The C.A.M.W.’s Holiday Homes
An S.O.S.
The C.A.M.W. has recently issued an appeal for the sum of 250 to enable them to proceed with the furnishing and equipment of a fourth Holiday Home in the South Westto meet the needs of that district and of South Wales.
The matter is urgent. The starting of each such Home involves an initial outlay of 500 for furnishing, equipment and structural alterations, and towards this new project, a generous friend has promised ?250 on condition that the remaining ?250 can be raised from other sources in a limited time. About three years ago the Association was fortunate enough to receive two or three legacies, and amassed a Special Fund of about ?800, but the whole of that fund has been spent on the three homes that have already been opened, and the general fund has had to subsidise the equipment fund heavily. Running expenses are met by the fee paid each week for the patients by the responsible Authorities, but this leaves no margin when rent, rates, salaries, food, etc., have been paid for. towards repayment of capital expenditure.
The Board of Control has paid a generous tribute to the Value of the work of the Homes, and is anxious to see their number increased as soon as possible. Contributions will be gratefully received by : The Chairman, Holiday Homes Committee C.A.M.W., 24 Buckingham Palace Road, S.W.I.*
Developments in Occupation Centres and Home Teaching Staffordshire At the end of April, Sir Laurence Brock, C.B., Chairman of the Board of Control, opened, at Newcastle-under-Lyme, the new Occupation Centre premises which will accommodate 60 children from the surrounding areas.
The building?which is the first of its kind to be erected expressly for use as a Centre?contains two class rooms and a central hall, a dining hall and kitchen, staff room, cloakrooms and a bathroom. Its total cost?met by the Staffordshire County Council?is estimated at above ?5,500 exclusive of land but inclusive of furniture and equipment.
The Staffordshire Association for Mental Welfare now administers for the County Council, eight whole-time and two part-time Centres and two Home Teaching Schemes, of which an interesting account was published in the Association’s Eighteenth Annual Report, recently issued.
Leeds ——The Annual Report of the Leeds Voluntary Mental Care Committee announces the adoption of a scheme for building a new Occupation Centre at a cost of ?10,000, to accommodate 150 children. The City Council is seeking borrowing powers to meet the cost of building and the Voluntary Committee will be responsible for payment of loan charges by way of annual rent.
Cambridgeshire ————-The Occupation Centre for which the Cambridgeshire Mental Welfare Association have been responsible for over eight years, has recently moved into * In our October number we hope to publish an article on the experience gained by the C.A.M.W. during the six years since its first experiment in providing holiday accommodation for defectives was initiated.
larger premises at Fitzroy Hall, Wellington Street, Cambridge, and opened on a whole-time basis.
In addition to a large hall and a well equipped kitchen, the premises include a small hut used by the children under 16 half as a storeroom for toys and apparatus, hats and coats and the other half for washing, etc. The large playground is surrounded by flowering trees and shrubs with possibilities for vegetable and flower cultivation, and there are two sandpits for the use of the children. Provision is made for the training of the older girls in domestic science and every day they help the cook in the preparation of the mid-day meal, etc. They are also taught to be responsible for the cleanliness of the children’s hut and to help generally in their care.
There are at present twenty-six defectives on the register, of whom fifteen are over the age of sixteen, four of these only attending part-time, as they are in employment.
In addition to the Centre, the Association is responsible for a Home Training scheme and seventeen defectives living in the country districts of the county are being taught regularly.
Hastings ——The Supervisor of the Hastings Occupation Centre teaches weekly in their own homes, seven defectives who for one reason or another are unable to attend the Centre, or who are too low grade to be suitably trained there. This work is recorded in the Association’s Annual Report to be gradually increasing and to be much appreciated by both children and parents.
Buckinghamshire ————–The progress of Home Teaching is also referred to in the Report of the Buckinghamshire Mental Welfare Association. There is no Occupation Centre in this area, and no Home Teacher specially appointed for the purpose, but use is made of the services of individual voluntary workers, and?in certain of the villages of junior members of the staff of the local elementary school who are glad to undertake the work out of school hours for a small per capita fee, and whose training and knowledge of children are of special value in the work.
Wiltshire ———During the latter part of the year covered by its new Annual Report, the Wiltshire Voluntary Association for Mental Welfare initiated, as an experiment, a part-time Home Training Scheme in the Trowbridge area.
