Mental Inefficiency and Crime
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Notes and News
To the following figures, taken from the report of the Prison Commission for the Year ending March 31st, 1922,* we draw the attention of our readers:? Cases Certified Handed over to
under M .D. Act Transferred under Local Authority during sentence. Section 9. on Discharge.
1922 1921 1922 1921 1922 192! Local Prisons 64 104 34 62 21 95 Convict Prisons 3 8 3 20 ? ? Borstal Institutions 18 28 20 9 ? ? In addition 42 cases in Local prisons were reported as being ‘ ‘weakminded’’ though not certifiable (1921, 67)?
Last year it may be remembered the Commissioners discussed the difficulties experienced in effecting the transfer to Institutions of Borstal inmates reported under Section 9 of the Mental Deficiency Act. They now record some improvement in this respect, which they attribute in part to the result of a Circular issued during the year to all the local prisons pointing out that Borstal training should br restricted to those ‘ ‘who are capable of receiving education and instruction in a trade,” and urging that wherever possible careful mental examination by medical officers should be carried out before such a certificate of fitness is given: in part also to the fact that Reception Classes have been established at Feltham and Aylesbury where special examinations are conducted with a view to the further elimination of unfit cases. In the prisons, however, the trouble continues as before.
The Commissioners are evidently much impressed by this problem and state emphatically that defectives, as well as offenders who though uncertifiable are of sub-normal or abnormal mentality, should not be sent to prisons or Borstal Institutions at all as they require curative treatment carried out by people with special training; prison environment only tends to aggravate their condition, and “if they continue to arrive there, a separate establishment with a special staff should be provided.’’
Another document of interest bearing on this subject is the report for 1921-22 recently presented by the General Purposes Committee to the Birmingham Justices and containing statements by Dr W. A. Potts and Dr Hamblin Smith on the work. During the year, 135 cases coming before the Courts were remanded in custody in the special remand department of H.M. Prison, for observation and examination. Of this number, Dr Hamblin Smith reports that only 30?less than 23%?were ultimately sentenced to imprisonment. 17 were certified under the Lunacy Act, 10 under the Mental Deficiency Act, and the rest were placed on probation, dismissed, adjourned, fined or bound over.
We learn with regret from the report of Dr Potts that very little use is made by the Justices of that part of the Scheme which provides for the special examination of juvenile delinquents not remanded in custody. Dr Potts to whom this ?To be obtained from H.M. Stationery Office, Imperial House, Kingsway, W.C.2. Price 2/1 J, post free duty is assigned, states that only one such case has been referred to him during tfie year, a fact which he deplores, on the ground that ‘ ‘one of the principles of the Birmingham Scheme is that special examination should be available alike for those who go to Prison and those who do not,’’ and that it is the young first offender who is most amenable to treatment.
A new area to be awakened to the importance of the ‘ ‘Special Examination of Offenders” is the County of Glamorgan. Dr E. Lewis, the Medical Superintendent of the Drymma Hall Institution for Mental Defectives, Skewen, nr. Neath, has recently submitted to his Committee a full report on the subject, deploring the state of affairs that exists in the county (only recently for example it has been found that twelve cases in Borstal Institutions are defectives who have passed through the Courts undetected) and suggesting the calling of a Conference “to discuss the need for correlation between Court, Prison Departments and the Mental Deficiency Act Committee.” We shall await with interest the outcome of Dr Lewis’s efforts.
Sir George Newman on Special Schools. ————————————In the Annual Report of Sir George Newman as Chief Medical Officer to the Board of Education published this year under the title ‘ ‘The Health of the School Child,” some interesting reflections are made on the subject of Special School education.
From its history he deduces three lessons which he regards as of exceptional value:?
(1) It has shown us that the real criterion of education is to equip the child for life, and not merely to add accomplishments. (2) It has revealed the contribution which psychology as well as physiology has to make to the problem of the defective child, and shown us that it is in the psycholgical approach that our chief failure lies. (3) It has brought into full relief the importance of After Care.
‘ ‘These are the characteristics,” he says, ‘ ‘which make the training of the defective child one of the high roads of psychology and one of the little trodden paths of preventive medicine. The record of facts in regard to these Special Schools is plain yet inspiring, and behind the facts lie some of the most interesting problems in the whole range of education.”
