities for training. The exPerien ^War should see numbers of men and women exPerien n we^are service anxious to use this be i0st ?e Plans are being made so that no time will skilis ofm Pfoviding training which will translate the health o WaFtime experience into the much needed mental TherrVlce.Sof Lilian life.
welcomp0rnm^tee anc* Staff of the Mental Health Course future m an^ suS?estions as to how the needs of the and invit ‘3est- met fr?m the training standpoint, instarti encluiries from any individual wanting help ^ese lines ?r continuing their professional training along HealthU^es can he made to the Tutor, The Mental PolitiVni <?Hrse> The London School of Economics and Scholars^- lence’. Houghton Street, W.C.2. (HOL. 9783). 1945/ applications should be received by April 1st, inzrdJ”bUr8h University. In order to help to meet the Workers ,demand for qualified psychiatric social instituted University of Edinburgh has recently Health f a, ?ne-year’s course of training in Mental has been?r ^ a Certificate in Psychiatric Social Work approved. Candidates for the course, who will be chosen by a selection committee, must be over 22 years of age and hold a Social Study Diploma or Certificate, or a Degree in Sociology, supplemented by practical experience.
The fee for the course is thirty guineas, but the University hopes to be in a position to offer a limited number of scholarships to students who appear to be specially -qualified to take the training, but who, for financial reasons, might be unable to do so. The course will normally start in October of each year, and applications for the next session should reach the Director of Studies (from whom a copy of the syllabus may also be obtained), Department of Social Study and Training, Edinburgh University, not later than September 1st, 1944.
Medical Officers’ Course
The twenty-fifth Course in Mental Deficiency and Allied Conditions, organized by the Provisional National Council for Mental Health (incorporating the Central Association for Mental Welfare) in conjunction with the University of London Tutorial Classes Council, was held from April 24th to May 5th, 1944, at the London School of Hygiene and Tropical Medicine. Forty-five Medical Officers from all parts of the country attended. This was considered very satisfactory owing to the great shortage of doctors and the heavy pressure of work on those engaged in civilian practice.
Lectures were given by Dr H. K. Cowan, Medical Officer of Health, Gloucestershire; Dr G. A. Danby, of Sandhill Park Colony; Dr S. G. James, of Moss Side State Institution; Miss Laird, M.A., Inspector of the Board of Control; and Dr A. C. Turner, Senior Medical Officer, City of Leicester Education Committee. There was also a session on Child Guidance by Dr Frank Bodman. Instruction in mental testing was, as formerly, given under the direction of Miss L. G. Fildes, B.A., Ph.D., assisted by the Provisional Council’s staff of psychologists, Miss Blythen, Miss Cleugh and Miss Johns, the necessary facilities being generously provided by Acton Elementary Schools, Willesden Special School and the Fountain Hospital. Each student paid one visit of observation to either the Manor Certified Institution, or to Willesden or Enfield Special School.
The Value of Boarding-Out
A Home Office Circular No. 93/1944 on the question of boarding out, gives particulars of increased payments allowed to foster parents of children and young persons committed to their care. Emphasis is laid on the valuable assistance which local authorities can give the Juvenile Courts by finding foster parents for children for whom the Courts wish to secure this form of treatment. Attention is drawn to the fact that the intention of the Statute as well as that of the Juvenile Court is frustrated if a child, unless its circumstances so demand, is placed in an institution, instead of being found a home with foster parents.
The employment of a special officer, preferably one who has taken a recognized course of training in some form of social work, and who has had practical experience of home visiting and children’s problems, is advocated. The salary of such an officer will be allowed to rank for grant as part of the expenses of the local authority in respect of children and young persons committed to their care.
The Scottish Association for Mental Hygiene
The Annual General Meeting of the Scottish Association for Mental Hygiene was held in Glasgow on May 27th, 1944. Sir John Jeffrey, K.C.B., C.B.E., Chairman of the General Board of Control for Scotland, was the principal speaker, and delivered a particularly interesting and stimulating address regarding the possible developments of the Association under the new Mental Health Services. Sir William W. W. McKechnie, K.B.E., C.B., LL.D., the President of the Association, presided over a large and representative audience.
Several important items were discussed, including the establishment by Education Committees of Occupation Centres for defectives who had been certified as unsuitable for instruction at Special Schools, and also the possibility of organizing a Course of Instruction in Mental Deficiency for Medical Officers employed by Local Authorities. It was reported that the Association had now completed twenty-two years of service in social welfare, and that, while work in some areas had been curtailed as a result of the war, there had been a general improvement during the past year. It had also been found possible to resume activities in several districts.
The Association has been invited to co-operate with the After-Care Organization (War Service Casualties) in their recently inaugurated scheme for the rehabilitation of Services personnel discharged from military and E.M.S. hospitals on psychiatric grounds. Contact is still being maintained with the War Office, Labour Exchanges and other officials concerned, regarding the question of the calling up of defective persons for military and national service.
Speech Therapy
A short memorandum on the necessity for making provision for Speech Therapy among schoolchildren has recently been issued by the College of Speech Therapists. Reference is made to the incidence of speech disabilities and, while statistics for the country as a whole are not available, it is estimated that at least 1 per cent, of the children attending all types of schools in the suffer from some speech disability, i.e. about 150,000 | England and Wales and 25,000 in Scotland. The rati of boys to girls varies from 5 to 1 and 3 to 1, according to the nature of the defect.
Local authorities responsible for the welfare of chil<fre and young people are urged to include arrangements to the correction’ of speech defects in their plans f?r ^ future, and it is suggested that speech therapists should o available for those attending all types of education* institutions, from Nursery Schools to County College ‘ The names of qualified members of the profession app?a on the National Register of Medical Auxiliaries. Fur’tn? information may be obtained from the Secretary oftn College, 86 Harley Street, W.l.
Allied Students in Training
Reference was made in a previous number of Health to the six months training course organized W the Provisional National Council for Mental Healtn> at the request of the British Council, for women of . s nations who are preparing to work in their own country during the relief and reconstruction period, course, which ended on March 31st last, proved extremely successful, and the Council wishes to acknowledge .ll indebtedness to the Ministry of Health, Local Authority and voluntary organizations for their valuable help. ^ providing facilities for some of the visits of observation made by the students to nurseries, welfare centres, schools, homes and hostels, etc., which formed an integral part of the course. . h The Provisional Council continues to co-operate the British Council in providing speakers in the trainiDB organized by the British Council itself for allied nationals, which deals with physical as well as mental healtn problems.
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