News and Notes
Board of Control
The Board of Control, with the approval of the Minister of Health, has appointed the following as honorary Consultants in connection with diseases occurring amongst the mentally defective patients at Rampton State Institution, Retford, Notts: ?
Surgeon: Professor Graham S. Simpson, F.R.C.S., L.R.C.P., L.D.S. Gynecologist: Professor Miles H. Phillips, M.D., F.R.C.S., F.C.O.G. The Education and Notification of Defective Children
The development of Special Schools for M.D. Children is practically at a standstill. In 1935, there was actually less accommodation in them (by 103 places) than there was in 1924, and as a result, something like 90,000 feebleminded children* in England and Wales are receiving no special education suited to their needs, despite the existence of an Act making it incumbent on Local Education Authorities to provide this. As a further result, the Mental Deficiency Act cannot fully function, for large numbers of defectives are leaving the ordinary elementary schools every year who, between 14 and 16, are left without any statutory supervision and who only become known to the M.D. Authority if they get into trouble or misfortune subsequently.
The C.A.M.W. has been concerned about this problem for many years, and has recently taken a definite step towards its solution by calling together a Special Committee, representative of a number of official bodies and organisations interested in the question?to consider a Memorandum drawn up as a basis of discussion by the Association’s Education Committee, and to draft an agreed policy with a view to approaching the Board of Education for the purpose of securing an Amending Bill.
The organisations represented on the Committee are as follows: ? Association of Medical Officers of Health, Association of County Medical Officers of Health, Association of Education Committees, Association of Directors and Secretaries for Education, Association of Medical Officers of Schools, County Councils Association, National Association of Inspectors of Schools and Education Organisers, National Special Schools Union, National Union of Teachers.
The points to be considered include matters of great complexity, such as: ? (a) Whether any methods for providing Special Education for defective children remaining in the Elementary Schools can be devised in association with the provision made for dull and backward children, in areas where there is no Special School available. (b) Whether the certification of such children should be abolished for educational purposes (as recommended by the Wood Report), or restricted to certain types of children only, such as those sent to Special Residential Schools, or those who are socially, as well as educationally, defective.
*This figure is based on the estimates used by Dr E. O. Lewis in the Wood Report, (c) Whether the Notification of defective children leaving ordinary Elementary Schools should be advocated, irrespective of their having received any type of Special Education, or whether this should be a condition of Notification. (d) Whether the existing definitions of feeble-mindedness in the case of children should be altered, and if so, what should be the terms substituted?
On all these matters, points of view are many and divergent, and it will probably be some time before the Committee is in a position to make any report. Meanwhile, three Sub-Committees?Medical, Educational and Psychological and Administrative?are starting work. The Rt. Hon. Lord Justice Scott has kindly consented to act as Chairman of the Committee.
The Board of Education and Special Schools
In a Circular (1444) on the subject of an ” Administrative Programme of Educational Development,” issued on January 6th, 1936, the Board of Education makes the following pronouncement with regard to the Special Schools: ?
” The problem of the sub-normal child is one which calls for careful attention. While additional Day Special Schools are not, as a rule, urgently required, there is need of increased residential provision for difficult children or those of low grade intelligence who are out of reach of, or unsuitable for, Day Special Schools, but cannot properly be retained in the ordinary public elementary school.”
Re-organisation?the Second Phase Four years ago the Chesterfield Education Committee published a “Record of Four Years of Experiment and Reconstruction,” containing a detailed survey of the educational facilities available in the area, and of the way in which re-organisation on the lines of the Haddow Report had so far been carried out.
Last November, a further Report on the subject was presented to the Education Committee by the Chief Education Officer, Dr H. G. Stead, which has since been published under the title ” Re-Organisation?the Second Phase.”
