News and Notes
The National Association for Mental Health Readers of this Journal will be aware of the long Protracted negotiations which have been taking place concerning the final amalgamation of the three bodies composing the Provisional National Council?the Central Association for Mental Welfare, the Child Guidance Council and the National Council for Mental Hygiene?into one incorporated organization. The ?oal has at last been achieved, and on November 25th, 1946, the National Association for Mental Health received its certificate of incorporation under the Companies Act, 1929. Its inaugural meeting is to be held on February 11th, when the Hon. Officers will be elected.
The new Association, as its Medical Director has Pointed out in his Editorial, is beginning to function at a time when exceptional opportunities are opening ?ut for the development of a truly preventive Mental Health Service, statutory and voluntary, and there is a rapidly growing demand for mental health education, lr?m individuals and from groups.
To meet this demand and to take advantage of these ?Pportunities, the new Association seeks the support of a large membership representative of every part of the country and of every class of the community, and readers of this Journal are invited to apply for a pamphlet Swing fuu particulars of the Association’s programme and of the terms it offers to those wishing to join as ^embers or associates. A Report of the activities of j^s immediate predecessor?the Provisional National Council for Mental Health?during the past two years ls also available and will gladly be supplied on aPplication.
Cental Health Conference, November, 1946
So many applications were received by the Provisional Rational Council for its Conference held on November J4th and 15th, 1946, that the place of meeting had to be changed at the last minute from the Caxton Hall, Westminster, to the St. Pancras Town Hall with its Jpuch larger seating accommodation. At each of the ?ur sessions there was an attendance of approximately thousand, of which number some 446 were representatives of local authorities and voluntary organizations. I?6Conference was officially supported by the Ministry of e eahh, the Ministry of Education, the Secretary 1 State for Scotland, the Ministry of Health and Local nf?cernrnent f?r Northern Irelajid, and the Ministry p cat^on f?r Northern Ireland.
(1 t^ers were siven on the first day by Dr J. R. Rees vate Consulting Psychiatrist to the Army, and Medical sector of the Tavistock Clinic) on ” The Application - the Civilian Population of Wartime Experience of eurosis and Backwardness in the Forces “, by Dr. n’Jr- Main (Medical Director, the Cassel Hospital) on ?the Employment of the Mentally and Emotionally o andicapped ” and by Professor A. J. Lewis (Professor p.. Psychiatry, London University and Director of Unical Psychiatry, Maudsley Hospital) on ” Comumty Care in relation to the Extended Powers of ealth Authorities under the new National Health rvice Bill The Conference also had the pleasure jj Welcoming the Rt. Hon. Aneurin Bevan, Minister of tin wh? addressed it on the new legislation in relaofn u? t^le Mental Health Services. The Chairmen these two sessions were respectively, Professor J. M. Mackintosh and Mr. P. Barter (Chairman of the Board of Control).
The first session of the second day, under the chairmanship of the Rev. John H. Litten (Principal, National Children’s Homes), was devoted to papers on ” The Care of the Homeless Child ” by Miss Lucy G. Fildes, and “Juvenile Delinquency” by Miss Margery Fry, J.P. In the afternoon, Miss Norah Gibbs (Educational Psychologist) spoke on ” The Integration of the Psychologic Services under the new Education Act ” and Dr. John Bowlby (Tavistock Clinic) on ” The Future Role of the Child Guidance Clinic in Education and other Services “. The Chairman at this session was the Rt. Hon. R. A. Butler, M.P.
A full Report of the proceedings is in course of preparation and applications for copies (price 3s. 6d., postage extra) are invited. The Report will be sent automatically to all those who took inclusive tickets for the whole Conference.
Child Guidance News
Immediately following the Open Conference of the National Association for Mental Health, a One-day Child Guidance Inter-Clinic Conference was held at the Caxton Hall, Westminster, on Saturday. November 16th, 1946.
