News and Notes
MENTAL WELFARE
Board of Control
The King, on the recommendation of the Lord Chancellor, has approved the appointment of Mr. Cyril F. Penton, M.A., Barrister-at-Law, as a Senior Commissioner of the Board of Control, in the place of Mr. S. J. Fraser Macleod, K.C., who has retired from the Service.
Mr. Macleod, who became King’s Counsel in 1905, practised on the Western Circuit until 1908, when he was appointed to be a Lunacy Commissioner. On the passing of the Mental Deficiency Act in 1913, he became one of the Legal Commissioners of the Board of Control; when the Board was further re-organised under the Mental Treatment Act, 1930, Mr. Mcleod was appointed to be a Senior Commissioner and legal Member of the Board. Mr. Penton, who now becomes a Senior Commissioner and legal Member of the Board, was educated at Eton and Trinity College, Cambridge, and was called to the Bar by the Inner Temple in 1912. He has been a Commissioner on the staff of the Board since 1931.
Ascertainment and Notification of M.D. Children
A Memorandum (No. 151) has recently been issued by the Board of Education on the Ascertainment and Notification of M.D. Children, in which the following points are stressed : ?
(1) Imbecile children should not be left in the elementary schools, but should be notified as early as possible, even in areas in which the M.D. Act is not being fully administered.
In doubtful cases a final decision should be made at the age of 11, and no imbecile child over this age should be left un-notified.
(2) As children leaving Special Schools can now be notified for Supervision, and such Supervision is needed by the majority of feeble-minded children, Education Authorities are urged to make the fullest use of their powers in this direction.
(3) The needs of feeble-minded children between 14 and 16 not in Special Schools, should be met by an arrangement for voluntary After-Care between the Local Education Authority and the Mental Deficiency Authority. This After-Care may be carried out in various ways, but its purpose should be ” to provide voluntary supervision until the child reaches the age of 16, and of maintaining informal contact with the Mental Deficiency Committee.”
(4) In the event of active trouble befalling a child between 14 and 16, a Local Education Authority is free to notify the child as a “Special Circumstances” case under Article 3 of the Mental Deficiency (Notification of Children) Regulations.
Graded Scheme of Educative Needlework
With the kind co-operation of the Royal Eastern Counties Institution, Colchester, the C.A.M.W. has prepared a graded scheme of educative needlework adapted to the needs of defectives.
Sets consist of five canvas samplers worked in colour stitches designed to illustrate the successive stages of the scheme, with three embroidery needles, three tapestry needles and two rug needles, accompanied by full and detailed instructions for teaching, and a catalogue of prices of materials used. The cost of a set is 10/-, and orders can now be received by the C.A.M.W., 24, Buckingham Palace Road, London, S.W.i. As each set takes some time to make, orders will be dealt with in rotation.
M.D. Prize Winners A Competition open to Guide Companies in Institutes and Special Schools was inaugurated last October, consisting of:?(1) Keeping a Company Log Book; (2) Making a ” Noah’s Ark ” from nuts, cotton reels, matches, pipecleaners, wire and paint; (3) Devising a method for teaching a Recruit the distinguishing Badges of the Commissioners and Secretaries of the Guide Movement.
We have pleasure in recording that the Second Prize for this competition was won by the 4th Edmonton Company attached to the Edmonton Occupation Centre, who turned out a most diverting array of animals for their Ark. Tied with them was the 96th Nottingham Company attached to the Basford (Section 37) Institution.
The First Prize was won by the 10th Streatham Company attached to the South Side (L.C.C.) Institution, who tied with the 4th Godalming Company attached to the Meath Home for Epileptics. The nth Colchester Company, from the Royal Eastern Counties Institution, won the Third Prize.
