Board of Control, Circular No. 750
News and Notes.
In April the Board of Control issued Circular No. 750 to Local Authorities with regard to their duties under the new Mental Deficiency Act, 1927, in con- nection with the training of defectives. It is particularly important with reference to the establishment of further Occupation Centres. The Board suggests for defectives that ” wherever a sufficient number of such cases can suitably attend a Day Centre this would be the most efficient way of providing for their training.” Of the 109 Centres now in existence, 104 have been provided by Voluntary Assoc- iations. The Board also suggests that ” In the case of approved Centres provided by Voluntary Associations any expenditure (after allowing for independent income and a small direct grant from the Board under Section 48), should be met by the Local Authority, whose contributions, subject to the Board’s approval, would rank for Government Grant.” The whole question of the provision and staffing of Occupation Centres is being considered by the Education Committee of the Central Association.
Western Counties Institution Gfrl Guides.
In our last issue we announced the success of Special School children in the Hastings Musical Festival. Another success of this kind has been gained by the Western Counties Institution (M.D.) Girl Guides. They were entered for the Devon Musical Festival held at Exeter in the Spring of this year, and were successful in gaining a first class certificate with 81 marks, the winning choir gaining 88. They were entered as normal children and judged as such in com- petition with choirs from all over the county. Any opportunity of this kind where the defective child can hold its own against the normal child must be very en- couraging to both teachers and children. We offer them our congratulations. G.A.M.W. Course.
A Course for persons engaged in the training of Mental Defectives in Occupation Centres, Institutions or Mental Hospitals, will be held in London from Saturday, September 8th to Saturday, September 29th. The Course will consist of three weeks training in the methods of teaching defectives, with special methods for low-grade types, and will include a series of lectures, Handicraft and Rhythmic Training classes and practical work in visiting Special Schools, Institutions, etc.
The Fee for the Course is ?12 12s. 0d., including registration fee of 5s., to be paid on application. This includes cost of board and residence at Notcutt House, Dorset Square, N.W.I.
Further details can be obtained from the C.A.M.W. Offices and applications mus: be sent not later than July 28th, 1928.
Exhibits.
The South East Lancashire Association for Mental Welfare took part in the Young People’s Week held in Manchester last June, organised by the Lord Mayor. An exhibition of work done by children attending Social Organisations in Man- chester included a stall arranged by the Mental Welfare Association. Unfortun- ately we are not able to insert here an interesting photograph of the stall which was seat to us. As an outcome of the exhibition quite a number of goods were sold ar.d orders taken for stools, bead mats, raffia bags, etc. There were several visitors to the Occupation Centres during the week, including Head Mistresses of Special Schools. From the point of view of advertisement and of encouraging interest the Exhibit was of very great help and other Local Associations may be glad to follow the example of South East Lancashire.
An interesting exhibition was organised by the Essex Voluntary Association for Mental Welfare in conjunction with their annual meeting at River Plate House, Finsbury Circus, on May 9th. The work exhibited was chiefly that of Special School Children and of defectives from Essex Poor Law Institutions. An exhibit was sent from the Central Office (London) to the Health Week held in Cardiff in May. On the C.A.M.W. stall were displayed various pieces of apparatus for training low-grade children and also articles of handicrafts made by defectives from several Institutions. Here also, considerable interest and enthusiasm for the work was displayed by the public in general.
Portsmouth Out-Patient Clinic for Nervous and Mental Disorders.
This Clinic which is held in the Out-Patient Department of the Royal Hos- pital, Portsmouth, was opened in 1926 through the co-operation of the Governing Body of the Hospital and the Portsmouth Voluntary Association for Mental Welfare. It has been progressing very satisfactorily and during the past year, 171 new patients were seen and the total attendances were 872. Dr Beaton (Medical Superintendent of the City Mental Hospital) writes, ” There are two aims which an Out-Patient Clinic should set out to realise. The first and most important is, of course, to help the individual patient in his difficulty at a stage of his illness long before the grave issue of certification has to be faced, and the second, is to act as a practical unit in the general social service of the community. The Clinic will never realise the first unless the second is kept in mind because it is often in the existence of some social difficulty that the early mental or nervous failure is first manifested. On the other hand the Clinic must not be allowed to degenerate into what may be described simply as a clearing house for community problems. The cases must be dealt with individually and from the medical stand- point.” An appeal was issued last November in the Portsmouth Press for funds to enable the Committee to send cases to the Country and to Convalescent Homes.