This Conference, reserved for representatives and professional members of staffs of Child Guidance Clinics, dealt with three topics: ” The Treatment of Children in Clinics and Group Play-Therapy “, ” The Position of Training for Child Guidance ” and ” The Treatment of Children in Hostels “. The Chairman of the morning session was Dr William Moodie (Medical Director, Child Guidance Training Centre) and the speakers were Dr W. Paterson Brown (Medical Director, Oxford Child Guidance Clinic), Miss E. M. John (Educational Psychologist, Birmingham Child Guidance Clinic) and Dr Kenneth Soddy (Medical Director, National Association for Mental Health). In the afternoon, Dr Frank Bodman (County Psychiatrist, Somerset County Child Guidance Clinics) presided, and the speakers were : Miss M. W. Hamilton (Regional Representative, National Association for Mental Health) and Miss Clare Britton (formerly Psychiatric Social Worker, Oxfordshire County Hostel Scheme). The Conference was attended by 300 people, and vigorous discussion?which would have been prolonged if time had allowed?was provoked by the three papers. A full report will be issued in due course. Up-to-date information on the present position in regard to Clinics in England and Wales has recently been compiled by the Child Guidance department of the Association. This is available to clinics and professional workers and to officers of local authorities at a cost of 6d.
Three new Clinics have been recently approved for the training of psychiatric fellows, bringing the total up to 13. The number of applications for Fellowships, from medical men and women, is three times as great as the highest number received during the war years, and facilities are now available for the training of 19 doctors per year wishing to specialize as Child Psychiatrists. In addition, at the present time, 9 holders of Fellowships in Educational Psychology are in training in selected Clinics.
Residential Nursery for Maladjusted Children This Nursery, originally administered by the Provisional National Council for Mental Health, as a wartime Residential Nursery for Maladjusted Children and now approved by the Ministry of Education as a Boarding Home, is shortly to be transferred from its present emergency premises at Pewsey, Wiltshire, to a house which has been recently bought by the National Association, at Westerham, Kent.
Here 24 children will be provided for, at a weekly charge of ?3 3s. per head. The age range is from 2 to’ 7 years, but admissions are limited to children not older than 5. The Home is at present full, but applications for the waiting list can be received.
Agricultural Hostels for Defectives
The Agricultural Hostels for male defectives on Licence from Certified Institutions, started experimentally during the war by the Central Association for Mental Welfare and now administered by the National Association for Mental Health, have been uniformly successful and two new ones?bringing the total up to eleven? are about to be opened in the East Riding of Yorkshire in addition to the two already established there. Although at the outset, some doubt was expressed as to the ultimate success of such a venture, the County Agricultural Executive Committees embarking on it, have become fully convinced of its value and are eager for extension.
Counties in which Hostels have been established are: Gloucestershire (4), Hampshire (2), Shropshire (I), and East Riding (4).
The Curtis Committee and the Training of Workers It will be remembered that the Interim Report of the Care of Children (Curtis) Committee, to which attention was drawn in our last issue, urged the importance of specialized training for the staffs of Children’s Homes., and in the final Report (issued in September, 1946)* there are many instances of failure in understanding children’s needs which have lack of training as their fundamental cause.
The National Association for Mental Health has been deeply concerned about this matter for some time, and in the spring of 1945 an attempt was made to organize a Six Months’ Training Course. Owing, however, to the lack of suitable candidates able to maintain themselves during training without financial assistance, this attempt had to be abandoned.
During 1946, the Association received from the Ministry of Health sufficient financial support to organize a twelve months’ Course to meet the needs of Heads of Homes and senior members of their staffs, and the Institute of Education generously offered to co-operate by supplying some of the members of its teaching personnel. A further effort was thereupon made to enrol students, followed up by an intensive enquiry from a selected sample of Local Authorities as to the possibilities of staff being released. In every case, however, the reply received was that even if there were staff who would benefit by training, it would be impossible to release them for as long a period as a year; on the other hand, if trained workers could be supplied, wellpaid employment as Heads and Senior staff workers would thankfully be offered to them. Further it was considered that the maintenance of students during training was, a matter for the Government and not for Local Authorities.
