130 Mental Health

Editorial The exchange of ideas between America and Great Britain has always been unrestricted and stimulating?and the fields of medicine and social services have been particularly fruitful.

Our readers will therefore take especial interest in the comprehensive survey on the work of the National Mental Health Foundation by Dr Pratt, the Foundation’s staff psychiatrist. His revelations of the backwardness of certain mental hospitals will come as a surprise to those who tend to look on America in general and New York in particular, as the acme of progress: but there can be no excuse for anyone to overlook the rate at which conditions in America are now changing. Even if the methods outlined to rouse the public conscience are perhaps not directly applicable in this country, the energy, breadth, and enthusiasm of the work must command our respect and deserve our emulation. As many besides the poet have lamented, opportunities to see ourselves as others see us, are given us all too rarely, and probably they are taken more rarely still. Dr Pratt’s comments on the standards of mental care in Britain are therefore of particular interest?though we fear politeness has perhaps dulled his critical sense.

Dr Pratt’s views are naturally views from the inside. As an interesting comparison, we publish also a report of an outsider’s view of American : social work. The authors, Miss Sambrook and Miss Wollen were recently on a visit to the States and have written a vivid account of their impressions. ” The first thing that struck them was the ‘ psychiatric invasion ‘ of all fields.” Some of the advantages and disadvantages which have resulted from this will interest those responsible for planning mental health services in this country ; in particular, the comment that psychiatrists do not appear to know what responsibility to delegate and how to use the services of the psychiatric social worker. Whether this defect occurs in this country and if so, ( how much it is due to faults in the administration and how much to inadequate training are questions on which we invite our readers’ views.

Many may also have visited America themselves and have contributions of their own to make on their impressions, and in particular as to how best the two countries can benefit from each other’s development.

Note.?We publish in this number the second of a series of articles on special problems?that of the misfit at home and work, by Dr Skottowe. We regret that we have had to postpone the first of the articles on services of value to the social worker until our next number.

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