Mental Deficiency (Amendment) Act, 1925
News and Notes.
The Mental Deficiency (Amendment) Act became law towards the end of ast session. It amends Section 7 of the Mental Deficiency Act, 1913, which Permitted the transfer by a judicial authority of a defective from guardianship to an institution, and it is now possible to transfer a defective from an institution ? guardianship without the presentation of a fresh petition with its accompanying nodical certificates, etc. Members of the Association will be interested to know at Sir Leslie Scott was one of the sponsors of the Bill. The new Act runs :? 1- Section seven of the Mental Deficiency Act, 1913, shall have effect as though the following- sub-section were inserted after sub-section (2) of that section :?
” 2. (a) Where an order has been made that a defective be sent to an institution, the judicial authority which made the order, or any other judicial authority, or where the original order was not made by a judicial authority, any judicial authority may, on application being made for the purpose by the Board or by the local authority, and on being satisfied that the case is or has become one suitable for guardianship, order that the defective T be placed under guardianship.”
his alteration in the law will remove some of the difficulties in the way of placing under guardianship many defectives who can be so placed, with advantage ? themselves, without detriment to the community, and with a definite saving public money. There are many high-grade defectives who, after a term of raining in an institution, could partly (at least) maintain themselves at home ere it not that their home conditions are unsatisfactory. For such as these, guardianship is needed, and while such defectives will themselves be happier and ess ?f an economic burden, their removal from institutions will allow cases in Urgent need of institutional care to be received. The Central Association for ental Welfare is devoting much time and effort to this aspect of the care of .ectives. There is need for great discrimination and tact in the task of finding suitable guardians, placing the defective wisely, and smoothing away the difficul- les that are bound to arise from time to time. The shortage of housing accom- odation still stands in the way of full development of the scheme of guardian- H?me Office. Third Report on the Work of the Children’s Branch, 1925.
As always, this Report of the Home Office makes extremely interesting reading. This year it contains a specially useful chapter on the ” Scope and aracter of the Juvenile Court,” which is a convenient summary of the different Practices of the various Courts, and in Appendix I. it emphasises the difficulty ? dealing in Industrial Schools with children suffering from the effects of ^cephalitis lethargica, and gives some figures of children who show mental j- ect either on committal by the Court or later. It stresses the need for early iscovery of mental defect and for co-operation with the Board of Control for subsequent care when the time for discharge arrives.
Prison Congress.
The International Prison Congress, which met in London in August, has been escribed as the most successful which has been held, both on account of Jts representative character and the important Resolutions adopted, since the first Congress in London in 1872. But for the War the Congress would have been held in 1915. There were 595 members of the Congress, of whom 243 were from Foreign States, and 25 from the Colonies, and among them were 82 official delegates nominated by 38 Foreign States.
The discussions were divided into 3 sections : Legislation, Administration, Prevention. It was in the Section of Administration that Dr Tredgold and Miss Fox submitted their papers (translated into French) dealing with the scientific examination of criminals, with special reference to examination for mental defect before trial. Dr Tredgold’s paper urges that as a first step in this country, physical and mental examination, with all possible details of personal and family history, should be conducted in the case of all first offenders, and those in whom mental disorder was suspected, and that no sentence should be pronounced until a report on their condition were received. In the course of her paper Miss Fox writes : ” Every country should so organise its community control of defectives that a very few only should find their way to prison… . The aim of the clinic should therefore be to diagnose the case speedily and to transfer him to the institution best fitted to receive him. For this, every type of institution should be available, irrespective of the fact that the individual has been in prison charged guilty of criminal actions. No enlightened country should place a difficulty in the way of dealing with a defective criminal as a defective and not as a criminal, whatever his crime may be.”
Eleven other papers were submitted on Lhe subject of the scientific examina- tion of criminals, and in the General Meeting there was an animated discussion, in which representatives from America, Belgium, Egypt, Germany, Greece and Roumania took part, when the following resolution was adopted; ” It is neces- sary that the accused as well as convicted prisoners should be physically and mentally examined by specially qualified medical practitioners, and that the neces- sary services should be installed for this purpose in the Institutions. Such a system would help to determine the biological and sociological causes of criminality and to suggest the suitable treatment for the individual offender.”
In spite of the strictures of Lord Darling, it is significant that such a repre- sentative assembly as the Prison Congress should pass resolutions such as ” Judicial studies should be supplemented by criminological ones. All who wish to be magistrates should be compelled to attend lectures on psychology, sociology, forensic psychiatry and penology.” ” Courses of Lectures should be established to complete their knowledge of criminology. They should have a full knowledge of prisons and similar institutions and should visit them frequently.” ” The Judge before determining the penalty should have a full knowledge of the physical and psychic conditions and the social life of the accused, and the motives for the crime.”
A Report in French and English of the Resolutions and principal speeches will be issued some time in October, and we would advise our readers to make themselves familiar with international opinion on the whole subject. Mentally Deficient Patients under the Metropolitan Asylums Board. The Report of the Board for 1924, recently issued, contains, as always, matter of much interest to those working among mentally defective persons, and the Mental Diseases Section of the Report can be obtained separately from the offices of the Board, Victoria Embankment, E.C.4. (Price 1/-). The extent of the Board’s activities can be judged by the fact that they provide accommodation for 9,748 mental cases of all ages and types, from the age of 3 years, and that there were on the 31st December, 1924, on the registers of their hospitals, Cater- ham, Darenth, Fountain, and Leavesden, 1,987 patients admitted under the provisions of the Mental Deficiency Act, and 889 other feeble-minded persons. As in previous years, the Report contains papers on aspects of mental disease by the Board’s medical officers. Dr E. B. Sherlock, Chief Medical Officer, writes ?n ” Mental Deficiency Practice in Belgium ” and gives an account of the Decroly method; Dr J. Nicoll, Medical Superintendent, Fountain Mental Hos- pital, gives a survey of some of the many types of mental defect among his patients, and his illuminating paper on the ” Stigmata of Degeneration is admirably illustrated by the photographs of Dr Brushfield.
