View report page

potential breakdown (which may be due to failure to continue drug treatment or increase
of family stress or any other factor) and may, by timely liaison with the general practitioner
or out-patient clinic, be able to avert the necessity for in-patient treatment.
One effect of the new Act, with the consequential expansion of the community care
service, is that inevitably a great variety of people with mental health problems are referred
from many sources. For a number of these no very constructive help is possible but it is
nevertheless impossible to shelve responsibility entirely, except in a very limited number of
'hopeless' cases. For the remainder, time and energy is often spent fruitlessly but unavoidably.
A number of mentally ill (also subnormal) adults find their way into London from the
provinces; some of these have spent earlier years in psychiatric hospitals. Before the establishment
of a community care service, many floated more or less happily from lodging house
to lodging house, only coming to the notice of the authorities if they appeared before the
Courts; a number are now referred to the mental welfare officer. In some cases it is
possible to help constructively but many have well established wandering habits and have
become unemployable. Frequently they are not sufficiently ill mentally to be made the
subject of compulsory orders and there is a tendency to wander in and out of hospital
voluntarily. This is also the pattern of life of many of the mentally disordered who are
Londoners and the burden is shared by all agencies, voluntary or otherwise, concerned with
the homeless and destitute, including of course the Council's Welfare department. Bodies
such as the Salvation Army and the Church Army provide temporary and sometimes
permanent havens for them and co-operate with the mental health workers in efforts at
rehabilitation.
The severely subnormal—Mental welfare officers remain in close touch with all severely
subnormal children and also the small number of children who are not severely subnormal
but are reported under sec. 57 of the Education Act, 1944 (as amended by the Mental Health
Act). By visits to the homes they are in a position to assess the situation and to recommend
short term care in times of crisis or when the family need a rest from the demanding care
of such children. It is also the function of the officers to explain more permanent hospital
care to enquiring parents and to help them to come to terms with the problem whilst
awaiting a hospital vacancy—frequently a very long wait.
They play an active part in explaining the value of training-centre training and in
persuading any reluctant parent to agree to the child attending. They also attend medical
examinations at the centres and in most cases arrange for any necessary treatment. A
number of officers attend centre open days; these affording valuable opportunity for
fostering good relationships with the family and liaison with centre staff.
Closeness of contact is usually maintained by mental welfare officers through the adolescent
and adult years of the severely subnormal person, when the problems frequently
become accentuated by the illness and increasing age of the parents.
The subnormal—The majority of cases coming within this category are those who have
attended schools for the educationally subnormal, leaving at 16 years of age. Most of these
boys and girls are capable of unskilled or semi-skilled employment and the majority live
at home. An after-care service is offered to the parent, just prior to the boy or girl leaving
school; if accepted, visits are paid to the home at fairly regular intervals or as the need
arises, until the mental welfare officer, the parent, or perhaps the boy or girl feels that this
is no longer necessary. The amount of help required depends as much, if not more, upon
the degree of stability of temperament as of that of subnormality. The service is partly
advisory and the social worker may have to deal with any general or specific matters
affecting the young people's welfare. This covers a wide range, from pocket money to
income tax, from matters affecting employment or recreational activities to how to deal
with potential delinquency. More concrete help is given as the need arises; this may take
the form of limited financial help, arranging holidays or attendance at clubs, sometimes
making alternative living arrangements when the home situation breaks down.
129