The Report is written in a philosophic vein, with an underlying basis of idealism and with a vision of the future before the writer’s eyes, but it contains much also of strictly practical interest to those who are concerned with retarded children. Chesterfield was part of one of the selected areas investigated by Dr Lewis for the Wood Committee, and in addition, a mental survey was later carried out covering two complete age groups?9.6 to 10.6, and 10.6 to 11.6. Although the areas investigated in each case were not quite identical, it is interesting to note that the number of defectives per 1,000 of the school population was estimated by the later survey to be 20, as compared with the Wood Report’s figure of 22, indicating a group of approximately 200 defectives in the Borough as a whole. Taking an I.Q. of 80 as the upward limit, it was found that there would appear to be a further 920 dull and backward children.
The Report points out, however, the fallacy of judging a child’s inherent ability entirely by his I.Q., as it may be influenced by a number of factors, emotional and physical, quite apart from native intelligence; with suitable treatment, such conditions could be remedied, and a v great deal of mental energy which is now wasted could be freed for constructive work.” Hence the importance of a Psychological Clinic, a detailed scheme for which is given at the end of the Report.
As the basis of educational re-organisation, the Report places ” a freer time-table, a freer discipline, a freer outlook ” in the schools. Although its value under present conditions is admitted, it is considered that the existence of a ” C ” section in a school is likely to develop a sense of inferiority in the children composing it, and an attitude of defeatism in the teachers concerned. “Children in the ‘bottom section’ are viewed as hopeless: often children from whole areas are damned from the start.” And yet real success with difficult children ” is the crown of a teacher’s task.” The need of the schools to-day, we read in the Report, ” is a method which develops activities in an individual, and if this is held as a faith, the necessary methods will soon be devised.”
This Report contains much that is challenging and invigorating and it should be read by all who are interested in educational reform. West Riding Educational Clinic
An ” Educational Clinic ” has recently been opened by the West Riding Education Committee at the Bingley Training College, to serve the areas of Bingley, Shipley and Keighley.
The object of the Clinic is to help teachers, parents and guardians in dealing with difficult children, and provision is made for medical and psychological examinations, for play therapy and observational handwork, and, where necessary, for courses of special lessons for educational backwardness.
At present the Clinic is in the nature of an experiment and its development is being watched with interest by educationalists.
Mental Treatment Clinics for Bedfordshire
The Bedfordshire County Council have been considering the question of the provision of Mental Treatment Clinics for out-patients and pending more adequate provision, temporary arrangements for such treatment have been made in Luton and in connection with the Bedford County Hospital.
A New Clinic for Glasgow
The Lansdowne Clinic for Functional Nervous Disorders was recently opened in Glasgow, under the auspices of the Royal Mental Hospital. The Clinic is intended to supplement the facilities in the city for psychiatric treatment at present available in connection with General Hospitals, with which it hopes to work in close touch, and it will be in a position to offer to selected cases the lengthy course of treatment which cannot be provided in hospital out-patient departments.
London Child Guidance Clinic
An interesting Survey of the Work of the London Child Guidance Clinic* has just been written by its Medical Director, Dr William Moodie. In every direction, he reports, the activities of the Clinic show rapid growth and development, and it is rapidly outgrowing the accommodation available in its present Islington premises. Patients come from all over the country and between 50 and 60 new cases are seen each month. As the work has been in existence only eight years, it is considered too soon to give any definite statistics as to the results of treatment, but Dr Moodie states that ” very careful analysis shows that over 50% of the cases handled are reported on as successfully treated.”
The Clinic’s staff now consists of a Medical Director, four Psychiatrists, four Honorary Psychiatrists, three Psychologists, and seven Social Workers. The sum required for adequate maintenance of the Clinic, serving as it does a wide area and fulfilling the purpose of a training centre as well as a centre for treatment, is ^9,000 a year. The Commonwealth Fund of America continues to contribute liberally, and an annual grant is received from the London County Council in part remuneration for work undertaken by the Clinic staff at the Ponton Road Remand Home, but for purposes of new developments and expansion it must rely on voluntary subscriptions and donations, and to this end an Appeal Department has been created.
Saving Maladjusted Children
The March issue of The World’s Children, contains the interesting announcement that the Save the Children Fund is about to issue an appeal for ?100,000 for the establishment and partial maintenance of an Open Air Residential School for between 60 and 80 “nervous and maladjusted children,” as well as for the provision of more Open Air Nursery Schools and toddlers’ playgrounds.
