Report on an Evacuation Hostel in Yorkshire
- Author:
Irene Turgel, M.D.
Visiting Psychiatrist This hostel, which was administered by the Joint Hostels Committee, was set up as a special psychiatric hostel in 1941, on the recommendation of the Mental Health Emergency Committee,* for those evacuated children who proved to unbilletable in private foster homes and who were also found far too difficult to be kept in ordinal hostels.
The work of this Committee is now carried out by the Provisional National Council jor Mental Health.?E.D. The Mental Health Emergency Committee acted as an advisory body to the Ministry of Health, and were generally responsible, along with the psychiatrist, for selection of the children and placement.
The hostel was not meant for mentally defective children, though a comparatively large number were of fairly low intelligence, but it was intended for seriously unstable boys and girls of school age, for children with behaviour problems and habit disorders, neurotic and delinquent children. The numbers were limited to 15. The staff was specially selected, and had to be comparatively large, a condition which unfortunately has had to be abandoned during the last years owing to the shortage of qualified staff. Individual treatment has been given once a week by the visiting Psychiatrist, who works in close co-operation with the members of the staff, advising them in aU general educational matters and planning with them the handling of individual children. A thorough discussion between psychiatrist and staff takes place on every visit.
31 children have been treated and observed, 20 of whom returned to their families or were transferred to other hostels or schools, for reasons to be explained later.
The background of these 31 children is as follows: 9 were brought up in big institutions or orphanages. 2 lived in various foster homes all their life. 15 came from broken homes (parents separated), or from other undesirable home conditions. 5 children only had a fairly normal family background.
Type of Problem
The problems which these children have presented can be classified as : ?Anti-social behaviour: Temper tantrums and aggressiveness, destructiveness, lying and pilfering. Anxieties and Emotional Instability. Negativistic behaviour: Obstinacy, sulkiness, babyish behaviour, lack of sociability and responsibility; selfishness and greed; slyness. Habit disorders: Bed-wetting and soiling; masturbation; eating disorders; nail-biting, thumb-sucking; speech defects.
Sexual precociousness.
It is understood that most of the children did not show one of the disorders only, but a variety of symptoms, the severity and violence of which had to be experienced to be believed. They were in fact quite uncontrolled and unresponsive to the Usual methods of handling. We had among the 12 bed-wetters some children with delinquent tendencies, others with symptoms of anxiety and ^security, excitable and aggressive children, and one very intelligent, obstinate, greedy boy, with babyish behaviour, masturbating and nail-biting as well. Most of the enuretics grew better with the improvement of their general symptoms; three children are definitely cured, but two or three are, in spite of good progress in their general behaviour, only slightly improved.
Six children were admitted for delinquency (mostly stealing)?three of them having been placed on probation with a condition of residence at the hostel for a specified period. Three of the six belonged to the lowest group of intelligence; one was a cunning little criminal, quite unresponsive to treatment; he was transferred to a Camp School with stricter methods. Another benefited very much from treatment and community life, but was taken home too soon against our advice. Three of the delinquents, children of normal intelligence, have well improved, and will benefit from a prolonged stay.
With regard to the underlying causes, we would comment as follows:
Most of the children observed show to a greater or lesser degree constitutional abnormalities (innate instability, very strong instinctual forces, incapacity to tolerate frustration, low intelligence). It seems however, justifiable to say that, with the exception of three or four psychopathic or prepsychotic children, the behaviour problems were in the main due to the very unfavourable factors of the environment. They were nearly all children frustrated of love during their early childhood, with no security and little individual care and attention, and who had to face a world of hostility and rejection at an early age.
They were shifted about in various foster homes or hostels, and thus suffered additionally from feelings of insecurity and inferiority, frequently increased by backwardness because of lack of continuity in schooling.
Some of the children had very severe shock experiences; one witnessed his mother’s suicide when he was five; another the outbreak of his mother’s insanity; two children were deserted by their mothers, one is an unwanted child, two at least are illegitimate; many of them witnessed alarming scenes between their parents; promiscuity, even inside the family; and those with a fairly normal family background suffered, with justification, from jealousy towards brothers and sisters, and from wrong handling.
The hereditary conditions were not favourable either. Insanity of one parent was reported in the history of five children. Mental deficiency and dullness exist in two or three parents. Syphilis was reported in three cases, and two children have been found to be affected. How many parents showed temperamental and moral deficiencies cannot be stated with certainty, but serious sexual irregularities occurred in at least two cases.
