Economy Reports
News
In view of the present necessity for economies in all the social services of the country, everyone will recognise the fact that the mental health service cannot expect to be exempt from restrictions in expenditure. The Report of the Committee on Local Expenditure,1 now popularly known as the ” Ray Report,” which was issued a month ago, outlines suggestions by which these economies should be effected.
Whilst agreeing in the main with the recommendations of the Committee we feel that it is a matter of regret that the suggestions have been made in such a way as to give the impression that the mental health service before others should be restricted?that the increase in expenditure on this service during a recent term of years is excessive and that in a sense money is being spent which would be better employed elsewhere since ” only a negligible number of men- tally defective persons are improved in condition by treatment.” In the narrow sense of medical treatment aiming at a cure of specific defect this may be true, but ” treatment ” for defectives includes the training of those who can after- wards adapt themselves to life outside an institution and aims at enabling them to become partially or wholly self-supporting and capable of giving help in the family circle. Again, with reference to the increase in expenditure on defec- tives it must be borne in mind that the cost is of necessity bound to go up until ascertainment is fairly complete and the years quoted (1920-30) cannot be taken as being typical of the further increase in cost over a similar period of time. The main recommendations of the Report seem to be reasonable and fair though, as we have stated, some of the arguments put forward cannot go un- challenged. The Committee recommends a reduction in the general cost of building of all types of Institutions under Local Authorities (with special reference to Institutions for defectives) to be secured mainly by a reduction in the standard of accommodation to be provided. They suggest a lower standard of certification, a transfer of suitable cases to less highly classified institutions, and the placing of selected cases, now occupying places in institutions under licence or guardianship outside. They also suggest the development of remunerative occupations in both Mental Hospitals and Institutions for defec- tives. With regard to Special Schools they suggest that the opening of new schools of this kind should be postponed.
The C.A.M.W. has for some time been considering the possibility of starting a scheme for the boarding out of suitable cases from Mental Hospitals under a form of Guardianship, and it is hoped that a scheme of this kind will shortly be initiated in a carefully selected area. As the Report states, this will help to free places for urgent cases and should ultimately decrease the amount of accommodation needed.
1 H.M, Stationery Office, price 2/6, MENTAL WELFARE i5 It is a matter of regret that Special School accommodation is to remain at a standstill but much can be done for defectives in the ordinary elementary schools by the organisation of special classes under a teacher who has received special training for this purpose. With reference to this, however, we would stress the urgent need of some administrative machinery which would enable defective children leaving ordinary elementary schools to be notified to the Mental Deficiency Authority for further protection if it were considered necessary.
The Report of the Private Members’ Committee of the House of Com- mons on Economy2 has also been published within the last two months. It is encouraging to read in this report the following recommendation with regard to voluntary associations in connection with mental deficiency work: ? ” The efforts of the Voluntary Associations under the Mental Deficiency Acts, in the care and guardianship of mental defectives, should be encour- aged. Much can thus be done to secure care and comfort of defectives, who otherwise require institutional provision. Such voluntary effort needs fostering, especially in the poorer and more industrial areas, where it may have had no chance to develop, and Local Authorities are apt to assume that official Institutions are the only means of meeting their needs.”
Conference on Mental Welfare, December 1st and 2nd, 1932 The bi-ennial Conference on Mental Welfare was held on Thursday and Friday, December ist and 2nd, in the Great Hall of British Medical Associa- tion House, one session being held jointly with the British Social Hygiene Council as a part of the National Conference on the Place of Biology in Educa- tion. The Rt. Hon. Sir Edward Hilton Young, Minister of Health, opened the Conference with a most encouraging and sympathetic address, and previous to the meeting visited an exhibition of work carried out by mental defectives at the various Occupation Centres in Middlesex and under the instruction of the Home Teachers. The Minister was much impressed with this Exhibition, which was a most valuable feature of this year’s Conference.
Owing to financial restrictions, delegates numbered rather fewer than in previous years, but the papers and discussions were of a high standard and the Conference was generally considered to be most satisfying,” and of real practical value as indicating directions in which mental health work could be developed on a sound economical basis.
A verbatim report of the Conference is to be published, at a cost of Three Shillings and Sixpence. It is hoped that this will be ready in February. An Order Form is enclosed in this Journal. King & Sons, Great Smith Street, S.W.I, price 1/-.