This enterprise is prompted by the great success of the Fund’s open air residential school at Broadstairs for physically debilitated girls, and by the fact that Local Education Authorities have no specific legal powers to make provision for the care and treatment of psychologically maladjusted children, other than by attendance at Child Guidance Clinics, although a proportion of *Tudor Lodge, 1, Canonbury Place, London, N.l. such children cannot be dealt with effectively unless their whole environment “s changed. The Committee set up by the Save the Children Fund for this new campaign, includes Dr Ralph Crowley and Sir Francis Fremantle, and on the Technical Committee, the following experts are serving:?Dr William Moodie (London Child Guidance Clinic), Dr Emanuel Miller (East London Child Guidance Clinic and Institute of Medical Psychology), Miss L. G. Fildes (Psychologist, London Child Guidance Clinic), Dr C. F. Harris (St. Bartholomew’s Hospital, Children’s Medical Unit) and Dr Susan Isaacs (Head of the Children’s Department of the Institute of Education, University of London).
We feel sure that Mental Welfare Workers throughout the country will welcome the Scheme and wish it every success.
Oldham Council for Mental Health
The Oldham Council for Mental Health is carrying on an active campaign in Oldham and district by means of Lecture-Discussions, meetings and distribution of literature. Its aims are : (1) to improve the Mental Health and welfare of the community; (2) to study Causes and Conditions of Mental Disorder and Defect with a view to prevention and amelioration; (3) to make known the Importance of Early Diagnosis and Treatment in the mental and nervous disorders of Children and Adults; (4) to study Delinquency with a view to the Prevention of Bad Conduct and Crime; (5) to render Human Relations happier through Education in Sounder Self-Understanding; (6) to develop a strong and enlightened Public Opinion.
The Council?which is affiliated to the National Council for Mental Hygiene?was initiated two or three years ago by a Conference called by the Public Assistance Committee. It has a strong backing from the Borough Council (the Mayor is its President and the Borough Treasurer is its Hon. Treasurer), and doctors, teachers and social workers in the town are keenly interested. There is a representative Executive Committee and the Council works in close co-operation with the South-East Lancashire Association for Mental Welfare.
Further particulars of the work of the Council will gladly be supplied on application to its Hon. Secretary, Miss Elizabeth Martland, Lyndhurst, Queens Road, Oldham.
” Q Camps ” We have pleasure in drawing attention to the leaflets enclosed in this issue, giving information about the first ” Q Camp which is to be started for young men between the ages of 17 and 25 exhibiting behaviour difficulties and in need of training under carefully chosen conditions.
This is an experiment which is badly needed and we hope that in their efforts to make a start, the Q Camps Committee will meet with abundant success.
Leeds Voluntary Mental Welfare Committee
The Leeds Voluntary Mental Welfare Committee held in February its Annual Reunion of defectives under Supervision, members of the Committee and Voluntary Visitors, which as usual attracted considerable public interest. The Tea and Entertainment were attended by 300 Supervision cases, and the gathering was addressed by the Lord Mayor and Lady Mayoress. The programme was provided by the Leeds Imperial Stage Academy, the 50 artistes taking part giving their services voluntarily. The charge made to the public for admission to this annual function defrays the cost, and leaves a balance which is devoted to the expenses of a week’s Summer Holiday Camp for defectives at the seaside.
In Leeds there are now three Occupation Centres attended by a total of 250 ineducable children with a staff of 15 Supervisors and Assistant Supervisors. For the adult defectives, Industry Centres are also flourishing, carrying on tailoring, boot making and repairing, joinery and cabinet making, rug and mat making, and firewood bundling. The trading income from these Centres last year amounts to .?1,515. The wages paid to the trainees amount to .?1,175. For the adult feeble-minded women the Voluntary Committee has also established the ” Pioneer Laundry,” which is conducted on purely commercial lines. At this Laundry employment can be found for any feeble-minded woman unable to obtain work in the open market. There are six normal workers and the remaining 28 women employed are feeble-minded. The Laundry is nearly self-supporting, the income for the present year amounting to -?1,865, having a deficit of only ^150 after paying all the expenses and wages of the workers.
