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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118
and the arrangements for medical examination are of a very varied character, as has
been previously described.
The whole question of juvenile court standards has recently been the subject
of a report by the Committee of the Children's Bureau of the United States Department
of Labour, which was issued last year. Their conclusions on the subject
of Places of Detention and the investigation of individual children are as follows :—
(i.) " Methods of Detention."—For temporary detention either a public
detention home or boarding homes under the supervision of the court should be
provided, available for the entire area over which the court has jurisdiction,
(ii.) The essential features of a detention home are the following:—
(а) The juvenile court, if not actually operating the detention home,
should control its policies and the admission and release of children.
(b) Provision should be made within the home for segregation of sexes
and types of children, and for adequate isolation facilities and medical care.
(c) Adequate facilities should be provided for the study of the child's
physical and mental health, but, except in rare instances, the detention
home should not be used primarily for this purpose.
(d) There should be specialised school work for the children detained,
and recreational facilities should be provided. The daily programme
of activities should be full and varied in order that constructive interests
may supplant morbid tendencies and undesirable companionships. Opportunity
should be given for the exercise of the child's religious duties.
(e) Effective supervision should be maintained at all times.
(/) The detention home should not be used as a disciplinary institution.
Study of the Case.—(i.) Social investigation should be made in every case,
and should be set in motion at the moment of the Court's earliest knowledge
of the case.
(ii.) The minimum essentials of adequate study of a case of delinquency
are—Study of the child himself, including a physical and mental examination
and study of his behaviour, developmental history, school career, and religious
background; study of his environment, including his family and home
conditions ; and estimate of the essential causal factors responsible for his
behaviour ; and in the light of this estimate, recommendations for treatment.
(iii.) Psychiatric and psychological study of the child should be made at
least in all cases in which the social investigation raises a question of special
need for study and should be made before decision concerning treatment,
but only by a clinic or examiner properly qualified for such work.
(iv.) The clinic for study of the child should be a separate branch of the
court or a separate organisation fully available. The personnel required
includes a physician trained in psychiatry, a psychologist, and one or more
social investigators.
(v.) The physical examination should be thorough and all the community
facilities for diagnosis and treatment should be utilised. Physical examinations
of girls should be by women.
(vi.) For rural communities facilities for study of the child may be provided
through the development of centres in urban communities or through travelling
clinics under the auspices of State Boards or Commissions or institutions.
Comparing the general practice in Canada and the United States with that
existing in London, the following points seemed to be prominent:—
(i.) That in the greater number of the cities from which information is
available there is little real difference in the kind of care, the nature of the
medical examination or of the data and conclusions which are laid before the
Court. There are some advantages in the Court House being adjacent to the
detention house.