Nine defectives, unable to attend the Occupation Centre, have, since November 1937, been visited by the Supervisor once a fortnight and given suitable training in simple handcrafts. These visits are eagerly looked forward to and the full co-operation of the parents has been obtained.
Yorkshire Association for Mental Welfare —————————————We regret to record that on 30th June, 1938, the Yorkshire Association, whose services have for many years been used by the Local Authorities for York City and for the North and East Riding, came to an end.
The Secretary, Miss Davies, has been appointed as the Executive Officer of the North Riding Mental Deficiency Committee, and an officer is to be appointed jointly by the Mental Deficiency Committees of York City and the East Riding.
Essex Voluntary Association —————————On April 1st, the Essex Voluntary Association for Mental Welfare was taken over by the Essex County Council and the Association’s staff is now employed directly by the Council, organised as a separate department. Provision has been made for the safeguarding of the voluntary work hitherto carried out by the Association, and for this the Council have assumed full responsibility. Jt is thus confidently anticipated that nothing of the ” voluntary spirit ” will be lost under the new regime and that grateful use will continue to be made of the Association’s local visitors whose number amounts to nearly 400.
Mental Deficiency in Scotland —————————-In the Twenty-Fourth Annual Report of the General Board of Control for Scotland, attention is drawn to the continued insufficiency of institutional accommodation for defectives, and to the desirability of Local Authorities grouping themselves together for the purposes of providing accommodation.
The urgent need for the development of Occupation Centres for defectives living in their own homes is stressed, and it is recorded with regret that under the Mental Deficiency and Lunacy (Scotland) Act of 1913, Local Authorities ” are not sufficiently empowered to set up Day Occupation and Training Centres,* and in only some areas are these provided by voluntary bodies.
Of the 4,982 cases known to the Board on 1st January, 1938, there were in Certified Institutions, 3,454, and in their own homes or with unrelated Guardians, 1,528. These latter cases, together with the 1,144 registered insane patients cared for in ” Private Dwellings ” are under the direct supervision of the Board and interesting extracts from the reports of the visiting Medical Officers are given. Dr Laura Mill referring to the Study Tour arranged by the Royal Medico-Psychological Association in the summer of 1937, for the purpose of studying the Scottish boarding-out system writes of their visit to the East Inverness, Moray and Nairn area :?
“The members of the Tour were greatly struck by the natural dignity and composure of many of the guardians. It is a fact that the innate courtesy and delicacy of feeling which characterise many of the people native to this area, together witli their sterling qualities make them eminently good and kindly guardians.”
In another report a medical officer (Dr J. M’Lauchlan Johnston) writes :? ” Of all placements, the most satisfactory is generally agreed to be that in a rural district. In the family circle of the guardian the patient is introduced to an environment where life is resolved to its most simple and natural factors. This is the whole basis of the scheme for the rehabilitation of the class of patient described. One cannot over-emphasise this aspect of its therapeutic value, it has so often been demonstrated in the past; it is a process of re-education in a simplified world. The patient now enjoys a measure of freedom and privacy; life is no longer regimented in the mass, his identity is no longer submerged, he can give freer rein to his individuality and personality; more attention can be given to his personal wishes; no great exception will be taken to his foibles; relations with his fellows are not exacting; fewer and less pressing demands are made for adaptation; and provided his behaviour is not offensive, degraded or violent, he will become an acceptable member of the household.” * “Statutory Supervision” is not included in the Act; defectives can only be sent to Certified Institutions or be placed under Guardianship.
The initiation of a system by which records of all defectives leaving Special Schools or Classes may be in the possession of the Board, is foreshadowed in this Report. At present, adequate information as to the early life and school history of defectives ascertained after adolescence is frequently not available, and there is no system by which records in the hands of Education Authorities are made readily accessible to the Board, although such early histories are of the utmost yalue to Medical Superintendents of Certified Institutions, as well as to the Courts and to Local Authorities.
Licence for Mental Defectives. New Circular ——————————————The Board of Control have issued a Circular (No. 850) on ” Licence for Mental Defectives,” announcing that they have decided that in future, cases of defectives who are still on licence at the end of a second year after leaving an Institution should be reviewed by the Board at that period and, if necessary, again at such further periods as they may determine. Where there is sufficient evidence that the defective can live outside an Institution without further supervision, the Order will be discharged by the Board. In other cases, the relative advantages will be considered of transfer to guardianship or of prolonged licence.
