View report page

social—i.e., emotional—factors in general health there seems to be a perceptible move
towards accepting even quite gross neurotic disturbance as illness, so long as it can be
seen to be an exaggeration of ' normal' emotional processes. Partly as a result of the
work of psychiatric services of all kinds in making this connection clearer, and partly
following the attention focused by the Royal Commission's report on local authority
mental health services, more referrals and requests for help are received than could
possibly be dealt with by the four psychiatric social workers at present employed, if
they were to make direct contact with every case themselves. In many instances, however,
much has already been done by workers in other agencies, who are quite prepared
to continue to carry the problem so long as they have someone to whom they can turn
for discussion of the issues involved when their patients' anxieties become too pressing.
This type of interpretative work has increased steadily through 1957 and it is hoped that
it will continue to do so, as it has the obvious advantages of continuity of relationship
for the patient, economy of effort for the workers involved, and the two-way exchange
of views on the situation. It also lessens the chances of' playing off' by the patient of
one agency against another—so often the pattern of dependence—with the consequent
rise of anxiety all round. Further, should the Royal Commission's recommendation
be legally implemented in its present form and all the after-care work of mental hospitals
become the responsibility of the local authorities, it seems clear that social workers
without mental health training would have to be employed under the general direction
of psychiatric social workers. The present consultative development is therefore invaluable,
both as giving information about the ways in which such a ' diluted ' service
might function, and in showing psychiatric social workers how to make the best use
of other social and welfare systems and the high standard of case-work achieved by
manv of them.
Sources of
referral
As already indicated, these are varied and, as would be expected, reflect administrative
and social contacts with other departments and welfare services working in the
community.
Durmg 1957, when for seven months there were only three psychiatric social
workers in the department, approximately 500 referrals were accepted, of which 269
(54 per cent.) were thought to call for at least one visit, and 231 (46 per cent.) were dealt
with on an advisory basis. Referrals came from the following sources :
Almoners
Borough Council officers
Care committee organisers
Chest clinics
Child guidance clinics
Children's offices
Citizens' advice bureaux
Community care services of other local
authorities
Divisional treatment organisers
Divisional medical officers
Dr. Barnardo's Homes (1)
Employment exchanges and youth employment
bureaux
Family Service Units
The Family Welfare Association
General practitioners
Health visitors
Housing welfare officers
The Hungarian Relief Service
Industrial welfare workers
The Invalid Children's Aid Association
The Jewish Board of Guardians
Lodging houses and hostels
L.C.C. M.D. Organisers
L.C.C. P.S.W.'s working in schools for
maladjusted children
The Marriage Guidance Council (1)
Mental hospitals serving the L.C.C. area
Mental hospitals serving the rest of the
country
Mental welfare officers
Ministers and missioners of different
denominations
Moral welfare workers
The National Assistance Board
The National Association for Mental Health
The National Children's Homes (1)
Old people's welfare workers
Out-patient Clinics—psychiatric and otherwise—and
day hospitals
The police
Prison medical officer (1)
Probation officers
Problem families—intensive case-workers
Prospective patients themselves
Psychiatrists—regional hospital board and
private practice
Relatives or friends of prospective patients
The Royal Courts of Justice (1)
St. Katharine's Foundation, Stepney (1)
The Samaritans Service
Welfare offices
98