Institute of Medical Psychology
This Institute, previously known as the Tavistock Clinic, with its premises in Tavistock Square, formally opened its new premises in Torrington Place, W.C., on December 9th. The visitors were received by Sir Henry and Lady Brackenbury and addresses on the work and the aims of the Institute were given by Sir Walter Fletcher and Dr Bernard Hart. A further reception was held on Saturday the 10th, for those who had not been able to attend the open- ing during the week.
The Institute has been ingeniously adapted from a building previously used by Messrs. Shoolbreds as a garage and packing department. One of the biggest improvements on the old premises is the provision of a large airy play- room for children with four consulting rooms for physicians treating child patients. The ground floor also contains two refectories, one for adult patients and one for staff, with a kitchen in between. The lecture room can seat 250 people.
Institute for the Scientific Treatment of Delinquency This new body, which has its headquarters at 56, Grosvenor Street, W.i, has been incorporated for the study of the psychological treatment of criminals and for the starting of a clinic to which magistrates can send cases for diagnosis and treatment.
Dr Edward Glover is the Chairman and there is a technical advisory committee of doctors who have made a close study of many aspects of crime. A public inaugural meeting of the Institute was held at University College on November 29th.
Sterilisation
A Parliamentary Committee of 10 members has been formed with the object of promoting a permissive Bill to legalise voluntary sterilisation of certain mental defectives. This Committee has circulated to members of the House a pamphlet setting forth the statement of the case for legalising sterilisa- tion and giving the text of the proposed Bill. We hope to give a full account of this Bill in the next issue of Mental Welfare. The German Medical Association in combination with the Hartmann Federation have requested the Minister of the Realm of the Interior to intro- duce a law to regularise sterilisation on eugenic grounds of persons with a disease of a seriously inheritable nature. The Medical Association are not in favour of compulsory sterilisation and to ensure against any abuse they suggest the establishment in every district of State Committees consisting of well- known doctors and lawyers who will have the right of decision in every individual case. The Association is particularly anxious to clear up the legal uncertainty which at present surrounds this matter.
News from Institutions
The following items of news taken from Reports on Institutions which we have received during the past few months may be of interest to readers.
Royal Western Counties Institution
During the year this Institution received the consent of His Majesty the King to use the title ” Royal,” and a special resolution was passed incorporating the addition to its name which is now ” The Royal Western Counties Insti- tution.”
A Farm Hostel has been opened for young men at Langdon and tempor- ary villas for low-grade male and high-grade female patients have been added to the accommodation. The Farm Hostel is proving most successful. It accommodates 20 men and also provides excellent facilities for training for a number of defectives who are sent daily from the main Institution. The defectives in residence at the Hostel are allowed full parole on return from their work. Their earnings vary from 10/- to 25/- a week.
Coleshill Hall, Birmingham
This is one of the younger Institutions and the Report for this year con- tains chiefly an account of the gradual development in the building, etc. A Boy Scouts Band has arisen out of classes in musical training which were begun early in January, 1932. Attendance at these classes is voluntary and 40 men have received tuition during the past year. Physical Training Classes have also become part of the daily routine. The classes have proved increasingly popular and the diffidence and opposition shown, particularly by the lower grade women, has disappeared.
A picturesque block of workshops has been erected, each consisting of a large workroom and store rooms adjoining.
Royal Eastern Counties Institution
In the report of this Institution for 1932, Dr Turner gives an account of the research work which is being carried on by Dr Penrose as Research Medical Officer, and Miss Newlyn his Research Investigator. Dr Penrose has already published three papers, one on the Position of Family of Mental Defectives, and two on Mongolism. Two other investigations have formed part of the work of the year, the first an investigation into the incidence of congenital syphilis amongst defectives and the second on the size of family and the average grade of defect amongst different social classes. Holiday Home for Mental Defectives, Littlehampton The Green Lady Hostel, East Street, Littlehampton, will again be avail- able as a Holiday Home for defectives during four months of 1933?April, May, September and October. Parties of defectives may be sent from Institu- tions in charge of their own staff, or if desired, the C.A.M.W. will undertake to provide the necessary supervision. Weekly charges will be as follows: ? For Supervising Staff … … … … 26/6 per week For patients bringing own supervising staff … 20/- per week For patients for whom C.A.M.W. provides supervision 25/6 per week Early application is advisable so that convenient dates for the various parties may be arranged. Further information may be obtained from the Secretary, C.A.M.W., 24, Buckingham Palace Road, S.W.i.
During the 14 weeks for which the C.A.M.W. rented the Holiday Home in 1932, a total number of 340 defectives was received, the majority for a holiday of a fortnight each. They came from all over the southern and mid- land areas of England and most appreciative letters have been received from the patients themselves and from those responsible for sending them. This has encouraged the Association to repeat the experiment in 1933 and it is hoped that the Holiday Home will again be well supported.