The Board remind Local Authorities of the Circular on the same subject issued in 1937 which pointed out the need for the careful supervision of cases on licence and where necessary the provision of training and occupation. , Finally, attention is drawn to the need for the judicious handling of cases in which defectives break the terms of their licence by ” absenting themselves from the care of the person in whose charge they have been placed.” Although it is necessary to take steps to trace the defective, the Board point out that ” there is no necessity to assume as some Local Authorities apparently do, that is it imperative to regard him as an escaped patient liable to recapture in the manner foreshadowed by Section 42 of the Mental Deficiency Act 1913.” Enforced return to the Institution may be necessary, but on the other hand, in spite of what has happened, the needs of the case may best be served by continuing the licence under altered conditions. In any event, it is urged that if the aid of the police has to be sought, ” every effort should, if possible, be made to avoid any procedure which may give the impression that the patient is being arrested.”
British Medical Association and Mental Health ———————————————The Council of the British Medical Association have appointed a special committee to study the problems of mental health, including the amount of industrial disability due to mental illness and the need for the extension and improvement of institutional facilities.
The question of prevention, and of the part played in it by the general practitioner, hospitals, clinics under the Mental Treatment Act, Child Guidance Clinics, etc., will also be considered together with the degree of success that can be attained with present methods of treatment, the type of staff required and the training of medical students in psychological medicine.
The following are the members of the Committee :?Sir Robert Johnstone (President), Sir Kaye Le Fleming (Chairman of Council), Dr H. Guy Dain (Chairman of Representative Body), Mr. N. Bishop Harman (Treasurer), Sir Henry Brackenbury, Dr J. A. Brown, Professor Millais Culpin, Dr R. G. Gordon, Sir Walter Langdon-Brown, Dr Mary C. Luff, Professor E. Mapother, Dr Doris M. Odium, Dr A. A. W. Petrie, Dr J. R. Rees, Dr Benjamin Reid, Dr D. Stewart, and Dr R. M. Stewart.
Mental Deficiency Bill ——————–Readers of Mental Welfare will, no doubt, have noted in the press the law proceedings in the case of a defective who claimed, in an action before the High Courts,* that he had been ” unlawfully restrained” under the Mental Deficiency Act by reason of the fact that although the Continuing Order detaining him had lapsed on June 23rd, 1931, that a fresh continuing order had not been made until June 29th. The contention made on his behalf was that this second Order was not valid, by reason of the interval that had elapsed, and that therefore during the subsequent five year period his detention had been illegal. The Board of Control claimed that although an Order made under Section II of the Mental Deficiency Act expires at the end of one year and the consideration of the special reports and certificates must be completed by that period, some delay in the final sealing and issuing of the continuing order was?if unavoidable?permissible. This view was upheld by a Divisional Court of the High Court, but on the case being carried further to the Court of Appeal, it was reversed and the claimant won his point.
This decision has necessitated the regularisation of the position by legislation, and a Mental Deficiency Bill, introduced by the Minister of Health, was given its Second Reading on May 30th; the Bill has now passed through all its stages in the Commons and is going through the House of Lords.
The Bill merely provides that Continuing Orders are valid if made within a period of thirteen months after the issuing of the original Order, thus giving the Board an additional month in which to review the case and complete the preparation of the Certificate, etc. The measure in itself would seem to be quite uncontroversial, but nevertheless a brisk little Debate on the Second Reading took place, and some determined opposition to it was voiced on the part of certain members who took the view that it was encroaching on the liberty of the subject by giving the Board further powers of detention.
Progress in Mental Hospital Provision ————————————During the last few weeks, Admission Villas have been opened in connection with two Mental Hospitals.
The new section of the Brighton County Borough Mental Hospital at Haywards Heath?which, to distinguish it from the main building, is to be known as Hurstwood Park Hospital?will provide for 50 patients. Every patient on admission will be placed there, and cases likely to make an early recovery will remain there until discharge. The Hospital is equipped with an operating theatre, etc., a dental surgery and the most up-to-date forms of hydro-therapy, including needle, spray and continuous flow baths.
At the Kent County Mental Hospital, Barming Heath, Maidstone, a new Admission Hospital is providing 125 beds with special facilities for every type of modern treatment.
