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It is not easy to explain the marked increase in the number of cases referred and
dealt with after the quarter which ended on 3rd April, 1965. Comparison with the previous
year is complicated by the fact that the London County Council statistics were compiled on
a health divisional, and not on a borough basis. The former Division 1 included the Metropolitan
Boroughs of Fulham and Hammersmith as well as Kensington and Chelsea but it is
undoubtedly the case that this borough, possessing as it does unusual sociological features,
has a potentially higher incidence of mental illness. The divisional statistics are not therefore
reliable for purposes of comparison.
It is, however, undoubtedly true that since the mental health service became a
local responsibility on 1st April, 1965 it has been possible to cultivate - largely through a
proportionate increase in staff - a greater degree of co-operation with psychiatric hospitals
and local out-patient clinics than was possible in the past. This welcome development has,
however, led in its turn to an increase in the number of cases referred since, with the regular
attendance of mental health social workers at the clinics held at St. Stephen's and St. Mary
Abbots Hospitals, referrals pass through the department and not, as hitherto, directly from
the Consultant to the admitting hospital. Furthermore, it will be realised that as the mental
health office is now accommodated in the same premises as other social work sections of the
Health and Welfare Department there follows the natural and desirable consequence that
cases of suspected mental illness are more frequently referred by the Welfare Section and by
officers concerned with maternity and child welfare, day nurseries and the home helpservice.
In short, the smaller area concerned has produced closer co-operation between
the various agencies in the borough concerned with the mentally ill. It has, however, produced
more referrals, hospital admissions and cases needing the provision of community care.
ADMISSIONS TO HOSPITAL
All persons referred to the Council as suffering from mental illness are visited by
the mental welfare officers and action taken according to the needs of the patient. Of the
961 patients dealt with during the year 384 were admitted to psychiatric hospitals under
arrangements made by the mental welfare officers. In addition to those shown as being
admitted to hospital informally, many others are in fact so admitted by arrangement between
the general practitioner and the hospital concerned without reference to the mental health
service and it is not therefore possible to provide figures of these cases.
COMMUNITY CARE
As will be seen in Table5, 348 persons have received visits from mental health
social workers. This figure comprised 128 mentally ill and 220 subnormal patients and
included those who attended the Social Club.
THE MENTALLY SUBNORMAL
Referrals are received mainly from the Inner London Education Authority following
the statutory examination of children at the age of five years for the purposes of Section 57
of the Education Act, 1944. In most cases arrangements are made for the child to attend a
training centre although in a minority of cases the degree of subnormality is such that it is
necessary to arrange permanent care in hospital. Referrals are also received in respect of
mentally subnormal children and adults moving into the Borough from other districts.
The Council have continued to hold the special clinic at Campden Hill Welfare
Centre initiated by the London County Council, which has as its primary aim the provision
both of skilled medical advice and sympathetic counsel to parents, many of whom are reluctant
to recognise the existence of mental subnormality in their children. This clinic, which
takes place once a month, is staffed by a Medical Officer of the Inner London Education
Authority with special experience in subnormality.
In times of domestic crisis or emergency, such as the pregnancy or illness of a
mother, arrangements havebeen made for severely subnormal children to go away for a period
of short-term care in appropriate surroundings. Such care, which does not normally exceed
eight weeks in duration, is arranged in hospitals if possible but because of the shortage of
hospital beds it is often necessary for the services of private homes to be utilised for this
purpose. In some cases care is provided in this way because of health needs of the severely
subnormal child, e.g., dental treatment, when admission to hospital is the only possible way
in which it can be provided.