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the establishment no longer catered for children from the former
Borough of Dagenham, although in practice a certain number of
these children have continued to attend until their treatment was
completed. The reduction in the number of cases referred from
Barking, however, was more than compensated by increased
referrals from the half of the Borough of Havering, which was
formerly known as the Urban District of Hornchurch and for which
this establishment did not formerly provide a complete service as it
was officially in the area of the Grays Clinic.
In the three quarters of the year 1965 with which this report
is concerned, 258 children were referred as against a total of 255
for the comparable period of 1964, the latter figure having been
catered for by the larger number of psychiatric sessions. The waiting
period for ordinary non-priority cases has, therefore, tended
to increase by approximately a fortnight per month since April
1965. Some cases may have to wait as long as four to five months
if their needs are constantly over-ridden by priority cases such as
Court referrals, psychiatric emergencies and school refusals with
emotional basis which have to be dealt with immediately if there
is to be any degree of success.
As it has not been possible for the whole of this year to fill
the post of Psychotherapist, a post indeed which can rarely be
filled owing to the national shortage of staff of this type, there is
the added pressure that psychiatrists have to carry out all treatment
themselves, unless it can be delegated to educational psychologists
or remedial teachers, and this can result in serious pressure being
put upon the educational psychologists.
With only a nine month period to cover, it is not proposed to
analyse cases in detail, but the total number of sessions worked
was 196 and the total number of out-patients interviewed by psychiatrists
was 1,883.
The Medical Director is responsible for psychiatric supervision
of the two nursery classes for maladjusted pre-school children and
also the Observation Unit for severely handicapped children in the
Manor School. He should supervise regularly the treatment of
Havering children who are placed in independent schools for maladjusted
pupils, as well as being available for consultation by headmasters
and staff of local authority schools in which maladjusted
children are placed. The Observation Unit at Corbets Tey has
proved to need psychiatric supervision too, since most of the children
admitted are diagnostic problems because of emotional difficulties
which are in some cases primary and in some cases secondary
to their mental retardation. All these units require visits at
least twice a term, but unfortunately this is out of the question
with the psychiatric time available and most of them have been
visited once a term during the period under review.
Parklands Nursery has had an average of eight children on
roll during the year, but at one period this was reduced because
of the difficulty of containing the aggressive behaviour of one little
boy who was subsequently treated by medication and transferred,
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