London's Pulse: Medical Officer of Health reports 1848-1972

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Brent 1970

[Report of the Medical Officer of Health for Brent]

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20
MENTAL HEALTH
(Tables 18—20)
MENTAL ILLNESS
Community Care and the Social Workers
The year started with a distinct improvement of the Mental Health Social Work services due. to
some extent, to the appointment of a trained Senior Mental Health Social Worker and also to the settling
down of field staff into the more efficient routine initiated in the previous year. Unfortunately, however, it
was not possible to maintain the higher standard of service for many months due to a variety of circumstances.
The size of the staff establishment became depleted for quite lengthy periods. One officer resigned
due to domestic circumstances and her replacement took considerable time. Another officer resigned because
she had obtained privately a place on a social work training course and again replacement proved difficult and
was possible only after a considerable lapse of time. In addition, financial stringencies did not allow a vacant
Trainee post to be filled. In these circumstances it needed only one or two officers to go on sick leave to
make the efficient running of the Section a great problem as this situation increased the social workers case
loads to unmanageable proportions.
A further strain was put on the staff due to emotional responses evoked by the impending
reorganisation of the services. In June, the Director of Social Services was appointed but although no
immediate organisational changes took place, unsettling rumours were rife and speculation abounded regarding
the fate of individuals. The strongly expressed feelings of insecurity felt by many had repercussions and
showed itself in the quality of their work. It is to be hoped that morale will improve rapidly once the
reorganisation is completed and officers are able once more to direct their full energies towards their work.
This difficult period underlined the fact that a service run on a bare minimum of staff is in grave danger
if an unfortunate combination of circumstances depletes the staff establishment markedly, even if only for
comparatively short periods.
Mental health social workers have now accepted a mixed case load of both mentally ill and mentally
subnormal patients thus more nearly approximating the concept of generic work.
The senior staff lectured on a variety of subjects to voluntary groups, thus accepting their role
as health educators and doing preventive work.
Boarding-out Scheme
This scheme has continued to operate, but once more, throughout the year, on a somewhat restricted
scale or at least not as extensively as had been hoped. The factors militating against the extension of the
scheme have continued to be the wariness of private persons to taking into their homes, as lodgers, people
who have been mentally ill. and the need to be extremely selective in choosing ex-patients for placing in
this sort of situation.
At the end of December, 17 persons had been boarded out under the scheme of whom 9 were still
in their lodgings. Only 2 of this number were having their lodging or board/lodging charges subsidised by
the Council, 4 were paying their own way in full from their earnings and the remainder were the responsibility
of Social Security.
"Brentholme" Hostel, 9 Willesden Lane, N.W.6
The affairs of this establishment have run smoothly throughout the year. This may well be due to
the fact that there has been no change of staff. Criteria for admission have remained the same. i.e. only such
cases are accepted as are deemed to be able to benefit from short term rehabilitation. Bed occupancy rates
have been approximately 90 per cent. and the turnover has been reasonably satisfactory. However this could
have been speeded up in a number of cases had there been better facilities available to accommodate those
residents who were rehabilitated to the extent of needing less intensive help from staff and were yet not
quite able to live completely independent lives. This type of accommodation is proposed to be provided in
the near future and is included in the Corporate Plan.
The Hostel, 73 Wembley Park Drive
This unstaffed Group Home for 6 ladies continues to prove the worth of this kind of accommodation.
It should be appreciated, however, that regular weekly evening visits by professional staff appear to be
essential support if the group is to function well. Time and again it has been found that comparatively
minor mood swings in one of the residents can set up a chain reaction which could prove most detrimental
to all 6 residents. It has not been possible to discharge anybody although 2 of the ladies could now be
considered ready to leave and share a flat together and support each other. Lack of adequate housing
provision however prevents this desirable step, thus clogging valuable hostel places.
Registration of Residential Homes—Section 37 National Assistance Act, 1948, as applied by Section 19,
Mental Health Act, 1959.
Ealon House, Mapesbury Road, N.W.6 remains the only voluntary hostel in the Borough. The
hostel is run by the Jewish Welfare Board to excellent standards. It is regularly inspected by the Senior
Medical Officer, Mental Health, who reports that the establishment, which is for 27 residents, is successfully
helping increasing numbers back into a realistic work situation. Those residents, not in employment, usually
attend the Board's Charles Jordan occupational therapy Day Centre in Finchley, special transport being
provided. The maintaining local authorities normally pay for this day centre placement for their cases.
Day Centre for the Mentally Ill, Belton Hall, Bertie Road, N.W.10
This Centre was opened in 1962 and was designed by the then Middlesex County Council to provide
for patients in the area now covered by the London Boroughs of Brent and Harrow and had as its prime