Mobile Child Guidance Teams in the Liberated Countries of Europe
- Author:
EHRENWALD, M.D.(Prague)
Acting Medical Officer, Royal Western Counties Institution, Starcross. Corresponding Member, InterAllied Health Charter Study Group
Apart from ” First Aid ” for physical ailments such as malnutrition, infectious fevers, tuberculosis, etc., the care of the mental health of the young will be one of the most important tasks of the Public Health Authorities in the period of reconstruction and rehabilitation.
We have learned from statistical work carried out in this country that nearly 1 per cent, of the child population is mentally defective and about 12 per cent, mentally subnormal, emotionally unstable or otherwise maladjusted. It may fairly be assumed that these figures likewise apply to mixed industrial and agricultural communities in Continental Europe. We know, further, that this maladjusted group, including delinquents, is likely to increase in number following the physical deprivations and the psychological stress of the War. Under normal conditions elaborate services for mental health, centred on the work of Child Guidance Clinics, are required to cope with this problem. In the Liberated Countries, the psychological rehabilitation of the young will require a similar organization?if possible on an even larger scale. But owing to the disruption of civil administration, shortage of staff, etc., Child Guidance will have to begin functioning as an Emergency Service, that is to say, Mobile Child Guidance Units will have to be set up, whose task it should be to cover as many districts as possible.
A mobile team thus conceived should consist of (a) a neuro-psychiatrist, (b) a trained nurse or social worker, (c) a clerical helper able to act as an interpreter when necessary and familiar with local conditions. The responsibilities of such a mobile team can briefly be stated as follows. It should visit schools, camps, hostels and other assembly points of children and young persons between 5 and 16 years. It should examine, classify and, if possible, assess the mentality of defective, difficult or otherwise maladjusted children, and make recommendations regarding their disposal and treatment to the Health Authorities. The neuropsychiatrist in charge of the unit should also be available to advise on cases of mental and nervous disorder in the adult population. He should further be required to collect data and submit recommendations on the further development of mental health services with special reference to the welfare of the growing generation.
It is essential that preparatory work for the coming of the Mobile Child Guidance Team should begin during the period of “First Aid It should be the task of relief workers and voluntary helpers on the spot to classify homeless, deserted or orphaned children found by them, in, tentatively, four categories:
(a) Physically and mentally healthy children who do not seem to be in need of special provisions and who can readily be placed with foster parents, in ordinary Childrens’ Homes, etc.
(b) Children suffering from physical ailments requiring medical treatment which can be provided outside hospital.
Children requiring admission to hospitals.
(d) Children showing symptoms of nervous debility, emotional instability, suffering from bedwetting or exhibiting other behaviour difficulties.
It is this last group of children whose closer examination, disposal and treatment will be the task of the Child Guidance Team. In carrying this out, its intervention would represent the second step within the proposed scheme for the mental health of the young. The third step should consist of the organization and continued supervision of Hostels for difficult or problem children, set up after the pattern which has proved a success during the wartime evacuation of children in this country, and which in turn shows interesting points of resemblance with the provisions made in Russia by the U.S.S.R. authorities for their homeless children?the ” bezprizornyi ?of the postrevolutionary period.
The importance of making the necessary provision for the care of these children in a methodical way from the outset need not be emphasized. The only alternative would be a method of trial and error, with all the waste of well-intentioned but misguided individual effort by voluntary helpers or public agencies, and with all the avoidable human suffering and its social repercussions which this would entailIt can only be hoped that both the respective Governments of the Liberated Countries and the U.N.R.R.A. authorities will give due consideration to the psychological side of post-war rehabilitation and provide facilities for putting into effect the proposals here outlined.
Outlines of Proposals submitted to the U.N.R.R.A. Authorities and to the Czechoslovak Ministry for Social
Welfare, January, 1945.
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