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16
MENTAL HEALTH
The Mental Health Division continued in 1966 to administer the community services for all types
of mentally disordered persons, i.e. the mentally ill (with its sub-group of psychopaths) and the mentally subnormal
and severely subnormal. In addition, an active programme of health education was persued
culminating in the Mental Health Week (5th June—11th June, 1966) when a press conference gave local
publicity to the problem of Mental Health.
Establishments remained as in 1965.
1. A Day Centre for the Mentally 111 (Belton Hall, Bertie Road, N.W.10).
2. A Hostel for 6 mentally ill female patients (post-hospital unit, 73, Wembley Park Drive).
3. A Junior Training Centre (at Neasden).
4. A Hostel for 12 subnormal working boys (191, Willesden Lane).
Unfortunately it was not possible to open the proposed Hostel for 27 mentally ill patients of both
sexes at 9, Willesden Lane due to some building difficulties, but the Superintendent and his wife as Housekeeper
were appointed and moved into their new premises in October.
The scheme for the new Junior Training Centre at Grove Park had to be deferred as loan sanction
was not approved by the Minister of Health in accordance with Government policy on expenditure. This
caused much bitterness locally as the old Centre remains inadequate to play its proper role in the training
of severely subnormal children. However, the year saw the opening of the detached and specifically adapted
Special Care Unit. Increase in the number of staff was a consequence of the increased intake of children.
It was not possible to accept the "Abadjian" factory for the purpose of an Industrial Rehabilitation
Unit. The scheme was rejected as too uneconomic for a Borough of this size. Instead definite allocation
for two patients, initially, was made by the Industrial Therapy Organisation (Thames) Ltd. Council approval
for £70 per patient was obtained for this.
When the Treasurers' Department vacated the self-contained room at Monks Park Clinic, it was
felt that the best use of this would be made by the Mental Health Division and it was thus allocated as an
interviewing room. Lack of private counselling facilities at Brent House had been felt keenly by the Staff
of this Division for a considerable time and the allocation of this room should go some way to facilitate
their work.
Brent has been selected by the Chiswick Polytechnic to train students in practical field work in
mental health. These young people are shown the day-to-day work of the division, i.e. referral of calls, compiling
case papers, etc., and are sent out with a mental welfare officer on emergency calls. This arrangement
proves to be stimulating to both parties and is a definite asset.
COMMUNITY CARE—MENTAL ILLNESS
The day-to-day care of these patients is the concern of the Mental Welfare Officers under the
guidance and instruction of the Senior Medical Officer (Mental Health) and the Chief Mental Welfare Officer.
The establishment has been increased by two staff, bringing the number up to nine. Intensive after-care with
an establishment of this size is often only possible by stretching the division's resources to an undesirable
point and ideally a further increase should be envisaged in the near future.
All Mental Welfare Officers work a considerable number of hours outside office hours when covering
emergency stand-by services and also when giving after-care to working patients, as this entails evening
work. Time in lieu has to be allowed for, which can easily amount to two full-time officers per week. Up
to 1965 their terms of employment allowed for overtime pay but this is no longer possible under the present
structure.
It is particularly unfortunate that it has not been possible to recruit a psychiatric social worker
although establishment provision for such a post now exists. Higher incentives might have to be considered
to attract workers with qualification of this kind.
The question of training for Mental Welfare Officers needs serious consideration. So far it has been
customary to accept mainly persons with nursing qualifications (R.M.N.) and after a variable initial training
period (minimum three months) during which time they are acquainted with the statutory duties, to appoint
them as Mental Welfare Officers. Case work training by the senior staff is initiated then and must continue
for a considerably longer period. This "working with the individual in the family situation" is not a
subject that can be taught speedily but has to be demonstrated in depth in each individual case. With scanty
theoretical background it is so often a matter of the officer's ability and adaptability, so that Mental Welfare
Officers of even one or two years' standing are unlikely to have acquired the necessary skill to deal
expeditiously with certain difficult patients, thus it becomes increasingly obvious that Mental Welfare
Officers have to become professionally qualified social workers if they are not to fall short of the requirements
made by the Mental Health Act, 1959. It no longer suffices to be an efficient statutory duties officer (i.e.
the old "Duly Authorised Officer") if modern concepts of psychiatry are to be implemented. At the present
moment the demand for trained, well qualified Social Workers are nowhere near being net—their numbers,
although steadily increasing, are still pitifully small and only the very highest bidder is likely to attract them.
This of course is the reason for accepting personnel with marginally suitable qualifications, i.e. in related fields
only. It is therefore important for each Local Health Authority to sponsor suitable Mental Welfare Officers
for the two-year courses in Social Work Training as recommended in the Younghusband report.
To cover the work of officers absent on course the establishment of Mental Welfare Officers will
then need to be increased.
Officers had the good fortune to receive interested help from the phychiatrists of Shenley Hospital
who have been most generous in inviting and maintaining the closest relationships with members of the
division, by initiating case demonstrations, conferences, or individual discussions. The value of close liaison