London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1924

[Report of the Medical Officer of Health for London County Council]

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114
(iv.) To give an account of the chief factors and problems with regard to
individual children—for the information of the Court in relation to the disposal
of the cases, and for the guidance of the probation officers or other agencies who
may subsequently be called upon to deal with them.
The centres therefore are not intended merely for the determination of the
feeble-minded or psychopathic, but rather to help and advise in the case of any
problem child. Furthermore, in the case of most centres attached to the Courts,
arrangements are made for children to be brought up for re-examination and further
report whenever the probation officer or others concerned deem it desirable.
The investigation consists of a social history, which is a record as complete
as can be obtained of the child's environment, the stock from which he springs, and
his developmental career. It is intended to describe not only the physical conditions
of the home, but the intellectual, moral, religious, and social atmosphere, and to
reveal the mental attitude of the individuals with whom the child is most in contact
; thus, by indicating the influences and interplay of personalities which have
made the child what he is, to suggest possible causes of mal-adjustment.
The physical examination is of the same character as is carried out in England,
though more stress is laid on investigations as to the incidence of venereal disease.
The mental examination aims at the estimation of the level of intelligence, of
educational progress, and the presence of special abilities or disabilities (which are
often of the greatest importance), while from the child himself is obtained an account
of his behaviour and his motives, is attitude towards himself, and his associates,
and other factors of his mental life experiences.
The recommendations made to the Court are of much the same character as
in London, but the judge all like a technical summary of the details set before them,
and have requested that the fullest recommendations should be made, whether or
not there was any prospect of their being carried out. Judges and officers of the
Juvenile Courts were unanimous in their opinion that full reports were of the greatest
advantage in cases where the children had been placed on probation ; nearly all
seemed anxious for the further development of following-up work with a close
co-operation between the probation officer, social workers, and the medical officer
at the centre, and in particular they urged that, in the case of young children, there
should be close co-operation with the education system. Mr. Leopre, the chief
probation officer of Buffalo, stated :—"The school has as close a contact with the
child and more information concerning his characteristics than any other agency
excepting the home—and more than some homes."
The State Criminologist of Illinois has suggested the formation of a division
of mental health in the Department of Education which would act in the closest
co-operation with the Juvenile Court, but which could also deal with the problem
children in a pre-delinquent phase. The probation officer of Cincinnati, in one of
his reports, points out the great advantages of extra legal action, stating that a
boy when charged in some cases becomes in his own mind a hero, while in other
cases he feels that a stigma has been placed upon him, but that in either case he
becomes a greater problem than before.
The time required for the necessary studies varies naturally according to the
type of problem and the amount of information that can be obtained. The director
of the clinic attached to the National Committee for Mental Hygiene in New York
estimates that it takes from 3 to 5 days to secure a complete history (though the
social worker or other officer might not be occupied the whole time on one case),
and that the child must spend from 6 to 8 hours at the Centre for mental examination,
though this naturally has to be spread over a period of several days.
Facilities for the medical examination of delinquent children are available in
the chief cities in Canada, and, according to the returns of the Washington Bureau,
in 77 per cent, of the Juvenile Courts in the cities of the United States with a population
of over l00,000.