A Conference on After-Care
Under the auspices of the London Association of Voluntary School Care Committee Workers in consultation with the Charity Organisation Society, a Conference was held in The Drapers’ Hall, London, on 17th February, 1938, on the subject of ” The After-Care of Children brought up in Hospitals, Schools or Voluntary Homes.”
Miss Evelyn Fox, C.B.E., opened the discussion on the ” Readjustment to life in ordinary society of children who have spent some time in residential schools for Mentally Defective children,” in connection with which she had collected material of considerable interest and value from Head Teachers of Residential Special Schools who had kindly replied to a Questionnaire sent them by her.*
The Residential Schools, Miss Fox pointed out, had many difficulties to contend with; for the most part, it was the unstable higher-grade defective child who was now sent to them, and very often they received children from a number of areas making any uniform system of ” After-Care ” impossible to provide. Nevertheless the results achieved were extraordinarily good. In one school, e.g., as many as 74 out of 100 of boys and girls leaving during the last six years, were now wholly or partially self-supporting; in another, out of 300 leavers (girls) in 7 years, 60 were in employment of some kind.
All the Head Teachers consulted had agreed that with a view to helping the children subsequently to readjust to ordinary life in the community, it was essential that the atmosphere of the school must approximate as closely as possible to that of the outside world, and that ample opportunities of mixing with others, handling money, rightly using leisure time, etc., should be provided, but the difference in opinion with regard to the value of Vocational Training during the last years of school life, pointed to the need for some definite research work on the subject.
Miss Fox urged the need for a closer liaison between the schools and the After-Care Committee workers?or with other social workers whose services could be enlisted for the purpose?-which was essential if After-Care was to be carried out with the fullest possible efficiency. Particularly important was it that the social worker should make a point of learning something about the character and attainments of the child whilst at school, about his special difficulties and the methods which had been used in solving them. She should also seek to gain some real knowledge of the home conditions to which he has returned?not the material conditions only but the psychological background and atmosphere. In addition to this, she should be acquainted with the facilities for employment offered by the district and its suitability for particular types of defectives.
” After-Care,” she suggested, was not a happy term. It was too specialised and not enough related to work for defectives in the community as a whole. ” Community Care ” seemed to her a much better term for the purpose carrying with it, as it did, the idea of co-operation and co-ordination. The whole subject under discussion was of growing importance in that as a result of the tendency to send to Special Residential Schools, children of a higher grade than formerly, an increasing number of such children would on leaving, have to find their places in the world outside, rather than be sent on to Certified Institutions for further care.
We hope to refer to these replies at greater length in a later issue.
Miss Whetnall, Social Worker, Lilian Greg Committee (working for exSpecial School boys and girls in Islington, London), emphasised the importance of the After-Care Worker being easily accessible to the cases for whom she was responsible, as they needed continual guidance in their affairs and would only apply for it if it could be had at any time by personal interview. She had found that the girls who married, particularly needed such help, so difficult was it for them to cope with the added responsibilities they had undertaken.
Refresher Course for Secretaries and Visiting Staffs of Voluntary Associations The Refresher Course arranged by the C.A.M.W. for four days at the end of March, was attended by 30 students from various parts of the country. The Lectures were as follows :?” The Leicester Experimental School ” by Mr. R. W. Dewhirst, Headmaster; “The Joint Register of Foster Homes and Schools for Nervous, Difficult and Retarded Children ” by Miss M. E. Cullen, Organiser, C.A.M.W.; ” The Place of the Observation Ward in the Care of the Mental Patient ” by Dr Letitia Fairfield, L.C.C. General Hospitals Department ; ” Social Work in Connection with Mental Hospitals ” by Miss E. F. Turner, Assistant Secretary, Child Guidance Council; ” The Work of the Educational Psychologist ” by Miss L. G. Fildes, Chief Psychologist, London Child Guidance Clinic; “The Work of the Children’s Courts” by Mr. Basil Henriques, J.P., President, Toynbee Hall Children’s Court; “Approved Schools” by Dr A. H. Norris, Chief Inspector of Approved Schools, Home Office; “The Woik of the Unemployment Assistance Board ” by Mr. J. H. Wright, District Officer of the Board; ” The Community Care of Epileptics ” by Dr Ralph Crowley.
