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The Psychiatric Rehabilitation Association has had links with Haringey Mental Health Section for
some time prior to this project in Tottenham. Before the Centre at Mitchley Road was started a number
of Haringey patients attended one or other of the P.R.A. Day Centres in East London. Arising out of
the success of these placements and in close association with the Department, the P.R.A. were
encouraged to open a Day Centre at Mitchley Road in September 1966, and at the time of preparing this
reportthere were 34 patients on the register of whom 26 are residents of Haringey. The importance of
the Centre and the need it fulfils is evident by the great demand for places at the Centre; even in the
most inclement weather the patients make the effort to attend. Including those currently attending,
73 Haringey residents have been referred since the Centre opened of whom 21 returned to employment,
12 were re-admitted to psychiatric hospitals, one was admitted to general hospital, 7 stopped attending,
3 attendances discontinued at the organiser's request, 2 were referred to P.R.A. Industrial Unit and one
moved to another area, a total of 47.
The Work: Whilst work is the basis for the group interaction it is not the main purpose of the
centre. The objective is to enable patients in a group situation to interact constructively with each
other and thereby regain self confidence to participate effectively in normal society.
The availability of appropriate work is governed by the amount of space available, and this in
turn isaffected by the availability of transport. Notwithstanding these difficulties the work situation
is improving due to the recent appointment of a P.R.A. Contracts Organiser and a cultivatedrelationship
with local industrialists.
The Future: Day Centres are a means by which chronic patients can be helped towards greater
self-expression and are a preparation for more realistic work situations. From experience, it is unlikely
that the majority of participants will be able to return to full-time employment without the availability
of additional rehabilitative situations.
In this connection, the next stage after the Day Centre must be more demanding but nevertheless
sheltered work situation Iike the P.R.A. Industrial Education Unit at Bethnal Green, and special sheltered
employment in industry, similar to the P.R.A. recent experiment at Maynards in Haringey.
The diagnosis and severity of illness of individual patients also varies greatly. The average
period of stay at the Centre of those returning to full-time employment was just under five months.
Selection for attendance at the Centre has, hitherto, been left largely to the discretion of the
Mental Health Section and the P.R.A. Selection on this basis has usually been more successful than
those referred through other sources. Of the few patients that we were able to follow up who were
re-admitted to hospital, there were usually domestic difficulties. This inevitably led to the patient
refusing to co-operate in the taking of medication and therefore resulted in the return of the symptoms.
The few patients who were found unsuitable for the Centre were either violent or too disruptive and,
therefore, diminished the benefit of attendance for the majority.
The expenses of the Day Centre at Mitchley Road are shared with Enfield on a per capita basis.
During the period January to December 1967 the 73 places mentioned above represented 2,610 attendances.
Those attending can take advantage of the other P.R.A. facilities, for instance, some have
moved on to the Industrial Educational Unit at Bethnal Green and five of the patients lived at the
residential centre, Nicholas House. Four of the members took part in the group holiday at Margate
and nine joined in a day trip to France.
The P.R.A. Evening Centre, meets at the Lutheran Church Hall, Antill Road and has proved a valuable
function in the rehabilitation of the patient or ex-patient at work. The high standard of the groupwork
and the success already evident emphasises the need for the Health Department to establish a workshop
of our own for the mentally ill as allowed for in the 10 year plan. The Association together with the
University of Surrey is currently studying the incidence of mental illness in North London with a view
to revealing its geographical distribution and sociological factors prevailing. This will no doubt
reveal some interesting material for the further development of the mental health services within the
Borough.
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