Speaking at the last annual meeting of the Cambridge Voluntary Association for Mental Welfare, Dr Beaton laid much stress on the value of social work in connection with Out-Patients’ Clinics. It was only by the clinic or hospital estab- lishing intelligent contact with other departments of social life that they could hope to get in touch with the patient before he or she had deteriorated too much. In that direction the social worker was of the utmost value; Dr Beaton further emphasised the necessity of special training for social workers who intended to take up this particular branch. The Clinic at Portsmouth co-operates with the Charity Organisation Society, After-Care Associations, the Church Army Coun- cils, Salvation Army, magistrates, police, Education Authority, etc. Oulton Hall.
The Oulton Park Estate, of some 315 acres at Oulton, near Wakefield, has been purchased by the West Riding County Council for the purpose of estab- lishing a Colony, in due course, for 1,500?2,000 mentally defective persons of all ages from their administrative area. The Hall has been adapted for the recep- tion of 160 males and patients are now being admitted.
The Committee have appointed as Superintendent and Matron, Mr. and Mrs. Towill, who until recently held similar posts at Seafield House, Seaforth, near Liverpool, and it is felt that patients will respond to training under their kindly and experienced control. The Committee have also been fortunate in obtaining the services of Dr P. G. Phillips as non-resident Medical Officer. He ha? had wide experience amongst mental and neurological cases and his advice should prove of great value.
The existing building will be quickly filled and the County Council are faced with the necessity of erecting further accommodation on the estate as soon as possible.
Admissions are restricted to West Riding cases.
First International Congress of Mental Hygiene, Washington. This Congress, organised by the International Committee for Mental Hygiene, was to have been held in April, 1929, but has now been postponed to the Spring of 1930.
A gift of 50,000 dollars has been secured to finance it but it was thought that as the American Psychiatric Association and the American Association for the Study of the Feeble-minded was holding a Congress in 1929, the several hundreds of psychiatrists going to this Congress would probably be unable to attend an International Congress of Mental Hygiene in the Spring of the same year. The Mental Hygiene Committee hope to get the other two Associations to hold their annual meetings during the Congress if it is held in 1930. The proposed change of date was agreed to by the members of the Organising Committee.
It is hoped to arrange for delegates to visit cities other than Washington and to study the way in which mental hygiene work is done in the clinics, prisons, homes, etc. Further details will be given in a later issue of the Magazine. The Child Guidance Council.
At a meeting on May 22nd the London County Council decided to accept the Child Guidance Council’s offer to establish a Child Guidance Clinic in London. With the approval of the Board of Education, the London County Council has agreed to recognise the Clinic as a School Clinic. Children will be referred to the Clinic by the School Medical Officers, subject, of course, to the consent of their parents or guardians. The London County Council are willing to use the Clinic thus for an experimental period of three years, during which time the whole of the expenses will be borne by the Child Guidance Council.
The Clinic will be opened in April, 1929, and some of the staff of the Clinic arc being appointed now, so that before taking up their duties, they may have the advantage of seeing some of the work done at Child Guidance Clinics in the United States. The Clinic will not be limited to children referred by the London County Council Authorities, and it is hoped that other Authorities, social agencies, and individuals, will use the Clinic readily. No decision has yet been made as to the area of London in which the Clinic will be placed. One of the principal objects of the Clinic will be the practical training of Social Workers in this field of work, and in co-operation with London University special Train- ing Courses are now under consideration.
The five social workers who were sent out last year by the Child Guidance Council for a year’s training at the New York School of Social Work are return- ing this month, some of them to take up their previous positions, with a greatly increased knowledge of the mental problems involved in their social case work. The Child Guidance Council is again this year sending five (or six) social workers for a similar training, and two other social workers (Miss Cosens and Miss Warner) for a special three months’ training at the Philadelphia Child Guidance Clinic. Dr Buchan (Medical Officer of Health, Willesden) and Dr. Shrubsall, are making Observational Visits to the United States, and possibly one or two other people who have been invited may be able to avail themselves of the opportunity this year. The generosity of the Commonwealth Fund in placing so large a sum of money for these several purposes at the disposal of the Child Guidance Council is indeed noteworthy.
It may interest our readers to know that the Reports made by Dr Fairfield and Miss Morton to the London County Council on their impression of the work being done in U.SiA., are now’published, and can be purchased from P. S. King & Sons, Ltd., Orchard Street, S.W.I, or at the County Hall.
Private Teaching Posts.
The Central Association would be glad to hear of people, who, having had a specialised training in the teaching of defectives, are willing to take private posts. The Association is appealed to from time to time to provide governesses for private cases.
London Association for Cental Welfare.
The Annual Meeting of the London Association for Mental Welfare was held on Wednesday, June 27th, 1928, at the Royal United Service Institution, Whitehall, the President, the Hon. Lady Lawrence, J.P., L.C.C., being in the Chair. There was a large attendance.
