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In order to prevent children being taken into care in the absence of the mother and the inability of
the father to cope, arrangements are made for a Home Help to visit in the mornings to prepare, and
take the children to school or the day nursery, and again in the evening to see to their needs. In
addition, special Home Helps are used in the training and rehabilitation of problem families. By
guidance, example and advice, these Home Helps play an important part in encouraging parents to
improve their housekeeping and domestic affairs.
The service is, of course, mainly devoted to the care of the infirm and for the lonely, handicapped,
or aged person a visit of the Home Help is often a vital link with life. The Home Help is able to
keep the old or handicapped person under surveillance in case they need medical attention, and to
ensure that they have one good meal a day.
Details of the number of cases in which this service was provided during 1965 are set out in Table 40,
page 70.
MENTAL HEALTH
(Mrs. R. S. G. Paterson, Principal Mental Health Social Worker)
On 1st April, 1965, the City of Westminster took over from the London County Council the
expanding mental health services which were developing through the implementation of the Mental
Health Act, 1959. The duties laid upon the local authority are manifold, some obligatory, some
permissive, but its main activities spring from Part II, Section 6 of the Mental Health Act and Section
28 of the National Health Service Act, 1946, which empowers the local authority to provide and
maintain patients in residential accommodation, appoint mental welfare officers, exercise functions in
relation to guardianship and provide ancillary or supplementary services.
The placing of persons under Order in hospital or under guardianship requires medical recommendations
and lay application which can be made by the nearest relative. If, however, a relative's
signature is unobtainable the application must be made by an appointed mental welfare officer.
An authority must therefore appoint welfare officers for this purpose otherwise the obligations of the
Act in this sphere cannot be fulfilled.
The authority is also responsible for approving the appointment of medical practitioners who are
authorized to sign recommendations under Sections 25 and 26 of the Mental Health Act. The
authority's other functions are more permissive and can develop in accordance with the needs of its area.
The day to day activities of the mental health service can be divided roughly into the immediate
responsibility of assisting in the arrangements for admission to hospital of acutely mentally sick
people and the long-term work of caring for those resident in the community.
The acutely mentally ill require to be dealt with as a matter of urgency and the City Council's
mental health social workers (mental welfare officers) are under particularly great pressure in this
field. Statistics produced by the London County Council show that a high proportion of all emergencies
arising in the area of the old County of London occur within the boundaries of the "new"
City of Westminster. There are many reasons for this, but one of the outstanding factors is the very
high proportion of people resident in Westminster who are not living in a stable family home. The
services for such emergencies must cover 24 hours, seven days a week.
Prior to 1st April, 1965 officers for this emergency service at night and weekends were drawn from
the whole of the London County Council's mental health staff and operated on a county-wide basis.
The need to provide a similar service within the area of the "new" City of Westminster with the limited
staff transferred could have resulted in the breakdown of the Westminster community care service as
staff time was of necessity almost wholly taken up with the day and night emergency work. The City
of Westminster recognized that an immediate increase in staff was required and five posts of mental
health social worker were added to the establishment and recruitment undertaken. By the end of 1965
only two vacancies remained unfilled and thus pressure was eased. The appointment of a City
Duty Officer outside office hours (referred to elsewhere in this Report) who deals with all enquiries
during these periods has greatly helped the mental health social workers. It soon became apparent, too,
that a much better service outside office hours was possible when this was being given by City Council
staff who are familiar with the area, are already known to other agencies and able to deal completely
with a case or pass on to their own colleagues problems that had not been resolved. Thus, if it is
not always possible for the same officer to deal with the case, he is at least able to hand it over to a
colleague with whom he will be working in the closest association.
In dealing with the admission of patients to hospital, whether formal or informal, the mental health
social worker called on is expected to "take over" the situation. He may not only have to exercise
his statutory function of signing an application under Section 29 (three day order), Section 25 (28 day
order) or Section 26 (one year's order) but he will also be expected to find a bed in hospital, sometimes