The Mentally Defective and the Poor Law
REPORT OF THE C.A.M.W. CONFERENCE AT WEMBLEY. ——————————————-The Annual Meeting of the C.A.M.W. at Wembley, on October 6th, was followed by a Conference on the Mentally Defective and the Poor Law, which was well attended by representatives of Boards of Guardians. The speeches made dealt chiefly with the work that Boaids of Guardians are doing in providing training and occupation for defectives under their care, and with the difficulties that are created by the failure of so many Local Authorities to carry out their duties under the M.D. Act. No verbatim report of the proceedings is being published, but we hope that the summary which we print below will be of interest to many concerned with the problem under discussion who were not able to be present.
Dr W. A. Potts (Birmingham), in opening the Conference, paid a tribute to tiie good work that was being done for defectives by so many Boards of Guardians, and said how much more serious the present unsatisfactory condition of affairs would be were it not for the way in which they were shouldering burdens which rightly devolved upon Local Authorities under the Mental Deficiency Act. At the same time it must be recognised that this was not the solution of t e pro em contemplated by the Act and that ultimately the Board of Control would have to insist on statutory duties being carried out. Meanwhile, however, there was ample scope for the work of both Local Authorities and Boards of Guardians, and indeed in many instances it was urgently necessary that both should do all they could, provided always that close co-operation between them was established. He would remind Guardians, in this connection, of the help they could give to Local Authorities in their work of ” Ascertainment ” by informing them of cases of mental defect chargeable to the Poor Law. He would also urge the importance ?f the provision in Poor Law Institutions of some sort of training or e ec wes temporarily maintained therein, and he indicated the help which the C.A.M.W. was able to offer in this through their Occupational Organisers. Another matter ?f great importance was the provision by Guardians of some form of After-Care ‘or defectives, and sub-normal persons leaving their institutions. Alluding to the problem presented by the woman who gave birth m the Poor Law Lifirmary to an illegitimate child, he said he sometimes wondered whether the time had not arrived for the routine examination for mental deficiency of every such woman who returned a second time to bear such a child at the public expense. To Boards ?f Guardians who invariably found their Medical Officer reluctant to certify any case referred to him, he would suggest the possibility of their giving facilities for his attendance at one of the Post-Graduate Courses in Mental Deficiency arranged for the University of London by the C.A.M.W., reminding them of the widespread ignorance that prevailed amongst medical men who had had no opportunity of special training in the work.
The Rev. H. B. Reiss (Chairman of the West Ham Board of Guardians), who then called upon to speak, declared emphatically at the outset that in hif opinion Poor Law Guardians ought to have nothing whatever to do with defectives, on the ground that?with the exception of those Unions which were able to open specialised institutions?they had not got the necessary facilities for dealing with them in the general Poor Law Institution. There was, moreover, no provision which compelled Guardians to educate mentally defective children under their care, in illustration of which he quoted the case of a youth whom he had come across in a common lodging-house recently. This boy, he found on enquiry, had been under the care of three or four different Boards of Guardians since the age of 5. He was fairly bright, but very difficult to manage, on account of an abnormal temper, and from the age of 11 to that of 13 he had been deprived of any education whatever, on the grounds that his presence had a bad effect on the other children in the Poor Law schools. And because he was under the care of the Guardians the Local Education Authority had no jurisdiction over him. Part of the present unsatisfactory state of things came, he maintained, from a lack of understanding on the part of both members of the Boards of Guardians and of the general public of the reality of mental deficiency, and part from the multiplicity of authorities dealing with defectives. The problem of Ascertainment, also, was a pressing one, and had been recently emphasised by the Board of Education’s Circular. He deplored the prejudice that existed in the minds of so many Guardians?more especially in those of women members?against certification under the Mental Deficiency Act, because they regarded it as an interference with individual liberty. This view seemed to him to leave altogether out of consideration the real interests of either the community or of the defective concerned. In conclusion, he dwelt on the importance of training defectives and commended the work of the C.A.M.W. Occupational Organisers, one of whom had recently spent a month in his Board’s Institution Schools and had given the staff extremely valuable help.
Mrs. Ward, J.P. (Member of the Barrow-in-Furness Board of Guardians) gave the Conference an enthusiastic account of what had been achieved in their Poor Law Institution in organising a scheme of occupation and recreation for the adult defectives detained there. She had always been; she said, impressed by the contemplation of the lives of these unfortunate inmates, who seemed to be destitute of any hope, any interest, any happiness. The problem was first vividly forced upon her attention when she paid a visit to their ward at a time when they had finished the routine work for the day, and had had their tea. There she saw forty women sitting round the walls absolutely idle, waiting for bed?waiting, too, she added for eternity. A visit to the Royal Albert Institution made her realise what could be done for patients of just this type, and made her determine that if it was in any way possible something should be done. She then got into touch with the C.A.M.W., the upshot of which was the Board’s employment of one of its organisers?Miss Price?for a month.
The results were, she declared, amazing. With the organisation of handwork, games, dancing and singing, the whole atmosphere of the dayrooms had changed. The patients were now eager, interested and happy. The staff seemed to have been lifted up to another plane and to be filled with enthusiasm and hope.
