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Child Guidance Centres
In Tottenham, the Medical Director, Dr. William Craike,
continued to see an increasing number of cases and he stresses the
importance of case conferences involving all the members of the Child
Guidance Team. During the year such a conference was held on a
special case, in which the mother was psychotic and had been
discharged from mental hospital. There were two young children
and the head mistress was concerned about their safety. Arrangements
were made to call together the Headmistress, the Psychiatric Team,
Mental Welfare Officer, School Welfare Officers and the Child Care
Officer, in an endeavour to find a satisfactory method of helping this
family. It is to be anticipated that more cases of this type will
arise, with the policy of early discharge of psychotic patients to their
homes, where they still live in the community, having home treatment
from their general practitioners though still under hospital supervision.
It is likely that stresses and strains will be thrown on the child,
which may be reflected in school and general behaviour. From past
experience it would seem that the adolescents are more likely to be
disturbed than the younger children; but this is one of the side effects
of the Mental Health Act which was not anticipated and which may
cause considerable concern in future years.
Dr. Craike has proposed an evening clinic for the Consultant
Psychiatrist to meet working parents and adolescents who cannot miss
time from school or employment.
Dr. Nina Meyer, writing about her work with the under-fives,
comments that the work has grown markedly in the last year. Most
have been cases of severe disturbance of sleeping in the under-twos.
In many it emerged that it was a problem of the inability of the
mother to let the young child separate from her. For many mothers
it is a difficult problem to make the transition from infancy to the
toddler phase, and this can be one in which disturbed patterns of
behaviour and personality are laid down.
At many of the diagnostic interviews, the health visitor concerned
with the child came with the mother; this was most helpful to the
psychiatrist and Dr. Meyer hopes that it will be increasingly so to
the health visitor. Suggestions were made of the sort of information
the health visitor can look for which may be helpful in psychiatric
consultation. Dr. Meyer suggests the health visitor will be able to
act increasingly as a liaison between psychiatrist and family. The
under-five clinic has no psychiatric social worker and this is an aspect
where the unique knowledge and experience of the health visitor is
so valuable in her helpfulness to the mother.
A further innovation was a monthly discussion group comprising
medical officers in infant welfare and toddler clinics and the Consultant
Psychiatrist. Here problems and points of view in relation to disturbances
of the under-fives were freely discussed with great benefit
to the psychiatrist and the medical officers.
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