Dealing with the “positive results” of the education of defective children, Sir George Newman records the fact that of the blind 50%, of the deaf 80%, of the cripples 75%, but of the mentally defective only 40% are able subsequently to support themselves.* The amount expended on Special M.D. Schools in 1920?21 is given as ?390,000f; on schools for the Blind ?79,000; on Schools for the Deaf ?115,000; on Schools for Cripples ?217,000; for delicate and pre-tubercular children ?144,000; and for epileptics ?11,000. The Board feel that this * Corresponding figures from the records of the Birmingham After Care Committee show that though in 1921 only 32% of their Ex-Special School children were in remunerative work, in 1919 and 1920 the figures were 48% and 45% respectively.
?f According to the Report of the Board of Education 1920-21 there is accommodation in Special M.D. Schools (Day and Residential) for 16,328 children. The average cost per head therefore works out at about ?23 per annum. The elementary education of a normal child costs about ?9 per annum. high cost is prejudicial to their development and must be reduced, and “ineducable children must be excluded.”
No new figures as to the number of defective children are given in the Report, there being no estimate later than that drawn up in 1920, J viz: feebleminded 31,000, imbeciles and idiots 6,000).
National Special Schools Union Conference. —————————————–The Hon. Secretary of the National Special Schools Union (Mr. J. Hudson) has kindly sent us an account of the recent Birmingham Conference of which the following is a resume:?
The Biennial Conference of the National Special Schools Union was held at Birmingham on the 23rd, 24th and 25th of November last. In matters of local government, Birmingham has long maintained a high standard of public service and has earned for itself a reputation for enlightened opinion and thorough and efficient administration. It is not surprising therefore to find that the Birmingham Education Committee took the Conference seriously; the papers were largelycontributed by Birmingham officials,?in the persons of Dr Innes, Chief Education Officer, Dr Thomson, Special Schools Medical Officer, and Dr Marion Bridie, Supt. of Birmingham Special Schools,?whilst for Chairmen it had the Chairman of the Education Committee (Councillor W. Byng Kenrick), the Vice-Chancellor of the University, and Alderman A. R. Jephcott, M.P. High honour was also shown to the Conference by the reception held by the Lord Mayor and Lady Mayoress and again by the opening speech delivered by the Lord Mayor on the morning of the 24th.
It was a serious Conference. One felt all the time that grave questions were being discussed in a spirit of earnestness and with high-minded desire to get down to bedrock of truth and assured fact. But at the same time there was, equally clearly, an atmosphere of deep sympathy with the afflicted members of the community whose present and future possibilities constituted the problems facing the Conference. This spirit and atmosphere, one felt, were most fittingly and delightfully gathered up in that closing speech delivered with such quiet earnestness by Councillor Miss Martineau, Chairman of the Birmingham Education Special Schools Committee.
The first note struck by Dr Innes in his very valuable and inspiring paper was that of the importance of keeping the public informed of what is going on in the schools. He also strongly emphasised the necessity of a special curriculum with special methods taught by teachers with special training and imbued with almost infinite patience and high ideals of service. These, he said, work wonders even with the comparatively low-grade feeble-minded, so that instead of becoming anti-social beings and liabilities on the state, the children become an asset to the community. Speaking of Occupation Centres, he could not regard them as to any extent capable of taking the place of Special Schools.* On the question of the leaving age, he was strongly in favour of retention in the school until 16. Truly the Conference would have been worth while had this been the only paper. But there were others whose principal motive alone I can here indicate. It may be briefly indicated in the words?experiment?tabluate?prove. Above all, prove. This note was particularly struck by Dr Thomson. I think I shall not misrepresent him if I say that his attitude is not “You are wrong” or even “I * The C, A .M ,W. fully share this view,?Ed ,
do not think you are right,’’ but ‘’You have not yet proved your case.’’ This is a challenge which Special School teachers cannot neglect. Sentiment may carry some of the public all the time, all the public some of the time, but not all the public all the time. It is fact, verified and verifiable, which will count in the long run. A very valuable paper by Miss Bridie had already shown how investigations on “Rates of Progress” had been carred on in Birmingham schools.
A Special School Boy’s Brave Act. ———————————We dwell so much on the sins and failings of defectives that we are apt to forget that here and there amongst them, on the other hand, qualities may be found which we ourselves do not invariably possess.
