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The principle underlying the scheme of visits by psychiatrists to the residential establishments
for children is that of mental health education of the staff, as the following extract
from a report to the Education and Children's Committees in 1952 makes quite clear:
"It is also becoming increasingly clear that one of the major factors in juvenile delinquency is deprivation
of a stable and secure home life. It follows that it is very important that the Council should do all
it can to provide the best possible environment for those children in its care, who are deprived of a normal
home life for any length of time, both in the interest of the child and in the interest of the community.
Staff in daily charge of children should have knowledge which will assist them in preventing emotional
disturbance and, to secure this, modern psychological knowledge and advice should be available, not
only to the officers-in-charge but to the staff who are in daily contact with the children. Staff can then
discuss the handling of children and any psychiatric problems which may arise in individual children.
This will help to prevent children becoming maladjusted, and to ensure that any early symptoms of
maladjustment will be detected, so that treatment can be obtained in the early stages."
Arrangements now exist under which regular or occasional visits are made according
to needs, by psychiatrists to the majority of the establishments, under both the Children's
and Education Committees, at which children reside. More important, perhaps, is the
fact that the staff at the establishments concerned are aware that the services of a psychiatrist
or an educational psychologist are available on request.
Enuresis has always been a problem in residential establishments for children and to
assist houseparents and other child-care staff to understand the nature of the problem,
a leaflet on the subject written by one of the Council's psychiatrists has been very widely
distributed amongst the staff concerned.
(d) Tavistock Clinic 'Neighbourhood Project'—During the past few years the concept
of a 'neighbourhood project' has been taking shape in the district around the Tavistock
Clinic in north-west London. A number of local schools are taking part in the experiment
under which the Clinic offers to each school the services of a team composed of psychiatrist,
psychologist and psychiatric social worker. The head of the school acts as convenor and
chairman of case conferences in his own school, and has access to the psychiatrist for
discussion of general problems.
Although it is too early to see how this idea will develop, it is already clear that the most
intractable problem is that of time. School-based case conferences and individual discussions
involve the expenditure of time by all concerned, yet it is clearly essential for the success
of the project that sufficient time should be available for everyone to attend. This will
undoubtedly be difficult for some members and calls for administrative readjustments and
flexibility if full participation is to be possible and full benefit derived.
Other child guidance clinics are working out similar schemes, which will establish a
'link' with local schools and centres.
(e) Staff training—Quite apart from the question of mental health education and
psychiatric 're-orientation' of staff of all grades, which has been discussed above, there
remains the problem of the national shortage of trained psychiatric staff. The Council has
always been ready to help to train students, post-graduate and under-graduate, provided
the interests of the children were not thereby prejudiced. This training is a direct stimulant
to the activities of the service, and provides a reciprocal benefit both to students and to the
staff concerned.
Brixton child guidance unit provides facilities for the training of doctors; the unit at
Woodberry Down undertakes the practical training of psychiatric social workers; whilst
Froebel student teachers visit that at Earls Court. Students working for qualifications in
educational psychology, or teaching qualifications for schools for the maladjusted, attend
all of the Council's child guidance units. Registrars, and other medically qualified psychiatrists
in training from the Institute of Psychiatry, Maudsley hospital, attend the remand
homes, to work with and assist the responsible psychiatrists.
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