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 table below shows the major types of initial action taken by the mental welfare officer for age groups of under 65 and 65 and over.
| Age group | Total | |||||
|---|---|---|---|---|---|---|
| % | % | % | ||||
| Removed to observation ward (less those referred to psychiatrist) | 3,463 | 79.5 | 458 | 32.9 | 3,921* | 68.3 |
| Brought before a Justice (less those referred to psychiatrist) | 504 | 11.6 | 792 | 56.9 | 1,296 | 22.5 |
| Other action | 386 | 8.9 | 142 | 10.2 | 528 | 9.2 |
| Total investigations where action was taken | 4,353 | 100.0 | 1,392 | 100.0 | 5,745 | 100.0 |
| No action | 1,230 | 22.0 | 456 | 24.7 | l,686† | 22.7 |
| Total investigations | 5,583 | 100.0 | 1,848 | 100.0 | 7,431 | 100.0 |
* Age not stated in three cases.
† Age not stated in Jive cases.
It will be seen that Justices of the Peace dealt with proportionately more of the
elderly : of the 792 such cases, 283 (35.7 per cent.) were certified. On the other hand,
of the 458 elderly persons removed to observation wards only 69 (15.1 per cent.) were
certified. Whilst it is not unreasonable to suppose that most of the few younger patients
referred direct to Justices of the Peace were so acutely disturbed that certification would
follow, it is policy rather than the degree of disturbance which had led to many of the
elderly being so referred ; hence, in view of the high certification rate among these
latter, it is considered that more of them should receive a psychiatric assessment before
final action is taken, and, as indicated earlier, considerable attention is being paid to
methods of achieving this difficult but desirable end.
As will be seen in the later paragraph devoted to the final closure of investigations,
whilst the proportion entering mental hospital was roughly the same as in 1956 there
was a reduction in the proportion of those who were certified ; this reduction was
greater with increasing age, being 15 per cent., 17.7 per cent. and 30.6 per cent. respectively
for those aged under 65, 65-79 and 80 and over.
| No. | % | |
|---|---|---|
| No action possible or necessary | 1,988 | 26.8 |
| Discharged by medical officer at observation ward | 1,317 | 17.7 |
| Transferred to general hospital | 65 | 0.9 |
| Other continued care including section 22 | 158 | 2.1 |
| Out-patient (psychiatric) | 23 | 0.3 |
| Admitted to mental hospital— | ||
| 1,928 | 25.9 | |
| (i) Tooting Bee Hospital | 279 | 3.8 |
| (ii) other hospital | 83 | 1.1 |
| (c) on temporary certificate | 48 | 0.6 |
| (d) on urgency order | 42 | 0.6 |
| (f) as returned escapee or under Magistrates' Courts Act | 7 | |
| Certified (Section 14/16) | 1,414 | 19.0 |
| Died | 56 | 0.8 |
| Miscellaneous* | 31 | 0.4 |
| 7,439 | 100.0 | |