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As in the past, voluntary and statutory bodies have been very co-operative,
showing real understanding of the problems of our patients. Gratitude must also
be expressed to the staff of the hostels in this area. Temporary care for the
mentally handicapped was arranged as each emergency arose; recuperative holidays
were granted for all urgent patients, and the Dymchurch holiday was again subsidised
by the borough.
All centres were open to the public during Mental Health Week and there was
quite an amount of interest shown by the general public. Students have been received
and the medical students from St. Bartholomew's Hospital continued to visit in groups
throughout the year. At the request of the Matron of St. Clement's Hospital the
Council agreed to an experiment with the General Nursing Council. A student nurse
has spent three months in his last year of training doing community work with the
mental health section instead of further training in a psychiatric hospital. This
seems to have been successful and a second nurse will be following the same course
in April 1967.
ST. CLEMENT'S PSYCHOGERIATRIC IN-PATIENT UNIT AND DAY HOSPITAL
The Consultant Psychiatrist to St. Clement's Hospital, J.J. Cockburn.M.B.,M.R.C.P.I.,
D.P.M., has kindly supplied the following report on the year's work of the hospital's
psychogeriatric in-patient unit and day hospital.
Satisfactory progress has been maintained in all departments during the year.
The In-patient Assessment Unit (Dundee Ward) had an increased turnover; admissions
(131 patients) show an increase of 22% over 1965 (see graph). The same overall policy
outlined in my previous report has been pursued, and we have tried to make the best use
of the existing facilities, including the long stay beds at Long Grove Hospital. Patients
are not admitted to Dundee Ward unless out-patient or day-patient treatment or assessments
are impossible. Most depressive patients can be treated on an out-patient basis, but of
course, psychotic patients in whom the suicidal risk is high, must be admitted. Another
group where out-patient or day hospital treatment is often unsuccessful, is the persistent
paranoid illnesses in the elderly, where adequate drug therapy is essential. These
patients are often suspicious and unreliable in taking their drugs at home, and hospitalisation
for a time may be unavoidable. Finally, it is only possible in hospital to investigate
fully younger organic dementias. Some older dementing patients, particularly
where there has been a recent rapid deterioration in their mental state, also require
in-patient investigation. The importance of physical illness such as bronchopneumonia
in this latter group can hardly be over-emphasized, and it is often difficult definitely
to exclude pneumonia on an out-patient basis. It often produces no pyrexia in the elderly,
and it may be difficult to examine the patient adequately owing to his mental state.
Many patients, with serious physical illness symptoms, have been treated in the in-patient
unit during this year, and have been able to return home or go to a welfare home.
48.