At the Hospitals,Nursing, Midwifery and Public Health Exhibition held in May at the University of London, South Kensington, there was a section on Occupation Therapy, to which many Hospitals and Institutions contributed. It is encouraging to Mental Welfare workers to know that for specimens of handwork submitted by the C.A.M.W., from Middlesex Occupation Centres and from defectives who are receiving Home Teaching, five First Class Certificates were awarded.
Congratulations to all these prize-winners and to those who trained them! West Midlands Joint Board for the Care of Mental Defectives This newly-constituted Joint Board consists of 21 members appointed by the Councils of Wolverhampton, Worcestershire County, Smethwick, Dudley, Burton-upon-Trent and Worcester City.
The purpose of the Board is to establish a Joint Institution for defectives in its area and it is anticipated that plans will shortly be developed to that end.
Middlesex Colony for Mental Defectives
With the formal opening, in May, of the Middlesex County Council’s M.D. Colony at Shenley, by the Minister of Health, the scheme for the Colony was completed except for 200 beds for children which have yet to be provided. The total accommodation will then be for 1,154 patients.
The Colony is built on the villa system, and can provide for the men patients ample agricultural employment, as the buildings are surrounded by farm lands. The women are occupied in the kitchen, laundry and workrooms, and there is ample provision for recreation, both indoors and out.
New Institutional Schemes
The Nottinghamshire County Council has recently adopted a scheme for the provision of a Colony for Mental Defectives at Balderton, for 540 patients. The Bucks, Oxon and Reading Joint Board for the Mentally Defective have in hand plans for increasing the accommodation at Borocourt by four villas, to accommodate another 224 patients.
Considerable attention has been given during the year by the Wiltshire M.D. Committee to the question of providing additional institutional accommodation, and a scheme for increasing the accommodation at the Pewsey Colony by another 200 beds has been adopted. This includes provision for 100 children, for whom hitherto the Colony has been unable to cater.
Wiltshire Mental Deficiency Committee
The Wiltshire Mental Deficiency Acts Committee has issued an interesting 14-page Annual Report of its work during 1935.
An examination of many of the inmates of the County Public Assistance Institutions has revealed the fact that 66 were certifiable under the M.D. Acts. In addition, it was found that amongst the patients in these Institutions certified under the Lunacy Acts, 60 were mental defectives. It is proposed to deal, under the Mental Deficiency Acts, with a few individuals in the first group during the year, but the majority are old and quite contented to remain where they are.
It is interesting to note that of the 76 cases under Guardianship, 54 were placed under the Guardianship of their parents or other relatives. Difficulty continues to be experienced in finding suitable people willing to undertake the Guardianship of defective children.
The Medical Officer refers to the greatly increased number of school children for whom information was sought by the police for the use of the Magistrates?a total during the year of 74. This was supplied from the school medical records in the majority of cases, but in four instances, special mental examinations had to be arranged. It is thought that the large increase is probably due to the Children Act Regulations which require the Local Education Authority to supply the Court with information as to the mental and physical condition of juvenile delinquents, in all except trivial cases brought before them.
Mental Deficiency in Scotland
The 22nd Annual Report of the General Board of Control for Scotland for the year 1935,* contains an interesting section on the Boarding-Out system, as used for both mental patients and mental defectives.
Dr Chapman (at the time of the Report, Deputy Commissioner), writes: I am firmly convinced of the benefits to be derived from the boarding-out system, not only to the patients, but to the general community. It provides useful employment, interest, and a home life for the patient, widens the outlook of those who come in contact with him, and helps to remove that all-too-prevalent opinion of the general public that the only place for the mentally afflicted is the Asylum.”
Of the 4,414 registered mental defectives in the country, there were, on ist January, 1936, 2,974 Certified Institutions, and 1,440 in private dwellings, of whom 493 were boarded out with ” Guardians,” other than parents or relatives.
Some progress is reported to have been made in the provision of institutional accommodation, but it is still very limited and vacancies are infrequent. The Report contains an interesting section on Methods of Treatment of the Insane, with a general description of Mental Hospital life as it is in Scotland to-day.