The Report notes that at the Fountain a temporary Research Laboratory has been fitted up with the necessary apparatus for the examination of patho- logical and other specimens and ” the medical officers hope that by this means new light may be thrown on the subject of mental deficiency, for they feel that in dealing adequately with mental deficiency the effects will ultimately become notice- able in the reduction of the number of cases of lunacy.” The subject of ” Encephalitis Lethargica ” is not neglected, and Dr W. T. Gordon Pugh, Chief Medical Officer, Children’s and Surgical Tuberculosis Services, contributes an article in the section dealing with Sick Children on ” Encephalitis Lethargica in its later stages.” It is disquieting to read that whereas from 1919-1923 there were in England and Wales 4,401 notifications, in the first nine months alone of 1924 the notifications numbered 4,424. It is evident from the Report that the Metropolitan Asylums Board is alive to the need of providing accommodation and Dr Pugh writes:?”As “the recognition of the disease is comparatively recent, the prospects of recovery from the mental states described cannot yet be accurately estimated. Some of the severe types are definitely hopeless. On the other hand, milder types of mental derangement following on the acute disease, Specially in children, if recognised early and suitably treated, are recoverable cases. Between these two groups are cases of mental disorder, in which, in the opinion of certain medical men of experience, treatment is worth trying with a view to recovery. In the juvenile case the mental features are those ?f a perverted personality with spiteful, aggressive, impulsive and mischievous behaviour, as well as restlessness (in some cases particularly at night) and lack of application and of control; very few cases display lethargic features or depres- sion. The older patient, on the other hand, suffers more from confusion and has the usual symptoms of insanity, differing much less in his altered personality from other mental patients, and for this reason the management of the later adult case would appear to call for less specialised arrangements than does that of the juvenile, for whom the best type of nurse or attendant is needed and an adequate variety of occupation. The opinion appears to be developing that for juveniles the use of a special institution or colony (” school of recovery “) is indicated, to “which they may be removed from the mental hospitals and smaller homes, the working of which they are apt to disorganise. It has been suggested that such an institution should be staffed by medical officers and nurses with experience in neurology as well as in mental diseases, and that physical sequelae should also receive appropriate remedial treatment, by massage, suitable exercises and electro-therapeutics. Transfer to a mental deficiency institution would follow if it became clear that the mental defect was unlikely to improve. I he question has been under consideration, and we are informed that the Board has now decided to set apart 100 beds for children at the Northern Hospital, Winchmore Hill. This is a notable decision, and we hope that the example of the Board may be followed by other authorities. The return of the Registiar-General, which we print below, is an unpleasant reminder that this dreadful disease con- tinues to claim its weekly victims.
Encephalitis Lethargica. Weekly notifications (reproduced from the Lancet) :? Week ending- Week ending Week ending July 4 … 57 Aug. 1 … 48 Sept. 5 … 43 ? 11 … 52 ,, 8 … 41 ,, 12 … 40 ,, 18 … 52 ,, 15 … 35 ,, 19 … 40 ,, 25 … 50 ,, 22 … 44 ? 26 … 48 ,, 29 … 34 211 202 171 Total 584
New Residential Special School and Certified Institution.
Sandhill Park, Bishop’s Lydeard, near Taunton, was opened in September as a Residential Special School and Certified Institution under the Somerset County Council. The accommodation is for 47 feeble-minded girls of school age, and 72 female defectives over 16, and it is intended later to establish a farm colony for men and women. The generosity of the late Mr. H. H. Wills and Dame Monica Wills made the new home possible, and the Somerset Voluntary Association collected about ?8,000 towards the scheme.
International Congress on Child Welfare.
The First International Congress on Child Welfare, organised by the Union Internationale de Secours aux Enfants, held at Geneva, has already been fully noticed in the press. The eight hundred members from 58 countries have shown a fine example of international goodwill for the sake of the child. There were many interesting aspects under discussion, and the question of the sub-normal child was not neglected. Dr Cyril Burt, in an interesting paper, defined intelligence as inborn, general intellectual ability, and went on to point out, ” Just as the central factor underlying intellectual abilities has been termed general intelligence, so the central factor underlying emotional tendencies may be termed general emotionality… . Mental deficiency, therefore, has two main forms, and two main forms alone; what I shall term intellectual deficiency and temperamental deficiency… . There are no tests for temperamental testing similar to the Binet-Simon scale for measuring intellectual defect. Such tem- peramental tests are an urgent need.” Dr Th. Simon (France) and Dr Erwin Lazar (Vienna) also submitted papers on the standardisation of the definition of mental deficiency.
” The International Year Book of Child Care and Protection,” ” Child Life in Westminster ” and ” Child Saving and Child Training : the Budapest Scheme ” recently issued by the Save the Children Fund of London, deal with child welfare in universal and in particular aspects. The Year Book, which gives a most interesting survey of legislation and administration concerning children all over the world, contains references to the care and education of sub-normal children in the various countries from which information has been obtained. We would like to suggest to the editor that the subject of the varied treatment of mentally defective children is of such wide importance as to be worthy of a separate heading, such as he has for ” Delinquency.”
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