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Prevention, Care and After-Care in relation to Mental Health
The work of the Psychiatric Social Worker
Again, as in the year 1956, preventive mental health work played a dominant role
in the caseload of the Psychiatric Social Worker. In contrast to 1956, where most of the
referrals were made by the M. & C.W. Section, School Health Services took the lead. The
Psychiatric Social Worker very much welcomed the 42 cases brought to her notice at an early
stage, so enabling her to give supportive treatment.
Example: Mrs.L. and Maurice.
This case was referred by a School Medical Officer. Problem: Mother overactive
and tense. All her emotions are concentrated on her only child Maurice, aged 5
worries about the child's feeding. Mrs. L. is a woman of 30, of above average intelligence,
over anxious, and says that her child is under-nourished because he does not want to eat.
Mother's efforts to feed him have failed.
She is convinced that she is a bad mother, and takes the child's refusal to take
food from her as a sign that Maurice does not love her. The child is, however very
different when not with his mother. P.S.W. suggested that the child should have school
meals.
His teacher reports that Maurice is eating well at school. P.S.W. was able to
help mother to see that her anxiety is reacting badly on the child, and it was therefore
necessary for P.S.W. to see her reglilarly once a week for a prolonged period. It became
obvious to P.S.W, that this woman is projecting onto Maurice anxieties which she herself
had experienced as a child. Mrs.L. is still seeing P.S.W. once fortnightly.
Maurice has improved considerably, and is now also eating quite well at home. He
is a lively child, and has made very good progress all round. He has become a better mixer,
and does not present any problem outside the home.
Mrs.L. has now started to take on part-time work and, though still anxious, is
finding it enjoyable. She welcomes the new interest, which enables her to divert her
attention during the time the child is not with her.
Eleven General Practitioners referred cases to the Psychiatric Social Worker,
one third of these cases needing after care following the discharge of the patient from
hospital. In two thirds of these cases, P.S.W. was asked to visit the home in order to
persuade a patient to accept psychiatric treatment, or to support relatives with their
often extremely difficult duties in connection with the mentally sick member of the family.
Example: Mrs.G.
Mrs.G. is the wife of a mentally sick husband. The case was referred by the
General Practitioner who stated that Mrs.G. is in need of help and support in order
to cope with her invalid husband who is supposedly suffering from the onset of senile
dementia.
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