International Congress on Mental Hygiene
The First International Congress on Mental Hygiene, which has already been mentioned in a past number of this Magazine, will take place in Wash- ington, U.S.A., from May 5th to 10th, 1930. The objects of this Congress are to bring together from all countries, workers in mental hygiene for the pur- pose of discussing social problems arising from all forms of nervous and mental disease; to consider methods of world co-operation for the promo- tion of mental hygiene; to attempt to correlate the knowledge and experience ?f psychiatrists, psychologists, social workers, etc.
The American Psychiatric Association and the American Association for the Study of the Feeble-minded will hold their 1930 Annual General Meetings in conjunction with the Congress.
Amongst the papers to be read are the following: ?Organisation of community facilities for prevention, care and treatment; psychopathic hos- pitals and psychopathic wards in general hospitals; special problems of adol- escence; parent and teacher training. Miss Fox has been asked to attend the Congress and to read a paper on the ” Social Aspects of Mental Deficiency.” All particulars may be obtained from the Administrative Secretary, International Congress on Mental Hygiene, 370 Seventh Avenue, New York City, U.S.A.
Institutional Accommodation In answer to a question in the House, Mr. Greenwood, Minister of Health, stated on December 12th last, that 28 local authorities in England and Wales had provided institutions for the residential care of mental defectives; 18 had schemes in progress, but 78 had not then made any institutional provision.
Organisation of Occupation Centres and Home Teaching in Middlesex A Scheme, allowing for the extension of the organisation of Occupation Centres and Home Teaching by the C.A.M.W., in return for an increased grant, has been approved by the Middlesex County Council and will come into operation on 1st April, 1930.
The scheme allows for extensions on the following lines by the end of the year 1933 : ?the establishment of 10 full-time Occupation Centres (Mixed) and 6 half-time Handicraft Centres (3 for boys and 3 for girls) and the organ- isation for the home teaching of 160 defectives. From experience, it would appear that one teacher can deal satisfactorily with 40 cases, so that by the end of 1933 four home teachers will be required, but it is intended to appoint these gradually as the need is shown and the organisation is possible. The cost of running a full-time centre has been estimated at about ?500 per annum and a half-time centre at ^300 per annum. The salary and ex- penses of a home teacher will amount, approximately, to ^225 per annum. These expenses, together with general administrative expenses, have been estimated at ,?21,940 for the grant period 1930-33. As stated above, the Middle- sex County Council have approved the scheme and have passed the estimates and the organisation of this work will begin in April next.
Manor House, Aylesbury
The Manor House, Aylesbury, which in April, 1928, was acquired by the Bucks. County Council as a home for Mentally Defectives, is already being extended to accommodate a larger number of cases. The cases originally admitted were crippled children, active girls, who though not crippled, were unable to do much for themselves, and higher grade girls and women. The proposed extension is to include two temporary buildings, each to accom- modate 25 male mental defectives.
With the growth of the Institution the County Medical Officer has found it impossible to continue to act as Visiting Medical Officer, and Dr Katherine Campbell, Medical Officer at the Borstal Institution, Aylesbury, has been appointed part time Visiting Medical Officer.
Sterilisation Proposals
The Council of the Association of Poor Law Unions received resolutions from several Boards of Guardians, either advocating the introduction of legis- lation to authorise the sterilisation of the mentally defective or pressing for an enquiry into the matter. The Council also received a copy of the Resolution of the Executive Council of the C.A.M.W. advocating that a Royal Com- mission be appointed to enquire into the whole question of the causation and prevention of mental deficiency. The Poor Law Unions Council submitted the whole subject to its General Purposes and Finance Committee, who recommended ” that in view of the varying opinions prevailing as to the efficacy, expediency or propriety of the measures advocated in the respective resolutions of the Lexden, and Winstree, Corwen and Bucklow Boards of Guardians, the Council expresses the opinion that the time is not opportune for legislation upon the proposals of such Boards; but that a full enquiry should be undertaken by the Government as to the best means of dealing with the unfit.” The Council decided to adopt the above recommendation of its Committee.
Rampton State Institution
Circular No. 728 was issued by the Board of Control last November to the Medical Superintendents of each County and Borough Mental Hospital, stating that there is now accommodation at the Rampton State Institution for juvenile mental defectives of dangerous or violent propensities and also that the new villas which have been provided are suitable for the admission of children suffering from mental defect arising from encephalitis lethargica who have developed dangerous or violent propensities.