An Irish Survey of Mental Defectives
The Irish Free State Government is about to make a survey of mental defectives in the country and has appointed Dr Louis S. Clifford, formerly Assistant Medical Officer at the Central Criminal Asylum, Dundrum, to conduct the work.
There is, in Ireland, no Mental Deficiency Act, and the care of defectives has hitherto been left to private charity. The pioneer work of St. Augustine’s Colony, Blackrock, under the auspices of the Brothers of St. John of God, has of late been attracting much attention, and has aroused public interest in the training of defectives; no doubt one outcome of the Survey will be a move to open further Colonies of the kind as a national undertaking.
Lankhills Special School, Winchester
In order to assist Hampshire teachers in dealing with retarded children in their schools, Short Courses have been instituted at the Lankhills Residential Special School, under the auspices of the County Education Committee. Each Course will last a fortnight, and not more than four teachers at a time will be taken.
The Courses will consist of tutorial work conducted by the Head Master Mr. J. Duncan, lecture-demonstrations, periods of observation, and attendance at model lessons, and opportunities will be given for practical teaching experience.
This is the first experiment of its kind, and its progress will be watched by educationalists with sympathetic interest. *Obtainable from : H.M. Stationery ‘Office, Adastral House, Kingsway, W.C.2. Price 1/3.
A Health Hostel
For sufferers from mental or nervous instability in need of an ordered, harmonious environment whilst receiving treatment at an Out-Patient Clinic, there has just been opened in Sydenham, London, a ” Health Hostel,” under the management of Miss E. M. Hankin, whose little book ” Doors of Hope,” was reviewed a few months ago in these pages.
The house which has been acquired for the purpose is conveniently near trams and trains and yet is beautifully situated 300 feet above sea level in a lovely and secluded garden. There are 12 large airy bedrooms, some of which will contain three beds, and 25 people can be taken. The minimum fee will be two guineas a week, and the Hostel is intended primarily for middle-class patients of limited means.
Occupation Therapy will be provided and every effort will be made to keep the patients interested and happy and bring them healing in mind and body. The Hostel is not a Nursing Home and there will be nothing in the nature of hospital regime, but those in charge of it are experienced in dealing with the mentally unstable, and a local medical practitioner has offered his co-operation.
This is a venture of faith which can only succeed if the necessary financial support is forthcoming, and donations will be gratefully received by Miss E. M. Hankin, 153, Sydenham Hill, London, S.E.23, who will also gladly answer enquiries or show the Hostel to interested visitors.
General Hospital Provision for Psychiatric In-Patients The plans for the re-building of St. George’s Hospital (London) include the provision of a psychiatric in-patient department of some 60 beds for men, women and children, to be filled mainly from patients attending psychiatric department for out-patients.
The Lancet, in commenting on this development, draws attention to its value from the point of view of medical education. Through such innovations in general hospital provision:
” the student will be enabled to see, as at present he cannot in hospital practice, how large a part in determining the inefficiency of human beings is played by influences that cannot be classified under any of the recognised organic diseases. The young doctor beginning private practice is generally more puzzled than by any other experience by the fact that many of his patients are suffering from no definite complaint in the cure of which he has been trained. Many of these people are in the early stages of what may become definite neuroses or even psychoses. Others perhaps could be put into no definite category of nervous disease, but are none the less in need of expert help. A department such as that outlined for St. George’s should do much to teach the future practitioner to give it to this large group of patients.”
Up to the present time, only two or three of the General Hospitals in London have been able to make any provision at all for the in-patient treatment of psychiatric cases, and the total number of hospital beds, as far as General Hospitals are concerned, available for Londoners suffering from this type of illness, is so small that it barely touches the fringe of the problem.
