Mentally Handicapped Persons
News and Notes
It may be remembered that last year an Advisory Council was set up by the Minister of Health on the arrangements to be made under Section 29 of the National Assistance Act for the welfare of ” persons substantially and permanently handicapped by illness, injury or congenital deformity or such other disabilities as may be prescribed by the Minister”. In the definitions given in the Act, it is stated that ” disability ” includes mental as well as physical handicap but the first Committees to be appointed by the Advisory Council dealt only with various categories of persons who were physically disabled. We are now glad to be able to report the setting up of a Committee on the mentally handicapped (other than those coming within the provisions of Section 28 and Part V of the National Health Service Act). On the Committee, the National Association for Mental Health has been invited to appoint a representative and Dr Alfred Torrie is serving in this capacity. Its final recommendations will be received with wide interest and should be of help in defining the needs of that group of persons who are neither certifiable as defectives not requiring mental treatment, but whose social efficiency prevents them from standing unaided on their own feet. .
Mental Defectives and their Savings
As is well known to those who are responsible for hostels for defectives employed whilst on licence from institutions, the savings accumulated by patients are often considerable, and the Ministry of Health has recently issued to Regional Hospital Boards and Hospital Management Committees, a circular on this subject.
It is stated that the Postmaster General has called attention to difficulties which have arisen because of the inability of some defectives to understand how to operate their Post Office Savings accounts. The suggestion is therefore made that in future such accounts should only be opened on behalf of patients who are fully capable of dealing with them. In other cases, the Hospital Management Committee should themselves make arrangements for the opening of an account under the name of ” Patients’ Savings Account”?to be operated by their nominated officers on behalf of the patient concerned. If the account reaches ?200, the matter would be reported to the Court of Protection. The responsibility for making these arrangements should devolve on the Chief Financial Officer.
Mental Health in Eire
To mark the Fourth Centenary of the death of its founder, the Hospitaller Order of St. John of God held in April, a three-day Psychiatric Congress at its Mental Hospital, Stillorgan, near Dublin. Psychiatrists from Britain were invited to take part in the celebrations, and the President of the Republic, with members of the Government and the Lord Mayor of Dublin attended the opening High Mass in the Hospital chapel. The preacher, the Rev. Professor E. F. O’Doherty (University College, Dublin) stressed the relation between religion and psychology each of which was concerned with man’s soul. The psychiatrist, he pointed out, was continually being confronted with the religious convictions and moral principles of his patients whilst psychology played an integral part in the curriculum of every seminary and university in their training of students for the priesthood. Lectures given during the Conference included ” The Individual’s Responsibility for Mental Health ” by Dr Alfred Torrie, ” Mental Deficiency ” by Dr L. T. Hilliard, ” Special Education for the Mentally Handicapped” by Mr. D. Kennedy-Fraser, and “Re-development of Mental Health Work in Connection with existing Social Services” by Professor Simey (University of Liverpool).
Eire has as yet no mental deficiency legislation and the only residential provision for defectives in the country is that made by the Brothers of St. John of God (in three Houses), the Sisters of St. Vincent de Paul at Cabra, and the Stewart Hospital , (Protestant). As a result of the Conference, a stimulus should be given to the Republican Government in their project for a mental health service embodying the state’s full acceptance of responsibility for its mentally handicapped citizens.
Working the New Mental Health Service
At the Annual Conference of the Association of Mental Health Workers held in Scarborough at the beginning of May, Mr. J. Castelow, psychiatric social worker, Leeds Mental Health Service, described the use which his Authority is making of their new powers under Section 28 of the National Health Service Act, for instituting a systematic After-Care scheme.
In June, 1949, a Psychiatric Social Centre was opened, staffed by a psychiatric social worker, two mental health workers, a handicraft instructor and a clerical assistant. The Rehabilitation Workshop has, since January, been on a full-time basis, and provides instruction for twelve patients at a time. It is intended primarily for ex-mental hospital patients who need a period of occupation therapy before resuming normal employment, but a problem is being created by the number of chronic psychopaths and mentally handicapped individuals who tend to fill vacancies, and for whom more permanent provision is needed.