The Board anticipates that there will be at first many more applications than vacancies and it is therefore not the intention of the Board to admit idiots or low-grade imbeciles. Similar Circulars have been issued to the Clerk to the Justices, the Superin- tendents of Certified Institutions and to Local Authorities under the Mental Deficiency Acts. Forms of Application for admission can be obtained from the Board of Control.
Obituary Notice
We regret to report the death of Dr Robert Hughes of Stoke-on-Trent, whose work for defectives is well known throughout the country. In addition to the valuable work Dr Hughes carried on in Stoke-on-Trent, where he was for many years School Medical Officer, he devoted much time to the develop- ment of Besford Court Mental Welfare Hospital, where he was an Hon. Medical Officer. His wide knowledge and experience will be greatly missed. Investigation into After-Careers of the Feeble-minded Dr Fox, Assistant School Medical Officer in Kent, has been conducting an enquiry into the after-careers of the feeble-minded in his area. He has ascertained the present state of 214 children certified as feeble-minded and now between the ages of 20 and 25. The enquiry was carried out by the Kent Voluntary Association for Mental Welfare through local visitors. The Tables showing the present employment of 116 certified males and 98 females are given below.
Males. 116 (a) Wholly self-supporting 12 on farms 2 motormen 2 brickfields 5 gardeners 3 in shops 2 casual labourers 2 roadmen 2 Army 16 various or unknown (b) Partially self-supporting 17 on farms 3 brickfields 4 gardeners 12 casual labourers 2 in shops 4 various Three of these are married. Nineteen attended special day schools. Of these, ten are now self-supporting, one was sent to an industrial school. Females. 98 (a) Wholly self-supporting 10 in service 9 as housewives (b) Partially self-supporting 10 in service 5 on farms 9 ” housework ” 1 in shop 10 of these are married, 72 single. The married women have 10 children and 7 of the unmarried have 11 children.
Further details are given of special training received, places of residence, delinquencies, etc., and comment is made on the low marriage rate. ” In conclusion, this investigation proves nothing. But within its slender scope, it can at least be said to give no support to the idea that the feeble-minded (not all grades of deficiency) are a serious charge on the community, that they multiply to an extent likely to affect the general average of intelligence, or that their behaviour has an effect on the number of police constables required. An inference is, not that they shall be ignored, but that sympathetic effort on their behalf is not thrown away.” The account of this investigation is reported in the Annual Report for 1928 of the School Medical Officer for the Kent County Council.
Additions to the List of Certified Institutions, Certified Houses, Approved Homes, Section 37 (Poor Law Institutions) approved by the Board of Control from 11th April, 1929
CERTIFIED INSTITUTIONS
Berks. Crauford Home, Maidenhead. 106 defectives, i.e., 92 adult females and 14 juveniles of either sex (cot and chair cases). Essex. The Retreat, Maldon Road, Witham, Essex. 33 adult male defectives. (Ancillary Premises to Royal Eastern Coun- ties Institution.) Somerset. The Old Rectory, Bathwick Hill, Bath. 21 high-grade feeble-minded females over the age of 16 years who shall only be received on licence from other Certified Institutions. Surrey. 6, Morland Road, Croydon (The Hermitage). 20 low-grade juvenile males.
Warwick. The Warwickshire Western Colony, Weston-under-Weatherley, near Leamington Spa. 40 males and 12 females. Feebleminded within the meaning of the Mental Deficiency Act, being cases over the age of 16 years. Yorkshire. Meanwood Towers, Stonegate Road, Meanwood, Leeds. 64 low grade males, of whom not more than 10 shall be cot and chair cases. (Ancillary premises to Meanwood Park Colony.)
APPROVED HOMES
Devon. Raleigh House, Ottery St. Mary (substituted for St. Anthony’s). 15 patients, of whom not more than 11 shall be juvenile female mental defectives, and of whom not more than 4 shall be males of tender years fit to live in association with girls. Dorset. The Rectory, Hinton Martel, Wimborne. 10 male patients over the age of 14 years and suitable to live in associa- tion with each other. Surrey. ” Lynton,” Coombe Lane, Kingston Hill. 6 females between the ages of 14 and 18 years on admission.
SECTION 37 (POOR LAW INSTITUTION)
Yorks. Doncaster Poor Law Institution. 20 males and 20 females. Medium to low grade patients over the age of 16 years. 24 MENTAL WELFARE Board of Control Committee As we go to press we have received the following notice from the Board of Control. The Board of Control, with the approval of the Minister of Health, have appointed a Committee with the following terms of reference: ? ” To consider and report what are the essential structural requirements of a complete colony for mental defectives of all types and to what extent the cost could be reduced by the adoption of semi-permanent or tempor- ary buildings or other new methods of construction, having regard to the comparative cost of maintenance, as well as the initial capital expenditure involved.”