Institute of Medical Psychology
In the Report of the Institute of Medical Psychology for 1935, there is a map showing the location of the site on which the Institute hopes in the near future to build a central hospital and educational centre, for which, owing to the ever-increasing demands made on its services, there is urgent need. The plans include the provision of 80 beds for in-patients needing treatment, equipment for laboratory investigation and research, adequate lecture rooms, facilities for occupational therapy, and an increased number of consulting rooms. The new Institute will be in Store Street, Bloomsbury, not far from the present premises, and close to Tottenham Court Road. The first visible nucleus of it will be the In-Patient Hostel, which has to move from Endsleigh Street in T937 The steady increase in the educational activities of the Institute during 1935 led to the creation of a new post?that of Director of Studies?occupied by Dr J. A. Hadfield. The University of London now recognises the Institute as a centre where candidates for the Diploma in Psychological Medicine can obtain their practical experience.
Institute of Child Psychology
The Institute of Child Psychology (26, Warwick Avenue, London, W.9) have embarked on a new venture in the publication of a News Bulletin, which will appear six times a year, price 3d. per copy, or 1/9 per annum. Mental Welfare workers are invited to apply to the Institute for free specimen copies of the first number, which gives information about the work of the Institute and outlines future plans for the Bulletin.
The next number will contain articles on Juvenile Delinquency, by Mrs. Corbett Ashby and Dr Margaret Lowenfeld, Co-Director of the Institute. The Mental Treatment Act in the West Riding
The Clerk of the West Riding of Yorkshire Mental Hospitals Board has supplied us with some interesting information as to the administration of the Mental Treatment in that area.
The Board now has Mental Treatment Clinics conducted by its medical staff, held at general hospitals in Wakefield, Leeds, Doncaster (2), Rotherham, Sheffield (2), Bradford and Huddersfield, which were attended during 1935 by over 2,000 patients, and negotiations are in hand for the establishment of additional clinics in other large centres.
In the Mental Hospitals, rapid strides are being made in the number of patients admitted without certification; thus, e.g., in 1935, 34% of the admissions to Wakefield Mental Hospital, and 28% of the admissions to the Wadsley Mental Hospital, were voluntary.
The Board are fully alive to the value of Social Work in connection with anv adequate Mental Treatment scheme and have established a ” Welfare Centre ” for the purpose. At present there is only one Social Worker whose time is spent chiefly in Mental After-Care, but plans are in hand for an extensive development of this service.
Mental Treatment Clinics
In answer to a question asked in the House during April, Mr. Shakespeare, for the Minister of Health, stated that there were now 143 out-patient clinics associated with public mental hospitals, as far as the latest available information indicated, and that the Board of Control was shortly issuing to local authorities a questionnaire on the subject.
A Study of Nocturnal Enuresis
During 1934, the London Child Guidance Council undertook a research into Nocturnal Enuresis in Children, by means of material obtained from 1,705 case records of six Child Guidance Clinics in the London area. The Research was conducted under the direction of a Committee consisting of Drs. Mildred Crea, R. D. Gillespie, Emmanlel Miller and Wm. Moodie. The following facts and deductions emerged from the enquiry : ? (1) Almost one out of every five children referred to the Clinics suffered from enuresis.
(2) Enuresis is not an entity in itself, but a symptom belonging to several conditions and brought about by varying mechanisms. (3) Amongst the enuretics studies, there was a smaller percentage of mental defectives than amongst! the non-enuretics.
(4) There are two main types of enuretics?the slow and lethargic, and the restless and anxious. (5) Constitutional and psychological factors appear to predominate in producing the condition.
(6) Enuretics show their peak at 8 to 10 years, and then decrease. The Report of the enquiry was first published in the Archives of Disease in Childhood, Vol. 10, No. 57, June, 1935.
Two New Pamphlets on Mental Deficiency Work
A useful 16-page pamphlet entitled Some Notes on Mental Deficiency Practice has been written by Dr Samuel E. Gill, Medical Director of The Guardianship Society, Brighton.
