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157
personnel for professional training during 1969/70 and a fourth
during 1970/71. From this it would appear that effective basic
training received in this Directorate has some bearing upon
acceptance for professional courses.
MENTAL HEALTH SERVICES
Early legislation in the field of mental health resulted in the
introduction of large institutions of up to 2,000 beds capable of
catering for all ages with ranging disabilities and erected remote
from the areas they served on the assumption that these hospitals
would be "self-sufficient" communities. Eventually these establishments
became overcrowded, difficulties of staff recruitment arose,
co-operation with local health authorities became unnecessarily
complicated and prolonged and, on occasions, acceptance by
neighbourhood inhabitants a problem.
Although some power was vested in local authorities by Section
28 of the 1946 Act, it was not until the Mental Health Act of 1959
that the duty of providing residential services for the mentally
handicapped not requiring hospital treatment was really made a
local authority responsibility. As a direct result, the provision and
expansion of day facilities and training centres has meant less
resources for residential accommodation. This, however, is
gradually being overcome. Nevertheless, for some years to come,
the nation will be dependent upon its inherited "old institutions"
not only for its treatment of severe mental handicap requiring
hospital facilities but also for the many patients who could
conceivably live in the community if sufficient residential accommodation
were made available by the local authority. Unfortunately,
local authorities are on the horns of a dilemma. With their
limited resources should they concentrate on preventive measures
with the young and so reduce the number of cases requiring
hospitalisation or should they provide more residential accommodation
to relieve hospitals of their undoubted heavy burden
and thereby fail to stem the tide of mental disability requiring
institutional treatment? Certainly experience has shown that
success is greatest where a case is accepted into residence directly
from the community and that the more prolonged the spell in
hospital the less able is a mental patient to return to normal society.
Patterns of hospital care are changing but because experiments
in the treatment of mental handicap are few and even experts
differ as to the ideal "set-up", no definite trend is discernible.
However, the modern approach is to seek for the integration of
services for the mentally ill into those comprehensive facilities to
be provided by the District Hospital and these are to be closely
linked with community services at present under the control