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conferences are held under his guidance.
Those family doctors who have been concerned with particular patients
have been most co-operative throughout in assessing those indicated by the
health visitor and by making ultimate referral to the consultant. Early signs
of breakdown were the subject of report in some cases. There were others
who were regarded as being unable to benefit from further psychiatric treatment
or who have resisted the assistance that psychiatrists or psychiatric
social workers can give them. It may be expedient for psychopaths to be
returned to their homes when no further treatment or hospitalisation is of any
value to the patient, but the burden of contending with them falls first of all on
the family and relatives. It is also inevitable that the one constant visitor to
the family, i. e. the health visitor, finds these cases come back to her or the
special services health visitor who with the family doctor help to sustain them
and their worried relatives.
Special Services for Problem Families
Miss H. J. Howse, special services health visitor for the Hornsey part
of the Area reports:-
"As so many agencies dealing with problem families or families with
special difficulties feel that even after intensive work any improvement obtained
does not last, endeavour has been made, where possible, to keep a check on the
families dealt with. After 2¾ years the result of my observations of some 28
families, having between them 105 children, is as follows: -
Children: -
Four who were "in care" are now at home with their parents.
Two children who were rejected by their mothers have had to
be taken into care.
Six children (three families) are in care because of severe
mental illness of the mother.
Two children (of one family) are in institutions because they
are imbeciles.
In all but one of the remainder of the cases the children have been kept
together with their own parents; the exception is with its grandparents.
It has been possible to keep 95 children at home with their parents and
to bring home again to their parents four children who were "in care".
Families
Fourteen families have had association with the N. S. P. C. C.
Twenty four parents have been under the supervision of probation
officers, on probation or in prison.
Twenty six parents suffer from mental illness or mental subnormality.
In dealing with problem families my experience has shown that: -
1. From the beginning every opportunity must be taken to get families back
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