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and from other social agencies, i.e. Disablement Resettlement Officers of Labour Exchanges,
social workers in voluntary organisations, such as the C.A.B., and Hospital Almoners. About
half of the 52 cases were pre-cares that is patients who had not had treatment in a Mental
Hospital, and the rest were patients who had had treatment in a Mental Hospital.
On 1st January 1950 the current case load was 39 and the attached figures show the
progress of the work.
The work of the P.S.W. in the Public Health Department covers the following:-
1. Social care of patients with psychological and social problems.
These are classified as pre-care and after-care.
2. Psychiatric Social Club.
3. Mental Deficiency.
(1). It was felt that the function of the Local Authority in Community Care was
preventive with the emphasis on the maintenance of health. Therefore, the P.S.W. first
visited the social workers, both voluntary and statutory, in the various organisations in
the Borough and explained the aims of this service. These social workers come into contact
with people, who have problems of a psychological kind, difficulties in their social
relationships, and in adjusting to their families, or to their employment, and so on, and
are able to refer these people to the P.S.W, whose function it is to help them through their
difficulties and where desirable to put them in touch with a Psychiatrist or whatever service
they need. Many people 6an be helped by a P.S.W. when facing a crucial problem, and it is
hoped that by dealing with such problems as they arise, a breakdown may be avoided. The
various social organisations also come into contact with people who refuse to see a doctor
or are afraid to see a Psychiatrist, but some people will often see a P.S.W., especially if
her office is not situated in a hospital or clinic. Then sometimes it is possible to overcome
such fears and persuade them to accept the treatment they need. These are the cases
known as pre-care. The social workers in West Ham have been most co-operative and have
shown considerable skill in selecting the kind of cases which the P.S.W. is trained to help.
The after-care cases are referred mainly by Goodmayes Hospital and as there is a
close link between the Council and the Hospital, it has been possible to work out a very
flexible scheme suitable to the needs of the patients.
Not all patients discharged from hospital need after-care and a systematic followup
is not considered desirable. Patients when recovered need confidence in their recovery
and the suggestion of after-care may sow seeds of doubt in their minds. The hospital
psychiatrist usually makes the decisions as to the advisability of after-care and whether
it should be done by the hospital or the West Ham P.S.W.
Those patients for whom after-care is usually suggested are
(a) those who have improved considerably but whose final recovery depends on their
adjustment to the world outside the hospital, and in this, they may need help,
(bj those patients who have recovered but have problems of employment, domestic
difficulties, family and social relationships, which need resolving, if their
recovery is to be maintained.
(cj those patients who feel inadequate and dependent and need support for a while
before settling down.
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