In her introductory remarks Lady Lawrence emphasised the value of the work of the Association to the London County Council and called attention to the work done by the Occupation Centres of which specimens were on exhibition. The number of these Centres she thought would have to be increased in the near future.
The Chairman, Miss K. T. Wallas, L.C.C., presented the Annual Report. She pointed out that during the past year about 8,000 cases had been under the care of the Association. Of the boys and girls between 16 and 18, formerly in attendance at Special Schools, 675 had been placed in situations by the Associa- tion during the twelve months.
The Hon. Treasurer, Lord Strathcona and Mount Royal, in presenting the Accounts and Balance Sheets, said that public attention ought to be called to the value of the work of the Association. It was a form of social service which should be supported by everyone. There was great need of financial assistance. This country was, he thought, as far ahead as any in the work of mental welfare but that was not to say that it had gone far enough.
Dr Edward Mapother, M.D., F.R.C.P., F.R.C.S., Medical Superintendent of the Maudsley Hospital, Denmark Hill, spoke on the work of a Psychiatric Clinic, which, he said, was an institution attempting to carry out the treatment of early mental disorder, all the patients being voluntary cases.
The difference between mental disorder and mental defect had always been rather artificial and was becoming more so. The gap which formerly existed between mental defect originating at or soon after birth and that appearing at adolescence had now been bridged by the occurrence of cases as a result of encephalitis. There was a large territory common to mental disorder and mental defect in which such cases as those of delinquency might be placed, and he thought there should be co-operation between the Association and Clinics in such work as ascertainment, investigation of social environment and lending a hand generally.
In the treatment of early mental disorder there were four considerations which decided the course of action. These were?the patient’s means, the severity of the disability, the willingness to accept treatment and the prognosis.
The criterion of a civilised country from a medical point of view was that everyone in regard to bodily health should be able to get medical help. As regards early mental disability there were in this sense no civilised countries. England in this particular matter was about thirty years behind the more advanced countries of the Continent such as Germany and Holland and the most progressive States of America. On the other hand in respect of established cases of mental disease the English Mental Hospitals represent a splendid effort to cope with the position. In the provinces however it was still difficult for other than well-to- do cases to obtain treatment unless pronounced suicidal or a burden or a nuisance.
He thought that there was no doubt that a demand existed for Clinics at which early treatment and advice could be obtained and valuable training afforded to doctors and social workers in the study of mental disability. In his opinion it was essential that such Psychiatric Clinics should be run by the Local Authorities with one Central Authority providing generous grants. Clinics which tried to run without such assistance were crippled for lack of funds.
The London Association for Mental Welfare was faced with a similar financial difficulty with regard to the voluntary cases under its care owing to the public apathy in all matters connected with early mental disorder and mental defect. Dr Letitia Fairfield, C.B.E., M.D., D.P.H., spoke on the care of the delin- quent defective. She confined herself to a description of the cases of woman prisoners reported to the London County Council under Section 8 of the Mental Deficiency Act during the period 1925-7. They were surprisingly few in number though they gave rise to a large amount of talk and writing.
The number notified from the police courts during these years were 49, and of these 13 proved ultimately not to be defective, being either sub-normal or chronic alcoholics, or cases which should have been certified under the Lunacy Acts and not reported as mental defectives. There were therefore 36 cases during 3 years and the number was decreasing. The corresponding number of boys and men was larger. There were always more men than women in the prisons, not, she thought, because women were more moral but because a woman who was clever at all could always get a man to steal for her.
It was often muddleheadedness rather than criminality that brought these women within the care of the law. With the exception of three the offences com- mitted were very trivial. The provisions of the Mental Deficiency Act were invaluable as affording a means of dealing with cases which stood outside the definition of crime or insanity.
Dr.. Fairfield said she had traced the history of most of these cases. A few came from definitely bad homes. The great value of suitable education and train- ing of defectives was shown by the fact that only 8 were ex-Special School pupils and none had been placed under statutory supervision and hence under the care of the Association.
The work for these women was important, not because they were dangerous to the community but from the human point of view. They were in general very miserable and showed great relief when they learned that they were to be placed in a Home out of the world with which they were not competent to deal. The police were amazingly kind to such cases when they were found wandering. They did not interfere unless there was some obvious reason and they used the kindest methods possible.
The fact that not one of these cases of which she had been speaking had been under the protection of the Association made it possible to hope that under the amendments of the Mental Deficiency Act, 1927, which made it possible to put more children from the Special Schools under statutory supervision, there would be a still more scanty record of mental delinquents to report.
The Meeting closed with a vote of thanks to the Speakers and President, proposed by Miss Evelyn Fox, Hon. Secretary of the Central Association for Mental Welfare, and seconded by Mr. W. J. O. Newton, London County Council Assistant Education Officer.
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