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162
MENTAL HEALTH SERVICES
Effective modern treatment has proved the fallacy of the old
idea that mental patients could be cosily divided into 3 groupand
that they would automatically pass from short-stay beds
through the medium to long-stay beds. It can be demonstrated
that through these 3 categories progression, retrogression or both
can occur in the same patient at different periods and that therefore
such classifications tend to be unsatisfactory.
It is evident that a district general hospital giving comprehensive
services in wards of say 30 beds providing for all categories
of mental patients would not only be more economical in manpower
but would produce better and more stable therapeutic
relationships. Here the same nursing/medical team could treat
the case whether as an in-patient, out-patient or day patient and
closer liaisons would develop between the hospital team, the local
authority and the family doctor. Indeed, it would appear that it
is the government's long-term plan to see that complete psychiatric
treatment will be made available at the local district hospital.
It has been suggested in the Tooth-Brook Report of 1961 that,
by 1975, only 1.8 beds per 1,000 population would be needed for
resident patients in England and Wales suffering from mental illness
although in the London area experience shows that even 0.5
beds per 1,000 could well be sufficient for adult cases.
Naturally, such revolutionary changes will take a decade or so
to show their effectiveness which in turn will depend for their
success upon a number of factors such as an efficient geriatric
service, day centres, sheltered workshops, hostels, etc., responsibilities
which, at the present time, are to a large extent those of
local authorities.
General
During 1968, mental health services continued as previously,
the introduction of improvements and new facilities still being
severely curtailed by financial expediency.
Staffing difficulties remain but all emergency demands upon the
mental health service were satisfactorily met.
Mentally Subnormal
Referrals are received mainly from the Nursing Service which is
responsible for the "At Risk" register and whose information is
obtained from hospitals, midwives, M. & C.W. clinics, doctors and
health visitors. Others originate from the Education Authority. If