News and Notes
” Mental Health “?the ” Week’s Good Cause ” A wireless appeal on behalf of the National Association for Mental Health was made by Miss Margery Fry, J.P., in the ” Week’s Good Cause ” (Home Service) on Sunday, April 11th, at 8.25 p.m. Miss Fry spoke about the main aspects of the work of the Association, and particularly of the community service which it provides in helping those who have suffered from mental and nervous disorders to find the kind of life and work in which they can recover. She referred to the unhappiness, particularly of children, which could be avoided, given the right kind of help and understanding, and referred feelingly to her experiences in the children’s courts where frequently it could be seen that a child’s growing nature was being deformed by the mental condition of one of his parents.
Her eloquent appeal has resulted in the receipt of donations totalling to date ?491 14s. 8d. Listeners from all over the British Isles responded and nearly 900 letters were received. Contributions were mostly in small sums, and there were several touching instances of oldage pensioners who, with true generosity, had saved up a few shillings. The Association is immensely encouraged by the amount of goodwill which the letters revealed, and the many expressions of keen interest in and support of its work. It would like to take this opportunity of thanking publicly all those who responded to the appeal and of recording its sincere gratitude to Miss Fry for her magnificent help.
National Health Service Act. Exempted Hospitals Under the National Health Service Act, provision has been made for the ” disclaiming ” by the Minister of certain Hospitals (including Mental Deficiency Institutions) with the effect of exempting them from transfer to the Ministry on the appointed day (July 5th). A list of such Hospitals has now been issued (see The Times, 1st April, 1948) which includes the following Institutions and Homes for Mental Defectives :
Durran Hill House, Carlisle ; St. Joseph’s, Sheffield; St. Raphael’s, Brentford ; St. Raphael’s Colony, Potters Bar ; Pield Heath House, HilJingdon ; St. Francis School, Buntingford ; St. Elizabeth’s, Much Hadham ; Etloe House, Leyton ; Tubwell Farm and Dungates, Brighton Guardianship Society ; Totterdown Hall, Weston-super-Mare ; Lisieux Hall, Chorley ; Gilliebrand Hall, Chorley.
Only a small number of applications for exemption still await final decision.
The Ministry explains that there are, in the main, three grounds for allowing exemption : (1) That a hospital does not come within the definitions of the Act. (2) That it is not required by the Regional Hospital Board as part of the hospital or specialist services for the area. (3) That it is staffed, either wholly or in large part, by members of religious orders.
Employment and Training Bill, 1948
This Bill repeals the Labour Exchanges Act of 1909 and the Unemployment Insurance Act, 1939, and brings up to date ” the statutory provisions regarding the functions of the Minister of Labour and National Service and the facilities and services provided by him in relation to employment and training for employment “. The second part of the Bill concerns the Juvenile Employment Service, providing for the setting up of a Central Juvenile Employment Executive to be staffed by officers of the Ministry of Labour and National Service, the Ministry of Education and the Home Office. In addition provision is made for the setting up of a National Juvenile Employment Council, consisting of 34 members appointed by the Minister of Labour, these to include persons nominated by various bodies such as the County Councils Association, the Association of Education Committees, the Association of Municipal Corporations, with representatives of teachers, employers, and workers, and of the Juvenile Employment Committees to be appointed by the Minister in such areas as he determines.
Local Education Authorities may be authorized to undertake any functions conferred on the Minister of Labour in connection with Juvenile Employment in accordance with schemes approved by him, such schemes to include provisions for the administration of unemployment benefit to persons under 18 years of age, and grants of assistance under the National Assistance Act to such persons. Further, the Minister may make regulations for requiring the proprietors of schools to furnish particulars as to health, ability, educational attainments and aptitudes of school leavers in order that vocational guidance may be adequately given.
This part of the Bill is based on the Report of the Committee on the Juvenile Employment Service issued in September, 1945, whose principles were accepted by the Government at that time.