Another area in which substantial progress is reported is the County Borough of Ipswich where extensive additions have been made to the Mental Hospital. As a first step in the scheme for isolated blocks for convalescent patients, a villa for 40 female patients has recently been completed. In all these new buildings, special attention has been paid to aesthetic considerations, and a distinguishing mark of them all is the general effect of lightness and brightness which has been successfully given.
Rex v. Board of Control Lunacy and Mental Deficiency for England and Wales, ex parte
Winterflood. 8th April, 1938.
North Eastern Council for Mental Welfare —————————————The Second Annual Report of the North Eastern Council for Mental Welfare (22 Ellison Place, Newcastle-on-Tyne), gives an interesting account of the work of placing out defectives from Institutions, on Licence or under Guardianship, embodying the Secretary’s experience of the ” snags ” to be avoided and the successes that may be achieved. 50 patients have been placed, the majority of them on farms in the country districts of Ripon, Northallerton and Whitby, and some idea of the amount of work involved in these transactions may be gauged by the fact that in connection with them it has been necessary to pay over 700 visits, to give over 500 interviews, and to cover over 25,000 miles by car. In addition to this work, the Council provides Psychiatric Social Service for the Newcastle City and the Gateshead Mental Hospitals.
Three new Authorities joined the Scheme during 1937, and the followingare now participating in it : Durham County Council, and the County Borough Councils of Gateshead, Middlesborough, Newcastle-on-Tyne, South Shields, Sunderland, Tynemouth and West Hartlepool. The C.A.M.W. has continued to contribute towards the expenses of administration.
Child Guidance Council. Report for 1937 There have been considerable changes in the officers and staff of the Child Guidance Council, recorded in the Report for 1937 recently issued. The Rt. Hon. Lord Alness, P.C., has become the Council’s Chairman, and a new Constitution has brought on to the Executive Committee representatives of the staffs of clinics and of public bodies connected with the work. Dr D. R. MacCalman, formerly Medical Director, left the Council early in 1938 to take up an appointment as lecturer in Psycho-pathology at Aberdeen University and his place was taken by Dr R. G. Gordon. The resignations of both the Secretary (Miss Robinson) and the Organiser (Miss Townsend) have resulted in the two new appointments of Miss I. G. Goddard, and Miss E. F. Turner.
Child Guidance Clinics and Local Education Authorities —————————————————-In a Foreword to the Report, there is an interesting reference to the growing interest taken in Child Guidance Clinics by Local Education Authorities, and a list of Clinics given in the Report shows that out of a total of 37 in England and Wales, 12 are wholly and 7 partially maintained by such Authorities. In an Appendix to the Report there is a note illustrating from an actual example the processes which may lead to the gradual transference of a Clinic from a Voluntary body to an Education Authority with a corresponding increase in the services it can provide.
The Report again emphasises the need for regarding a Child Guidance Clinic not as a ” foreign body within the social services of the community ” but as ” an integral part of the ordinary medical and educational services.”
Only two new Clinics were opened in England during 1937, but the opening of nine others is foreshadowed, which raises, it is pointed out, the problem of how to secure the necessary number of experts which will be required. Up to the present time, the Council has financed three Fellowships in Psychiatry and three in Psychology held at the London Child Guidance Clinic, but clearly this will not meet future demands, and it is suggested that one way of solving the difficulty might be if authorities proposing to set up a clinic would arrange to ” second ” members of their staffs with sufficient general psychological experience, for the purpose of taking a course of special training at a well-organised Clinic. The Tavistock Clinic (Institute of Medical Psychology)
The Report of the Tavistock Clinic (Institute of Medical Psychology) for 1937, records a total of 1,133 new patients (of which 341 were children) treated during the year, a steady increase in the number of students attending its Courses for Medical Practitioners and others, and the carrying on of research work under grants from the Sir Halley Stewart Trust and the Rockefeller Foundation in several different directions. Two lines of research are particularly noted in the Report?viz., that into the relationship of physical and emotional states with special reference to peptic ulcer, hay fever, heart pain and ulcerative colitis; secondly, a follow-up of 53 adult patients discharged between 1921 and 1927 (showing that out of 53 such patients, 30 have remained well as a result of the treatment received), and of 500 patients treated in the Children’s Department between 1921 and 1934 (of whom approximately 70 per cent, were reported to be in a satisfactory condition).
