News and Notes
Mental Welfare at the Public Health Congress.
The C.A.M.W. is taking part in the Public Health Congress which is to be held in London at the Agricultural Hall, Islington, during the week beginning November 16th.
The two Sessions for which the Association is responsible are those on Friday afternoon, November 20th, and on Saturday morning, November 21st.
The first Session will be presided over by Sir Laurence Brock, Chairman of the Board of Control, and papers are to be read by Dr Tylor Fox (Lingfield Epileptic Colony) on The Need for Community Care of Epileptics, and by Mr. E. W. Cemlyn Jones on The Extension of Holiday Home Provision for Working Patients in Mental Hospitals. The Session on Saturday morning will be devoted to a discussion on Mental Testing of Children in Elementary Schools to be opened by Dr S. }. F. Philpott of University College. Lord Justice Scott, President of the C.A.M.W., will take the chair on this occasion. The Association is also being responsible for an exhibit of handwork made by defectives which will be on view in the Exhibition Hall of the Congress. On Friday, November 20th, the Board of Control is arranging a Session dealing with physical training and recreation in mental hospitals.
Particulars of the whole Congress can be obtained from the Secretary, Public Health Congress, 13, Victoria Street, London, S.W.i. For further information as to the C.A.M.W. Sessions, enquirers are invited to write to 24, Buckingham Palace Road, London, S.W.i. European Mental Hygiene Re-Union.
The Fourth Mental Hygiene Reunion is being held in London in the Conference Room of the Ministry of Health, as we go to press. The Conference, which was opened by H.R.H. Tne Duke of Kent, is discussing: ” Mental Hygiene and the Cinema,” ” Mental Hygiene and the Nurse,” and ” Mental Hygiene and the School.” Distinguished representatives from a number of European countries are taking part, and reports of their papers will appear in forthcoming issues of Mental Hygiene, the organ of the National Council for Mental Hygiene, in England.
Left-Handedness and Stammering.
An interesting Inquiry into the incidence of left-handedness and the effects of training in right-handedness, has been conducted by Dr C. W. Jeremiah, Second Assistant County Medical Officer for Nottinghamshire, on behalf of the School Medical Service.
The Inquiry has been proceeding during the past three years and was inaugurated to investigate the validity of the widely prevalent idea that the training of a left-handed child in right-handedness predisposes to stammering.
The results of the enquiry go to disprove this popular belief. During the three years, 1933,1934 and 1935,1,901 examinations of left-handed children in Nottinghamshire were conducted by the School Medical Department. In I933? out ?f 8?? cases, the percentage of stammerers was 0.63; in 1934, out of 783 cases, the percentage was 0.62; in 1935, out of 318 cases, the percentage was 0.63. The incidence of stammerers in the whole school population was (in 1933) 0.88 per cent.
Of the 12 cases of stammer found in the left-handed children examined during the enquiry, in only one was it considered to be directlyj due to special training. In two, training was considered to be contra-indicated as the result of the stammer. In the remaining cases, training was undertaken without any bad effects, and in one case a pre-existent stammer disappeared during the time that the training was being given.
Dr Jeremiah, therefore, gives it as his considered opinion that the training of the left-handed child in right-handedness is of practical value and that it does not in itself tend to produce a stammer.
Progress under the Mental Treatment Act.
The Board of Control record in their Annual Report for 1935, steady development in the administration of the Mental Treatment Act. The number of voluntary admissions to Mental Hospitals in the year under review (5,834) showed an increase of 43.06 per cent, compared with those of the previous year, and the number of temporary admissions (1,258) increased by 80.49 Per cent- Excluding these temporary admissions, one person in every four who entered a public mental hospital in 1935 did so voluntarily. A Table giving the figures relating to Admissions since 1931, shows that in 1935 voluntary admissions rose to 24.1 per cent, whilst certified admissions fell to 70.1 per cent., and the Board prophesy that in time, at least half the total admissions will be voluntary.
Out-Patient Clinics.
The most recently ascertained figures with regard to Out-Patient Clinics provided at, or in connection with, Mental Hospitals, show that there are 162 such Clinics in existence. The Board, however, deplore the fact that for the most part, the Voluntary Hospitals have not availed themselves of the opportunity of providing for mental treatment under the Act.
The Distressed Areas and Nervous Disease.
In his Annual Report on the Cardiff City Mental Hospital, Dr McCowan, urges the need for the establishment of a hospital ” for the treatment of nervous and early, curable mental diseases on the lines of the Maudsley Hospital in London and the Jordanburn Nerve Clinic in Edinburgh.”
