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60
the Health Department to the new offices near Bromley North,
since it seems inevitable that an area office in one form or another
would have to remain as a permanent feature of the service.
ATTACHMENT OF MENTAL WELFARE OFFICERS TO
FAMILY PRACTICES
In August, 1967, a pilot scheme was launched by attaching
five Mental Welfare Officers to five family practices in the Penge
and Beckenham areas. To ensure as far as possible the success
of the scheme, the practices were carefully selected. All Doctors
were community orientated and were already working on the
team approach lines through previously existing attachments of
Health Visitors. None expressed anxiety about "outsiders" breaking
into the doctor/patient relationship. Before the scheme had
the official approval, good working relationships existed between
the Doctors and the Mental Welfare Officers involved and every
G.P. expressed willingness and even enthusiasm to take part in
the scheme.
The Authority and the G.P.s were from the start in agreement
as to why the attachments would be advantageous to them and
to the community as a whole.
Firstly, it was felt that the team approach already referred
to above, could with advantage, be extended. Not only emotional
and social difficulties of the patients whether primary cause of
the illness or secondary to the illness, were more likely to be
diagnosed and/or high-lighted by this member of the team whose
training and routine work makes him most sensitive to this area
of human functioning.
To investigate this side of the complex nature of illness is
very time consuming, and the notoriously overworked G.P. is
seldom able to afford the time needed. The time factor would even
more be involved in therapeutic situations where general support,
explanations and reassurance has to be given unhurriedly and
more than once.
Secondly, a well established kindly family doctor is often the
first post of call in marriage difficulties, transient depressions or
social inadequacy. Whilst the frankly psychotic patient presents
no medical problem to the G.P. as long as the services of the
Consultant Psychiatrist are available, the number of those suffering
from vague mental ill health is steadily growing. This is the group
where a substantial number of G.P.s feel the M.W.O. should be
the main therapist.
When our basic mental health services are truly adequate
and we turn to apply ourselves to a primary prevention programme,
we envisage that the M.W.O. will be called in as a