” Staff Aids ” in a Mental Hospital The Nottinghamshire County Mental Hospital, like every other institution of the kind, is seriously understaffed and as one way of dealing with the emergency, the Committee has instituted a new experiment. With the co-operation of the Matron and Sisters, and the approval of the Board of Control, it has been decided to employ selected female patients, graded according to working ability, as part-time ” staff aids For their services small weekly payments will be made by way of reward and encouragement but the work is regarded chiefly as part of their general remedial treatment helping towards rehabilitation.
Patients capable of it are, of course, in all mental hospitals frequently given small household tasks to carry out, but the introduction of monetary reward and of a definite status and designation should act as an incentive and create a new interest.
International Congress of Psychology
The Twelfth International Congress of Psychology (postponed from 1940) is to be held in Edinburgh from July 23rd to 29th, 1948. The Congress fee is ?3 for Members and 30s. for Associates. The Members’ fee is inclusive of the ” Proceedings ” containing abstracts of the papers which will be published. Accommodation will be provided in Hostels for a considerable number, at an inclusive charge of ?4 excluding midday lunch. It is hoped to find hotel accommodation for those desiring it, but early application is requested.
Enquiries should be sent to the General Secretary of the Congress, Godfrey Thomson, Moray House, Edinburgh 8.
N.A.M.H. Courses for Transferred Relieving Officers In our last issue, we referred to the experimental course, organized by the National Association for Mental Health in co-operation with the Extra-Mural Department of the University of Manchester, for Relieving Officers and other Local Authority officers likely to be appointed Duly Authorized Officers in the new Mental Health Service. This course was attended by 39 men and one woman, and the report on it made by the Tutor (Miss M. Hamilton, one of the Association’s Regional Representatives), shows that despite many difficulties inherent in the situation, it was an experiment that fully justified itself. The students were specially interested in the medical lectures on mental disorders and mental deficiency, and the visits of observation to Mental Hospitals, Mental Deficiency Institutions, Occupation Centres and Special Schools were observed to have a particularly vivifying effect. The?Association is indebted to the University of Manchester for its co-operation in freeing lecturers to take part in the course and in providing premises.
A similar Two Months’ Course began in London on April 6th. This is being attended by 38 students, the majority of whom are Relieving Officers (and in two or three cases, Mental Deficiency Officers) from the Home Counties although there are also students from as far afield as Newcastle and Plymouth.
A third Course is being held in Liverpool during May and June, intended primarily for Relieving Officers from the Lancashire area.
These two Courses also, are organized in co-operation with the Extra-Mural Departments of the Universities concerned and their syllabuses follow the lines of the Manchester Course including lectures on psychology and the social services, the mental health services and mental health social work, the work of a Duly Authorized Officer, mental disorders and mental deficiency, provision for the educationally subnormal child, child guidance, and epilepsy.
Ample opportunity is provided for discussion in small groups and visits of observation are arranged at intervals throughout the course.
Incidence of Epilepsy in School Children
An interesting article of this subject by Dr Peter Henderson, a Medical Officer of the Ministry of Education, was published in The Lancet of March 20th, 1948. The article reports an investigation, covering a school population of approximately 1,700,000 in the Northwest Metropolitan area, East Anglia and some of the Home Counties, carried out between October, 1946 and February, 1947, to ascertain the number of epileptic children who were in need of special school education and the total number of all children known to be epileptic.
The returns showed that out of a total of 776 epileptic children reported to the investigator, 519 (i.e. 0-3 per 1,000) were considered to be in need of special education and only 279 were actually receiving it. Of the remaining 240, 109 were not attending any type of school. Despite the wide variations in the ascertainment rate in the regions sampled?from 0-2 to 2-5 per 1,000 of the school population?the investigation yielded clear evidence that if the average rate of 0-3 per 1,000 epileptics needing special education is applied to the whole country, the number of school places needed would be about 1,500 instead of the 660 (0-12 per 1,000) at present available.
