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contact with the mentally ill and their relatives, the work called for a high standard of
integrity, tact and sympathetic understanding. This work, unrelieved by other duties,
made great demands both physically and mentally on the officers concerned.
Organisation and staffing
Before the Mental Health Act, 1959 came into operation, the responsibility for the
Council's mental health services rested with the Health Committee and the services were
administered centrally from the County Hall. Mental welfare officers, employed as duly
authorised officers under the Lunacy and Mental Treatment Acts, and psychiatric social
workers for community care work with the mentally ill were based at the central office
under the supervision and guidance of the part-time consultant in mental health. The
medical work arising from the operation of the Mental Deficiency Acts was carried out
by medical officers on the central staff and the bulk of the social work in this sphere was
carried out from four district offices each under the control of a local organiser with the
general supervision centrally of a senior organiser.
Decentralisation of staff and services—As from October, 1960, the bulk of responsibility
for the day-to-day operation of the mental health services was delegated to the nine
divisional health committees and the staff of the services then existing were allocated to
the divisions. The three categories of mental health worker were thus brought together and
a mental health social worker team was set up in each division under the immediate direction
of a Divisional Mental Welfare Officer responsible to the Divisional Medical Officer for
the day-to-day operation of the local services. A Principal Mental Welfare Officer was
appointed to the central staff to supervise and co-ordinate all mental health social work
and to act as the chief professional adviser to the department in this field. The remaining
members of the team included a deputy to the Principal Mental Welfare Officer, deputy
divisional mental welfare officers, senior mental welfare officers, mental welfare officers,
assistant mental welfare officers and psychiatric social workers. The background, training
and experience of the members of the divisional teams varied widely. A number were
qualified psychiatric nurses, others held social science qualifications, some were recruited
from other fields of social work and included recruits from other departments of the
Council. The bringing together and pooling of this varied knowledge and experience has
been invaluable.
The Council had been considering for some time the desirability of extending the
work of mental welfare officers to include community care. The opportunity was therefore
taken to reduce specialisation in the various branches of the mental health services
by giving the staff the opportunity to widen the scope of their duties beyond those
in which they had particular experience, the ultimate aim being to weld an integrated
organisation of social workers within the mental health field.
Certain aspects of the work were retained under direct central control where it was clear
that provision on a wholly self-contained basis for each division would be uneconomical,
e.g. the provision of hostels and day centres. Similarly, a number of medical examinations
of mentally subnormal and severely subnormal persons continue to be dealt with centrally,
either because they required the services of a particularly experienced medical officer or
because they did not fall to be dealt with by a particular division. Responsibility for giving
medical evidence to courts in respect of subnormal and severely subnormal or psychopathic
patients, for the submission of evidence required by Mental Health Tribunals and for
obtaining hospital beds for subnormal and severely subnormal persons was also retained
at the centre.
As part of the general devolution of responsibilities for the mental health services to
Divisional Health Committees, responsibility for the day-to-day administration of training
centres, including the maintenance of premises, supplies, the arranging of visits, centre
functions and general staff administration passed to the divisional medical officers at the
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