Margaret Macdowall Memorial Scholarship, 1933
Applications are again invited from persons wishing to obtain specialised training in the care of mentally defective children for a scholarship available in 1933 under the Margaret Macdowall Memorial Fund. The Scholarship will be tenable at one or other of the Courses arranged by the C.A.M.W., according to the qualifications and eligibility of the successful applicant.
The Fund is administered by a Committee of the C.A.M.W., who act as Trustees, and all enquiries and applications regarding the Scholarships should be addressed to the Secretary, C.A.M.W., 24, Buckingham Palace Road, S.W.i.
Training Courses in 1933 The following Courses have been arranged by the C.A.M.W. to take place during the year 1933 : ? 1. Course for Medical Practitioners on Mental Deficiency and Allied Conditions at the University of London, South Kensington, S.W. Part I. May 8th to 13th. Part II. May 15th to 20th. 2. Courses for Enquiry Officers, for Supervisors of Occupation Centres and for Institution Staffs, at Notcutt House, Dorset Square, London, N.W.i. July 1st to 22nd. 3. Courses for the Training of Teachers of Retarded Children (a) The Nine Weeks’ Course will be held in London from Monday, May 22nd to Friday, July 21st. (b) The Short Courses organised by the C.A.M.W. on behalf of the Board of Education will be held as follows: ? Advanced Course (in London), July 4th to 27th. Elementary Course, September 8th to 30th. (Probably in Liverpool, but place will be announced later.) Note.?The dates given for the Teachers’ Courses are provisional. Details will be circulated in February.
Forthcoming Lectures
A Course of five lectures on Defective Speech and How to Improve It, will be given by Miss Eileen MacLeod at University College. Gower Street, London, W.C.i. The lectures will be held on Wednesdays, at 5.30 p.m., com- mencing on January 18th.
A more advanced course in Orthophonies will also be given on Wednes- days, commencing on February 22nd. The fee for each course is 1 guinea and the fee for the two courses together is 2 guineas. Particulars may be obtained from the Secretary, University College.
The Institute of Medical Psychology, 6, Torrington Place, W.C.i, have arranged the following series of lectures for next session: ? Theory and Practice of Mental Hygiene for Advanced Social Workers. 16 lectures, commencing on Tuesday, January 17th.
Theory and Practice of Mental Testing. Six elementary lectures, on Mondays, commencing January 16th.
The Significance of Mental Tests in Psychiatric Work. Advanced Course of three lectures, commencing February 27th. A lecture on Occupational Therapy, followed by a Demonstration. 3 p.m., Saturday, February 4th.
Particulars of these and other Post-Graduate Courses may be obtained from the Hon. Lecture Secretary of the Institute, 6, Torrington Place, W.C.i. Mental Health Course for Social Workers
Owing to the continued generosity of the Commonwealth Fund, a further grant of six scholarships to the value of ^200 each for diis Course, is announced by the London School of Economics for the coming session.
While candidates for scholarships must fulfil certain formal conditions of age, training and experience, the Selection Committee lays primary stress upon the importance of personal qualifications for this exacting and responsible work.
The practical training of the Course is arranged under the special educa- tional supervision of medical directors and social supervisors at the Maudsley Hospital and L.C.C. Out-Patient Clinics, and the London and East London Child Guidance Clinics. A short period of training in mental deficiency work 1S provided for through the co-operation of University College Hospital and the Central Association for Mental Welfare.
The increasing demand for systematic training in the mental hygiene aspects of social work is evidenced by the large number of enquiries about the Course received each year, and the diverse branches of social work from which applications are received. It seems clear that this training has ceased to be the monopoly of those definitely intending to take up work in Clinics and is wel- comed by many of those concerned in a less specialised way with personal and social well-being.
Attention is called to the advertisement of available Scholarships on page 26.
Association of Mental Health Workers
A small presentation was recently made by members of the Association of Mental Health Workers to Mrs. Pinsent on her retirement from the Board of Control, as a mark of appreciation and esteem. This took the form of gram- ophone records. It is the sincere hope of all members of the Association that Mrs. Pinsent may enjoy every happiness in her retirement.
The Annual Week-end Conference of the Association is due to be held in London next April. A Circular has been sent to all members to ascertain whether it is their wish that the Conference should be held this year. Members are asked to give the matter early consideration and to reply to the circular as soon as possible.
Further news of the Association will be seen on page 27.
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