The Development of Social Work
- Author:
Somerville
Twenty-five years is but a brief span in the age-long history of human progress. And yet within such a period, one may be fortunate enough to witness the birth and gradual development of some great movement making for the common weal. Often its origin is obscure. It may spring simultaneously from widely different sources, as if they had been quickened by some common spiritual impulse. Or one nation may make a new beginning and others follow the example. In either case, as definite results begin to appear, men see it for what it is?a step nearer the elusive Kingdom of Good. In relation to health, physical and mental, the last twenty-five years has witnessed rapid developments. Placing the child in the midst as the most eloquent expression of good and evil in behaviour and environment, the Child Welfare movement has set itself to study systematically the causes and effects of high death rates, of high damage rates in child life, of ineffective response to physical and mental stimuli, and to consider the influences on the child of ante-natal life and thought, of environment and of early habits. To-day, a great mass of information on these subjects has been acquired. But even yet the end is not in view.
I have been asked to write this paper as one who has been personally associated with Child Welfare work in Scotland since its inception. Its development can, I think, best be expressed by some vivid memories which present themselves to my mind.
For a short time in Glasgow and for over twenty years in Edinburgh it has been my privilege to share in the voluntary movements (and for the last twelve years also in the official movements) which have centred in and around the child. During this period intensive and extensive developments have taken place in Clinics, ante-natal and post-natal, in Maternity Services, in Hospitals, in Homes, in Child Gardens, in Nursery School and Toddlers’ Playrooms, in School Medical Inspection, in the provision of food, in the care of cripples, in the care of the blind, in the care of the deaf and dumb and, more recently, in the concentrated care of the feeble-minded.
Local Authorities have been called upon to consider schemes for combating Tuberculosis, and for dealing with the many problems arising from the presence of Venereal Diseases. They have been encouraged to carry out vast building schemes, embodying the latest improvements in sanitation and in lighting and in heating. They have been urged to provide open spaces, recreation grounds, opportunities for sport and for the wise employment of leisure.
Under the Local Government Act of 1929 the Mental Services, formerly entirely under the care of the General and Local Boards of Control (the latter embodied in the Parish Council), were placed under the jurisdiction of the Local Authorities, whether of County or Town.
It fell to me to be elected the first Convenor of the Mental Services Sub- Committee of the Public Health Committee of the Corporation of Edinburgh and for two and a half years I have followed with the utmost interest the development of schemes for the care and treatment of the mentally unbalanced and of the mentally defective under the care of the Corporation.
Quite early in the study of causes affecting adversely the well-being of children, it had been recognised that mental instability played a marked part, far more difficult to solve than problems of physical environment. Confer- ences were convened in Glasgow, in Dundee and in Edinburgh; Miss Dendy of Sandlebridge spoke eloquently of the latent capacities for development even in the feeble-minded; teachers in Special Schools and others pleaded for more effective After-Care. Already, before the taking over of the responsibilities by the Local Authority, Edinburgh had moved forward in many directions.
Five Special Schools with an annual enrolment of about 500 had been well organised. Gogarburn, an Institution for the permanent care of the feeble- minded, had been founded and plans for future development had been laid. A voluntary After-Care Committee, working under the Council of Social Service and recognised by the General Board of Control, had undertaken a Visitation Scheme and had organised one or two Occupation Centres.
It remained therefore for the Corporation not so much to originate schemes as to co-ordinate efforts, to ascertain and fill up any gaps. This co- ordination was made possible by the Local Government Act of 1929, under which the three Committees dealing with the problem of the mentally defective, viz., the Education Committee, the Public Assistance Committee and the Public Health Committee, were united under one administrative head?the Town Council.
The most effective co-operation has been established between the Educa- tion and the Mental Services Committees of the Public Health Committee in the provision of care for the ” ineducables “?those children who, when tested, were found incapable of being received into Special Schools. Until last year these children were gathered in small groups and were looked after by the Care Committee of the Council of Social Service. The efforts then made undoubtedly led the way to the scheme now in operation, whereby the Educa- tion Committee provides accommodation, appoints teachers, and selects suit- able equipment, and the Mental Services Committee meets all expenses. In this way, at the present moment, over 80 children are collected from different parts of the City and are transferred by bus to a Centre outside of the City proper where they are given suitable training and are made happy and healthy by the exercise of such faculties as they possess. The results are astonishingly good and fill the minds of parents and visitors alike with wonder and gratifica- tion. ” All Edinburgh should see this! ” one of the mothers exclaimed as she stood looking at her own and other children obedient, self-controlled, enjoying their Christmas dinner.