Unfortunately, however, the financial position of the Clinic continues to be critical, and there is a Waiting List of 500 patients accepted for treatment. The site purchased for the projected Hospital and Institute has been retained but it has not been possible to take any step towards building and unless further financial support is forthcoming, the abandonment of the whole scheme is threatened. The continuance of the work on its present basis alone, without any new developments, was only made possible by some special donations and by the ” extremely generous offer of the medical staff and some of the social workers to forego their honoraria.” A further difficulty which has confronted the Council during the year has been the enforced closing down of the In-Patients’ Hostel in Endsleigh Street, due to the need for extensive structural repairs. Lack of funds have prevented the acquiring of other premises, despite the urgent need for them as shown by the fact that at the time of closing down, there was a waiting list for accommodation containing 26 names.
Royal Western Counties Institution ———————————-The Langdon Extension of this Institution, waa formally opened by Sir Laurence Brock, Chairman of the Board of Control, on May 18th. As a result of this scheme?in which the County Councils of Devon, Somerset, Dorset and Cornwall, and the County Borough Councils of Exeter and Plymouth are participating?the Institution will ultimately be able to provide for an additional 1,000 patients and accommodation for 342 in the 6 villas at present completed is now available.
The Extension is situated on the main road between Starcross and Dawlish, nearly 2 miles from the Central Institution at Starcross.
Great Barr Colony Extension ————————–On May 5th, 1938, the Rt. Hon. The Earl of Harrowby, Lord Lieutenant of Staffordshire, opened a new extension of this rapidly growing Colony. The new buildings include 10 Homes, each for 60 male patients; a Home for 40 male patients; workshops for men; an extension to the School by the addition of 6 classrooms; and an extension to the Nurses’ Home.
It is interesting to know that a considerable amount of the building work has been carried out by the patients themselves under the direction of the Colony’s Clerk of the Works. A great interest has been taken by them in this activity which has been carried out cheerfully and willingly.
A Home for Epileptics in Eire —————————-Eire will have its first specialised institution for epileptics, when the Oliver Plunket Epileptic Colony for 50 normal epileptic youths under the auspices of the Brothers of St. John of God, is opened next month.
The Colony has over one hundred acres of land, and farming and gardening will be the principal occupations, together with carpentry, tailoring and bootrepairing.
It will be remembered that the same Brothers are already responsible for a Colony for Mental Defectives at Blackrock, County Dublin, and it is good news to hear that accommodation for an additional 200 patients there is being planned. Staffordshire ” Study Week “
A Study Week has been arranged by the Staffordshire Association for Mental Welfare for those engaged in the teaching of mental defectives in Institutions. Occupation centres, Special Schools and Classes for backward children. The Course will be held from Monday, October 3rd, to Friday, October 7th, inclusive.
The Course will include lectures on the medical aspect of mental deficiency, the functions of the social worker and demonstrations and practical work in physical education. There will be practical classes in handwork and needlework and a special demonstration showing the use of graded apparatus and opportunities for discussion in study groups.
Those interested can obtain full information from : The Organiser of Centres.
Crabbery Chambers, Crabbery Street, Stafford. ———————————————Alderman Joseph Crookes Grime, O.B.E., LL.D., J.P. We regret to record the death of Alderman Joseph Crookes Grime, Lord Mayor of Manchester, which took place suddenly on June 29th, ten days after Manchester University had conferred upon him, as Centenary Lord Mayor, the honorary degree of Doctor of Laws.
For many years, Alderman Grime has served on the Executive Council of the C.A.M.W., as the representative of the Mental Hospitals Association. His was a familiar figure at its meetings, which he rarely missed and he took an active part in the Council’s deliberations. At the time of his death he was Chairman of the Lancashire Mental Hospitals Board and Chairman also of the South East Lancashire Association for Mental Welfare, an office he had held since the formation of the Association in 1920 for (to quote from the Manchester Guardian) ” his interest in mental welfare went back to a period when that subject, now widely recognised as one of prime importance, was much more generally neglected by the public than it is to-day.”
Tributes in the same paper refer to Alderman Grime’s long years of civic service culminating in his arduous labours as Lord Mayor carried out with unfailing courage despite serious ill-health, during a period when the City’s Centenary Celebrations made the burden of office an exceptionally heavy one.
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