A deadlock is thus revealed which must in some way be broken, for without trained staffs, the recommendations of the Curtis Report cannot be implemented. The National Association still hopes to institute its projected year’s Course and it is convinced that there is available a nucleus of young men and women with valuable experience of work with children during the war, who are ready for training provided they can be financially maintained during it. Training facilities are ready?on lines approved by the Curtis Committee? and if the Government is prepared to give the support needed, the scheme outlined above can be put into operation in the autumn of 1947.
Meanwhile, however?so urgent is the immediate need?the Association has been exploring alternative possibilities afresh, and it is now in touch with two Local Authorities eager to provide facilities for experimental courses of training to be given in existing Homes in their areas.
A psychiatric social worker (Miss Clare Britton), formerly employed under the Oxfordshire County Hostel Scheme, has been appointed to take charge of this new activity, and her advice and help in regard to staffing and other problems, is being placed at the disposal of Local Authorities from whom applications are invited.
It will be remembered that the Curtis Committee further urged the need for specialized training of Boarding Out Visitors or Children’s Officers :
‘’ who must be capable of assessing the suitability of a foster home for the needs of a particular child … of establishing friendly and helpful relations with the foster parents and co-operating with them for the good of the child; and of recognizing quickly any change in the situation in the home which might be detrimental to the child and taking or recommending the necessary action “. As an experiment, the National Association organized, in February, 1946, a month’s course for Welfare Officers engaged in the Boarding-out of children. Such provision is in no sense a substitute for the comprehensive year’s course considered necessary by the Curtis Committee, but it will be seen from the list given on page 81 that as an emergency measure, another Course on the same lines is being held in March for which over 30 students have been accepted.
Attention is drawn to the publication by the Association of the evidence?collated and interpreted by Miss Ruth Thomas, its Senior Psychologist?which it presented to the Curtis Committee. Copies may be obtained from 39 Queen Anne Street, price 3s. 6d.
Memorandum on Boarding Out
A useful Memorandum on ” Boarding Out of Children and Young Persons ” has just been issued jointly by the Home Office and the Ministry of Health, which amplifies and elucidates two new Boarding-Out Orders recently issued, viz. The Children and Young Persons (Boarding-Out) Rules, 1946, and the Public Assistance (Boarding-Out) Order, 1946.
The Memorandum written ” to encourage a constructive and resourceful approach ” to the work, discusses the whole problem in detail and makes * H.M. Stationery Office. 3s.
suggestions as to methods of dealing with it, both from the Point of view of the administrator and from that of the Children’s Officer engaged in day to day dealings with the individual children concerned.
An Appendix lists the points on which the new Children and Young Persons Rules differ from those issued in 1933 which are now revoked.
This Memorandum can be warmly commended for careful study by all who are concerned with this branch ?f children’s work.*
Special Education Treatmentf
Section 8 (2) (a) of the Education Act, 1944, requires Local Education Authorities to include in their educational programme, plans for providing special educational treatment for handicapped pupils, and Section 33 directs the Minister to make regulations as to categories and methods.
In order to elucidate and amplify these provisions of the Act and to follow up the Handicapped Pupils and ^chool Health Services Regulations subsequently issued, this pamphlet has been written for the guidance of Authorities and teachers confronted by new duties and responsibiIities.
After noting the characteristics of the groups concerned “7~the blind and partially sighted, the deaf and partially deaf, the delicate and diabetic, the educationally subnormal and the maladjusted, the epileptic and the physically handicapped, and children with speech defects and with dual or multiple disabilities?the pamphlet discusses methods of provision for each group giving some useful statistics as to the probable extent of their varying needs. In regard to the educationally subnormal (as indeed is the case with most of the other Sroups) no up-to-date figures are available, but it is generally accepted that the proportion of these children In the normal school population is 10 per cent.; it is estimated that of these, ? 25 per cent will need boarding chool accommodation, 1 per cent, will be best educated n day special schools, and that for the remaining or 9 per cent, special educational treatment in ordinary chools will meet the need.