Edinburgh is very fortunate in having as Mental Expert, under the Medical Officer of Health, Dr McAlister, the Medical Superintendent of Rangour Mental Hospital. Under his guidance, further steps towards co-opera- tion have been taken. A Mental Clinic has been opened in the centre of the City over which Dr McAlister presides and cases of difficult children and unstable adults are brought or come for consultation. In connection with the Sick Children’s Hospital, Clinics of the same kind are held by Dr Charles McNeill and records of cases seen are sent on to Dr McAlister, who is also in direct touch with the examining body of the Education Committee. The Roman Catholic Community has organised a special Child Study Centre.
Very close co-operation has been established between the Medical Officer of Health for Child Welfare, the Medical Officer of Health for Venereal Diseases, and Dr McAlister. Supreme in authority over all branches of the work is the Town Council acting under the guidance of its Medical Officer of Health.
Gogarburn Institution for the permanent care of the feeble-minded is now able to receive about 300 patients and under the skilled control of Dr. Bailey is doing excellent work in affording suitable environment, occupation and also school facilities for these patients. The Corporation has in view, in the immediate future, provision for the reception of a further 200 inmates.
One department of care has not yet been organised in Edinburgh, although attention is concentrated on it at this moment and information from other centres of organisation is being eagerly sought. Children leave the Special Schools at 16 years of age. Some, a small percentage in Edinburgh, find occupation for themselves. These occupations are described as ” more or less satisfactory.” The majority, however, remain permanently unemployed. For these, Industry Centres are essential if the education acquired in the Special Schools is not to be lost. Could it be proved that the amount of self-support of which these children are capable would reduce public expenditure on their maintenance, a scheme for establishing Industry Centres might be accepted even under the present financial strain. A report on these lines has been asked for from the Town Clerk, the City Chamberlain and the Medical Officer of Health.
The scheme for Industry Centres, if adopted, might be under the manage- ment of a united Care Committee consisting of members of the Education, Public Health and Public Assistance Committees, with co-opted members representing the Social Service Care Committee. With such co-ordination, a wise and successful scheme should be possible of achievement.
In order that the members of the Town Council might be able to realise the extent of the problem of the feeble-minded in their midst, a census was recently taken by the Public Assistance Committee and the Care Committee of the Council of Social Service. The following are some of the figures given in this Census:?
#Number of Mental Defectives known either to the Public Assistance Officer or to Edinburgh Committee for Mental Welfare … … … … … … … 1020 Of these, 319 are in Institutions?Gogarburn… … … 152 Bangour … … … 104 Elsewhere … … … 63 Of the remaining 701? 64 are in urgent need of institutional care 100 are in employment?more or less satisfactory 70 attend Occupation Centre at Slateford 66 having left Special Schools are regarded as suitable for Industry Centres if such existed
68 in private dwellings paid for by Corporation of Edinburgh The majority of the remainder are attending Special Schools, while a few are ineducable defectives who are kept at home. It is now some months since the Census was taken (in the Spring of 1932)- Since then Gogarburn has been able to receive many of the cases from Bangour Population of Edinburgh at last census, 438,998, and from some of the other Institutions. The number of defectives in the Occupation Centre has risen to 82.
The problem is now, therefore, a defined problem and future develop- ments will have a relation to that knowledge. A yearly Census will keep information up-to-date.
Deeper still and more necessary for the vision of the future health and happiness of the human race is the urgency for research into the causation of mental instability and mental defect. The whole subject is now under the consideration of a Committee appointed by the Ministry of Health and as a lay student of social conditions I have been gratified to note that several smaller pieces of research are being carried out into one or more of the possible causes, such as: ?consanguinity, venereal diseases, accidents at birth or during in- fancy, under or over secretion of thyroid glands, wrong diet during pregnancy, abortions and interference with processes of natural conception, sepsis in throat, nose, mouth, and so on.
These suggested sources can be, in the main, controlled by the individual educated conscience and an educated enlightened public. Codes of sex behaviour, social customs, sanctions, inhibitions, commandments, have not in any community appeared as arbitrary Laws, but are based on deeply rooted attempts to reach and to retain the highest possible level of health, physical and mental, of the various races of Man.
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