All these lectures were received with keen interest and the C.A.M.W. greatly appreciates the co-operation of the outside lecturers who so readily gave their services. Mr. Basil Henriques delighted his audience with an account of personal experiences in the Children’s Court, revealing such a rare understanding of the young delinquent, such a deep compassion for the sufferings of wronged and unhappy childhood, and such a profound faith in spiritual values that no one could hear him without being refreshened and inspired. Of special value also (owing to the newness of the subject) was the instructive address given by Mr. Wright, who stressed the desire of the Unemployment Assistance Board to co-operate with other social workers and invited the help of Mental Welfare Associations in dealing with sub-normal cases.
In addition to the lecturers, there was a Case Conference arranged by Dr. Wm. Moodie of the London Child Guidance Clinic, and each student took part in one of four visits, viz., to the Girls’ Borstal Institution, Aylesbury (by kind permission of the Home Office), to West Park L.C.C. Mental Hospital, to the Ellen Terry Home, Reigate, or to the Edmonton Occupation Centre for a special display of physical work.
Northumberland’s New Colony
The Northumberland County Council’s new Colony for mental defectives? St. Andrew’s, Morpeth?was opened at the end of February, by Alderman McHugh, Chairman of the County Mental Deficiency Committee.
Ultimately the Colony will provide for 1,000 patients, and the scheme includes four children’s houses and a school. In this initial stage, 300 patients can be accommodated,
Jerusalem Home for Mentally Defective Children
An account has reached us of the progress of a gallant pioneer enterprise to help Jewish mentally defective children in Jerusalem, which has been initiated and carried on since 1933 by Miss Irene Gaster (whom we are proud to claim as a former member of the C.A.M.W.’s Occupation Centre staff).
Miss Gaster, on settling down in Jerusalem, quickly perceived the need for something to be done for these children, and thereupon took two of them to share the room she occupied on the outskirts of the town. With another two children she then moved into a larger apartment of three rooms, and when the numbers continued to grow she took the house in Abyssinian Street, Jerusalem, which she now occupies. For the care of 43 defectives she has the help of three young and untrained girls only, so that she still does the greater part of the work herself, and at night is in sole charge.
Applications for the admission of defectives are received direct from parents, from strangers who bring in children from the streets, and from various organisations all over Palestine. A third of the cases are helpless low-grades, but the others?despite a lack of facilities which would daunt all but the stoutest-hearted ?have been successfully trained in habits of cleanliness and self-help and in mutual consideration, one for the other.
Parents and organisations are asked to pay ?2 10s. a month for each child cared for in the Home, but many pay less than this and some do not pay at all. In order to help in the development of the work, and make it possible for new premises and equipment to be acquired, and trained staff to be engaged, a Committee has been formed in Palestine, consisting of Miss Henrietta Szold. Dr Halperin (Strauss Centre), Dr Herman (Consulting Physician to the Mental Hospital, Jerusalem), Dr Bruno Grunfelder (Child Specialist to the Hadas sah) and Mrs. Levin-Epstein. At the same time a Committee representative of members of the Jewish Community in England has been formed?with Viscountess Samuel as Hon. President?whose aim it is to raise sufficient funds to help to equip the Home and to put it on a sound financial basis.
To those who realise what the task of training low-grade defectives involves? even under the best conditions?this valiant piece of work will make a special appeal and we feel sure that our readers will wish to send, through the pages of ” Mental Welfare,” their good wishes for its success and an assurance of their high appreciation of Miss Gaster’s devoted and courageous service.
Institute of Child Psychology
The Institute of Child Psychology, formerly at 26 Warwick Avenue, Maida Vale (London), has moved to new and attractive premises at 6 Pembridge Villas, Notting Hill Gate.
The Play Therapy rooms will continue to be the centre of the Institute’s activities, and much thought has been given to their decoration and equipment. They include a ” Water Room ” and a ” Mess Room ” (for modelling in wet sand) with impermeable floors and waterproof walls and ceilings (in connection with which it may be noted, the Institute’s ” News Bulletin ” appeals for twenty mackintoshes and pairs of gum boots to renew the present supply). In the Music and Rhythm Rooms, there is ample space for physical re-education of every type. The new premises have been given by a generous donor, but the Institute is looking to its friends for help in regard to furnishing.
