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Report of the County Medical Officer—General. 69
while 011 the journey. At present many of the institutions are situated a considerable distance from
London, so that in case of delay, meals have had to be provided for the patients.
One hundred and sixty cases have been placed under supervision, and the Council has, for an
experimental period of six months, entrusted this work to the London Association for the Care of the
Mentally Defective. The supervision is carried out by visits and inspection of the homes or places
occupied by relatives of defectives, and assistance and guidance is given to the relatives for the benefit
of the defectives. The visits are made at intervals according to the needs of the case, but in any case
each defective is visited at least once in three months. The results of the visits are tabulated and
forwarded to the medical officer, who reports to the local authority when further treatment is considered
desirable.
The local authority has no duties in regard to defective children over the age of 7 years and under
the age of 16 years,except those whose names and addresses have been notified to them by the education
authority under the provisions of the Act. Defectives under the age of 7 years are only to be dealt with,
therefore, provided that they are neglected, abandoned, without visible means of support, or cruelly
treated ; or are inmates of, or liable to be sent to a certified industrial school. The ordinary age of
admission to public elementary schools is, however, 5 years, so that medical officers carrying out school
inspection, attendance officers, and others become aware of the existence of certain defectives at an
earlier age than 7 years. Should these, for the above-mentioned reasons, be liable to be dealt with
under the Act, they are reported to the Committee in the usual manner, but such circumstances are
extremely rare. Children who are defective, but capable of benefiting by education, can be sent to
special schools, and their attendance can be enforced thereat between the ages of 7 and 16 years, but
children who are idiots or imbeciles cannot be sent to special schools. In the past, when the child
was returned as an idiot or imbecile, it was not likely to be seen again for a considerable period. When
there was no prospect of ultimate educability, such children were noted down as invalid, and therefore
unfit for school attendance for such period of time as might be necessary" to bring them up to the age
of 7 years, when arrangements were made by the divisional superintendents of the education authority
for the cases to be re-nominated for medical examination. This practice is being continued, but cases
not liable to be dealt with are not called definitely idiot or imbecile until after the age of 7 years, as
otherwise there would be a risk of their being marked off the books of the attendance branch, and so
escaping notice at a later period. All cases are re-examined after attaining the age of 7 years.
It has not been possible to place the work upon a permanent basis, but up to the present
the Council has appointed additional medical staff to the equivalent of five sessions a week, and a
full time inspector, and has approved the full time medical staff for the purpose of conducting medical
examinations, and three inspectors, in addition to the one specially appointed, to convey alleged
defectives to places of safety. The following information furnished by the Clerk of the Asylums and
Mental Deficiency Committee, shows the number of cases of alleged mental defect dealt with up to the
31st March, 1915, and the action taken.
Information received from various sources of alleged cases of mental defect in 995 cases.
Number dealt with by Local Authority 349
Cases not liable to be dealt with by the L.C.C. 9
Cases found after inquiry and medical examination not
to be subject to be dealt with under the Act 74
Cases referred by the Education Authority.. 6
Cases not ascertained and no action taken 27
Cases still under the consideration of the Local Authority on
1st April, 1915 530
Information as to cases dealt with was given:—
By the Police Authority 17
By the Board of Control (i.e., cases in prison) 47
By the Board of Control (i.e., cases in receipt of poor-law
relief) . 15
By the Local Education Authority 208
By miscellaneous informants 62
The cases have been disposed of as follows:—
Cases sent to institutions :—
Under detention orders made by Metropolitan magistrates
under section 8 11
Under orders made by other Judicial Authorities
on petition under section 5 53
Under orders made by the Secretary of State under
section 9 13
— 77
Cases placed under supervision 160
Cases sent to places of safety pending the presentation of
a petition 25
Action could not be taken owing to the lack of suitable
accommodation 31
Cases discharged from prison before action taken 19
Referred to or dealt with under poor law 19
No action for other reasons 18
Supervision.
Infectives
under seven
years of age.
Cases
notified and
action tali en.