The other main activity of the Centre is a Therapeutic Social Club, meeting once a week, /nis js intended for patients who have completed ^dividual psychiatric treatment, and invitations to J?m it are given by the psychiatrist and the social porker, though in addition members are referred by the Department of Psychiatry of the University. Preventive work is being developed through discussions, exhibitions, meetings, etc., and six jnonths ago a Consultation Service was inaugurated to enable general practitioners to refer patients JJKh social or socio-medical problems. Up to date, Jnirty-six cases had been referred. Emphasis is Jid on co-operation with other social agencies in ttle City with a view to facilitating earlier diagnosis and treatment of mental illness, and when adequate staff is available, further expansions of the preventive service are planned.
In a paper given at the same session, Miss F. S. Rogers,?former Secretary of the Cambridgeshire Mental Welfare Association which is employed by the Local Authority both for carrying out certain statutory duties under the Mental Deficiency Acts and “community” care under Section 28, of the Rational Health Service Act?referred to a similar Advisory Service available both to general Practitioners and to social agencies in the area, set J|P eight months ago during which period, 106 cases have been referred. Here also, the problem of the Patient who is socially inefficient by reason of dull intelligence and instability, is being confronted, howing the need for the provision of residential nd non-residential training and employment of a yPe which does not yet exist.
People In a circular issued to Local Authorities by the ^unistry of Health last January, dealing with welfare ervices for old people as provided for under the . ational Assistance Act, stress is laid on the importance of co-operation between local authorities nd local voluntary organizations.
All Local Authorities ” it is stated, ” should do everything in their power to encourage further voluntary efforts to meet the needs of old People, especially those living in their own homes, and there should be close and continuous collaboration between all the statutory and voluntary agencies working for their welfare.” , Two circulars have recently been issued by the juiistry to Regional Hospital Boards, on this same doject, one on April 1st under the title “Care of the ged Suffering from Mental Infirmity ” and the ner on May 15th, on the “Treatment of the lderly Chronic Sick”.
fhe purpose of the former circular is to guide egional Boards in planning their arrangements for ne care of persons suffering from mental infirmity ismg from old age, which should include provision (a) short-stay psychiatric units and (b) long-stay in nexes- The short-stay unit should be established o a general hospital in the Region for the purpose diagnosis and classification to determine which patients can, after treatment, return home, which may need mental hospital care, and for how many other types of accommodation are required. The long-stay annexes may be associated with mental hospitals if more convenient, but they should have distinctive names and should be reserved for patients without marked behaviour disturbances who suffer ” from mental infirmity due to old age and who do not require detention.” Provision of this type is not only desirable in the interests of the patients concerned, but would, of course, release urgently needed beds in mental hospitals.
The May circular deals with arrangements for the care of old persons suffering from chronic illness of a physical nature, and makes suggestions for the establishment of a hospital geriatric service including convalescent and long-stay annexes, as well as for domiciliary services.
A further indication of the growing recognition of the special needs of old people, is the holding in Liege from July 10th to 12th, of the First International Gerontological Conference. It is to be noted, however, that no psychiatrist is listed amongst the speakers on the printed programme and that the aspects of the subject to be dealt with, appear to be limited to physical conditions.
Lasker Award for Mental Hygiene
This is an Award presented every year for an outstanding contribution on some field of mental hygiene, and those in this country who were active in the early days of the Child Guidance movement, then financed so largely by the Commonwealth Fund of N.Y. City, will be interested to hear that the recipient for 1949 is Miss Mildred Scoville, Executive Associate of the Fund. The presentation was made by a former recipient, Dr J. R. Rees, Director of the World Federation for Mental Health who paid a tribute to Miss Scoville’s contribution to the mental health movement in England as well as to that in the United States. In her acceptance of the award, Miss Scoville stressed the widening concept of the function of psychology and psychiatry, whose subject matter has to do with the ” living together of people ” and is therefore closely related with the social sciences. On the same occasion, another Lasker Award was made?one for ” Public Information leading to Public Action in Mental Health This was given to Mr. Albert Deutsch who has for ten years devoted himself to assembling and publicizing facts regarding the needs of the mentally ill, and whose book, The Mentally III in America, revised in 1949, is still in great demand.
