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107
a week and provides training and occupation under the direction of an occupational
therapist for mentally sick patients with a view to their rehabilitation to normal life.
The clubs meet on one evening a week and are attended by persons living in the
community who need a measure of mental support and assistance to enable them to
carry on their normal lives. The Council is represented on the board of governors of
the Institute.
Long term
care
The Council has undertaken responsibility for the cost of maintenance of a number
of mentally sick persons in homes owned or sponsored by the Mental After Care
Association and in one home managed by the National Association for Mental Health.
There are at present 71 patients boarded-out under this scheme and they are nearly all
chronic or senile patients who have neither homes nor relatives able to care for them
and do not require hospital or nursing care. It is considered that the maintenance of this
type of patient in these special homes provides a very valuable service as the patients
need a greater degree of supervision than can be given in ordinary welfare homes or
hostels. The patients are visited regularly by the social workers of the Mental After Care
Association and also by one of the Council's psychiatric social workers. The weekly
charge made by the Mental After Care Association was increased from 54s. 10d. to
₤33s. a head for those patients maintained in homes sponsored, but not owned, by the
Association and to ₤313s. 6d. a head for those maintained in homes owned and managed
directly by the Association. Patients are assessed according to their means and some
contribute towards the cost of maintenance. Those who have no means receive 6s. 6d.
a week pocket money from the National Assistance Board. In suitable cases, voluntary
patients on their departure from hospital and certified patients on discharge are maintained
for periods up to a maximum of three months in Mental After Care Association
homes to enable them to adjust themselves to community life and to find employment.
Recuperative
holidays
Recuperative holidays are provided in Mental After Care Association and other
selected holiday homes on medical recommendation for persons suffering from mild
psychiatric disability, including those attending psychiatric out-patient clinics, who
primarily need rest, fresh air and good food and who present no special behaviour
difficulties. A contribution towards the cost of each holiday is recovered according to
the means of the person for whom the service is provided ; 158 recuperative holidays
were provided in 1952. This figure, which includes cases of certified and voluntary
patients discharged from mental hospitals maintained temporarily in Mental After Care
Association homes, shows a considerable increase compared with 1951, when 93 holidays
were provided. There is no doubt that holidays arranged in the early stages of mental
illness, in conjunction with suitable out-patient treatment, if necessary, often avoid the
necessity for admission to hospital. The cost of maintenance rose considerably during
the year and the average weekly cost per head was approximately £3 18s. compared
with just over £3 in 1951. The average length of each holiday was three weeks.
Removal of
persons of
unsound
mind
Work under the Lunacy and Mental Treatment Acts
The Council's proposals under section 51 of the National Health Service Act, 1946,
provided that the work performed by duly authorised officers of securing that persons
of unsound mind are placed under care and control and subsequently of obtaining
reception orders for their detention if necessary, should be carried out from the four
district offices from which mentally defective persons are supervised. Owing to problems
caused by the shortage of beds in observation wards and office accommodation difficulties,
however, it was not possible to arrange this and, with the approval of the Minister, the
work was centralised at the County Hall as a temporary measure. The question of
decentralisation has been reconsidered from time to time but the shortage of observation
ward accommodation has persisted and this and the further factor that decentralisation
would involve considerable additional expenditure and manpower have resulted in a
continuation of the centralised arrangements. The question has been reviewed annually.
It was the intention that the duly authorised officers (mental welfare officers) should