The Committee is constituted as follows: ? Walter Hedley, Esq., D.S.O., K.C., Recorder of Newcastle-on-Tyne (Chair- man); Mrs. F. Rose Davies, J.P., Alderman, Glamorgan County Council; Miss Clara Martineau, J.P., Member of the Birmingham City Council; Sir George Oatley, F.R.I.B.A.; Dr A. Rotherham, Commissioner of the Board of Control; A. Scott, Esq., M.B.E., A.R.I.B.A., Chief Technical Officer, Ministry of Health; Sir Lindsey Smith, J.P., Chairman of the Board of Gov- ernors of Holloway Sanatorium; F. Douglas Turner, Esq., M.B., Medical Superintendent of the Royal Eastern Counties Institution, Colchester; with Mr. H. J. Clarke, of the Board of Control, as Secretary.
Mental Treatment (H.L.) Bill. 20 Geo. 5 Bill 107 In an article printed on page 15 of this issue, Dr R. Langdon-Down explains the provisions of the above-named Bill. It may be of interest to readers to know that at a meeting held on January 13th, 1930, the Executive Council of the C.A.M.W. decided to press for the following amendments to the Bill when it comes before the House of Commons next session: ? Words in square brackets constitute the suggested amendments. 1. Clause i (i) to read : ?
Any person who is desirous of voluntarily submitting himself to treatment for mental disorder, and who makes a written application for the pur- pose, may without a reception order be received as a voluntary boarder in an institution within the meaning of this Act, or in any hospital or nursing home | or training or other establishment] approved for the purpose of this section by the Board of Control, or, with the consent of the Board, into single care.
Also consequential amendment in Clause 6 (2). (This amendment arises out of the evidence given by the Association before the Royal Commission on Lunacy and Mental Disorders, approved by the Executive Council on May 26th, 1925, which included a series of Recom- mendations as to the provision by Local Authorities of Special Training Homes for ” persons under the age of 21 years who are suffering from disorder of mind, not certifiable under the Mental Deficiency or Lunacy Acts,” and the power ” to contract with the Managers of any such recognised home for the reception and maintenance of such cases.”) 2. Clause 6 (3) (c) to read : ?
Subject to the approval of the Board of Control, a local authority shall have power (c) to make provision for | social services for] any persons who | are undergoing or who] have undergone treatment for mental disorder, including the after care of such persons, and to contribute to the funds of voluntary associations formed for that purpose.
NOTE?The actual wording of this amendment will have to be carefully con- sidered by a Parliamentary draughtsman, in view of the very wide mterpretatio?i that might be placed on the term ” social services.”) This Clause affects mental welfare work in so far as the social services mentioned might be carried out in some areas by the Mental Welfare Associa- tions, some of which actually undertake work in connection with Mental Hospitals and Clinics. The Clause as it stands gives power to contribute to the cost of ” after-care ” only; this is an important part, but is not the whole, of the social services which should be connected with Mental Hospitals. If the Mental Welfare Associations whose work is already covering this wider field are asked by Local Authorities to undertake its further development, it is of importance to them that all forms of mental welfare work carried out for Local Authorities should be eligible for grant.
For example, in Clause 6 (3) (a) of the Mental Treatment Bill, power is given to the Local Authority to establish Out-Patient Clinics. In connection with these Clinics there will be a great need for skilled, trained social workers ? ? . . to visit homes, report as to home conditions, and to co-operate with the staff of the Clinics.
Another form of social service is that of Hospital Visiting. Up to the present, this has been done voluntarily, and attached to most of the L C.C. Mental Hospitals are Visitors, working with the consent and co-operation of the Medical Superintendents, who visit, not only the patients in the Hospitals, but also the homes of the patients, their relatives, and generally form a link between the patients and the outside world. They also visit, for the Medical Superintendent, die homes of patients whose discharge is under consideration. Voluntary visitors are doing splendid work, but it is impossible for the ground to be covered adequately by voluntary workers, and the suggested amendment would make it legally possible for a Medical Superintendent to employ a trained social worker for the purpose, should he so desire. In any case, it will be noted that Local Authorities have a ” power ” only, and not a ” duty ” in the matter, so that the insertion of an amendment such as is suggested would not render compulsory the employment of a social worker.
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