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APPENDIX A.
MENTAL HEALTH IN LONDON IN 1961 AND THE IMPLEMENTATION OF
THE MENTAL HEALTH ACT, 1959
Introduction
In that part of my Annual Report for 1957 which dealt with the mental health services,
particular emphasis was given to the findings of the Royal Commission on the Law relating
to Mental Illness and Mental Deficiency which were welcomed by the Council as providing
an imaginative charter for a comprehensive mental health service. There was no doubt that
the former legislation no longer reflected modern attitudes towards persons suffering from
mental disorders and the drastic revision of the whole legislative structure introduced by
the Mental Health Act, 1959, which came into operation on 1 November, 1960, underlined
the concepts now accepted by many of the general public, as well as by those who
are directly concerned with the care of mentally disordered patients, that mental illness and
mental subnormality should be regarded in the same way as physical illness and physical
disability.
The main principles upon which the new Act were based were:
(a) that as much treatment as possible, both in hospital and outside, should be given
on a voluntary and informal basis;
(b) that proper provision should be made for the residual category of care where
compulsion is necessary, either in the interests of the patient or of society;
(c) that the emphasis in mental care should be shifted, so far as possible, from hospital
care to care within the community.
The Act provides for the establishment of a comprehensive community care service by
local health authorities to meet the needs of all types of mentally disordered persons not
requiring hospital treatment. This includes—
(a) provision of residential accommodation;
(b) provision of centres for training and occupation;
(c) exercise of functions relating to persons placed under guardianship;
(d) provision of day centres, social clubs, recuperative holidays and short-term care;
and
(e) visiting and general welfare of patients in the community.
In common with other local health authorities, the Council was required, in accordance
with Ministry of Health circular 28/59, to submit its proposals for implementing the new
legislation. The account which follows gives specific details of these proposals and indicates
to what extent it has been found possible, up to the end of 1961, to put them into effect.
The present mental health services are also described in relation to the progress which
has been made in recent years and reference is made to the tasks which still face the Council.
Historical developments
Services for subnormal and severely subnormal persons—Social work for persons now
classified under the Mental Health Act, 1959, as 'subnormal' or 'severely subnormal'
has continued in London since the Mental Deficiency Act, 1913 came into operation, when
social workers employed by the London Association for Mental Welfare undertook the
supervision of such persons living in the community on behalf of the Council. A nucleus
of officers designated as Mental Deficiency Act 'Inspectors' was appointed directly by the
Council and was based at the County Hall to carry out initial enquiries for the ascertainment
of new cases; to exercise compulsory powers; and to be responsible for the supervision of,
and general social work for, persons placed under guardianship.
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