Parents of Backward Children
A convention of members of Associations of Parents and similar groups, held at the Fountain Hospital, London, in May, has resulted in the formation of a national body made up of the various pioneer associations which have sprung into being during the last few years, including the well-known one organized by Mrs. Fryd of Harpenden, and the ” Friends of the Fountains
The Conference, attended by 122 parents, some of whom had travelled through the night was welcomed by Dr L. T. Hilliard, Physician Superintendent of the Fountain Hospital, and the chair was taken by Mr. J. C. Davies, chairman of the ” Friends The decision to amalgamate was reached in an atmosphere of general good will, and the objects of the new Association were defined as follows : ‘1. To promote the material, mental and spiritual welfare of backward children.
2. To foster mutual help and support among the parents and relatives of such children. 3. To promote closer co-operation and understanding between parents and others responsible for their welfare.
4. To encourage more research into causes and treatment of mental handicap.
Various officers were elected, each to have charge of one department of activity. There are two Joint Secretaries?Mr. H. D. F. Hutchings and Mrs. Fryd ?and Mr. Hutchings is also acting as Organizer. Enquiries about the Association should be addressed to him at 3 Willowhaye Gardens, Worcester Park, Surrey.
In the United States this movement is developing with equal vigour and speed, and in The Training School (Vineland) Bulletin of February, 1950, we read that attention was drawn to it by the authoress, Pearl Buck. In a gathering assembled to pay tribute to Mrs. Alice Nash on her retirement from a life of active service to the Training School, Mrs. Buck said :
” Many of you are parents, and to you I would like to say that I think it is extraordinary and an important thing that parents are coming together in mutual aid and co-operation. The parents’ groups now forming in many areas need help and guidance, but they will do much to encourage each other and help their handicapped children. There are wonderful and hopeful signs of a new attitude toward the mentally deficient. The attitude of society is being slowly changed. Parents can do more to change it than any other group by facing their situation with courage for themselves and hopefulness for their children. It is no longer enough merely to get a retarded child into an institution. The child has the right to all the fruits of research and education so that he may fulfil his potentialities and so find happiness.”
World Federation for Mental Health At the Third Annual Meeting of the Federation to be held in Paris at the Cite Universitaire, from August 31st to September 7th, there will be four main topics for discussion :
Mental Health in Education.
Occupational and Industrial Mental Health.
Mental Health of Transplanted and Homeless Persons.
Leadership and Authority in Local Communities.
Registrations have so far been received from the following countries : Argentine, Brazil, Canada, Denmark, Egypt, France, Germany, Great Britain, Greece, Holland, India, Israel, Mexico, New Zealand Sweden, Switzerland and the United States. The April issue of the Bulletin includes an interesting article by Dr J. R. Rees, on ” Work for Mental Health in Germany in which he notes that during a short visit there last December, the main topic which he was asked to discuss with the psychiatrists, social scientists and other professional men and women whom he met, was that of training for child guidance work. This, he points out, was only to be expected in view of the fact that Germany’s most urgent problem is that of how to help children and young people ” while they are still helpable.”
The Bulletin may be obtained from the Federation at 19 Manchester Street, W.l, at an annual subscription of 5s.
” The Patient is Human ” In this broadsheet published by ” PEP” (Political and Economic Planning) in Planning for February 13th, 1950,* we have our attention drawn to human relations in hospitals. Such subjects as ” Out-patients ” Inside the Wards ” Relations and Friends ” and ” The Right Staff” are discussed, and emphasis is laid throughout on the importance of establishing good patient-nursedoctor-visitor relationships.
Reference is made to the controversial question of visits in children’s wards and to the different points of view about their frequency and desirability, and in general, the need for a more sympathetic handling of visitors by nursing staff is stressed.
“Too often ” it is stated, ” there is nobody who seems capable of telling relatives how the patient is doing… . Nurses are often forbidden to express any opinion, ward sisters are noncommital, and the wretched relations go away puzzled, bewildered and anxious.”
All these matters have a direct bearing on mental health?both of patients and those who belong to them?and PEP is to be congratulated on giving them publicity.
Obtainable from PEP, 16 Queen Anne’s Gate, S.W.I 2s.
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