An instance of this has recently been brought home to us afresh by a press report which we have received of a London Special School boy (attending the Cloudesley School, Islington), who was a few weeks ago, at a gathering of his teachers and schoolfellows, presented with the Certificate of the Royal Humane Society in recognition of his bravery in saving a child from drowning, at the risk of his own life.
It may be remembered that in our July number we recorded similar acts of lifesaving on the part of two other Special School boys (from Edward Street School, Deptford), and to all these three children as well as to their respective schools, we are proud to do honour.
Course on Mental Diseases for Secretaries of Local Voluntary Associations. This week’s Course originally arranged for May and announced in our April number was held in October and attended by great success. The following account of it which appeared in the Lancet of 11th November 1922, will we think be of interest to our readers.
4 ‘An interesting development in mental welfare work took place recently at Horton Mental Hospital, Epsom, when by permission of the Mental Hospitals Committee of the London County Council and with the co-operation of Lieutenant-Colonel J. R. Lord, medical superintendent, 19 secretaries of voluntary associations for mental welfare received a week’s course of instruction in mental diseases with a view to their better equipment to deal with the borderland cases about which they were frequently consulted. Lectures were given by Colonel Lord on the following subjects:?Historical Retrospect of Insanity; The Normal and Disordered Mind; Causation of Insanity and Early Symptoms of Nervous Exhaustion; Clinical Forms of Insanity; Lunacy Law, Institutional and Home care of the Insane (including suggestion for reform .)* A special demonstration on clinical types was given, and the students paid visits to the wards of the hospital and attended the patients’ weekly dance.
In addition to the instruction at Horton, lectures were given at the offices of the Central Association for Mental Welfare by Dr E. A. HamiltonPearson on Nervous and Unbalanced Children, and by Dr Norwood East on Co-operation with the Work of Medical Officers of Prisons, whilst visits were paid to the Manor Institution for Mental Defectives recently opened by the L.C.C. at Epsom, and to the Ministry of Pensions Neurological Hospital at Ewell. The students also had an opportunity of discussing with the secreReprinted in this number.tary of the Mental After-Care Association the possibilities of co-operation between that association and associations for mental welfare.
Although a week’s course cannot obviously be looked upon as an adequate training in this branch of mental welfare work, the experiment has nevertheless fully justified itself. The students not only gained a clearer idea of the nature of insanity and of its several forms and their varying prognoses, but they were also given opportunities of realising the difficulties inherent in the problem of mental hospital administration and the impossibility of making any serious contribution to the cause of lunacy reform without a foundation of first-hand knowledge. Such opportunities have hitherto been lacking. This pioneer effort may be the forerunner of developments on a much larger scale when courses of longer duration will come to be regarded as an indispensable part of the training not only of secretaries of associations lor mental welfare but of all social workers in general, most of whom are at some time or other brought into contact Avith the problem of the unbalanced mind.”
New Hospital for the Treatment of Early Mental Disease. ——————————————————Another development in Mental Hygiene which we have great pleasure in recording is the opening of the Maudsley Hospital, Denmark Hill, London, S .E .5. The Hospital has been established by the London County Council at the suggestion of the late Dr Henry Maudsley who made a generous contribution to the cost of building, and it would have been available some years ago had it not been for the necessity of diverting it to war purposes.
It is intended for the treatment of nervous diseases, especially for patients suffering from incipient curable forms of mental disorder who are themselves desirous of treatment. Accommodation is being provided for both Out-patients and In-patients; at the moment of writing only the department for Out-patients is operating. The wards will be opened during the month of January. Patients having a legal settlement in London will be required to contribute according to their means, as at the voluntary Hospitals; others can only be received if prepared to pay the full cost of maintenance. In addition there will be a number of private rooms (for women only), for which special charges will be made. Enquiries for further information should be addressed to the Medical Superintendent, Dr Edward Mapother, M.D., F.R.C.S., M.R.C.P., at the Hospital, or to the Chief Officer, Mental Hospitals Department, L.C.C., at the County Hall, Westminster Bridge, S.E.I.
Rug - Weaving for Defectives. —————————-We should like to draw the attention of those interested in occupations for defectives to a special type of Smyrna Rug-weaving which is used with great success at an Employment Class for defective girls in Croydon, and in which lessons have recently been given to workers in the C.A.M.W. offices.
The process is an extremely simple one, and the materials are not costly. No loom is required, the work being done at a table on a light wooden frame which, for a small mat, need not be larger than 3 feet xl foot, 8 inches. The rugs produced are effective and have been found to secure a ready sale.
