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Of these, 15 benefited to the extent of being discharged recovered, while the mental
condition of 50 others was considered to have improved subsequent to the operation.
Having regard to the fact that other forms of treatment had failed to bring any relief
of symptoms, and that consequently the prognosis before operation was uniformly
bad, if not entirely hopeless, the results achieved by leucotomy in the Council's
mental hospitals must be considered distinctly encouraging. Without a careful and
systematic follow-up over a long period, it is impossible to say whether the recoveries
will be permanent; but, even if there were no discharges, it is obvious that pre-frontal
leucotomy has something to offer. The change from noisy, violent and destructive
behaviour to that of orderly habits and of cheerful compliance with hospital routine is
an indication of a peace of mind that brings relief not only to the patients themselves,
but also to their friends and to the nurses who have to minister to these distressing
manifestations of mental disorder. A further inquiry will be made as to the progress
of the patients treated in this way.
The experimental scheme authorised at the end of 1943 whereby, subject to
necessary safeguards, patients at St. Bernards' and St. Ebba's hospitals were allowed,
as preparation for discharge to take local paid employment on a daily basis, returning
each night to the hospital, was commenced in the spring of 1944, but in June, 1944, the
former hospital was heavily damaged by enemy action, with the result that it was
necessary to evacuate about 1,900 patients to other hospitals, of whom some 200
patients were sent to St. Ebba's, and the consequent disorganisation made it impossible
to develop the scheme at either hospital to the extent anticipated. Nevertheless,
by the end of April, 1945,12 patients at St. Bernard's hospital and 14 patients
at St. Ebba's hospital had been dealt with under the scheme with such success that
the scheme was continued as a permanent arrangement at those hospitals, and
authority was given for the scheme to be operated on the same conditions at any
other London County mental hospital where the medical superintendent considered
it would be in the interests of the patients for it to be introduced.
Rehabilitation
of
patients
Owing to the increased cost of living, the maximum maintenance allowances
which may normally be granted by hospital sub-committees at their discretion were
increased from 15s. to 20s. a week (a) for limited or prolonged periods to patients
who are permitted to be absent on trial in the care of relatives or friends from London
County mental hospitals, and (b) during a period of convalescence not normally longer
than four weeks, to patients who are discharged from Tooting Bee Hospital to the care
of relatives or friends, or who have undergone voluntary or temporary treatment in a
London County mental hospital and are returning to their normal environment.
After-care
allowances
The purpose of these allowances is to provide patients with the means to secure
necessary comforts during convalescence, and to relieve them of financial worry during
their trial period. The amount payable in individual cases is authorised by the hospital
sub-committee after considering a report on the patient's financial circumstances,
and in special cases the amount of the allowance may be increased up to the current
cost of maintenance of patients in the hospital, with the proviso that every instance in
which more than £1 a week is allowed is reported to the Mental Hospitals Committee.
The maximum allowance for the maintenance of mental defectives placed under
the statutory guardianship of relatives was also increased from 17s. 6d. to £1 a week.
During the year 1945, the area of land farmed by the Mental Health Services
decreased by 16 acres, the total acreage on 30th September, 1945, being 6,543 acres
Farming
operations
(3,777 arable and 2,766 grass). Figures for previous years were:—
30th September, 1944—6,559 acres (3,793 arable and 2,766 grass)
1943—6,324 „ (3,574 „ 2,750 „ )
1942—5,983 „ (3,169 „ 2,814 „ )
1941—5,144 „ (2,239 „ 2,905 „ )
At outbreak of war—2,789 „ (1,041 „ 1,748 „ )
In addition, approximately 250 acres of land attached to general and special
hospitals and educational and social welfare establishments are under the general
supervision of the Mental Hospitals (Farming Operations Sub-) Committee.