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Psychiatrist to the Prince of Wales's General Hospital, to members of the
medical and health visiting staff on "The implications of the Royal Commission
Report on Mental Health". He made a plea for closer co-operation
between hospital and local authority services.
Later arrangements were made for a monthly case discussion session
for health visitors in the psychiatric department at the Prince of Wales's
General Hospital at which health visitors presented cases known to them
of early signs of mental breakdown.
It was not intended that the Consultant should see any patient who
might be the subject of the case conference, except by referral from the
family doctor, and no person concerned was asked to attend while the
case was under discussion.
The purpose of such case conferences is to assist health visitors to
obtain a fuller understanding of mental health and methods by which
health visitors can more adequately assist individuals and families; and are
particularly helpful where families find it difficult to cope with a mentally
sick adult or one nearing breakdown living at home.
The first case conference was held in the late afternoon of 2nd June and
at monthly intervals for the rest of the year. These occasions have proved
to be a very real help to health visitors who have presented cases and
others who have attended as observers.
It is perhaps too early to assess the effect this may have beyond
emphasising that the conferences are fulfilling the purpose for which
they were started and to state how fortunate we are to have the guidance
and counsel of Dr. Sawle-Thomas at a time when a great many people
are pondering on the effect that new legislation may have in this country.
This is also the first year in which the health visitor has been able to
refer young children directly to a psychiatrist specialising in child guidance.
The health visitor makes appointments for parents to attend with the
child and she is herself present throughout the interview. The psychiatrist
(Dr. C. Phillips) attends one session a week to see children of under
two years of age who are revealing early patterns of behaviour which
cause disquiet or uneasiness for their parents.
Children suffering from sleeplessness, feeding difficulties, retardment of
speech, over-activity and other disorders have been seen.
While it is common for mothers to be the sole parent present at the
initial interview it is not at all unusual for both parents to attend subsequently
or for fathers to offer to be present. Children, parents and health
visitors have profited from these interviews although the reaction to the
technique used varies considerably. Time cannot be allowed to be a
pressing factor if the underlying motives for behaviour are to come to
the surface. It is for this reason that a small number of interviews is
arranged for each session.
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