” It appears to me,”.he says, ” that the necessity for the provision of such a hospital should be brought before the South Wales Commissioners for the Distressed Areas … The conditions of life in South Wales at present increase appreciably the incidence of nervous and mental disease, and makes the present a particularly appropriate time for the provision of such a hospital.”
The number of patients attending the Mental Treatment Out-Patient Clinic held at the Cardiff Royal Infirmary increases yearly, the total number of attendances in 1935 being 1,484 of which, 305 were made by new patients. A waiting-list has had to be established in order to avoid overcrowding and delay. Dr McCowan’s emphatic recommendation would suggest the desirability of a detailed enquiry into the relationship between economic distress and the growth of nervous and mental disorders.
Child Guidance.
A Child Guidance Clinic has recently been opened by the Bristol Education Committee, with Dr R. F. Barbour as psychiatrist, Miss Ruth Griffiths, as psychologist and Miss Hilda Howarth as social worker. This is the third Education Authority to avail itself of the recognition now accorded to Child Guidance Clinics by the Board of Education and their eligibility for Treasury Grants, and it is anticipated that others will follow suit.
In his Annual Report: for 1935, the Medical Officer of Health for Devon (Dr L. Meredith Davies), stresses the need for a Child Guidance Clinic in the County and suggests that it might be combined with an Observation Centre for borderline and ” pre-delinquent ” children, and a Remand Home for delinquents whose conduct is seriously anti-social.
A Resolution urging the provision of Child Guidance Clinics by Education Authorities as a necessary supplement to their existing Health and Education Services was carried at the Southport Conference of the National Council of Women of Great Britain held in the summer.
The Three Day Course for Workers in Homes and Residential Schools for Children arranged in London by the Child Guidance Council, as an experiment, in the spring, proved so successful that a similar Course was organised in Liverpool from September 29th to October 1st. The enthusiasm with which these Courses are received has fully proved their value and the great need for their development, and the Council hopes that an extended Course may be held next year.
Occupation Therapy in Mental Hospitals.
In a section of his Annual Report dealing with Occupation Therapy, Dr. Eager, Medical Superintendent of the Devon Mental Hospital, urges the need of co-operation and interest on the part of the Hospital’s medical and nursing staff if activity in this direction is to be fully developed, and the present percentage of ” occupied patients,” viz., 75 per cent, is to be maintained.
He points out the difference between the employment of ” willing and convalescent patients in ward work, the kitchens, farm and garden, laundry, etc.,” and Occupation Therapy in its true meaning, which he interprets as being the giving to those of an introspective type some other interest, despite the difficulties which have to be overcome in arousing this. Such an achievement implies, he contends, ” the co-operation of the staff as a whole for the benefit of the individual patient rather than the placing of a patient in the most useful form of occupation so far as the hospital is concerned.”
Classes in physical culture, started as a new venture, have been held daily for both male and female patients, conducted by members of the staff. By the end of the year under review, there were 140 patients enthusiastically taking part in the classes which are held out of doors in fine weather.
Dr McCowan, in his Annual Report of the Cardiff Mental Hospitals, states that Occupation Therapy continues to be one of its main features, 82 per cent, of the male patients and 82 per cent, of the female patients being employed in useful work. ” All the Sisters and male Charge Nurses with their deputies are now fully qualified to supervise this treatment in their wards. All Probationer Nurses receive a month’s tuition in the central classrooms as a routine part of their training.” A new enterprise has been the opening of a ” hairdressing saloon and beauty parlour ” in which several patients, trained by the hairdresser, assist. The experiment has proved an outstanding success in stimulating interest and self-respect in patients. Classes in physical drill and country dancing are also much appreciated.
An interesting tribute to the value of Occupation Therapy is paid in his Annual Report by Dr Neil McLeod, Medical Superintendent of The Retreat, York, in which, speaking of its value in the treatment of chronic cases, he writes:?
” Employment suitably chosen for each individual produces astonishing results nowadays in improving the entire mental and physical condition of patients for whom complete recovery cannot be expected. Such patients do not now deteriorate as they formerly did. They are enabled to preserve varying degrees of health, happiness and usefulness.”
Board of ControlWith the approval of the Minister of Health, the Board have appointed Mr. J. C. Rawlinson and Mr. H. R. Green (Barristers-at-Law) to be Commissioners.
Psycho-Therapy and the Church.
Those who have read Jung’s Modern Man in Search of a Soul must have been struck by the following statement: ?