Oldham Council for Mental Health
From a copy of the Annual Report of this Council kindly supplied to us by its Hon. Secretary, Miss Elizabeth Martland, we take the following extracts to which zee call attention in the hope that they may help to stimulate the initiation of similar pioneering enterprise in other areas. ” As in previous years, educational work formed a large part of the Council’s activities during the year 1937.”
” A most auspicious introduction was afforded by Professor J. F. Duff, M.A., M.Ed., Professor of Education in the University of Manchester, who gave an address on ” Difficult Children ” at the Annual Meeting in January. Another outcome of the Annual Meeting was a series of Talks upon the same subject, broadcast at the Council’s request from the Northern Station of the B.B.C., as the result of a suggestion made by an unknown member of the audience.” ” The outstanding feature of the early spring was a Course of four Lectures arranged with the assistance of the National Council for Mental Hygiene, with which we are affiliated. The first of these, entitled ” Mental Life and the Community,” was delivered by Dr Murdo Mackenzie, a distinguished specialist in psychological medicine working in London. This was followed by a more detailed paper by Dr Larkin of the West Ham Mental Hospital upon “Mental Disease and Mental Defect.” The third Lecture, by Dr MacCalman 011 ” Child Guidance,” was of special interest to parents and teachers, and to magistrates concerned with juvenile delinquency. In the fourth Lecture, Dr J. Burnett Rae, taking as his subject ” Functional Nervous Disorder,” ranged over a wide field in psychology, ethics and religion, to the delight and edification of those who had struggled through a blizzard to hear him.”
Hardly less valuable to us were three Lecture-Discussions of a more informal kind given at the Town Hall last October, November and December. Dr Mary Cardwell opened the series with a most practical and stimulating Talk on “The Psychology of Infancy”; Mr. Reginald Edwards followed with a learned and well-reasoned paper 011 “The Psychology of the Child of School Age”; and Dr. Winifred Burbury, who was recently appointed psychological expert to the Manchester Education Authority, wound up with an extremely able Address on ” Some Aspects of Adult Psychology.” The fact that the Manchester City Council has taken this step of appointing a psychological specialist for the treatment of its children is one of the most encouraging events of the year, which is bound to have repercussions, and has already justified itself.”
” It would appear that some kind of centre or clearing-house is called for in Oldham, to which people in need of such advice could apply. Many of the teachers are aware of a similar need in dealing with children whose behaviour or mental health shows signs of abnormality. Many parents are commenting upon this gap in our medical and social services. Those most concerned are now giving earnest attention to these matters, and progress may be looked for in the near future.” ” In the course of the year, close contact was maintained with the Oldham representatives upon the Lancashire Mental Hospitals Board, the members of the Public Assistance Committee who administer and visit the mental wards of our Institution, and our Members of Parliament, who are deeply concerned in our problems from a national as well as a local point of view. Dr J. Chalmers Keddie, our Medical Officer of Health, very kindly invited us to send him an account of our work to incorporate with his official report upon the health of the Borough, recognition which we deeply appreciate.”
Psychotherapy in Prison
In the Report of the Commissioners of Prisons for 1936,* just published, the Medical Commissioner, Ur. Norwood East, discusses the question of the psychological treatment of crime, its value, its limitations and its abuse. The four year programme established at Wormwood Scrubbs Prison in 1934 under the direction of Dr W. H. de B. Hubert is not yet completed, but meanwhile enough experience has been gained to justify certain tentative conclusions. Dr East refers to the mental classification of criminals suggested in his last report, viz. : the normal, subnormal, mentally defective, mentally inefficient, psychoneurotic and psychotic. Dealing with the first group he says : ? ” The more one studies human behaviour, especially perhaps criminal behaviour, the more difficult does it become to determine normality, and the more probable does it seem to be that there is no such person as a normal man. There can be no doubt that a tendency to break the law and acquiesct in certain forms of crime is more common than has sometimes been supposed and for practical purposes it is convenient to consider the normal man who commits crime as one whose offence cannot be attributed to pathological causes. Judged by this standard the number of law-breakers who fall into the normal group is very considerable. Clearly they are unsuitable for psychological treatment.”
