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47
properly brought to notice. This adds to the case load of already overburdened staff and prevents
staff from seeing their patients as frequently as they feel is necessary to give them the support
they so badly need.
In August 1967 it was seen that the establishment of mental health social workers would need
to be increased but the national economic situation has prevented any steps being taken to add to
the staff. The mental health team is anxious to give a far more extended service to the City's
mentally sick residents but at present is quite unable to do so.
It had long been felt that the City's Mental Health Service would benefit from the services of a
psychiatrist and in August, 1967, Dr. J. D. Hailstone, Senior Psychiatric Registrar of St. Mary's
Hospital was appointed on a part-time basis to the City. Dr. Hailstone has been engaged in
surveying the services for the mentally ill throughout the City and relating these to the lines on
which our future work might be planned. His report is expected early in 1968.
During 1967 negotiations for premises for a hostel for the rehabilitation of mentally ill patients
were started, and the Mental After Care Association is being associated with this project. It is
anticipated that this hostel will be opened by the end of 1968.
In 1967 the City Council considered its existing services for the subnormal and severely subnormal
patients with a view to planning for the future a truly comprehensive scheme. It is valuable
to note that in the 0-15 age group the figures for Westminster relate closely to the national average
but it must be remembered that the City will always have an above-average number of subnormal
and severely subnormal children dealt with privately and who do not come to notice at all or until
a much later age. It must also be appreciated that at any point in time the position can change
through alterations in population distribution, birth rate, etc: these hazards are common to the
planning of any personal health service.
In view of the difficulty of finding sites and premises it is obvious that no detailed description
of proposed establishments can be given but if a plan is in existence and a flexible outlook is
retained opportunities can be seized and if an ideal cannot be achieved at least partial progress
can be made.
The adaptation of Linnet House Maternal and Child Welfare Clinic to become a special care
unit is an encouraging example of what can be done in this way.
The provision of a junior training centre for Westminster children is thought to be an outstanding
priority. This should provide eventually 100 places but occupation should be phased to minimise
the need to disturb children already well established in other centres, and consideration should
be given to the inclusion of a special care unit of 15 places in this scheme.
A very valuable facility would be the provision of temporary residential accommodation for a
small number of children, mainly for short stays, to cope with acute family crises.
Adult training centres are an essential part of any Local Authority service, and our present
trainees are well established, and it must never be forgotten that many patients have attended a
centre for many years and both their lives and those of their families are entwined in centre life.
Arbitrary uprooting of such trainees would cause deep personal distress and should therefore
whenever possible be avoided. It is again suggested that it is for the future that we must plan
and that a mixed adult training centre should come into being not later than five years after the
opening of the junior training centre. The adult training centre will then be ready to receive the
16 year old due to leave the junior training centre and younger trainees in other centres, 16 to 25,
might well be transferred as being more able to adapt than their older companions.
In the first instance, an adult training centre of 50 places would appear to be a realistic
suggestion but the policy of the retention of severely subnormal patients in the community will
greatly increase the number of places needed in 10 to 20 years' time. In developing an adult centre,
therefore, consideration should be given to providing a large centre which could in part be used for
some related purpose for some years, or finding a site or premises where expansion can be undertaken
when required. This centre should provide occupation, training in domestic and social skills,
craft work and some industrial work and should provide a real centre of interest and activity for
severely subnormal people who will never be able to compete in open industry and whose ability
to share in ordinary social activities is seriously limited by their mental handicaps.
In addition, an employment training centre providing about 25 places is required for trainees
who are likely after a period of not more than two years, but preferably less, to be able to find
work in open industry. It would provide for educationally subnormal school leavers whose stage of
emotional and social maturation prevents their retaining work without further opportunity to
develop in a sheltered environment. Some maladjusted school leavers and older subnormal people
with similar problems would be accommodated; also trainees from adult and junior training centres
who have reached the required standard.