” During the past thirty years, people from all the civilized countries of the earth have consulted me. I have treated many hundreds of patients, the larger number being Protestants, a smaller number Jews, and not more than five or six believing Catholics. Among all my patients in the second half of life?that is to say, over thirty-five?there has not been one whose problem in the last resort was not that of finding a religious outlook on life. It is safe to say that every one of them fell ill because he had lost that which the living religions of every age have given to their followers, and none of them has been really healed who did not regain his religious outlook.”
In view of this condition of affairs, emphasised by so eminent an authority, it is a welcome announcement that the Archbishop of York has recently appointed a psychologist, Miss A. Graham Ikin, to work in his diocese with the object of trying to effect a working liaison between psychotherapists and the clergy, so that people coming to them for help in nervous and mental illness may be more effectively healed.
Amongst the medical psychologists supporting the scheme arc Dr J. R. Rees (Director of the Institute of Medical Psychology), Dr H. P. Newsholme (Medical Officer of Health, Birmingham), Dr John Hay (late professor of Medicine, Liverpool University), Dr Neil Macleod (Medical Superintendent, ” The Retreat “), Dr T. W. Mitchell (late Editor, British Journal of Medical Psychology) and Dr Maxwell Telling (Professor of Forensic Medicine, Leeds University). Clerical supporters include the Bishops of Blackburn, Chester, Liverpool and Manchester.
The Joint Secretaries, from whom further particulars can be obtained, are Canon J. F. L. Southam, 5, Abbey Street, Chester, and Canon F. PatonWilliams, St. Ann’s Church, Manchester.
Institute for the Scientific Treatment of Delinquency. The Second Annual Report of the Institute for the Scientific Treatment of Delinquency, records a large increase in the number of patients treated, and in the use made of the Clinic by relatives, probation officers and social workers in asking for advice and help.
The number of new patients treated in 1934 was 71; in 1935, 116; in 1934, in only 7 instances was advice sought in respect of cases which could not themselves be seen, whereas in 1935, this type of enquiry had increased to 63. In 1934, 35 cases were received direct from Courts; in 1935, 75 cases were referred in this way, the increase being attributed to the effect of the lectures and seminars which were given to Probation Officers and to personal interviews with magistrates to explain the work. To this cause also is attributed the large increase in theft cases referred.
With regard to ” results “?during the year under review, 10 cases were discharged as cured, and 19 as improved, and none of these, so far as is known, has relapsed. In some cases, adequate treatment has been impossible because of the lack of an In-Patient Department or of a Flostel where the patient can stay during treatment. Inability to find work in London and consequent removal, has in several cases meant the premature cessation of much needed treatment. Urgently indicated research work is also held up through lack of facilities for receiving In-Patients.
” Funds ” constitute the Institute’s great need?funds for research, funds for providing residential treatment, funds for enabling paid psycho-therapists to be employed so that more cases can be dealt with. To secure such funds a vigorous appeal campaign has been conducted and new subscribers are gradually being obtained, but financial instability continues seriously to handicap the work.
The Institute’s office address is now 56 Grosvenor Street, London, W.i. The Clinic is conducted at the Out-Patient Department of the West End Hospital for Nervous Diseases, in Welbeck Street.
Defectives as Wage-Earners.
Out of 660 defectives over the age of 16 under Statutory Supervision, the Essex Voluntary Association for Mental Welfare states that 34.7% of the males and 17% of the females are self-supporting, and in its Report for 1935-36, gives instances of the stability shown by certain of these defectives as wageearners. Thus one man has worked on the same farm for 10 years; another has been employed for 7 years on a golf course; a third has been with one firm as a porter for 7 years?and equally good records could be given in the cases of a number of the girls. The Association therefore feels justified in drawing attention to the fact that ” employers need have no hesitation in engaging wellrecommended candidates for posts.”
Birmingham’s Ex-Special School Children.
The Report of the Birmingham After-Care Committee for 1935 contains, as usual, much carefully prepared and classified detailed statistical information as to the careers of boys and girls who have left the Special Schools, the records now cover a period of 32 years and concern 6,349 individuals, and the work of keeping in touch with so large a number of cases has become so great that the Committee has decided in future, to visit only infrequently the older and more stable cases so that greater attention may be paid to those who are younger and more in need of help. Complete statistics will hereafter, be given in the Reports of alternate years only.
The number of ex-Special School pupils in employment in Birmingham at the present time is the largest yet recorded exceeding that of the previous year by 236. C.A.M.W. Holiday Homes.
The C.A.M.W. Holiday Homes at Bognor, Rhyl and Seaford have had another busy season.
