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surgeries weekly in order to help with short term preventive case work. Also general practitioners have
attended monthly case discussions in the mental health section run by the department's consultant
psychiatrist.
This drawing together of the local authority, the catchment and teaching hospitals and the family
doctors has been taking place very gradually in Islington since 1965. This is an essential development if we
are to care for more and more of the mentally ill and the severely mentally handicapped in the community.
DAY CENTRES AND TRAINING CENTRES
With the increasing emphasis on community care rather than hospitalization, considerable responsibility
is carried both by the mental health social workers and by the staff of day centres and training centres.
Purpose-built premises have been available for only one of the seven centres opened since 1965. Many of
the buildings are far from ideal but the important thing seemed to be to get these centres going in whatever
premises were available, and each centre is designed to meet an entirely different type of need.
Of the three day centres for the mentally ill, one is run on group lines providing short-term rehabilitation
for younger clients, one is for longer term treatment in an industrial setting and the third provides for
psychogeriatric clients. For the mentally handicapped, we now have two mixed adult centres so that some
grading can be arranged according to age and ability, one purpose-built training school (including special
care unit) and one separate special care unit to provide the extra places needed for the children with dual
handicap. In addition we have the use of a 24 place day nursery run for the Borough by the Islington
Society for Mentally Handicapped Children. The training school and separate special care unit will be
transferred to the Inner London Education Authority on 1st April, 1971. All the centres are now well
established and are running at maximum capacity to meet a wide variety of needs.
ADMISSION TO HOSPITAL
The fact that community care has developed considerably in scope and quality since 1965 does not
obviate the necessity for hospital admission in some cases and mental health social workers have continued
with their "rota" work for emergency day calls and also during the night and at week-ends. This work can
be very stressful and sometimes dangerous, as those will realize who heard of the experience of one of our
social workers recounted by the B.B.C. on the early morning news bulletin some months ago.
PROVISION FOR THE MENTALLY HANDICAPPED
A feature of mental health in Islington is that the Borough has a tradition of caring for the mentally
handicapped which dates from the time when Elfrida Rathbone set up the first "Occupation Centre" in the
Borough in the 1920's and, to augment the work carried out by our social workers, much help is now given
with the after-care of former E.S.N, school children and their families by the Islington Elfrida Rathbone
Committee. It should also be mentioned that the Islington Society for Mentally Handicapped Children has
been working constructively with the local authority for more than twenty years, perhaps its most notable
achievement being its excellent day nursery, already mentioned, where young children with varying degrees
of mental handicap are accepted and given a high standard of care and training. Both these voluntary
organisations continue to be grant-aided by the Borough.
PLANNING FOR THE FUTURE
This is the last report on the service as a responsibility of my department. In conformity with national
policy mental health social workers will, by this time next year, have joined with their colleagues in the
Welfare and Children's Departments to form the Borough's new Social Services Department. Therefore, in
the latter part of 1970 welfare officers and child care officers were invited to spend days in our mental
health section in order to see something of social work from the mental health angle and our social workers
have participated in combined working parties, meetings and discussions in preparation for the future.
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