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of the great physical and financial burden now being shouldered by
the hospital and local authority services.
It is known that genetics figure largely in mental illness but,
with knowledge in this field at present being very limited, prevention
in these instances can lie only in the application of eugenics with the
local authority playing a supportive role. Such a role would include
efforts enabling all individuals to realise their full potential capacity
with a view to ultimate social adaptation and integration within the
family and community. However, the establishment of "genetic
clinics" would seem to be one logical step which could quickly
reduce the numbers requiring supportive services.
Elimination of brain damage in the newborn—perinatal as well
as congenital—would be a further step towards prevention of mental
illness and, in time, the "at risk" registers should provide some of
the answers. This would, of course, depend upon fully recording
neonatal illness and the maintaining of thorough clinical examinations
of selected children at regular intervals up to about the age of
three months.
Causes of mental retardation were often difficult to isolate except
in cases resulting from infection such as encephalitis which, in
theory at least, should be preventable. Prompt relief of hypoxia
and modern methods of resuscitation in respiratory distress in the
maternity unit, the regular monitoring of bilirubin in the newborn,
routine screening (preferably by blood testing) for phenylketonuria
and galactosaemia were all avenues open particularly to the
paediatrician in the quest for prevention.
A comparatively novel aspect of mental disability is to be found
in drug addiction which, unless controlled, is certain to add its quota
of psychotics and schizophrenics to the ever-growing number of
smokers, insomniacs and neurotics, etc., whose illnesses are considered
to be psychiatric.
Human evolution itself, which is the adaptation of an individual
to its environment, may also be implicated in the production of
neuroses found in families which, having for several generations
adapted themselves to a particular society, are compulsorily
removed to an entirely different area and environment.
Mental impairment which is frequently met with in elderly people
could, to a large extent, be prevented by regular surveillance. In
geriatric cases a great deal of dementia arises from isolation and
loneliness following loss of relatives or friends, from "unreported"
illness, from compulsory retirement or financial difficulties and very
often from malnutrition resulting from the "tea, bread and butter"
diet.