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control in a place to which the public have access. Such a person may be detained for
not more than 72 hours for the purpose of enabling him to be examined by a medical
practitioner and to be seen by a mental health social worker and for making any necessary
arrangements for treatment or care. During 1964 mental health social workers were
concerned in the compulsory removal to hospital of nine such cases.
Power is given to the Courts to make Orders for the compulsory admission to hospital
or guardianship in respect of certain offenders or children or young persons found to be
in need of care or protection or beyond control; provided that the Court is satisfied, on the
evidence of two doctors, that the offender or child or young person is suffering from mental
disorder the nature or degree of which warrants his detention in hospital for medical treatment
or his reception into guardianship and that in the circumstances the making of such
an order is the most suitable method of disposing of the case. The Council's central medical
staff are concerned in the examination and submission of evidence in relation to such
persons who are suffering from subnormality or severe subnormality and any necessary
reports on the patient's home and social conditions are furnished by the mental welfare
staff. During 1964 the Council's staff were concerned in the compulsory removal to
hospital of 199 persons as the result of Court Orders.
Guardianship—Under the Mental Health Act, 1959 a local health authority can itself
act as guardian and guardianship may also be used as a form of control over mentally
ill and psychopathic patients who do not need to be in hospital. Up to the end of 1964,
however, this form of control had not been used by the Council for mentally ill or psychopathic
persons. In most cases it is possible for mentally disordered persons to receive
community care without being subject to the legal control of guardianship over their
place of residence in everyday life, but a small number of patients in the community still
require control for their own welfare or for the protection of others.
The procedure of placement under guardianship follows the same lines as that for
securing compulsory admission of a patient to hospital. Applications to the Council for
securing care under guardianship, which must be accompanied by a medical recommendation,
are made by the nearest relative or by a mental health social worker and in these
applications reasons must be given why the person cannot properly be cared for without
powers of guardianship. The powers conferred are those which would be possessed by the
guardian if the authority or the person concerned were the mentally disordered person's
father and the person was under the age of 14. Guardianship in relation to subnormality
or psychopathic disorder is limited to persons under the age of 21 years but there is
no such age limit on severe subnormality or mental illness or in relation to patients who
are the subject of Court Orders.
Under the new Act a 'responsible medical officer' had to review all persons remaining
under guardianship on 1 November 1960, in order to classify under the Act the form of
mental disorder from which they were suffering and to decide whether it was necessary
for them to remain under guardianship. Of 92 London cases then under guardianship
51 were discharged and continued in community care on an informal basis, three were
admitted to hospital and 38 continued under compulsory guardianship.
It was decided that, save in exceptional circumstances, the Council should itself seek to
undertake the function of guardian in all cases where this form of control was appropriate
for mentally disordered persons under its care and that the Council's whole-time medical
staff, who have been approved for the purposes of section 28 of the Act, should be
authorised as 'responsible medical officers' in relation to these functions. These officers
act for the Council under the provisions of regulation 24 (1) of the Mental Health (Hospital
and Guardianship) Regulations, 1960. Six members of the Health Committee are appointed
to exercise the power to order the discharge of a patient from guardianship, a power which
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