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106
from time to time, as is considered advisable by your Medical
Adviser. Frequent visits to the defective's home for supervision
purposes are, however, in a large percentage of cases a
very fruitless task, for the most part the home conditions
cannot be changed, nor is it possible in very many cases to get
the defective into an Institution or give any other additional
help. In these circumstances it is not unnatural that the
relatives of the defective should often refuse to supply needful
information.
Appointment of Ascertainment and Supervision Officers.
As stated above, the Committee's Nurse has had many
year's experience in ascertainment and supervision work.
There is no special Officer appointed for ascertainment alone.
The cases come to my knowledge chiefly by means of Health
Visitors, School Nurses, School Attendance Officers, School
Teachers, Sanitary Inspectors, and Voluntary Societies, though
it is not part of the actual duty of the Authorities' Officers
mentioned to report such cases. They report all cases of a
doubtful character which come to their knowledge. These
cases are then exhaustively examined by your Medical Adviser.
Occupation Centres.
Occupation Centres have been established in many districts.
The Board of Control report that these Centres are
still in the experimental stage, but have already achieved a
large measure of success. Eighty of these Centres are controlled
by voluntary Associations, and three by Local Authorities.
There are certainly in West Ham a number of
defectives of the type who should benefit by attendance at such
Centres. The Committee might deem it advisable to consider
the possibilities of an Occupation Centre in this area.
There is much diversity of opinion as to the best method
of dealing with mental defectives. There are some who favour
a lethal chamber as the best method of ridding the Community
of Mental Defectives; others suggest sterilisation; others
again, complete incarceration. On the whole, it would appear
that there is no one method which has any outstanding
advantage.
Mental Deficiency is a disease, the prevention of which is
a very involved problem, embracing many factors, both in
respect to the parents and to the child. Syphilis, Alcoholism,
Consanguinity, play an important part: it is, further, a matter
for investigation as to how far environment and other relative
conditions conduce directly and indirectly to menta
derangement.