(This estimate is, the report notes, borne out by the experience of the Manchester Education Committee who maintain in their Special School at Sass Moss, 0-4 per 1,000 of their school population.) Only a small proportion of the total number of children included in the Survey had been given a systematic intelligence test and the group so tested were evidently composed largely of those who had been refused admission to residential schools on account of low intelligence. The investigation could not therefore yield any conclusive results on the general subject of intelligence and epilepsy. But it is good to find the cause of the subnormal epileptic child is pleaded so earnestly by Dr Henderson who writes ;
To refuse a child admission to a special school, simply because his intelligence quotient is below 70, or even below 60, is doing that child a grave injustice. The very nature of epilepsy and the dulling effect of some forms of medication may combine to lessen a child’s response to intelligence testing ; to be fair to a child, these tests should be given on more than one occasion and should not be applied soon after a seizure. … Even if after a reasonable trial at a school an epileptic pupil is found to be ineducable and in need of colony care, the experience gained at school will often make him a better colonist. The handicap of epilepsy is often a barrier to employment that becomes well-nigh impassable to those who are also educationally subnormal and have not received education suitable to their limited abilities and aptitudes. A retarded epileptic who fails to secure or keep employment is a drag on society and a misery to himself and his associates. Employment is, too, the best anticonvulsant.
Thus, both on social and economic grounds, it is essential that every epileptic child, even if doubtfully educable, should be an opportunity for special education.
Summing up his conclusions he lays emphasis on the following five factors to which attention must be given if the problem of epilepsy is to be effectively dealt with : (1) proper ascertainment by the school health service ; (2) greatly increased special educational facilities ; (3) regular medical treatment ; (4) effective after-care ; (5) a more enlightened public opinion.
Dudley Voluntary Children’s Care Society
This is an interesting piece of pioneer work based on co-operation between a Local Authority and voluntary enterprise and arising out of new opportunities consequent on the establishment of Statutory Children’s Committees.
The chief aims of the Society may be summarized as follows :
(1) To act as a link between the local authority and the general public in promoting the welfare of deprived children for whom the local authority has become responsible.
(2) To assist the local authority in the finding of foster-homes and to help foster-parents to understand the needs of the children under their care.
(3) To help the local authority in providing a home background for children in Residential Homes, and in the provision of after-care and suitable lodgings for children placed in employment or under training.
A representative committee, under the chairmanship of Councillor Dr F. G. Lewis (Chairman of the Children’s Committee) has been appointed and applications for membership of the Society are being invited. Further particulars may be obtained from the Hon. Secretary, Mr. C. M. Walker, Director of Social Welfare (at present acting as Hon. Secretary), 7 St. James’s Road, Dudley, Worcestershire.
Council for Music in Hospitals
In November, 1947, there was formed, with the sanction of the Board of Control and the active support of a group of medical superintendents of Mental Hospitals, a Council with the following objects : “To organize and provide regular series of concerts of music of a high quality ; to assist in organizing lectures, meetings of gramophone clubs, etc., in hospitals on some planned scheme; to assist hospitals in experimental work on the value of Musical Therapy for individuals or for groups ; to encourage patients on leaving hospital to continue their interest in music and to keep them in touch with musical circles near their homes.”
Already a number of concerts have been given by eminent artists, prefaced by simple explanatory talks which are greatly appreciated. Programmes ? are, moreover, sent to the Hospitals in advance to enable preliminary lectures and gramophone recitals to be given to the patients as a further help in understanding the music which they are to hear.
The Chairman of the Council is Mr. Frank Howes (Music Critic of The Times), and the Hon. Treasurer, Mr. Stanley Rubenstein, who is well known to London hospitals through the gramophone recitals which he has been giving them. The members of the Council consist of ten Medical Superintendents, and Captain Croft-Cohen of the Board of Control has been appointed as an ” observer
The formation of a Sub-Committee for research work on the therapeutic value of music assisted by reports received from Medical Superintendents, nursing staff and artists taking part in the scheme, is one of the Council’s immediate projects.
