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It is therefore possible, on receipt of information that a child has left a non-Council
establishment, for the same basic procedure to be adopted as for children leaving Council
establishments, i.e. the name and fullest possible documentation is forwarded to the
Principal Mental Welfare Officer, for consideration as to whether community care is
needed.

* Includes visits by students.
School refusal
The problem of school refusal—the so-called 'school phobia'—has been much in the
public eye recently, and an attempt has been made to co-ordinate the various types of action
—medical, educational, and administrative—taken in London in dealing with individual
cases.
The problem appears to be two-fold—first, and of paramount importance, is the
diagnosis, and following that, the choice of appropriate action.
To supplement the diagnostic services provided by the child guidance clinics in London,
and in an attempt to find and carry through the most appropriate recommendation for
children who fail to attend clinics or whose cases have proved too complex for the divisional
services to handle, a special arrangement has been made for such cases to be seen by a
psychiatrist and a psychologist at the County Hall. During the year 18 cases were dealt
with, all previously regarded as more or less insoluble.
These 18 cases seem to represent a fair cross section of the types of problem involved—
always excepting the 14.year.olds in their last year in school, amongst whom the occurrence
of truancy appears to be of almost epidemic proportions.
Six of the children were found to be true cases of anxiety and their non.attendance was
part of a deep psychological disorder. They were all referred to child guidance clinics and
were still under treatment at the end of the year, maintaining occasional attendances at
day special schools or classes.
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