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66
all the other agencies, both statutory and voluntary. He also deals
with problems of special difficulty and carries a small specialised
case load.
Mental Welfare Officers and Community Care
The family is taken as the unit and Mental Welfare Officers
give help, not only in the interest of the primary client but also with
regard to the family relationship as a whole. The client is the focus
of the programme. All treatment, services and institutions are
viewed as interlocking parts of a programme which is designed to
meet the needs of the client. The aim is not to provide institutional
or community care but a whole range of possible social environments
either in or out of hospital which are the most suitable for
a particular client at any particular time. We thus aim to provide
continuity of relationships from the beginning to the end of treatment
and if possible in successive treatments. As the patient moves
from community to hospital and back again through a continuam
of treatment an attempt is made to provide the client with a figure
with whom he can build up a relationship. This may be with a
psychiatrist or a social worker in the hospital or the Mental Welfare
Officer, or all of these.
In providing a comprehensive Mental Health Service, prevention
is as important as treatment. To this end we have continued
our policy of attachment of Mental Welfare Officers to General
Medical Practices. As well as the original pilot scheme in the
Penge area, we now have a further attachment to a Group Practice
in the Orpington area. From both the doctors' point of view and
that of the Mental Welfare Officers, this scheme is well worthwhile.
There is little doubt that the anxiety experienced by the patient/
client has been relieved and the doctors are becoming aware of the
Mental Welfare Officer's capacity in helping the General Practitioner
in his daily work. In justifying this scheme there seems to be
several points worthy of note. There is the problem of referral
both from the doctor and patient's point of view. Most General
Practitioner's are well aware of the strain under which all social
work agencies function. This tends to make him less ready to
refer cases which are not severe but with an attached Mental
Welfare Officer this is a vital point at which to pick up a case if
prevention is to be achieved. On the patient's side there is often
a great reluctance to meet and share the problem with strangers,
especially in the community setting, as this is not such a recognised
form of contact as, for instance, going to the hospital out-patient's
department. However, most patients find it more acceptable to see
a Mental Welfare Officer within the surgery setting.
As well as the attachment to the General Practitioner, 2
Mental Welfare Officers attend regular local hospital out-patient
clinics giving social work help to the consultant psychiatrist and