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14.
3. MENTAL HEALTH
The continuing improvement in the bodily health of
schoolchildren and the welcome (if in places slow)
improvement in their physical environment is giving greater
prominence to mental and emotional difficulties which
constitute an increasing challenge to the School Health
Service.
It is not surprising that this should be so when it is
known that nearly one half of all the hospital beds in
Ehgland are occupied by the mentally ill and one third of
all the prescriptions written are for tranquillisers or pep
pills. Children of psychiatrically disturbed parents are
especially liable to be similarly affected, if not through
the inheritance of a similar mental and emotional
constitution, then through the effect of their environment.
While little can be done to modify the effect of
inherited predisposition to mental or emotional instability
a great deal can be done to ameliorate the effect of
environment. Early recognition of symptoms of maladjustment,
guidance to parents in their handling, removal of
precipitating causes, careful choice of schools, advice and
support, can all help to prevent breakdowns and every year
the proportion of such cases seen at the School Clinics
continues to grow, children are seen at the request of
parents or referred by Heads of schools or by general
practitioners and the great majority of them can be helped
by advice and by treatment in conjunction with the family
doctor. The Health Visitor/School Nurse can give valuable
help in the home environment besides maintaining close
liaison with the school staff in their care of the child.
The most severe and resistant cases are referred to
the Child Guidance Clinic which is now handling a greater
volume of work than ever before. Despite the provision of
new premises and the increase this year to eleven
psychiatric sessions a week the case load is such that
there is still a wait of several months for a diagnostic
interview.
Because of the need to avoid a crushing overload on
the Child Guidance Clinic, already embarrassed by frequent
Juvenile Court referrals, which have to be given priority
at the expense of other urgent cases, it is necessary for
School Medical Officers to be able to select critically
those cases where trained psychiatric help is imperative
and to treat themselves those which can be dealt with by
doctors with some paediatric experience and knowledge of
child psychology.