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by timely intervention. Such things as endocrinal disturbance and
metabolic disorders are amenable to medical diagnosis. The
possible place of eugenics in these intractable problems has yet to
be developed and considered. Heredity and sociological factors are
more difficult and a great deal of research into social pathology is
required before any tentative conclusions can be advanced. The
hospital and local authority services might be deemed to be
secondary prevention inasmuch as treatment, support and rehabilitation
prevent a recurrence of the illness, and it is in this light that
the local authority services have been organized and should be
judged. All the services described below are to some extent based
on an empiricism, and the approach and results will have to be
assessed over a period of years.
Mental Health Officers
In respect of persons suffering from mental disorder and where
the appropriate relatives are unwilling or unable to make application
for the admission of such persons into hospital or into
guardianship then, in accordance with the provisions of the Mental
Health Act, 1959, the Mental Health Officer (statutorily entitled
Mental Welfare Officer) is required so to do. Before undertaking
this procedure, which he does entirely on his own responsibility,
the mental welfare officer must satisfy himself not only that such
an application ought to be made but that, having due regard to
the wishes of relatives and taking other relevant circumstances into
account, it is necessary or proper for the application to be made
by him. It is his duty to escort and convey mentally disordered
persons to hospital and, subject to the provisions of the Act, any
person absconding from hospital or guardianship may be taken
into custody and subsequently returned thereto by the mental
welfare officer. Moreover, where an officer has knowledge that a
person suffering from mental disorder is living alone, or is being
cruelly treated or neglected, he has a duty to apply to the Court
for a warrant to enter such premises with a view to ascertaining
the situation.
Apart from emergency applications where only the medical
recommendation of the patient's own doctor is required, it is
necessary to obtain a further medical recommendation from a
doctor approved by the local authority as being experienced in the
diagnosis and treatment of mental disorder. Arranging for the
visits and co-ordination on the part of doctors often proves difficult
and time consuming, most cases taking a minimum of half a day
but often considerably longer.
Greater emphasis is given to prevention than to 'aftercare'
but before, during and after necessary hospitalisation when advising.