In the Subnormal group he includes criminals of inferior intelligence not amounting to mental defect, and also those whom he terms the ” constitutional psychic inferiority sub-group which from the point of view of recividism is of great importance. These individuals are of two types?the non-aggressive and the aggressive, the distinguishing feature in both cases being the likelihood of their returning to prison. Neither of these types are likely to respond to psychological treatment, the former because their faults are too negative, the latter because they are too positive.
The two groups in which psychological investigation and treatment appears (in selected cases) to have the best chance of success are, Dr East considers, the mentally inefficient (e.g., unstable adolescents, temperamentally unstable adults, the psychologically maladjusted, and the psychopaths including alcoholists drug addicts and sexual perverts), and the psychoneurotic group including individuals suffering from neurasthenia, hysteria, anxiety, and compulsive-obsessive states resulting in recidivism or isolated crimes.
Dr East sums up his discussion as follows :? “… the psychological treatment of crime is not to be recommended lightly or pursued without discrimination. If good may follow its application in some cases, harm may follow it in others.The suitability or otherwise of this form of treatment in delinquent cases can only be ascertained by the unbiassed psychiatrist who has special experience in this class of work. Even he will make mistakes.”
He urges, finally, the need for adequate research into the fundamental disabilities causing the delinquent conduct of the ” subnormal criminal group “, which we at present understand so dimly and which is bound up with the whole problem of recidivism. * H.M. Stationery Office, 2/-. MENTAL WELFARE 61 The Guild of Pastoral Psychology In the announcement of the formation of this Guild it is pointed out that to the lay medical psychologist an increasing number of distressed people are taking problems of the inner life about which hitherto the minister of religion would have been consulted, for the medical psychologist is trained to deal with them and the minister is untrained. “Consequently, the intolerable position has to be accepted at the moment that an accusation of incompetence in the field of their own special labours can be sustained, with evidence to support it, against some in the ministry of the Christian churches, and others who by the warrant of their faith, undertake the treatment of the spiritual and mental disorders of mankind.”
To meet this situation, the Guild of Pastoral Psychology?which in the course of a few months has obtained over a hundred members?has been founded to help ministers and clergy to acquire the psychological knowledge they so urgently need, and to promote a closer co-operation ” between the church and the medical profession in the redemption of life for the service of God The membership is of four types:?Founder Members, limited in number; Members, those with a general interest in the Guild and its objects, paying an annual subscription of 10/6; Status Fellows (to December 31st, 1938, only), viz., doctors, clergy and ministers who afford evidence of competence to give psychological treatment; Fellows, consisting of qualified physicians and ordained ministers of religion admitted by examination followed by a probationary period of personal training and clinical work under supervision. In connection with this last section, arrangements are being completed for the opening of a Clinic and Training Centre, under the direction of a medical man, for practical instruction. Several medical psychologists have promised their co-operation in this department of activity and on its committee there will be an equal proportion of ministers and doctors.
The Chairman of the Guild is the Rev. Dr F. E. England, and its Treasurer, the Rev. H. Mattinson; the Committee consists of Dr Phyllis Horton, Dr. Kathleen Kitchin, Rev. L. Wyatt Lang, Rev. D. Glan Morgan, Rev. W. H. Peacey and Dr T. S. Rippon. Amongst its medical supporters are Dr Eleanor Montgomery (Tavistock Clinic), Dr Burnett Rae (Department of Psychological Medicine, Croydon General Hospital), Dr R. G. Gordon (Consulting Neurologist, Stoke Park Colony), and Dr Noel Harris (Physician in charge, Woodside Hospital). The Secretary is Mr. A. B. W. Fletcher, 29 Dorset Square, London, N.W.I.
A Holiday Home for Leeds Defectives
The Leeds Voluntary Mental Welfare Committee is making arrangements to open a Seaside Holiday and Convalescent Home at Arnside on the shores of Morecambe Bay, which it is hoped will be ready for occupation in about a month. A short lease has been entered into for a detached house on the promenade facing the sea and with an excellent view of the surrounding country. It is intended to send defectives there for fortnightly periods from the Institutions under the Mental Health Services Committee and also a number of voluntary cases who are under supervision and attending the Industry and Occupation Centres.
This is good news for it is hard to over-estimate the happiness that such Homes give, and the existing holiday accommodation is far too small to meet the need.
Mental Disorder and Mental Deficiency in Scotland
The Secretary of State for Scotland has appointed a Departmental Committee with the following terms of reference : ? “To inquire into the existing law of Scotland relating to: ?
