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38
In my reports for 1956/57 I sketched briefly the future trends in the service and the necessity
for some reorientation of the health visitors' work. in order not to overload her community effort.
In particular her work in the Mental Health field requires patient and time consuming observation,
interrogation and instruction with both mother (or parent) and the child. Co-operation with
the Mental Health Department and discussion with the family doctor and the clinic medical officer are
usually necessary in each case to obtain a comprehensive picture and ensure the best advice is given.
With old people the health visitor exercises a most invaluable advisory and supportive function,
maintaining contact with the hospital or general practitioner, other medico-social services of the
authority and alleviating loneliness. She is often the first to detect senile or pathological mental
change, initiating action most appropriate to the best Interests of the persons and menage concerned.
But it is the problem family that makes the greatest demands on the time and resourcefulness
of the Health Visitor. Access to such homes is notoriously difficult, accurate Information as to
income budgeting and domestic circumstances only elicited almost with surgical dexterity and time
seems to have little importance here. And the Health Visitor must be ever vigilant not to get too
involved emotionally in the endless disputes between the parents and relatives and neighbours of her
clients.
Indeed it can rightly be said the "problem family" is the most exhausting and least rewarding
of all the tasks the Health Visitor is asked to deal with. In this corner she will get more buffets
than bouquets but must carry on with equanimity and calm determination not to be side-tracked from
her chosen vocation.