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are usually represented to be in urgent need of care, treatment and control for their
own welfare or for the protection of others because of acute or advanced mental illness.
Sometimes the officers are unjustifiably criticised for not facilitating procedure by
petition by a relative as an alternative to the summary reception order apparently under
the erroneous impression that certification is thereby avoided. This, of course, is not so.
Moreover, if a relative proceeds by petition he must pay out of his own pocket for
medical examinations by two doctors to obtain the two medical certificates which are
required, apart from running the risk of subsequent recriminations from the patient
or other members of the family. It is surely a good thing that the relatives should be
saved as much trouble as possible at a time which must in any event be extremely
distressing to them. It is obvious that relatives who would be willing to present a
petition for a reception order are not likely to be concerned that two medical certificates
should be provided instead of one as required for a summary reception order.
In some cases which the officers are called upon to investigate, they find that no
action by them of any kind is possible or necessary. Sometimes trouble has arisen
because of domestic disagreement in which violent temper has been displayed by a
member of a household which has subsided by the time of the officer's intervention
or which in his opinion is a matter for the police ; or it may be that a person possesses
an isolated eccentricity or even delusion which although extremely annoying to other
members of the household or neighbours is not sufficient to justify compulsory removal.
In other cases the officer may find that the patient is too ill physically to be moved or
he may suspect that the patient's mental symptoms derive from some physical cause
which should be investigated before he should take action, or he may have other doubts
about the case. Further possibilities are that he may think that the patient's needs could
be satisfactorily met by admission to a welfare home (this is often the case with elderly
patients) or by visits by a psychiatric social worker or by other means. In all these cases,
it is the practice of the mental welfare officer to explain his views to the general practitioner
as a result of which the patient may continue to be treated at home or be
admitted to a general hospital or be dealt with by one of the methods referred to above
or be referred to a consultant psychiatrist for a further opinion and advice.
When in his opinion a patient is in need of in-patient mental treatment the officer
considers whether it is possible for this to be provided without resorting to compulsion.
Before 1948 there was an arrangement by which elderly senile patients could be
admitted in certain circumstances to Tooting Bec Hospital without legal formality.
This practice has been continued and many old people are admitted in this way each
year. Suitable patients are admitted also to psychiatric geriatric units in other hospitals.
Recently the Ministry of Health has given authority for some mental hospitals, where
conditions are appropriate, to receive any suitable patients informally on a non-statutory
basis and the mental welfare officers not infrequently arrange such admissions. Many
patients are also admitted as voluntary patients and some as temporary patients under
the Mental Treatment Act, 1930.
An example, fortunately extreme but by no means without parallel, of the difficult
situations with which the mental welfare officers may be confronted occurred during
the early hours of 13th March, 1957, when the police were called to deal with a
Nigerian who had become very disturbed mentally. In response to a request from the
police, the Council's mental welfare officer on duty went to the house at 12.45 a.m.
A police officer and a police dog had been stabbed by the patient who had locked
himself in his room, which was a small room on the second floor reached by a narrow
stairway. The patient was stamping about his room screaming and chanting in a foreign
tongue. He was armed with a knife and stiletto and was threatening to kill anyone who
approached him. It was agreed with the superintendent of police that a hole should be
bored in the door and a barricade erected outside to prevent the patient breaking out
and running amok. After many hours of patient persuasion by both the police and
the mental welfare officer, the patient was persuaded to surrender his weapons. The