London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1957
[Report of the Medical Officer of Health for London County Council]
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The following table shows the extent to which the mental welfare officers used the various forms of initial action open to them :
| Initial | 1956 | 1957 | ||
|---|---|---|---|---|
| % | % | |||
| None possible or necessary | 1,666 | 21.8 | 1,691 | 22.7 |
| Referred for continued care* (other than at mental hospital) | 62 | 0.8 | 63 | 0.8 |
| Admitted to mental hospital— | ||||
| (a) as voluntary patient | 181 | 2.4 | 235 | 3.2 |
| 20 | 0.3 | 41 | 0.6 | |
| 39 | 0.5 | 51 | 0.8 | |
| Referred to psychiatrist | 123 | 1.6 | 138 | 1.9 |
| Removed to observation ward | 4,091 | 53.6 | 3,924 | 52.6 |
| Referred to J.P. other than at observation ward | 1,448 | 19.0 | 1,296 | 17.4 |
| 7,630 | 100.0 | 7,439 | 100.0 | |
* Referral to welfare department, sanitary authority, psychiatric social worker, back to general practitioner for possible
help on general medical grounds, etc.
f An arrangement applicable largely to Tooting Bee Hospital, antedating the National Health Service, and relating in
the main to persons aged 70 or more who have not previously been certified.
It will be seen that in 1957 there were increased numbers both absolute and relative where no action was possible or necessary, in informal admissions to mental hospitals and in referrals to a psychiatrist ; on the other hand there were fewer removals to observation wards or referrals to Justices of the Peace. If' no action ' cases are excluded the percentage of the balance can be classified as follows :
| 1956 | 1957 | |
|---|---|---|
| Independent action by mental welfare officer | 5.1 | 6.8 |
| Referred to psychiatrist | 2.1 | 2.4 |
| Removed to observation ward | 68.5 | 68.3 |
| Referred to J.P. | 24.3 | 22.5 |
| 100.0 | 100.0 |
Viewed in this light the changes are limited to an increase in independent action or
referral to a psychiatrist accompanied by a decrease in referral to Justices of the Peace.
It is a matter of policy that in cases where the choice open to the mental welfare
officer is restricted to removal to an observation ward or referral to a Justice of the
Peace the former option is exercised in so far as vacancies permit.
No action cases—In view of the fact that over a fifth of the total investigations resulted
in no action being found possible or necessary by the mental welfare officers, a sample
of such cases was examined independently both by myself and the senior psychiatric
social worker concerned to see what proportion of cases might have benefited from the
services of a psychiatric worker. In the event it was found that in only one or two per
cent. might help usefully have been given and the outstanding impression left as the
result of the examination was the very wide range of situations to which the mental
welfare officers were called and in which, without doubt, no action was the proper
course.
| No action possible or necessary | 15 | |
| Out-patient appointment not kept | 23 | |
| Recommended for continued care other than as in- or out-patient | 5 | |
| Out-patient | 23 | |
| Admitted to observation ward and discharged by medical officer Admitted to mental hospital as : | 2 | |
| (a) voluntary patient* | 60 | |
| 3 | ||
| Certified (Sees. 14/16)* | 2 | |
| Result of assessment unknown | 5 | |
| 138 | ||
J*