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16
MENTAL HEALTH
(Tables 18—20)
The Community Mental Health Services were administered, as in previous years, by the Mental
Health Division, dealing with all types of mentally disordered persons:—
Establishments include:—
A Hostel for 27 mentally ill men and women
A Hostel for 6 mentally ill women
A Day Centre for 30 mentally ill
A Junior Training Centre (Including Special Care Unit), 106 places
A Hostel for 12 subnormal working boys.
Of the 1,000 or so mentally disordered people living in this Borough and known to the Department,
only a proportion need services at any one time, yet the involvement of the community is much greater than
sheer numbers would suggest. It is not always appreciated that for any one patient many other persons in their
environment become involved and indeed occasionally these contacts themselves become mentally ill.
Fortunately the disturbance of their minds may well be of a transient nature only. "No man is an island" and
in this way disturbing influences affect wide circles, particularly involving the family but also work relationships.
COMMUNITY CARE—MENTAL ILLNESS
Mental after care is carried out by the Division's social workers (Mental Welfare Officers) who are responsible
to the Senior Medical Officer (Mental Health) and the Chief Mental Welfare Officer. Patients are
seen at home or at the office. This does involve a fair amount of evening visits with those clients who are out
at work all day. This is unavoidable if continuous support is to be given, but places a strain on the Department's
manpower resources. This was a major consideration in the need for an extension of the social worker
establishment which is dealt with in some detail below.
Mental Health Social Worker Establishment
My Report for 1966 pointed out that the establishment was inadequate. It did not provide for a
proper career structure and in no way contributed towards the provision of more highly trained staff. In
addition the mental health social worker/population ratio is below that of many other local authorities. For
these reasons and to redesignate posts in terms of modern concepts a reappraisal of the staffing situation became
necessary and the Council at its meeting in November approved the change in establishment and designations
which it is hoped to bring into operation in the next financial year.
Present Establishment Approved Establishment
I Chief Mental Welfare Officer 1 Chief Mental Health Social Worker
1 Senior Mental Welfare Officer 1 Deputy Chief Mental Health Social Worker
1 Psychiatric Social Worker (vacant) 2 Senior Mental Health Social Workers
7 Mental Welfare Officers 7 Mental Health Social Workers
1 Mental Health Social Worker (full time)* (Mental Welfare Officer's duties)
2 Mental Health Social Workers (part time)* 1 Mental Health Social Worker (full time)*
equivalent 1 full time 2 Mental Health Social Workers (part time)*
1 Domiciliary Psychiatric Nurse 1 Mental1 Health Social Worker (part time)
(boarding out duties)
2 Trainee Mental Health Social Workers
1 Domiciliary Psychiatric Nurse
* = subnormality duties
The newly approved establishment will allow one Mental Health Social Worker to be seconded on full
pay to a course in social work training leading to the Certificate in Social Work Training. In addition,
the creation of trainee posts will make it possible to appoint young persons to work within the Division for a
period of approximately two years before secondment to the above course.
There have been very few personnel changes during the year under review. This makes for a more
stable atmosphere among the staff which is bound to reflect favourably on their relationships with patients.
The Boarding Out Scheme
This scheme was initiated by the former Middlesex County Council. Its purpose was to encourage
mentally ill patients to live in the community even with a reduced earning capacity. It is a sad fact that many
mentally disordered persons cannot readily accept work to which they would appear to be well suited
intellectually. This results frequently in poorly paid unskilled type of employment or indeed in unemployment.
However, some of these people are quite capable socially to live in suitable lodging rather than, say, in a hostel
or even remain in hospital. Apart from therapeutic value, this is economically a much more attractive
proposition. The above scheme, therefore, intended to be used to supplement board and lodging expenses, was
launched to be used in conjunction with the post of a social worker acting as Boarding Out Officer.
Unfortunately very little use has been made of the facilities since the resignation of this officer in
1966, who had been transferred from the Middlesex County Council to the London Borough of Harrow on the
"appointed day" and shared with Brent. It had been hoped that Mental Health Social Workers/Mental Welfare
Officers would be able to carry on the scheme with regard to their own cases. This, however, proved an
unrealistic assumption—heavy case loads did not allow enough time for additional duties of a somewhat
arduous nature.
Recently the need for such a scheme has made itself felt more acutely. With the opening of the
Hostel, 9 Willesden Lane, it has become evident that patients will need additional help if they are not to
prolong their stay at the Hostel unnecessarily. Indeed, this applies at least as much to the Hostel for 12