View report page

MENTAL HEALTH
Historical developments
Social workers have been employed on mental deficiency work ever since the Mental
Deficiency Act, 1913 came into operation. From the beginning the social enquiries
necessary for the ascertainment of new cases were carried out by social workers, designated
Mental Deficiency Act inspectors, employed by the Council and based at County Hall,
but the supervision of mentally subnormal persons (then known as mental defectives)
living in the community was originally undertaken on the Council's behalf by social
workers employed by the London Association for Mental Welfare. The work of that
body was taken over by the Council in 1930 and the social workers continued to operate
from four local offices. The work of the inspectors remained separate and centralised
until 1955 ; these officers were then allocated to the local offices with the object of
integrating the social work in this field and a senior organiser with over-all responsibility
was appointed. This arrangement, whereby a group of social workers was engaged
exclusively on mental deficiency work, continued until the mental health services were
re-organised in 1960.
The Council recognised early that the provision of centres for the trainingand occupation
of mentally subnormal children and adults living in the community afforded the means
of achieving their fullest possible development and social adaptation. Occupation centres
(now referred to as training centres) were first provided by the London Association for
Mental Welfare, with financial assistance from the Council, in 1923. The Council took over
the running of these centres in 1931 when there were 18 small centres providing accommodation
for about 300 persons, although only three of these operated on a full-time basis.
By the outbreak of war in 1939, when the centres had to close, about the same number of
persons were being accommodated in 12 larger centres. It was not possible to start reopening
the centres until 1948 and most of the centres then had to be accommodated in
hired premises, the best available but many of them far from satisfactory. The period
since 1948 has been one of rapid expansion to meet an increasing demand for places,
as well as planning to improve the standard of accommodation in use. By the time the
Council's proposals under the Mental Health Act, 1959 were formulated, although much
remained to be done, the training centre service had been expanded to provide places
for 1,270 persons in 21 centres (including one industrial centre); some of the least satisfactory
hired premises had been replaced; some specially adapted Council-owned premises
had been brought into use and the first two specially designed centres had been opened.
Social workers for the mentally ill were employed by the Council in its mental hospitals
before the first mental health course for the training of psychiatric social workers was
instituted in 1929, following which fully trained social workers were employed in the
mental observation wards at the Council's general hospitals and subsequently at the
county mental hospitals. When the hospitals were transferred to the Ministry of Health
in 1948 under the National Health Service Act, 1946, these social workers were retained
in the hospital service.
Community care services for the mentally ill were started in 1943, at the request of the
Ministry of Health, by the National Association for Mental Health for ex-service personnel
who had been discharged on psychiatric grounds. Responsibility for this work, which
from 1948 was extended to civilians, was assumed by the Council under section 28 of the
National Health Service Act, 1946, the work at first being carried out by the National
Association for Mental Health and the Mental After Care Association as agents for the
Council. In 1953 the Council took over direct responsibility and in 1960, when the mental
health services were re-organised, there were five psychiatric social workers, including
one senior, working from the County Hall under the general direction of the consultant
psychiatrist employed by the Council as consultant in mental health.
93