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The emergency removal of mentally ill persons to observation wards and hospitals
was for many years the responsibility of the Boards of Guardians. This work, which was
taken over by the Council in 1930, was first performed in the newly-constituted Public
Assistance department; in 1948 it was transferred to the Public Health department, the
relieving officers so employed being re-designated as duly authorised officers and transferred
to the department to form the nucleus of the staff of mental welfare officers. From
then until 1960, these officers were employed almost exclusively on the work of taking
the initial proceedings in providing hospital care and treatment for persons suffering
from mental illness.
The Council welcomed the findings published in May, 1957 of the Royal Commission
on the Law Relating to Mental Illness and Mental Deficiency as providing an imaginative
charter for a comprehensive mental health service. There was no doubt that the former
legislation no longer reflected modern attitudes towards persons suffering from mental
disorders and the drastic revision of the whole legislative structure introduced by the
Mental Health Act, 1959 underlined the concepts now accepted by many of the general
public, as well as by those directly concerned with the care of mentally disordered patients,
that mental illness and mental subnormality should be regarded in the same way as physical
illness and physical disability.
In common with other local health authorities the Council was required, in accordance
with Ministry of Health circular 28/59, to submit its proposals for implementing the new
legislation. The account which follows gives specific details of these proposals and indicates
to what extent it has been found possible, up to the end of 1964, to put them into effect.
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 all the services
were administered centrally from the County Hall.
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 under a divisional mental welfare officer (now divisional mental health social worker)
responsible to the divisional medical officer. A principal mental welfare officer (now
principal mental health social worker) was appointed 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 background, training and experience of the members of the divisional
teams varied widely and the bringing together 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 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 together 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 divisional basis 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
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