For Glamorgan’s Mental Defectives
Accommodation for mental defectives in Glamorgan has recently been substantially increased by the opening of six new blocks at Hensol Castle Colony. The new blocks can accommodate an additional 320 patients, and it is intended ultimately to increase the accommodation to 2,000. The Glamorgan Mental Deficiency Committee have also been considering the development of Occupation Centres in the area, and the establishment of a Holiday Home, but progress in these directions is, at the moment, at a standstill.
Lancashire’s New Scheme
The Lancashire Mental Hospital Board is about to launch a scheme for the building of a new institution for 2,000 mental defectives and a mental hospital for at least 1,000 patients, both to be erected on the Lathom Park Estate, near Ormskirk.
Lancashire is suffering from a grave shortage of accommodation for both mental patients and mental defectives, and the projected new institutions are urgently needed.
South Africa
The Annual Report of the Commissioner for Mental Hygiene for the Union of South Africa, reveals a serious condition of overcrowding in Mental Hospitals. During 1934 there was an increase of 240 in the number of patients certified, and it is anticipated that there will be an annual increase of 5% during the next few years. At the end of 1934, there was an overcrowding in all mental hospitals of 48 European and 542 non-European patients, and the need for additional accommodation is therefore urgent.
It is interesting to read that psychiatric services are supplied to the Courts in the areas served by the mental institutions of the Union and to the Juvenile Courts at Johannesburg and Capetown. There are Out-patient Psychiatric Clinics in Port Elizabeth and Durban, and similar Clinics at Capetown, Johannesburg and Pretoria, in connection with general hospitals.
In the two Institutions for Mental Defectives there were on December 31st, 1934, 1,869 patients. At the Witrand Institution, Potchefstroom, a ward for male defective delinquents has been opened.
Sterilisation in the U.S.A.?An Enquiry
A Report on Sterilisation issued by a committee of the American Neurological Association, which was appointed in May, 1934, to investigate the whole subject, takes roughly the same view as that taken by the Brock Committee in this country. It recommends to the Association that any sterilisation law should be voluntary rather than compulsory, and that it should be applicable not only to patients in State institutions, but to others. Sterilisation Boards should be the final arbiter in each case and there should be adequate legal protection for members of such a Board and for surgeons carrying out its recommendations.
The Committee emphasise the limitations of Sterilisation as a policy, and consider that it is applicable only to selected cases of certain diseases, subject to the consent of the patient and of those responsible for him. We understand that the Report is at present unavailable, a limited number of copies only having been printed, but a second edition, amplified in book form, is being prepared by Dr Abraham Myerson, Chairman of the Committee.
North Eastern Guardianship Scheme
The C.A.M.W. have been successful in initiating a Guardianship Scheme, on the lines of that recently launched in South Wales, to cover the North Eastern area, and an office has been opened in Newcastle from which the work will be carried on.
The Scheme will be operated under the direction of a Guardianship Committee consisting of representatives of each of the Local Authorities participating in it, and of one representative from each participating Mental Hospital. For an experimental year, the C.A.M.W. is supplying a Guardianship Officer (Miss G. T. Crosse), and in addition, its Organiser (Miss M. E. Cullen) is working in the area for the first three months.
The cases to be placed out will include defectives from Certified Institutions, on license or under guardianship, and cases from Mental Hospitals.
After-Care of Epileptics ————————There is at present no organised system of After-Care for epileptics (other than those dealt with under the Mental Deficiency Act) on leaving special schools or epileptic colonies, and there is reason to believe that the need for this is a very real one.
The matter was brought to the attention of the Council of the C.A.M.W. some months ago, and a questionnaire was issued to Secretaries of Local Associations for Mental Welfare, asking for information about any epileptics (normal or defective) known to them. The returns have disclosed the need for further preliminary enquiry, and a small experimental investigation is now being conducted from the C.A.M.W. office, in certain selected areas in Essex.
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