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but this limitation we must accept, knowing that this work, if successful, will gain
force, and that, moreover, members of such discussion groups themselves may act
indirectly as 'educators' by influencing their friends.
37. Reading matter is being increasingly employed in health education. It is hardly
possible, however, to find approaches which will suit all—or even a majority—and such
impersonal methods are not without danger. To some extent health education journals
are already concerning themselves with mental health. For the understanding of common
developmental phases, there may be a case for well-designed pamphlets—some of them
reduced almost to picture strips. Some parents, on the other hand, may be referred to
more comprehensive reading, and joint schemes with public libraries already exist in
some parts of the County. There is as yet little experience in this country of concerted
mass approach methods but it is known that they have caused difficulties elsewhere
and any development of such methods should be considered with reserve.
In-service training of public health staff
38. We have already expressed our view that improvements in the basic training
of public health staff, with proper emphasis on mental as well as physical preventive
medicine, are necessary and urgent, but they can only gradually come into being even
if agreement in principle is reached on them. Moreover, existing staffs will not benefit
directly from any improvements of basic training and ways must be found to enable
them to play their full part in a programme of Preventive Mental Health. It is the
unanimous opinion of the Group that the key to success of such a programme lies in
the promotion and maintenance of close ties between individual child welfare and child
guidance teams. We believe that such a link-up would be of the greatest mutual
advantage and represent the only sound basis for a scheme of this nature. There are, of
course, cases which are so profoundly disturbed that they are beyond the scope of
preventive methods and early treatment. Such cases will require to be referred to the
child guidance team. Close liaison, however, will ensure continuity of treatment and
minimise the alarm often felt by parents when psychiatric advice is recommended.
39. In the training of public health staff in preventive mental health, two lines of
approach may be distinguished; first, the broad orientation of medical and nursing
staff and, secondly, the more intensive training of a smaller number of doctors and
health visitors on the basis of individual cases.
40. In dealing with the first line of approach reference has already been made to
seminars on preventive mental health which have revealed wide-spread interest among
medical officers, health visitors and social workers. Such orientational courses should
be frequently held, wherever possible on the basis of local discussion groups. We
consider it essential that the Council's midwives should be given every opportunity to
participate in such activities.
41. The second approach must be on a much smaller scale. Its keystone must be a
more intensive training of a necessarily much smaller number of doctors and health
visitors by giving them the opportunity of discussing individual cases with a psychiatrist
and psychiatric social worker from a child guidance clinic. In this way they will acquire
insight, experience and clinical skill in recognising factors which may give rise to
emotional disturbance and maladjustment and in dealing with them in their very early
stages.
42. We have referred to experimental work of the Brixton child guidance team
in child welfare centres and to the further development of this technique by introducing
a regular weekly case conference into a child welfare centre. By using this type of case
conference at some of the early meetings of our own Group, we gained insight into
the kind of problems likely to be met in child welfare work. We are agreed that this
is an extremely valuable method of training. It constitutes the most practical means of
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