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between the component parts of the National Health Service has been stressed so much that it would appear
superfluous to do so once again were it not for the fact that this contact is so extremely hard to maintain.
It is a constant effort and a drain on everyone's time to keep the "other sides" informed of everything that
concerns any particular patient. The Mental Welfare Officer and indeed the Senior Medicail Officer have
cause to be grateful to the readiness with which the hospital phychiatrists invite approach. The bond between
the London Borough of Brent and Shenley Hospital has been further strengthened by the appointment of the
Senior Medical Officer (Mental Health) to the Management Committee of that hospital and the appointment
of the Chief Mental Welfare Officer to the League of Friends of Shenley Hospital committee. This has
made possible contact with many hospital officials in addition to the medical staff, undoubtedly leading to an
increase in the understanding of the difficulties both sides are likely to have to face on occasion.
The secondment to the Mental Health Division from the Domiciliary Nursing Service of a psychiatric
nurse has also helped towards unification of hospital and community services. This nurse (R.M.N.) is
in the unique position of accepting cases from the psychiatric units of Central Middlesex Hospital and
Wembley Hospital for supervision in the home. In this way she plays an important role in the prevention
of hospital admissions and re-admissions. This is achieved by her general support of the patient and also
the very specific one of ensuring that medication is taken as prescribed. Only too often the success of treatment
at home breaks down due to the patient's discontinuation of prescribed drugs.
The psychiatrists concerned have frequently expressed their appreciation of the availability of this
nursing service and have also requested consideration of an extension.
Rehabilitation of post-hospital patients is facilitated by the "Gateway" Club which is run by the
Chief Mental Welfare Officer with the help of occupational therapists from both the Day Centre and Shenley
Hospital. A psychiatrist from Shenley Hospital also attends on occasion. A club of this kind fulfils chiefly
the purpose of encouraging patients to join in communal activities, helping them to overcome the most crippling
symptoms of mental ill-health—isolation, due to difficulty in communication. It has been found that
friendly, outgoing people with a gentle and tactful approach are those most likely to help to overcome
certain patient's difficulties. Club members appear to enjoy themselves thoroughly.
Encouragement is given to relatives and friends to attend. Without doubt the Club provides a
very necessary and useful purpose. This is reflected in the rising membership.
Patients in need of hostel accommodation on discharge from a psychiatric hospital or unit have been
placed by the Borough in various after-care hostels provided either by other Local Authorities or by appropriate
voluntary organisations.
Post-Hospital Unit, 73, Wembley Park Drive.
This unstaffed hostel accommodates up to 6 female working residents and has now become established
as the most suitable means of rehabilitation for certain types of patient.
Medical supervision rests with the Senior Medical Officer (Mental Health) in close liaison with a
Shenley Hospital consultant psychiatrist should the need arise. This arrangement has worked well. A staff
nurse from Shenley Hospital continued to visit to support particularly those patients discharged from her
own ward. Regularly weekly visits were made by the Senior Medical Officer and a seconded Mental
Welfare Officer. There is no doubt of the special advantage of such an unstaffed unit. It has been
particularly interesting to observe that deteriorating patients are often tolerated very well by other patients
without the presence of resident staff. Three patients did in fact break down but were helped over the
crisis situation without returning to hospital. It was only during the second serious breakdown of one of
them that she had to return to Shenley Hospital. Two patients had attained such measure of independence
to arrange their holiday and join a party going abroad: one went to Italy, the other to Austria. It is
interesting to note in how precarious a state their mental health still remains: the second of these patients
was one of those who relapsed some time later in the year. The reason was that she felt so well she
omitted taking her medication. Encouragement by the visiting staff and help from the other residents
helped her over that period.
This Christmas several patients stayed at the hostel and celebrated together. It is most gratifying
to see people caring for each other and truly enjoying life once more.
The Day Centre for the Mentally Ill, Belton Hall, Bertie Road, N.W.10.
Excellent service continues to be given at this Centre for the rehabilitation of mentally ill men and
women. The service is available to patients from adjacent Local Authorities (who are financially responsible
for them) as well as to the residents of this Borough.
The staff remained as before: one head occupational therapist with two occupational therapists
cater for over 30 patients.
Miss Cass, head occupational therapist, reports: —
"The Occupational Therapy service in the London Borough of Brent has continued through the year
to be the only provision of domiciliary occupational therapy with a Day Centre of its kind in the Shenley
Hospital catchment area, so patients have continued to be referred from all Boroughs in that area. The
referrals have fluctuated, through the year, reaching a low level in August, but subsequently increased. The
main factors contributing towards the decrease were: —
(1) The work of the occupational therapist at this centre was disrupted due to either illness among
themselves or in near relatives (including death of a parent) to an unprecedented degree. These
absences occurred at least convenient times allowing little opportunity for adequate cover.
Locum services, although useful emergency measures, did not provide the necessary skill of
experienced staff.
(2) Shenley Hospital is in the process of major reorganisation.
These factors contributed to breakdown in communication and shows how very essential it is to have
close liaison between the centre staff and hospitals for a service to be used to its fullest advantage.