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The "Gateway Club" is held at Willesden Day Centre every Tuesday night. Professional staff attending
comprise a community mental health social worker, a Shenley Hospital psychiatrist and occupational
therapists from the Day Centre as well as from Shenley Hospital. The purpose is purely social and the professional
workers are unobtrusively supportive and avoid being in any way directive. A Club of this kind on
occasion might appear to be in need of a more structured setting and the professional workers have to resist
the demand for an authority figure. However, to be of real benefit to the patients' rehabilitation and their
need to learn to function as part of a group, it is necessary that they find their own solutions to management
problems with only minimal professional help. Attendances have steadily increased during the year and it is
not unusual to find about 30-40 people present. Recreational activities are varied and games of many kinds
are encouraged. Attention has been focussed on the need for forming a members' committee and the indications
are that this will be forthcoming in the near future specifically for the purpose of organising entertainments
and outings.
The "Do-It-Yourself Club" is held on Thursday evenings. The purpose is to help patients in developing
hobbies, in the attempt to widen their usually very restricted interests and to enrich their lives. Certainly
this Club also fulfills an important social function in giving people a further opportunity to relate to one
another in a stimulating work situation.
A senior occupational therapist is in charge and another occupational therapist attends. A Members'
Committee is responsible for the various activities which on occasion even includes special outings.
Membership is 35 but only about a dozen or so patients attend at any time. Some members also
attend the "Gateway Club" and a few the Club run by the neighbouring Borough of Camden. Indeed "Outings"
are often a joint affair between the members of all three clubs.
Day Care for the Elderly Mentally III
The needs of this group of patients are partially met by the provision of 10 places at the Harrow
Day Centre for the Elderly Mentally Infirm. As in previous years there have only been a handful of referrals
for day care and all have been able to be placed at the above Centre. However, it is known by various means
that the actual size of the problem is very much larger than is reflected by the number of official referrals. In
response to this pressure a small number of such patients (10-12) have been offered a club-type placement on
one afternoon per week on the premises of "Brentholme" Hostel under the guidance of an occupational
therapist from the Willesden Day Centre. These and many more similar patients should find their specific
needs catered for by the proposed provision of a Day Centre for the Elderly Mentally Infirm on the same
premises in the coming year. Initially this will provide 12 places on three full days per week as a pilot scheme
to assess the true demand for such a Centre in the Southern part of the Borough. Transport and mid-day meals
will be provided. An occupational therapist will be in charge helped by two lay assistants.
Provisions of this type undoubtedly will ease the pressure such elderly persons may cause their
families (or landladies) and can prevent, or at least postpone, residential admission. This is surely both economical
and humane. It is revealing to see how much deteriorated elderly people can still improve if placed in
such a setting. Agitation and restlessness can completely subside under professional handling during the day.
Provision of a mid-day meal is a very important adjunct to therapy—eating together is so very much part of
normality and it has been found that patients who on admission, would hardly communicate at all, first did so
at the dinner table. From then on progress can be expected to be quite rapid. For this reason meals will be
provided even for those who can only be accommodated for part of the day.
The choice of location for the proposed scheme was governed by the fact that better use could be
made of premises that are virtually empty during the day and the games room in conjunction with the dining
room at "Brentholme" Mental Aftercare Hostel appeared a good choice for this limited project.
Shenley Hospital
The appointment of a hospital consultant psychiatrist (one session weekly) to this Department has
considerably improved the liaison between the Mental Health Division and its catchment hospital for the
mentally ill. It has been possible to smooth out many of the difficulties formerly encountered where patient
admission is concerned. The easy accessibility of the consultant to the mental health social worker has recently
facilitated crisis admissions (formal and informal) and improved liaison for after-care purposes arising from
discharges. It had been a matter of considerable concern to the community mental health staff that a number
of patients were discharged without prior adequate preparation or consultation with them. Patients were suddenly
found to be back at home and the worker's attention was only drawn to this after some communication
from worried relatives. Occurrences of this kind should now be a thing of the past as mental health social
workers regularly attend the relevant consultant psychiatrist's discharge case-conferences.
In an endeavour to bring community problems nearer to the Shenley Hospital nursing staff, small
groups of student nurses now attend the Mental Health Division and participate in some of the activities of the
Division Complementarily senior mental health staff lecture to the nurses during their formal instruction periods
at Shenley Hospital. Additional links between Hospital and Community are maintained by the attendance at the
"Gateway Club" of a psychiatric senior registrar and an occupational therapist as well as the continued membership
of the Senior Medical Officer on the Shenley Hospital Management Committee.
Voluntary Societies
It is with regret that I have to report that there exists still no local branch of the National Association
for Mental Health. Since the dissolution of the Willesden Branch in 1965 only the feeblest interest in such a
venture has been shown by a few members of the public. This is a great pity as a local branch of this Association
could be a great asset to the community.
League of Friends for Shenley Hospital
The Brent Branch, in conjunction with the Harrow one, have continued to provide patients with a
number of amenities which neither hospital nor Local Authority would have been in a position to make