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Out posting from the Centre has continued to be developed with the patients working from the
Centre within the Health Department, the garden at 73, Wembley Park Drive Hostel and the Junior Training
School, Neasden in various capacities. This is a very valuable asset where the patient needs a realistic situation
prior to taking open employment.
Discharge of patients starts for the majority wiih the contact of the Labour Exchange through the
weekly visits of the Disablement Resettlement Officer to the Centre. This enables the patients to be seen
informally and they are able to discuss any problem of employment and become registered prior to attending
the Labour Exchange. The majority of the twenty-two patients returned to open employment during the
year were placed by the Disablement Resettlement Officer.
Close contact has also been kept with the community services. Good relations have developed with
the voluntary bodies and this is a great asset with the re-socialising of the patients.
The Therapeutic Social Club (Gateway Club) has been regularly attended by one of the Day Centre
staff every week this year. In this way patients and ex-patients have been encouraged to keep in touch.
Conclusion.
Group activity is of advantage to the rehabilitation of patients attending the Centre, and it will be
the aim of future programmes. Those arranged for the immediate future: —
(a) Cookery demonstration to a group arranged to be given by the North Thames Gas Board.
(b) Beauty Counsellor to give a series of make-up demonstrations to a group.
(c) Six-month group project to assist in furnishing proposed Hostel at 9, Willesden Lane.
I would like to thank all the administrative staff of the Health Department for their help and understanding
in the change of administration and for their understanding in accepting patients into their Department
for occupational therapy."
COMMUNITY CARE — SUB-NORMAL AND SEVERELY SUB-NORMAL
Supervision in the Home.
Over recent years it has been shown beyond doubt that the retention within the community of severely
sub-normal and sub-normal persons is beneficial to the individual and his family and to the community. This
end can, in many cases, only be achieved by the support of social workers. In this borough one mental health
social worker and, for a small proportion of cases all mental welfare officers, look after some 500 sub-normal
and severely sub-normal cases. All of them need help to a greater or lesser extent, but it appears that during
the year under review some of the routine visiting has had to be less frequent than is considered desirable, as
the case loads are too heavy. Some cases, particularly the educationally sub-normal school leaver on the
one hand and the under 5-year-olds on the other, need intensive support as crisis situations occur relatively
frequently. In the case of the adolescent, various agencies have to be contacted (Youth Employment Officer,
Disablement Rehabilitation Officer, National Assistance Board) and often the employer has to be supported as
well as the whole family. With the pre-school child, it is chiefly the mother who needs frequent encouragement
and guidance in the handling of the child. This is particularly necessary in the absence of adequate nursery
services.
In consequence a large amount of time has to be given to these urgent cases. More staff is needed
to give the amount of care desirable. Throughout the year the Medical Officer for Mental Health has seen
cases at any one of the local authority clinics, as well as at Brent House, and home visits were made in many
cases. Health Visitors are becoming aware of the advantage of making early contact with the Mental Health
Section and a mutually beneficial working relationship is becoming established. For this reason, the idea of
one clinic only for the whole of the area has not been considered to be in the best interest of all concerned,
specifically in the case of very young children, but it may well be that a 'walk-in' type of clinic will be made
available to known cases in the future.
Admissions to Hospital.
Leavesden Hospital, near Watford, is the only psychiatric hospital available for cases of subnormality
and severe sub-normality living in this London Borough. Vacant places occur very infrequently
indeed and the number on the waiting list remains woefully high.
Cases admitted during 1965 4
Cases on Waiting List on 31.12.65 40
Urgent 29
Others 11
The hospital has used its vacant beds to some extent to give short term care for the relief of parents
for part of the holiday period and to help in cases where critical situations arise, and also to provide the
patient with surgical, medical and dental treatment. This service has proved to be of great value.
Number of cases admitted for short term care during 1965: 58.
Although it is very desirable for the majority of sub-normals and severely sub-normals to stay within
the community, this does not apply to many of the severely sub-normal patients who suffer from additional
handicaps, either emotional or physical. They require special nursing techniques and in certain cases it is
quite unrealistic to expect parents and siblings to cope with patients of this kind if they feel unable to do so.
For the sake of parental mental health, hospitalisation is the only answer. However, due to the lamentable
shortage of hospital beds, special care units have become an established pattern of day care for such children,
and this borough supports such a unit within the Neasden Junior Training School. This type of care only
partially relieves the family's heavy pressure, particularly as the patients can only attend in term time. It
would appear highly desirable to extend the service all the year round.