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to their work and to give them every opportunity of keeping abreast with new and changing
ideas, it has been possible during the year to start in-service training on these lines. A case
discussion group has met weekly, made up of a mental health social worker from each
division and led by the assistant principal mental health social worker. The response
in growing understanding and awareness has been most encouraging. Springfield hospital
arranged for the second time a useful intensive course lasting a week and two social workers
attended it. Staff have also started to attend seminars in mental subnormality at Queen
Mary's hospital, Carshalton.
Five training centre staff were seconded on one-year full-time courses arranged by the
National Association for Mental Health and six returned to duty. Five assistant supervisers
successfully completed the diploma course for teachers of the mentally handicapped,
one of whom gained the highest examination marks and was named the student of the
year. One assistant supervisor completed the diploma course held in Birmingham for
staff of adult centres.
Medical and diagnostic services
Since the passing of the Mental Health Act, the medical services concerned with the
diagnosis, supervision and care of the mentally disordered have continued to expand.
The increased responsibilities placed on the local health authority, the varying legal
procedures to be adopted and the abolition of the Board of Control laid emphasis on the
need for accurate diagnosis and specialised medical supervision by doctors specially
experienced in this branch of medical practice. The Council maintains a team of medical
officers working full time under a principal medical officer specialising in mental
subnormality. These officers, based centrally at the County Hall, are responsible for the
more difficult and complicated clinical work arising from the local health authority's
duties under the Act and are also available for carrying out diagnostic examinations
in the divisions at the request of the divisional medical officers. They also have responsibilities
for carrying out special examinations at the request of the Courts or the Prison
Medical Service; for exercising any necessary medical supervision in relation to subnormal
persons under guardianship or receiving community care and for undertaking special
examinations in difficult cases involving very young children or multiple handicaps.
Special advisory clinics
The Royal Commission on the Law relating to Mental Illness and Mental Deficiency
had urged the need for a diagnostic service for severely subnormal and psychopathic
patients and indicated that the initiative in organising such a service should generally
lie with local health authorities.
Special clinics have been set up in all the Council's health divisions, where parents and
relatives of mentally subnormal children can obtain advice and help. These clinics were
primarily designed to cater for children under the age of five years, rather in the nature
of special maternity and child welfare clinics for parents who, because of their child's
obvious mental abnormality, were unwilling to bring them to an ordinary clinic. It was
soon evident, however, that the clinics were filling a real need and their number and scope
were extended until at present they offer a very similar service to the out-patient department
of a hospital, where a patient can not only be diagnosed and the nature and severity of
mental disorder explained to the parent but where 'follow-up' examinations can be
arranged and the various facilities available for care and training indicated and necessary
arrangements made. These clinics are staffed by medical officers with considerable
experience in mental subnormality, most of whom are approved under section 28(2)
of the Act as having special experience in the diagnosis or treatment of mental disorder,
and are also attended by mental health social workers and health visitors.
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