The occupation is therefore one which can be recommended for defectives living in their own homes, as well as for those in Institutions and for Employment
Classes. We suggest also the possibility of introducing it successfully into Mental Hospitals as a simple Ward occupation. We shall be glad to show the method to anyone who is able to call in at the Office, and we are hoping shortly to have for demonstration purposes a small model apparatus which can be sent by post to enquirers living at a distance. Circulating Library for Mental Welfare Workers.
We shall be glad to hear from readers of this Journal who would like to join a Circulating Library of books on Mental Deficiency, Mental Hygiene, Psychology, Mental Tests, etc., which we are prepared to form should the demand for it be great enough.
It is proposed to fix the subscription at 10s. a year: postage of books will probably amount to about 5s. in addition to this, making the total annual cost per member for one book at a time approximately 15s.
A tentative preliminary catalogue of some 50 books and periodicals with which we suggest the Library shall start as soon as the necessary minimum number of 40 members is obtained, has been prepared and can be had on application. The C.A.M.W. and Sterilisation.
The Medical Committee of the C.A.M.W. which has been considering the question of the sterilisation of defectives presented its report to the Council of the Association on October 30th last.
The report was approved but before publication it was decided that it should be incorporated in a larger pamphlet to be prepared by a specially appointed Sub-Committee of the Council which should deal with the social as well as the purely medical aspects of the problem.
Until the appearance of this pamphlet the Association is reserving any public announcement of its policy. Occupation Centres?New Developments.
Official Recognition of Centres. ——————————-We have great pleasure in informing our readers that the future of Occupation Centres is assured, for the Board of Control announce that they are now empowered by the Treasury and the Ministry of Health to contribute, to a limited extent, towards the expenses incurred by Voluntary Associations in carrying them on, and a Circular has accordingly been sent to Secretaries setting out the particulars which should be furnished in applying for grants.
To the C.A.M.W. and to all those workers who, in spite of great difficulties, have given practical effect to their convictions that every defective child has a right to training?and amongst them we would specially mention Miss Elfrida Rathbone, for it was she who with the opening of the Lilian Greg Centre led the way?this.fruition of their labours will bring hope and encouragement. Once again, too, has been demonstrated the great value of voluntary enterprise in blazing the trail for future official activity.
This new development makes it more than ever important that the work of Occupation Centres should be co-ordinated and put on a basis which will allow of easy expansion and the C.A.M.W. hopes to arrange shortly a meeting of Secretaries and others intimately concerned in order that the whole situation may be reviewed and a scheme of co-operation drawn up.
A Local Authority’s Centre. ————————-A Centre under the direct control of a Local Authority in an area where no Voluntary Association exists, is a further development which has recently taken place.
Such a Centre was established after the summer holidays by the Norwich Statutory Committee for the Care of the Mentally Defective and an interesting account of it has been kindly supplied to us by the Town Clerk. From this we quote the following passage:?
“The Board of Control at first appeared somewhat doubtful as to whether a Local Authority under the Mental Deficiency Act had statutory authority to incur expenditure in establishing an Occupation Centre, but eventually agreed that the provision of simple training at such a Centre for defectives ‘subject to be dealt with’ might come under the heading of suitable supervision. The Centre was established after the Summer School holidays, and the experience gained so far tends to confirm the view of the Local Authority that the supervision required to be provided under s.30 (b) of the 1913 Act is much more effective where the visitation and inspection of homes laid down by the Regulations as a minimum obligation is supplemented by the closer personal relations obtainable in an Occupation Centre, coupled with the value in the training of the defectives of the regular habits acquired.”
The Centre is conducted by the Committee’s Lady Enquiry Officer and is open on five mornings a week from 10 to 12 o’clock. It is attended at present by six children, whose ages range from 12 to 17, and its activities include singing, games, and physical exercises, light woodwork, ralfia work, knitting and crochet, rugmaking, writing and number. A very successful Christmas party was held, attended by members of the Committee as well as by the parents, at which the children provided a programme of eleven items. Until recently the Centre has been held in the Committee’s office, but more suitable premises have now been acquired in a parish hall.
In spite of the fact that the children have only been attending three months and of the handicaps under which the work has been carried on “there is no doubt,” our report emphatically states, “that the children are better, happier and more attentive as the result of their first term’s work.”
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