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With but few exceptions, every case was submitted to a detailed physical examination,
and the general findings were similar to those of previous years and do not call for further comment.
There was a large increase in the number of cases of vaginal discharge, but a marked
decline in the incidence, real and relative, of gonorrhoea. In 104 cases of vaginal discharge,
of which 7 were recurrences, there were 21 cases of gonorrhoea. In 1937 there were 65 cases of
vaginal discharge, of which 27 proved to be gonorrhoeal.
As in former years, the great majority of cases other than those awaiting hearing at Court
were mentally tested. In those cases in which there was no request for a psychiatric report,
and where the opinion expressed by the headmaster of the school attended by the child or young
person was that the mental ability was normal, this was quoted in the routine medical report.
In the remainder, the general intelligence and mental endowment were estimated by applying
standardised mental tests. Aetiological diagnosis and classification were made only in a minority
of these cases. Detailed psychiatric examination was confined largely to those cases in which the
magistrate requested that full medical and psychological examinations should be made. Such
investigations and reports form the main body of the work under review. During the year
579 special reports were furnished, compared with 487 in the preceding year.
It was found that the longer the time spent on an individual case the more accurate and
precise was the diagnosis. Any attempt to shorten the psychiatric interview is found in general
to defeat its own purpose. The economic gain which results from the increased accuracy of
diagnosis and remedial measures indicated is very considerable.
In my last report I gave some account of the psychological classification employed. In
the examination of an individual case certain principles are followed. Any behaviour can be
regarded only as a final resultant of various component factors (i.e., it is a reaction of the total
personality to the environment). It is always the outcome of interaction between a psychobiological
unit and its milieu. This is always a dynamic relationship. Individuals differ from
one another quantitatively and qualitatively in their psycho-physical endowment. In the analysis
of an individual case the physical and mental state of health is considered both from objective
and subjective aspects. In either or both senses the physical state may be an asset or a handicap
to which an individual may react in a variety of ways. The particular nature of the temperament
and disposition has to be evaluated. The intellectual endowment, general and specific, is measured.
The strength and direction of the instinctual drives require careful elucidation. The moral
character of the individual can be understood only by a direct study of his social and other
attitudes revealed in the history and during the examination. To appreciate accurately the
significance of age and the degree of maturity it is necessary to have a systematic knowledge of
the mental, bodily and social behaviour, attitudes and interests of normal children at each age
level.
In order to understand the personality of an individual, these components and their subtle
inter-relationships must be recognised and assessed. If they are moulded together in a harmonious
pattern orientated towards the general social environment the personality is a healthy one. Where
there is disharmony, undercurrents of tension lead to dissatisfaction and frustration which may
result in delinquency. That environmental conditions alone cannot account for delinquency is
shown clearly by the great frequency of non-delinquent siblings living under the same conditions
as a delinquent. Healy and Bronner find that it is the less tangible and the less obvious emotional
factors which are the most important in delinquency, and my experience in general serves to
confirm this.