The intellectual endowment of these children, compared with a group of normal children, showed a greater percentage of dullness. The distribution of intelligence, as expressed by the I.Q. is as follows : I.Q. 75- 85 .. 9 children. 85- 90 .. 5 90-100 .. 13 ? 100-125 .. 4 Temperamental deficiency was found in two children, who were so unstable and uncontrolled that for the protection of the younger children they had to be sent away; one boy, belonging to the highest group of intelligence, was able to be transferred to a residential School for older difficult children ; a very dull girl with dangerous outbursts had to be sent to a mental hospital for treatment. Some of the emotionally unstable children were found to suffer also from metabolic disorder (e.g. subnormal level of blood sugar), increasing their restlessness, eating and sleeping disorders, and these were helped by general medical treatment.
Summary of Results
Before discussing the form of treatment, here is a summary of the results:
6 of the children returned to their families could be called normal, and were likely to get on well provided their environment proved satisfactory. 8 had improved, but still showed behaviour difficulties; prognosis depends largely on their further experiences.
6 of the children who were transferred to hostels for dull and backward children, to residential schools, etc., showed only slight improvements at that time, but partly adjusted themselves later. At the moment the hostel is reduced to 11 children, of these: 7 have considerably improved; 3 still present serious problems; 1 has not been staying long enough to allow a conclusive opinion.
Form of Treatment
The aim of the hostel is educational as well as therapeutic; that is, to give the children security, self-confidence, and confidence in the grown-ups, who are their friends and comrades, not their masters; to encourage independence, helpfulness and responsibility ; to teach them the pleasure of give and take and the appreciation of a decent life. The methods are steady friendliness, respect for their individuality, encouragement of their assets, and a great variety of activities which serve as outlets for their aggressive and destructive instincts, and stimulate their constructive and creative power. Woodwork, drawing and painting, gardening and games, especially football, are equally popular. The atmosphere is that of a happy big family, the character of which is emphasized by the presence of the two little children of the warden-couple, who have called out in nearly all the hostel children a protective gentle attitude. The members of the staff understand the individual problems well and try to give each child the responsibility and freedom he needs, increased affectionate attention and encouragement, or stricter supervision where this is required. The children move freely in the village, attend the two local village schools, mix with. activities, and are accepted surprisingly well considering the difficulties.
The psychiatrist visits weekly. Treatment consists in play therapy, which enables the children to give expression to their inner tensions, their anxieties and aggressiveness, and to gain insight into their problems. With the older boys and girls direct talks are used too. The relationship between the children and the psychiatrist is one of friendship and confidence, and the continuity of contact contributes much to their feeling of security. Though treatment interviews are often stopped for weeks, where it seems no more necessary, they can always be taken up again when lapses occur or the child feels temporarily unsettled and in trouble.
Duration of Stay
The length of time spent at the hostel has varied from ten months to nearly five years, with an average stay of two years. Discharge, however, was not only determined by an improvement of the child’s behaviour, but often by the parents’ wish to have their child back; while, on the other hand, some children cannot be discharged in spite of considerable progress because they have no families, and are unsuitable for foster homes and institutions. They feel secure and happy in the hostel and will have to be kept there as a comparatively stable and settled group ready to help difficult newcomers to settle down and fit into the group-life. With the experience of their own problems they are somehow better suited to accept children with anti-social behaviour or other difficulties than normal children would be, who might either reject their abnormal playmates or more easily be led by them. Conclusions
1. In my opinion there is a definite need for this type of hostel for children who have been hitherto presenting serious social problems. There should be no difficulty in keeping it filled. 2. Close co-operation with other hostels and childrens’ homes in the local county area is desirable to help with special problems, and to enable the authorities to arrive at the best placement possible, according to the individual hostel set-up and the special needs of the particular child. Indiscriminate grouping often interferes with success.
3. It is advisable that selection and placement of the children should be the responsibility of a psychiatric social worker and the psychiatrist. 4. In view of the necessarily small number of children in any one hostel, if the sound idea of family grouping is maintained, it would help if two hostels could be near together, so that children of similar age could unite for organized activities, e.g. acting, games, Nature Club, etc.
Our experience has taught us that the efforts above described have been well worth while, and that the children who have a sound family background can return eventually and meet the demands of normal life, and that the rest have developed, and do remarkably well within the happy atmosphere of the hostel.
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