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166
SECTION VI
MENTAL HEALTH SERVICES
Introduction.
In the following pages detailed descriptions are given of the
aims and purposes of the mental health services which are being
developed in the Borough. Reasonably accurate estimates can be
given regarding the incidence of mental subnormality, but the
degree of mental illness in the community requiring the attention of
the local authority is difficult to estimate correctly. According to
the most recent figures available, if Greenwich is typical of the
national average we can expect somewhere in the region of 700 of
the population to be mentally subnormal, of which total perhaps
180 at any one time will be under the age of 16.
Because of the care taken by midwives and health visitors in
compiling the "At Risk" and "Handicapped" registers, it is doubtful
if many mentally handicapped children do not come to the
notice of the department. Nevertheless, even with all precautions
some can escape ascertainment, especially children under the age
of five.
The numbers of mentally ill in Greenwich who may require
community services may be about 600, but this figure can be
nothing more than an intelligent guess. In any case these numbers
are not static. Population is a dynamic agglomeration. The birth
rate fluctuates. The differential age structure is changing perceptibly.
The expectation of life of the mentally disordered and handicapped
is increasing with new methods and treatment. All these
factors, complicated in themselves, have an influence at any one
time on the numbers who may require community support. The
services have therefore to be geared to a reasonable expectation
of possible requirements and, apart from the broad and obvious
purpose of helping the disordered and handicapped to live as useful
and purposeful a life as the limits of their disability will allow, a
great deal of public education and enlightenment on these important
questions is desirable and it seems that this can only be done
by the local authority. Great stress is now being laid on the fact
that these patients are part of a family and members of the community,
and both families and the community have to be educated
to accept them and to play their part in this new field.
It may be asked where prevention comes into these endeavours.
Prevention embraces genetics, heredity and sociology as well as
neurology and psychiatry, and it is difficult to see, in the present
organization of society, great and spectacular advances on a wide
front. Nevertheless, certain types of mental illness can be prevented