One case she instanced in particular, as showing the miracles that had been wrought. This was a boy of 18?deaf, dumb, crippled by spinal complaint, spending his whole life in a wheeled chair. He could neither read nor write and for years had done nothing whatever but watch other people. At the end of the organiser’s visit, this boy had become a different creature. Taught to do some simple raffia work, after four days he became so absorbed in it that at first he could hardly be persuaded to leave it to eat his meals. His expression had changed, his disposition had changed. He was now always wanting everybody to see what he could do. Referring to the difficulties that must be anticipated in starting such a scheme, Mrs. Ward said that the outstanding one was that of staff, and that it was absolutely essential that before the organiser’s visit their interest and sympathy should be enlisted. They had had at Barrow a special meeting to explain what it was intended to do, and everyone’s support and co-operation, from the Matron downwards, was secured. That made all the difference to the success of the venture.
In conclusion, Mrs. Ward read the reports from both the Matron and the Medical Officer, bearing out her testimony as to the wonderful good that had been accomplished by Miss Price’s visit, and one from Miss Price herself, describing exactly the nature of her work.
Miss Woolston (Secretary of the Ipswich Association for Mental Welfare) spoke on the subject of the possibilities of co-operation between Guar lans Institutions and Occupation Centres, explaining how successful had been the plan adopted in Ipswich on these lines. The Ipswich Poor Law Institution was certified under Section 37 of the Mental Deficiency Act for 15 male and 1 o fema e defectives, and used also for a limited number of children detained there as a Place of safety. The Ipswich Mental Welfare Association had an Occupation Centre for low-grade ineducable children open five half days a week, ft was arranged that the services of the Supervisor in charge of this Centre should be shared with the Guardians and she spent every afternoon in their Institution. Two afternoons she was with the defectives in the Infirmary, two with the ablebodied defective women, and one with the able-bodied defective men.
Basket- work, canework and raffia, knitting, crochet and embroidery were amongst the subjects taught, whilst time was also given each afternoon to games, music a d dancing. Recently there had been added, at the patients own sugges^on, an evening Bible-class, with hymns and songs. The sale of patients work’ was effected in connection with the Brabazon Society, paid for a sum?r outing and for Christmas gifts, as well as providing some of thematerialsne their handwork. Although this scheme is not ideal, and it was hoped! that, the Guardians might be able to employ a whole-tune teacher, or that the d^fectives would be transferred to a special institution, it had worked very smooth y a brought much happiness into lives that would otherwise have been monotonous mTa.’ H. Ward (Clerk to the West Bromwieh Union, and to Great Barr Colony for Defeetives) emphasised the great amount of work that Guardians_were doing for defectives, and though he did not dispute the content,on tha the ?,cal Authorities under the Mental Deficiency Act were the people who oughtto be responsible for the work, said that he was anxious to correct the impression felt other speakers might have created that Guardians were not doing their share.
To illustrate what they could do, he described the special Institution at Great Barr, owned jointly by his Board and that of Walsall, which is providing for 228 patients and would shortly provide for 300 or 400 more. They had secured the close co-operation of Local Authorities of the district, including Birmingham, from whom they received cases. There was, he said, considerable vacant accommodation in many Poor Law Institutions, and he urged Guardians not only to use this for defectives, but to provide for them systematic training.
The Rev. H. B. Reiss here interposed to say that his criticisms were not directed towards the use of specialised institutions provided by Guardians for defectives, but that he had in mind ordinary Poor Law Institutions where no separate provision of the kind was made. It remained true that children could be kept in workhouses without receiving any education.
Miss Blake (Enquiry Officer, Wiltshire M.D. Committee) said she wanted to draw attention to a custom very prevalent in country Poor Law Institutions, viz., that of retaining feeble-minded women because they were so useful to the Matron instead of reporting them at once, to be dealt with under the Mental Deficiency Act. This practice frequently resulted in their discharging themselves before any steps could be taken by the Local Authority, and in their subsequent return with possibly a child to support as well.
Mr. Falkingham (Superintendent, Hollow Meadows Institution, nr. Sheffield) pointed out how unsuitable ordinary workhouse accommodation was for defectives. Its whole routine was designed to meet the needs of the aged and infirm, and the needs of defectives was entirely different. The staff had neither the knowledge nor the time to undertake any systematic teaching and training. The fact that the other inmates could take their discharge at will whilst they themselves were detained was resented by the feeble-minded girls and discipline was consequently very difficult. To crowd defectives into workhouses was worse than useless, and frequently lead to their deterioration rather than their improvement.
Mr. Fisher (Enquiry Officer, Bucks. M.D. Committee) referred to the need for closer co-operation between the Clerk to the Guardians and the Medical Officer. The failure to report cases of Mental Deficiency to be dealt with under the Mental Deficiency Act was often due not to any negligence on the part of the members of the Board, but to the fact that the Medical Officer did not always realise what powers the Guardians possessed in the matter.
Miss Evelyn Fox concluded the discussion by outlining the terms and conditions upon which the Association’s Organisers could be employed by Boards of Guardians,* explaining that their services were intended more especially for Poor Law Institutions where only a few defectives were received and where it was not possible to engage a trained staff. The organisers were people specially chosen for their experience of Institution life, and nowhere had they met with any difficulty as regarded their relations with staffs. Many applications for their services had already been received, but she would welcome additional ones and would be glad to answer enquiries on the subject.
The Conference terminated with the showing of the C.A.M.W. Film. * These terms are as follows:?Payment of one month’s salary, lodging allowance of ?1 a week, and 8rd class railway fare from previous place of work. The total cost may roughly ba estimated at ?25 for the month.
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