Further particulars will gladly be supplied by the Secretary, Miss Sheila McCreery, 4 Campden Hill Square, London, W.8.
Answers in Parliament Maladjusted Children
In answer to a question on February 19th, the Minister of Education stated that there was accommodation at present in special schools and boarding homes, for 527 maladjusted children. The number of children ascertained as maladjusted was, on January 1st, 1947, 5,795 (boys, 3,896 ; girls, 1,899), but it was considered that the great majority of these could be appropriately treated in Child Guidance Clinics.
There are eight proposals for special schools for this category of handicapped children under consideration at the present time.
Mental Deficiency Institutions
The Minister of Health stated on November 6th, 1947, that 160 beds would be available in the near future in premises recently acquired by local authorities.
Further accommodation would also be available in three colonies released by Service departments.
No comprehensive figures as to the number of defectives awaiting institutional vacancies have been issued since the publication of the Board of Control’s Report, for 1946, in which it was stated that there were on January 1st, 1947, a total of 3,890 waiting cases.
International Congresses of Medical Sciences
In April, Dr Soddy represented the International Congress on Mental Health at the second meeting held at UNESCO House, Paris, of the Organizing Committee of the Permanent Bureau for Co-ordination of International Congresses of Medical Sciences. The Bureau is jointly sponsored by UNESCO and the World Health Organization, and representatives were also present from the United Nations Social and Economic Council and the International Refugee Organization. Other organizations represented on the Committee are those concerned with venereal diseases, paediatrics, surgery, cancer, radiology, rheumatism and tuberculosis.
The Committee unanimously recommended the establishment of a Permanent Bureau with the following functions:
I. Information and Assistance. (1) To collect information on all national or international organizations of a medical or paramedical nature, and on the congresses which they organize.
(2) To give all possible material assistance and in particular, specialized conference services (staff, technical material) and travelling facilities for congress members (visas, etc.).
(3) To study methods of facilitating the transfer of funds needed by congress members.
(4) To study and disseminate information on the technique of congresses.
Co-ordination.
(1) To take active steps to suggest to international medical bodies, appropriate dates and places for the holding of their congresses.
(2) To make a special effort to group disciplines together.
(3) To give financial assistance to the scientific work of congresses and make grants to congress members who particularly merit them.
(4) To give grants to enable representatives of different disciplines to take part in congresses.
Diffusion of Information.
(1) To take steps to circulate information received in accordance with Paragraph I (1).
(2) To study the whole problem of the dissemination of medical knowledge, including the circulation of documents resulting from the work of the congresses.
The bodies eligible to participate will be international organizations of a medical character.
Dr Soddy reports that he was struck with the degree of mutual confidence attained at this meeting and the unanimity displayed by the members of the Committee in their desire to establish the Bureau, creating an atmosphere too seldom achieved at international gatherings.
A South African Psychiatric Hospital The Vice-Chairman of the National Association for Mental Health, Lady Norman, paid a visit to South Africa during the winter and saw much municipal and voluntary social work for Europeans and non-Europeans in the Union.
Amongst the many hospitals, schools and institutions she visited on behalf of the National Council of Social Service, she mentions the Tara Psychiatric Hospital, a few miles outside Johannesburg. She writes :
” Tara Hospital in Johannesburg is a legacy of the war, but is now devoted entirely to civilian patients of all ages, and run by the Provincial Authorities. Dr Alice Cox, M.D., Glasgow, took me all round, as the Medical Superintendent was away and the Matron, Miss Marwick, was in England taking a Course at the Maudsley Hospital.
Some of the work was exceedingly interesting and in some ways rather novel. There was a dolls’ house for children where the weekly clinic is held; the furniture is all small, and it is fitted out with pots and pans and china, a little kitchenette, a bedroom and everything to delight a child. The children’s clinic is held in this dolls’ house once a week, the children coming out by private bus, from the town.