It may be noted with satisfaction that stress is laid n the need for integrating the group of children receiving nis special treatment, into the school organization: ” These children may need special help in certain parts of their work… but they should not be deprived of general activities with other children which are suitable for their age. This kind of organization presents opportunity for experiment and careful planning which schools will try out for themselves but clearly the defects to avoid are, on the one hand, the isolation of a special class, and on the other, too wide a spread of age among children selected for special help.’’’’ tQVVherc, however, the pamphlet may be disappointing teachers and administrators is that it fails to give SD-Se anc* much needed guidance on the setting up of Pecial classes, particularly in view of the high hopes ised by Regulation 27 of the Handicapped Pupils orations, which explicitly states that the number cnildren in any one such class should not exceed 20. 0 this figure no reference is here made, and we read ^’y (para. 65) that the classes should be ” small Ahe section on maladjusted children draws attention to the need for Educational Psychologists in the schools and for Child Guidance Services, as well as for Special Boarding Homes and Schools and for some system of foster-home placement.
In a final section dealing with the preparation and training of teachers of handicapped children, it is observed that since special educational treatment may now be given in any school, every training college student should at least ” be able to detect the presence of a handicapped child in his class and know what lines his education should follow if he is not removed to a special school Those who wish to specialize in the work must, it is noted, bring to it not only understanding and sympathy, but the equally important qualities of:
” freshness and vigour and emotional normality as a pattern or example, and a skill in instruction that will make the most of their children’s mental or physical abilities ” bearing in mind that ” despite all that can be done for the handicapped, their way in life is likely to be hard, and they must be encouraged to be self-reliant, optimistic in outlook, hardworking, and so far as possible, skilled “.
To this end a large increase in the number of Courses on Special Educational Treatment will be necessary if the relevant provisions of the new Act are to be effectively put into force.
The fact that at the time of writing, the first edition of this pamphlet has been exhausted, is proof of the eagerness with which guidance and enlightenment on its subject matter is awaited.
The Board of Control
We are glad to be able to record that the Board has now returned to London after its long sojourn in Lancashire. The new address is: 32 Rutland Gate, London, S.W.7. Telephone, Kensington 3456. Mental Health workers also welcome the recent re-publication of the List of Certified Institutions which was suspended during the war years. This is obtainable from H.M. Stationery Office, York House, Kingsway, London, W.C.2, or through any bookseller, price 9d. With the Board’s Annual Report?publication of which has also been resumed?we deal on another page.
A Picture Library for Hospitals The Board of Control have drawn the attention of Managers of Mental Hospitals and Certified Institutions to a scheme organized by the British Red Cross Society for bringing to patients who have to spend a long time in hospital, reproductions of the works of great painters ?chosen as desired from a large selection, and changed periodically.
The scheme is designed as a practical contribution to rehabilitation and is the result of a successful experiment carried out at King Edward VII’s Sanatorium at Midhurst, by Adrian Hill, an English painter, and Dr. Todd, O.B.E.
It is found that many patients who had never before thought of taking pictures seriously, have developed through this scheme a keen interest in them even to the extent of desiring to learn themselves to draw and paint. In hospitals where the scheme is fully established, such newly awakened interest is followed up by lectures and talks on all aspects of art.
Memorandum on Boarding Out of Children and Young Persons. H.M. Stationery Office. 4d.
t H.M. Stationery Office. 9d. L For Spastic Children Two notable advances have been made recently in provision for children in this country suffering from various types of cerebral palsy (commonly called ” spastic paralysis “).
St. Margaret’s School, recently opened at Croydon, is recognized by the Ministry of Education (Medical Branch) as a centre at which some 40 to 50 children handicapped by cerebral palsy will receive both physical and school education. Applications inevitably exceed the accommodation at present available (for 30 boarders and from 10 to 15 day children) and preference is being given to cases in which there seems to be good prospects of improvement.
One of the three medical directors of the school (a physical medicine specialist) acts also in an advisory capacity to the cerebral palsy unit at the L.C.C. Queen Mary’s Hospital for Children at Carshalton, a pioneer unit which has been working for about four years (the subject of an article in a former issue of this journal by Mrs. Collis).
