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the feeding and care of young children, the minding of school children
until parents return from work, school children getting "out of hand",
housing difficulties, discharges from hospital, the care of the elderly,
and matters causing trouble such as marital relationships and
disharmony within the family. Social workers in other local
authority or voluntary services have given full co-operation when
requested. There is generally a very cordial relationship with all
types of social welfare workers throughout the area.
Special Services for Problem Families
The most difficult cases taken over by the special services
health visitors have been those where one or both parents were either
of sub-normal intelligence or unstable.
Family doctors and hospital psychiatrists have given considerable
support and advice to health visitors in such cases. This triad of
health visitor, family doctor and psychiatrist seems to be an intrinsic
combination in dealing with early signs of breakdown or other psychiatric
disturbance including those of long-standing.
Mental Welfare Officers have taken over some in emergency
and have referred back a few cases to the health visitor but these
have proved to be very few numerically.
It has been interesting to examine the sources of referrals of
problem families to the special services health visitors. By far
the largest number were brought forward by health visitors themselves.
The remainder were reported by various local authority departments,
by probation officers, almoners and family doctors. Before a
particular case is accepted by the special services health visitor the
health visitor for the district on which the family lives is consulted.
Between them they decide whether the case is urgent and needs
intensive work or can be carried by the health visitor. This act
of selection is important in the interest of really urgent problems
and to prevent the overloading of the special services health visitor's
case load. The close contact between the specialist and other
health visitors has been most rewarding in temporarily relieving
health visitors of certain families until intensive work has been
completed and in providing the specialist worker with background
knowledge of the case and a constant field worker to whom the family
can be returned.
Mental Health Case Conferences
Mental Health Case Conferences have been attended at the
Prince of Wales's Hospital each month. Health visitors discussed a
variety of cases with Dr. Sawle-Thomas, Consultant Psychiatrist.
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