Since April 1936, the Homes have received 1,056 defectives either individually or in parties. They have been sent by twenty-six different Authorities, from all over the country, and in the majority of cases the parties have spent a period of two weeks each on holiday.
An interesting new development, which it is hoped will be extended, has been the use of the home at Seaford by two parties, each of 30 women patients and 3 nurses, from the Chartham (Kent) and Hellingley (Sussex) Mental Hospitals.
We have received from Mrs. Benson, Organiser of the Staffordshire Occupation Centres, a diverting account, written by the Supervisor, of a fortnight spent at Rhyl by children attending the Tipton Occupation Centre, from which we take the following extracts: ? ” Bod Donwen itself, our home for the fortnight, was viewed with great awe by the children; houses like Bod Don’wen are few and far between in the Black Country. To live for a whole fortnight in such a house was quite beyond their powers of imagination… . Some of the children had never been in a big bath before and the tinies especially were very thrilled to watch the water running away. …”
” One child used to say to Matron every morning before he attacked his porridge: ” It isn’t this morning we go back, is it?” When she assured him it was not, then he set to work on his breakfast happily. One of the girls was very horrified to find the sea miles out one morning when on the previous afternoon it had been ” high ” and almost up to the wall of the Promenade. She was certain it wouldn’t come back again, but in the afternoon, back it came, and all was well!”
” On arriving back at Tipton one boy was asked where his bucket and spade were! ” Oh,” he said, ” I’ve left them at Rhyl ready for next year!” I hope he has, for already the children are asking if it is time to start saving up for the seaside again.”
” I feel the effort necessary to take these children for a fortnight’s holiday is amply repaid by their keenness to go again and by the obvious improvement in their health. As Supervisor of an Occupation Centre, I know how few opportunities mentally defective children have of variety. Their experience is so limited, the people they meet so few, and their vocabulary so small. A social side to their lives is non-existent During a fortnight at the sea, the children had opportunities, which in their own town would have been impossible. At Rhyl, the whole environment was so pleasantly different, everyone around was in a holiday mood, there were so many new situations arising every day, so many new objects both on the beach, in the fields, and on the Promenade. The children had to adapt themselves to each occasion as it arose, so that apart from their improved health, the holiday has been invaluable from an educational point of view.”
A similar tribute to the value of such holidays could, we do not doubt, be given by all the Supervisors and Superintendents who have been concerned in arranging them, and the C.A.M.W. is now considering the acquisition of a fourth Holiday Home to be situated on the Yorkshire coast.
Holidays and Guardianship.
During the summer the C.A.M.W. Guardianship Department has arranged individual holidays for over 70 girls and boys, and sent a party of 31 girls to the Holiday Home at Seaford. In addition, several of the girls in domestic service have accompanied their employers on their annual holiday.
The Brains of Defectives.
An interesting account of some research work done at Stoke Park Colony on normal and defective brains was published in the British Medical Journal of July nth, by Dr R. J. A. Berry, who is working at the Colony under the Burden Research Trust.
An examination of the brains of 70 defectives and 39 normal individuals has led Dr Berry to form the conclusion that:
” mental deficiency is in the great majority, the result and consequence of a brain too small for its proper functions, and that this cerebral deficiency affects the whole central nervous system.”
The proportion of the product of the defective brain to the normal after the cessation of brain growth (this occurs in normal children between the 8th and the nth year of age) is, he found from his material, 76 to 100?i.e. ” the majority of mental defectives are so because their brains are about one quarter too small.” The brains of mongols were discovered to be more lacking in size than those of other types of defectives.
Dr Berry has some interesting things to say in his article, with regard to the diagnostic importance of estimating the ” brain size of a defective, as deduced from his head measurements (according to the results arrived at by the Burden Mental Research Trust, based on a previous research on the head products of 10,000 Australian children, by Berry & Porteous, the proportion of brain size to head size may be roughly assessed for clinical purposes at twothirds). This has; he points out, a practical bearing on the education of defectives, as if it is found, e.g. that a defective of 8 years has a brain1 approximately the size of a normal infant of 2 months, to attempt to teach him anything in the nature of ” the three R’s ” can obviously only prove to be abortive.
Home Teaching in Birmingham.
A Home Teaching Scheme for defectives has been organised by the Birmingham After-Care Committee to help children who cannot attend any of the four Occupational Centres available for defectives living in the central districts of the area.
Since September 1935, when the Scheme was instituted, 18 ” children ” of ages varying from 8 to 24, have been taught in their own homes at weekly or fortnightly intervals, in some cases a small group of 2 or 3 pupils being taken together. All kinds of handicrafts are taught, as well as speech and sense training, singing and physical exercises. Simple reading and writing lessons are given in addition to any child who is capable of benefitting from them.
