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66
concerning the heart and great vessels have advanced by 15% from
0.80 per 1,000 births in 1965 to 0.92 in 1968. Over the same period
the Greenwich rate has never risen above 0.59 for this particular
anomaly.
Mental Illness
In this Borough, all our endeavours are directed towards dealing
with mental handicap within the community and home environment.
These include the provision of Junior and Industrial Trainin
Centres, Day and Combined Centres, a Day Hospital, various
Clubs and a recently established Hostel, all of which are under
constant surveillance with a view to introducing improvements to
meet changing circumstances. A dedicated field and adminstrative
organisation provides efficient support.
Effective preventive action is based upon profound knowledge
and understanding backed by accurate information. Regrettably,
in the case of mental illness, much of the data in use at present
is empirical although, with recently awakened public interest and
the establishment of a number of research study groups, this is
being remedied.
Prevention of mental illness, if made possible, would bring in its
train enormous advantages not the least of which would be the
release 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.
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.
Causes of mental retardation are often difficult to isolate except
in cases resulting from infection such as encephalitis and those
resulting from birth injury which, in theory at least, should be
preventable.