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own homes. The majority of the cases are referred by general practitioners, who
recognise the early symptoms of emotional and psychiatric disorders. Psychiatric
help and advice given by the mental welfare officers, sometimes coupled with outpatient
psychiatric treatment, often enable the patient to remain in the community,
thereby avoiding the necessity for admission to hospital. As it is desirable for a
social history to be provided by a mental welfare officer on a patient attending an
out-patient clinic for the first time, an arrangement exists with the local hospitals
for the referral of patients to the mental welfare officer for this purpose, and 53
social histories were supplied on request during the year. In addition, 113 social
reports were supplied to Friern and Claybury Hospitals on new admissions.
The demand for psycho-geriatric admissions for elderly confused patients
remained high and domiciliary support was provided for patients and their families
during the waiting period.
The mental welfare officers endeavour to establish an unbroken relationship
with all classes of patients admitted to hospital and, where necessary, advice and
assistance are also given to the patient's family whilst he is in hospital. During the
year the number of patients referred for supportive after-care was 291, and the
number of home visits to mentally ill patients totalled 6,440 in addition to 523
office interviews.
Hospital Admissions
Part IV of the Mental Health Act, 1959, provides for the compulsory admission
of patients to hospital and also their placement under guardianship. The principal
features of this procedure is that application is made by the nearest relative or a
mental welfare officer, and is supported by a medical recommendation.
An admission for observation in emergency (for up to 72 hours) requires one
medical certificate. For admission for observation or for treatment other than in
emergency, two medical certificates are required, one of which should, if possible,
be given by a doctor approved by the local health authority as having specialist
knowledge of the type of mental disorder from which the patient is suffering.
In approving medical practitioners for this purpose under Section 28 of the
Mental Health Act, local health authorities are required to consult not less than
two members of the local advisory panel for the area as to the experience of the
doctor concerned, and shall not approve the application for such purposes unless
two doctors of the panel so consulted are satisfied that he possesses such special
experience. The local advisory panel consists of consultant psychiatrists appointed
by the North East Metropolitan Regional Hospital Board.
During the year, three medical practitioners were approved by the Council for
this purpose and nine were listed in the borough as having been so approved at the
end of the year.
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