London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1961
[Report of the Medical Officer of Health for London County Council]
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Table (iii
| Initial disposal to hospital | Final disposal to hospital | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Under 65 years | Over 65 years | Total | Under 65 years | Over 65 years | Total | |||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | |
| Informal admission | 668 | 22.0 | 229 | 32.4 | 897 | 23.9 | 1,783 | 80.0 | 515 | 91.3 | 2,298 | 82.2 |
| Compulsory admission: For observation (sec. 25) | 685 | 22.5 | 215 | 30.5 | 900 | 24.0 | - | - | - | - | - | - |
| Emergency admission (sec. 29) | 1,583 | 52.1 | 250 | 35.4 | 1,833 | 49.0 | - | - | - | - | - | - |
| For treatment (sec. 26) | 103 | 3.4 | 12 | 1.7 | 115 | 3.1 | 447 | 20.0 | 49 | 8.7 | 496 | 17.8 |
| Total | 3,039 | 100.0 | 706 | 100.0 | 3,745 | 100.0 | 2,230 | 100.0 | 564 | 100.0 | 2,794 | 100.0 |
It will be noted that the major use of sec. 29 was in relation to those under 65 years of age
but that about two-thirds of the '65 and over' age group who appeared to need psychiatric
hospital care, even temporarily, were removed compulsorily. Prior to the full introduction
of the Mental Health Act, 1959 there were voluntary patients and some informal admissions,
whilst others were admitted under three-day orders, urgency orders, temporary certificates
or sec. 14/16 of the Lunacy Act. Voluntary patients are now referred to as informal
patients and sections 29, 25 and 26 replace the various orders and certificates stated above.
Although, in the case of patients under 65 referred to mental welfare officers, there
was a reduction in the proportion of compulsory admissions, i.e., from 89.4 per cent.
of total cases removed in 1959 to 78 per cent. in 1961, the reverse took place in the age
group '65 and over i.e., a rise from 63 per cent. to 67.6 per cent. Reasons for this require
further investigation, bearing in mind also that whereas the proportion of total cases
seen by mental welfare officers which resulted initially in informal or compulsory admission
to hospital was the same for the under 65's in 1959 and 1961, it rose from 60.9 per cent. in
1959 to 65 per cent. in 1961 for the elderly group.
Bearing in mind the comments on initial disposal, particularly with regard to the elderly,
the comparative percentages for patients retained in hospital under compulsion (table iii)
were as follows:
Under 65 65 and over
% %
1959 31.9 31.2
1961 20.0 8.7
These comparisons show that in 1961 there was a major reduction in the percentage of
elderly persons retained in hospital compared with the increased initial compulsory rate
already referred to. These factors will be taken into account in carrying out the further
investigation referred to above.
Admissions to the five emergency wards in general hospitals within the county area fell
from 2,977 in 1959 to 1,442 in 1961. The increase in the statutory period of observation
from 17 to 28 days introduced by the new Act and the numbers of patients now admitted
informally to these wards with no restriction on their period of stay have affected the
position, in that increasing numbers of patients are now being admitted for observation
to psychiatric hospitals outside the area, often remote from their residences. There were
1,750 patients so admitted in 1961.
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