I saw some of the excellent work being done by the patients, who are of course all voluntary, and the millinery was of the highest standard, as well as the leather work done by men and women. From the point of view of occupational therapy, I have never seen anything to beat it.
I also saw a gymnasium class, both for men and women, taken separately ; it was very remarkable, for it was taken by a first-class teacher who, besides being very good at her job, was good to look upon, had a beautiful figure and exquisite face. Patients seemed to enjoy the work, which was done to music, the piano being played by a gifted pianist. The final exercise was one of complete relaxation, lying on the floor and taken to very soft music and the gentle beating of native drums. When it was over, it was quite a long time before the patients felt inclined to get up, and I myself felt very rested and at peace with the world.”
Unfortunately, Lady Norman reports that there is a possibility of the Tara Hospital being closed down, owing to the enormous expense per patient. In view of the splendid service it is giving to the patients (some 150 of them), in addition to its out-patient facilities for young children, it is devoutly hoped that such a disastrous contingency may be averted.
Children and the Cinema
The Home Secretary, the Secretary of State for Scotland and the Minister of Education have recently appointed a Committee to consider and report upon : (a) the effects of attendance at the cinema on children under the age. of 16, with special reference to attendance at children’s cinema clubs; (h) whether, in the light of these effects, any modification is desirable in the existing system of film classification, the existing position with regard to the admission of children to cinemas, or in the organization, conduct and management of children’’s cinema clubs.
The omission of a child psychiatrist from the Committee appointed, whose membership is representative of so many other interests, calls for comment. The work upon which the Committee is engaged is the subject of study and also of special interest to mental health experts whose views and knowledge would undoubtedly be of value in an enquiry of this kind.
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Social Psychotherapy
In reply to our request, Dr Joshua Bierer, has kindly sent us the following information about the work of the Social Psychotherapy Centre (Institute of Social Psychiatry) of which he is the Head.
This Institute includes two agencies :?
1. The Therapeutic Social Club Centre. This Section, which has now been opened exactly a year, is to centralize the activities of the Therapeutic Social Clubs : to advise all hospitals and out-patient departments with regard to the opening of the new Clubs, and, if possible, provide workers for them : initiate new Clubs and generally encourage and organize therapeutic work through the Clubs, combined later on with training and providing literature.
Patients, who are considered suitable for membership of a Social Club are referred to this Centre, where they are interviewed by a psychiatrist and recommended to attend a suitable Club (some of the existing Clubs are slightly different in character to meet the needs of the various types of patient for whom the Centre has to cater). The Clubs are entirely democratic, all types mix well, and there is no financial obligation although a small weekly voluntary contribution, according to the person’s means is asked for to meet the overhead expenses of the Clubs which are self-supporting.
2. The Social Psychotherapy Centre, the work of which is in its early stages, administers a combination of five forms of treatment, as follows :
Individual Psychotherapy.
Group Psychotherapy.
Social Club Therapy.
Occupational Therapy.
Art Therapy.
In the course of a patient’s mental rehabilitation, and in his re-adaptation to normal life, it is often found that he will respond to all the above mentioned forms of treatment, given simultaneously, or to a combination of certain of them. The form of treatment suitable for each patient referred is decided by a Psychiatrist. The patients are asked to pay a small amount towards their treatment to help to cover the expenses of the Centre. The amount is fixed according to their means. The Institute of Social Psychiatry will also act as a Research Centre, in connection with these particular forms of treatment.
A training Scheme for Social Therapists is now under consideration and it is hoped will materialize in the near future. We are in the process of publishing a monograph on Social Club Therapy.
A plan for Membership of the Institute of Social Psychiatry is also being drawn up, whereby members would pay a fixed subscription and possibly receive two publications a year.
All enquiries should be addressed to : Dr J. Bierer, Institute of Social Psychiatry, 7 Fellows Road, Hampstead, N.W.3.