One of the physiotherapists and one of the occupational therapists on the staff of St. Margaret’s School have recently been in the U.S.A. to study the treatment carried out at the Children’s Rehabilitation Institute, a centre near Baltimore, set up by Dr Winthrop M. Phelps, who initiated much of the cerebral palsy treatment being carried out in the States. A psychologist (appointed by the National Foundation for Educational Research) has also been in America to see the work being carried out at the chief centres there and will have a close contact with St. Margaret’s and other similar schools which may be established.
Besides research into the problems and best methods of educating and rehabilitating children with this handicap, it is intended that the centre at Croydon shall also train workers to help to staff other centres which may later be opened in different parts of the country.
In December, the British Council for the Welfare of Spastics (and those with allied conditions) was formed under the chairmanship of Professor J. M. Mackintosh, Dean of Public Health at the London School of Hygiene and Tropical Medicine.
The Council has been assured of support from all the government departments concerned and is widely representative of educational, medical, social and local authorities’ interests.
It will act as a central advisory, co-ordinating and consultative body for all activities in Great Britain and Northern Ireland directed to the welfare of children and adults who suffer from the disabling effects of cerebral palsy.
The Council is also interested in promoting the provision of special treatment and educational facilities and in fostering local associations of parents and others interested in the work. Further particulars of the Council may be obtained from Henry P. Weston, Esq., M.A., Hon. Organizing Secretary, British Council for the Welfare of Spastics, 34 Eccleston Square, London, S.W.I.
An Appeal
Copies of the Annual Reports of the Central Association for Mental Welfare, for 1923-4 (Tenth) and 1924-5 (Eleventh), are urgently required for binding. If any reader happens to have these, they would be most gratefully received by the Librarian, 39 Queen Anne Street, London, W.l.
Hostel Treatment for the Delinquent Child
In a letter published recently in the British Medical Journal, Dr Sessions Hodge (Psychiatrist, Somerset County Council) draws attention to the need for the scientific investigation of delinquency, referring to a paper read by him before the Electro-encephalographic Society in which he recorded that of a group of 63 cases referred from Courts of Summary Jurisdiction for examination. 36-5 per cent, might, on complete investigation, ” be considered to suffer from epilepsy or ‘ epileptic equivalents ‘ “.
The value of treatment in a controlled environment for the delinquent child and the persistent offender may, in future, be recognized, but Dr Sessions Hodge points out that the composition of such a controlled environment will be all-important and pre-eminently so in regard to the resident staff, in whose selection he expresses the hope that the advice of specially experienced psychiatric social workers may be sought.
Training for Mental Nursing
In 1945 the Athlone Report of the Inter-Departmental Committee on Nursing Services, made certain recommendations as to conditions of service, recruitment and training for mental nurses, particularly in regard to the existing examination system. These recommendations have now been put into effect, and henceforth no further candidates for training will be accepted by the Royal Medico-Psychological Association.
The responsibility for such training is being taken over by the General Nursing Council, and the names of all nurses holding the Final Certificate of the R.M.P.A. in Mental Nursing or Mental Deficiency Nursing will be entered on the State Register for England and Wales on applications received by the General Nursing Council on or before December 31st, 1951.
Training schools in England and Wales approved under the old system by the Royal Medico-Psychological Association will be approved, for the time being, by the General Nursing Council, although before final approval is given they will be subject to inspection by that body. The effect of these new arrangements should help to break down the barriers which separate mental nurses from their colleagues in general hospitals, by bringing all types of nursing from henceforward, under one single training authority.
Convalescent Home for Epileptics
The fact that epileptics are excluded from ordinary convalescent homes and that no special accommodation is reserved for them, has long troubled social workers who will welcome the news that the National Association for Mental Health hopes to open within the next two or three months, a small Home in a beautiful part of Ashdown Forest (Sussex).
Adult epileptics of both sexes in need of convalescence on discharge from hospital after ordinary illness or in attendance as out-patients and needing rest and change* will be eligible for admission. According to present provisional estimates, the weekly cost per head will be three guineas and this must therefore be the fee chargeable. It is hoped, however, that a small fund may be available for meeting the needs of really necessitous cases. The normal length of stay will be one monthParties of men and women respectively will be received in rotation.
Further particulars may be obtained from the Nation*1 Association for Mental Health, 39 Queen Anne Street, London, W.l.
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