As in other areas, it has been found that the teacher is cordially received and that the results achieved by her pupils have fully justified the scheme.
Royal Eastern Counties Institution.
Research Work into heredity and the causes of Mental Deficiency has received a great impetus through the generous help of the Hon. Alexandrina Peckover who has given a Donation of ^2,000 for the building of a Laboratory and Research Offices at the Royal Eastern Counties’ Institution at Colchester. For the last five years an important enquiry has been carried on at the Institution by Dr Lionel Penrose and his assistants, and has been jointly financed by the Medical Research Council, the Darwin Trustees and the Institution.
It is felt that far reaching results should accrue from this work and as the Research Department had outgrown its previous temporary quarters a new Laboratory was urgently required. It is interesting to recall, that 36 years ago the late Lord Peckover presented to the Institution the Peckover Schools and Workshop which have had such a beneficial and lasting influence on the success of the training carried on therein.
News of New Institutions Co. Durham. The foundation stone of a new Institution at School Ayliffe, Co. Durham, was laid on August 19th by the Chairman of the Durham Committee for the Care of the Mentally Defective.
The Institution is to accommodate, in the first place, 360 patients of all grades of mental defect, and ultimately it will provide accommodation for 100 patients.
It is hoped to open the first part of the Institution in the spring of 1938. Brighton.
The Brighton Town Council have approved a scheme for an Institution, on a portion of the Laughton Lodge Estate, of two villas of 60 beds each for male defectives, and one villa of 60 beds for female defectives. Lancashire.
A competition has been promoted by the Lancashire Mental Hospitals Board inviting Chartered and Registered British and Irish Architects to submit plans for the Mental Hospital and Institution for mental defectives which is to be erected on the Lathom Park site, near Ormskirk. The Hospital is to be planned for 1,000 patients and the Certified Institution, for 2,000.
Glasgow.
Glasgow’s new Institution at Lennox Castle, ten miles out of the city, was opened on September 24th by the Lord Provost of Glasgow.
The opening of the Institution, which is planned for 1,200 defectives and is designed and equipped on the most up-to-date and efficient lines, has aroused great interest throughout Scotland and considerable press publicity has been accorded to the event.
A New Reception Hospital.
On June 17th, a step forward was taken in the provision of facilities for the treatment of mental patients in Essex when Sir Laurence Brock, Chairman of the Board of Control, opened a Reception Hospital (” Warley woods “) which has been built as an annexe to the Brentwood Mental Hospital.
The new Hospital provides for 55 female and 60 male patients and is entirely separate from the main building into which as Sir Laurence Brock pointed out, there was every chance that many patients would never enter.
The Hospital has been planned to ensure the maximum amount of sunshine and fresh air with ample verandah space for beds, and a ” sun-parlour annexe ” for patients who arc up and about. Every facility has been provided for the adequate classification of patients and there are single rooms for private cases. A photograph of the Female Patients’ Sitting-room shows a many windowed room with plenty of comfortable upholstered chairs and small tables.
We are informed that since the Hospital was opened, approximately 60% of the patients admitted have been uncertified cases.
For Epileptics in the Rand.
News has reached us from South Africa of an interesting experiment destined to help epileptics.
The scheme was initiated in April 1934 by a small group of members of the National Council for Mental Hygiene in Johannesburg.
A plot of land was lent by a sympathiser and 4 epileptics were put to work on it under the supervision of an overseer who was an ex-mental nurse. The men lived in a house under the charge of the wife of one of them, and were paid 30/- a week wages, out of which they paid /ia week for board and lodging. An appeal to the public brought in the sum of ^300 which enabled the work to be maintained during the first experimental months, and in July 1935 the City Council of Johannesburg granted to the new Association seven acres of land at a nominal rental. The Government, on representations made by the Commissioner for Mental Hygiene, agreed to give a subsidy of ?2 10s. per man per month, and there are now 14 men in the Association’s employ. The principal output of the Colony is flowers, and it was hoped at the time of the publication of the Annual Report ending January 1936, that ?20 per month would shortly be realised by this means, and that as more land was brought under cultivation, the proceeds of sales would show a substantial increase.
The results of the Scheme have been fully justified in an increase of health and happiness of the men concerned, although there have been, of course, many difficulties of every kind, not the least of them being those connected with the patients’ uncertain mental stability.
For further details, readers of Mental Welfare interested in the welfare of epileptics, are invited to apply to the Rand Epileptic Employment Association, P.O. Box 1253, Johannesburg, South Africa,
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