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The second venture was initiated by the Willesden Area Probation Service. Probation officers were
getting concerned about the steep increase in the number of drug abuse cases and they invited interested
professional workers to discuss this problem. The group included members of the mental health staff, a school
medical officer, a headteacher, a general practitioner and psychiatrists from Shenley Hospital. The outcome of
these meetings was the opening at Kilburn Square Clinic of a session run jointly by the probation officers, and,
on a voluntary basis, a general practitioner and a psychiatrist. At this evening clinic so far only clients on
probation and their relatives are dealt with and at this stage all "hard drug" abusers have been excluded. It
will be interesting to see how this venture develops.
The above mentioned group also recommended seminars for teachers by school doctors on the subject
of drug abuse in an attempt to reach as large a part of the susceptible teenage population as possible. The first
stage of this scheme was a series of two lectures given by a psychiatrist well versed in the problems of drug
abuse to a group of school doctors. It is hoped that steps like this will reinforce the memorandum on this
subject sent out by this Department to all teachers of senior schools.
Approved Medical Practitioners
Two additions were made in 1967 to the list of medical practitioners approved for the purposes of
Section 28, Mental Health Act, 1959.
COMMUNITY CARE—SUBNORMAL & SEVERELY SUBNORMAL
Supervision in the Home
Three Mental Health Social Workers (equivalent 2 full time posts) deal exclusively with the care of
the subnormal and severely subnormal and their families. In addition several other Mental Health Social
Workers carry a varying case load of this type of patient.
It is worth stressing that their work mostly concerns the family rather than the patient as the latter in
practically all cases attends some kind of establishment or other where his specific needs are catered for.
Parents very often regard "their" officer as a friend and readily turn to her in times of need. This
relationship makes it possible to avert crisis situations which so readily arise particularly in households where
it is a child who is mentally subnormal.
Immigrant patients present the specific problems connected with low socio-economic status. However
in one respect the cultural pattern of their community leads to a specific difficulty :—West Indian women are
afraid of mentally disordered children and refuse to "mind" them. The result is that parents of such a child
will press for permanent hospital care because family finances compel the mother to go out to full-time employment.
This need could be met by admission of the child to a Day Nursery but is rarely practical as places
always fall short of demand. At any rate this type of placement could only be a stop-gap measure as the child
has to leave at the age of 5 years. Daily placement at the Junior Training Centre or Special Care Unit
unfortunately does not help these mothers as the attendance time is too short and the child has to be cared for
at home during school holidays. Much ingenuity is needed by the Mental Health Social Worker to help such
families until the child can be admitted to hospital.
Admissions to Hospital
The catchment area psychiatric hospital for mentally subnormal and severely subnormal persons
remains Leavesden Hospital. Cordial and profitable co-operation between the hospital and local authority
professional staffs continued. Although the community's need for hospital beds still falls short of requirements,
one aspect at least of this need has been imaginatively dealt with and the hospital has evolved at long last a
unit for babies and very young children. As this incorporates a research project, admission criteria are strict.
However, it has been possible to plan for the admission of at least some babies. Up to recently there seems to
have been very little doubt in the mind of medical authorities on this subject, that care in the parental home is
greatly to be preferred, to that in any kind of institution. This maxim has applied to both, normal as well as
handicapped children. Latterly, however, some doubt has been thrown on this concept, specifically pertaining
to the mentally severely retarded child. Unfortunately many parents overtly, or more often in a manner
masked, reject these children and it has been said that an environment of this kind will do little to further
their impaired developmental potential. When on the other hand, such a little patient is introduced into a
specially devised hospital environment, it is quite remarkable how much improvement in learning ability does
in fact emerge. The Leavesden Experimental Baby Unit has been evolved with such a child in mind. It is
intended to bring up the baby not in an isolated children's unit, but to mix children with older female patients
who can and do take on a new, maternal role, and this will prove beneficial to their own emotional life as
well as to that of the babies. It is envisaged that the young child will stay in the same place, if necessary for
the whole of her life, thus obviating the damaging change from ward to ward on age progression and to combat
isolation within her own age group. This experiment is designed to match these children with similar controls
who are likely to stay within the community. The hospital psychologist initially visits both types of child in
their own home in the presence of the Mental Health Social Worker to whom this is proving a very stimulating
thought provoking experience.
A completely different type of patient admitted to Leavesden Hospital is the delinquent boy, or more
rarely girl, who arrives on a court order after some specific brush with the police. These youngsters are usually
former educationally subnormal pupils who for various reasons have not been able to adapt to normal community
requirements. The hospital in these cases functions as a training establishment both for work and
general social needs. Leavesden Hospital fortunately has an excellent, modern industrial unit and competent
staff skilled to train individuals of this kind. However, when patients are discharged after varying lengths of
stay, they do not necessarily fit unto the community without a great deal of hard work by Mental Health
Social Workers. Young people whose behaviour and social adaptation gave rise to high hopes while still in the
hospital, often find life at home by no means comparable with that in hospital and this in spite of the usual
long periods of leave to accustom them to community life once more. Hostel accommodation appears to fill
this gap and we are fortunate to provide this for boys, but as yet this facility is sadly lacking for girls.