(a) The certification, detention and supervision of persons who are, or are alleged to be, of unsound mind. (b) The temporary or permanent release of such persons. (r) The arrangements made for persons who have not been certified but who are suffering from mental illness, including the powers and duties of local authorities with respect thereto. (d) The procedure followed in the case of lunatics who are dangerous or are alleged to be dangerous. (e) The procedure followed in the case of mental defectives accused of criminal offences. (/) The definition of mental deficiency. (g) The arrangements for dealing with mental defectives up to the age of 16 who are not in attendance at school, and for dealing with mental defectives on attaining the age of 16. (h) The procedure followed in the case of mental defectives becoming temporarily insane.
and to report what amendments, if any, are desirable as a preliminary step to the consolidation of the law of Scotland relating to lunacy and mental deficiency.” The members of the Committee are : The Hon. Lord Russell (Chairman); the Hon. Mrs. J. E. Hamilton; Professor David Kennedy Henderson, M.D., F.R.F.P., J.S., F.R.C.P.E.; Sir James Colquhoun Irvine, C.B.E., LL.D., F.R.S.; Mr. William Leonard, M.P.; Mr. William Donald Patrick, K.C.; Lord Provost John Phin; Bailie Violet M. C. Robertson, C.B.E.; Professor Thomas Murray Taylor, M.A., LL.B.; and Dr Aidan G. W. Thomson, M.B., Ch.B. The Secretary to the Committee is Mr. J. A. W. Stone, Secretary to the General Board of Control for Scotland (25 Palmerston Place, Edinburgh).
A ” Visiting Teacher ” for Devon’s Retarded Children
We are glad to report that the Devon Education Committee have appointed Miss M. J. Davis B.A.(Lond.) as Organising Teacher of Retarded Children. At the outset, we are informed, her work will be generally experimental and the duties attached to it cannot therefore be precisely defined. She will carry out intelligence tests to determine the incidence of retardation in school children throughout the County, but her principal duties will be the ” teaching of, and organising teaching methods for, retarded children in the elementary schools.
Royal Eastern Counties Institution Research Department
On Friday, 7th January, 1938, the Board of Directors of the Royal Eastern Counties Institution for the Mentally Defective, Colchester, entertained the Members of the Darwin Trust to lunch at the informal Opening of the Research Laboratories attached to the Institution.
Amongst those present were : Colonel The Earl of Stradbroke, K.C.M.G., C.B., C.V.O.; The Viscount Dunwich; Sir Hubert Bond, K.B.E.; Miss Darwin; Professor Adrian; Dr Landsborough Thomson; Dr E. O. Lewis; Mr. E. C. Ransome, O.B E., J.P.; Colonel Gilbertson Smith, T.D., D.L.; Mr. P Astins. Towards the cost of the building the Hon. Alexandrina Peckover contributed ?2,200, The Hon. Lady Darwin ?500, and it is hoped that other contributions will be received. The Rockefeller Foundation have given a grant of ?700 and the Darwin Trustees ?50 towards the cost of equipment and the Rockefeller Foundation are giving an annual grant of ?600 for five years to provide additional research workers.
Dr L. S. Penrose, who is a member of the External Scientific Staff of the Medical Research Council, is directing the work. The permanent workers in the Department are a Social Investigator, two Laboratory Technicians, and a BioChemist. Attached to the Department are Dr Munro (Beit Fellow), and Mr. J. C. Raven (Medical Research Council Grant).
The building is single storied in red rustic brick 77 feet long by 40 feet broad on a site provided by the Institution in Turner Road adjacent to Turner Village. It contains one Laboratory suitable for Bio-Chemical and Pathological investigations, another for Microscopical work, a Clinical Room, Dark Room for Photography, three Offices, Testing Room, Workroom and Lavatories. Amongst the interesting items of equipment is an Electric Calculating Machine costing ?187, provided by the Rockefeller Foundation and the Darwin Trustees.