The publication of the pamphlet
has resulted from the discovery by Dr Gill of the difficulty found by medical men who attend patients for the Guardianship Society, in assessing mental capacity for the purposes of making Special Reports and Certificates under the M.D. Acts. With this particular need in view, Dr Gill therefore compiled these valuable notes on the nature of Mental Deficiency, and the type of questions and simple testing which best reveal mental capacity.
The pamphlet, price 1 /-, can be obtained from the Guardianship Society, 8, Grand Parade, Brighton, and we warmly commend it as a useful guide to put into the hands of students and voluntary workers visiting defectives. The C.A.M.W. has recently issued a small pamphlet on Defectives and the Mental Deficiency Acts, giving the main features of the Acts and their administration. Copies can be obtained from the C.A.M.W., 24, Buckingham Palace Road, S.W.i, price 2d. each, post free, or lod. a dozen.
Research into Human Heredity
We are asked to make the following announcement’.? The British National Human Heredity Committee was formed in 1932 for the collection of data and the investigation of human pedigrees, as a branch of the International Human Heredity Committee, founded by the International Federation of Eugenic Organisations. It has now been enlarged as a Council and secured accommodation at 115, Gower Street, London, W.C.I; and in collaboration with the Galton Laboratory, aims at setting up a Clearing House for material on Human Genetics. The Council consists of a number of geneticists and leading medical men, with Professor Ruggles Gates as Chairman, Sir Laurence Halsey as Treasurer, Dr Fraser Roberts as Honorary Scientific Secretary, and Mrs. C. B. S. Hodson as Honorary General Secretary. The direction of the work is to be in the hands of a small Executive Committee. The Council would be grateful to receive all available material from institutions and individuals, furnishing well authenticated data on the transmission of human traits, whatever these may be. Family histories or pedigrees, twin studies and statistical researches are mainly contemplated. As research workers and others who send in material may in some cases wish to retain the sole right of publication or copyright, those who so desire are asked to accompany their material with a statement to that effect.
Reprints of published work would also be most acceptable. Many authors, when publishing material, may also have collected a number of pedigrees which they have been unable to reproduce in detail. It is the object of the Council that such records, by being included in the Clearing House, should not be lost. Those wishing a copy of the standard International Pedigree Symbols may obtain one from the office.
Material should be accompanied by all available details in regard to source, diagnostic symptoms, and the name and address of the person or persons who vouch for accuracy. All such details will be regarded as strictly confidential. The other objects contemplated in this enterprise, namely, facilities for study, replies to enquiries, and information service, cannot be initiated for some time. Announcement of these activities will be made later.
National Union of Townswomen’s Guilds
At this year’s Annual Conference of the National Union of Townswomen’s Guilds, the following Resolution on Mentally Defective Children was passed: ? ” That Guilds should be asked to study the Board of Education Reports, 1932, 1933, 1934, and the London County Council Reports, 1931, 1932, 1933, from which it appears there is a steady closure of Schools, especially those for mentally defective children, with a view to ascertaining if proper provision is being made for children suffering from various defects.
Guilds should be asked to consider whether a change of law would be desirable, on the lines of the recommendations of the Mental Deficiency Committee, which would ensure mentally defective children being sent to the appropriate schools without being certified as mentally deficient, threby being relieved of the stigma that may now attach to such pupils through life.”
9o MENTAL WELFARE Dr Hamblin Smith The death of Dr Hamblin Smith last April has deprived the C.A.M.W. of yet another of its friends.
To quote from the obituary notice published by The Lancet, ” he made such use of his opportunity for studying both mental defect and mental disorder, that scarcely a case of either passed through the Birmingham courts without being recognised by him,” and as Medical Officer of Birmingham Prison and author of ” The Psychology of the Criminal,” he was widely known and respected amongst mental welfare workers.
After his retirement from the prison medical service, he continued to lecture at Birmingham University and Bethlem Hospital on the psychology of the criminal, and he was Hon. Physician to the Education Clinic at Oxford, where he lived during the last three years of his life.
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