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Psycho-Geriatric Service. St. Clement's Hospital
The catchment area for the psycho-geriatric services provided at
St. Clement's Hospital comprises the boroughs of Bethnal Green, Poplar
and Stepney. The Consultant Psychiatrist, Dr.W.M.Ford Robertson, at
the Psycho-Geriatric Day Hospital and Dundee Ward in St.Clement's
Hospital, reports:
"It is extremely disappointing to find that there is a further
falling off in the use of this service, chiefly in the referrals by
general practitioners. It is hard to believe that the needs of the
psychiatrically aged person in this area are being met. One essential
step towards this end would be the compilation by practitioners
of a register of old people, an aid which is rare, I understand, but
which has been recognised elsewhere as worth the time involved and
is in course of production by some. Referrals by Old People's
Welfare Associations and Mental Welfare Officers have also decreased
but this could be attributed to the development of a better awareness
that patients should be psychiatrically ill to be admitted and not
just social stress problems. This is all to the good but the problem
of finding who is at risk because of mental illness seems to be as
difficult as ever. It has been suggested that political uncertainty
due to the Greater London reorganisation may have inhibited local
authority action and if this is so we may hope for improvement in
the coming year but there are also other factors. The increase in
referrals by psychiatrists is explained by the use being made of the
Day Hospital after a stay in Dundee Ward as a further step in the
process of rehabilitation. One of the indirect effects of a
restricted turnover is seen in the much larger number of patients
whom we have allowed to stay on, because they have become largely
dependent upon us and to discharge them without alternative support
of a suitable kind could be disastrous.
"The tendency to have an increasing residue of socially non-viable
persons due to the onset of dementia is difficult to avoid and in
this context it will be seen that the average age of admission is
rather higher. One notes that 20 patients in 1963 as compared with
8 in 1962 had to be maintained throughout the year as being too
vulnerable to social stress and isolation to be discharged. Day
Centres suited to this type of patient would be helpful, also socalled
"Clubs" such as the one now functioning successfully at
Trinity Church. The work of our staff has attained as high a
standard as before, having gained in fact by experience, and it is
sincerely hoped that its endeavours will be more fully utilised in
the coming year.
"The picture of the in-patient geriatric work continues to be a
very satisfactory one. Close integration with the Day Hospital has
worked well, contributing to a shorter average length of stay and
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