Balderton Colony, Notts
In 1933, the Nottinghamshire Mental Deficiency Administration was transferred from the Mental Hospital Department to the Public Health Department under the County Medical Officer, and the services of his staff of 39 Health Visitors became available for ascertainment and supervision. As a result of intensive efforts directed towards speeding up, the number of defectives ascertained rose from 637 in 1932 (viz.,1.42 per 1,000 of the population) to 1,240 (2.7 per 1,000) at the end of 1937, these figures excluding 544 educable defective children, 77 alleged defectives in the County Mental Hospital, 42 defectives detained under Section 24 of the Lunacy Act, and 13 in the State Institution at Rampton. On 31st December. 1937, it was estimated that 465 defectives were in need of colony care at once, in addition to a proportion of 300 others still awaiting examination and classification.
To meet this need, the Balderton Hall Estate has been acquired where a Colony is to be established providing at first for 540 beds, and permitting of an ultimate extension to 900. The plans include a School block to accommodate 100 children. Building operations are to begin shortly and it is hoped that the scheme will be completed within three years.
Chesterfield’s Plans for Retarded and Difficult Children The Chesterfield Education Committee has had under discussion for two years a proposal to establish a children’s Psychological Clinic. Brambling House, a pleasantly situated mansion, together with fourteen acres of garden and woodland, has been acquired for the joint purpose of this Clinic and an open-air School. The necessary work of reconstruction and additions to the existing building has just been commenced, and it is hoped that the joint School and Psychological Centre will commence work in September.
Over two years ago a Study Circle of some dozen young teachers was formed under the leadership of the Education Officer (who holds degrees for Psychological research). It is one of these teachers whose services are to be utilised in connection with dull and backward children, with a view to attempting to determine the causes of backwardness and so to institute remedial work. Ultimately this work, and it is hoped some vocational work, will link up with the work of the Psychological Centre in a complete psychological service.
International Conference on Musical Education of Defective Children The Society for Musical Education (whose headquarters are in Prague), is dedicating its next International Conference to the subject of the “Musical Education and Pedagogy of Defective Children.”
In a circular issued by the Society it is pointed out that this subject has been chosen because :?
” The experiences made in the rhythmical and musical education of deaf and dumb, blind, defective and weak-minded children bring many interesting results of great importance not only for scientists and special teachers, but which are also leading to new problems for psychology and for pedagogy in general.”
The Conference will be held in Switzerland, from June 23rd to 28th, 1938, in co-operation with the Swiss Union for Musical Pedagogy and the Seminary for Pedagogy of Defective Children, Zurich. The first meetings will be in Zurich, after which the members of the Conference travel to Berne, and thence to Basle. Applications for further particulars of the Conference should be addressed to the Secretary for Musical Education, Prague IV, Toskansky palac, Czechoslovakia.
New Occupation Centre at Sheffield
In January, 1938, the Sheffield Mental Deficiency Committee opened an Occupation Centre in premises consisting of a large house in the suburb of Pitsmoor, previously used by the Board of Guardians as a girls’ Training Home. At present there is no provision for children?though these will be admitted later?and the Centre is chiefly designed to serve the needs of older boys, 25 of whom are employed in the garden and workshops. In addition there are 9 older girls who act as domestic staff and are employed in the cooking of the midday meal, cleaning, etc. The paid staff consists of an Occupation Officer (Mr. H. V. Baker) and a kitchen supervisor.
Although the Centre has been open so short a time, Dr F. J. S. Esher, Medical Officer to the Mental Deficiency Acts Committee, writes that already parents of boys and girls attending it have testified to the improvement that has been shown in their behaviour at home.
” Psychological Problems in Institutionalising Defectives ” In a letter congratulating the Editor on the publication of this article in the last issue, Dr F. Douglas Turner, Medical Superintendent of the Royal Eastern Counties Institution, writes:?
” On page 6, at the bottom of the second paragraph, the writer of the article asks why it should not be possible ” for endorsement of the Final Certificate in any one branch of training, to occur a little later in some other branch?” This can, I think, only refer to the R.M.P.A. Certificate, as the General Nursing Council one is not divided into separate branches.”
” The R.M.P.A. Certificates can be, and have been ever since the Certificate for the Mental Deficiency Section was started, endorsed with additional training sections. We have many members of staff who have taken two or three sections, and it is seldom that they take two sections at one time. They get through one section first, and then take another. We have had them do it both ways?take bedside nursing first and then P>. or C., or alternatively take B. or C. first, and later on, bedside nursing which is A. 1 think this ought to be made clear.”
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