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Clinic team in general, but you have not yet found a way of ensuring
that this fruitful type of meeting takes place at anything but rare
intervals, so that one important part of our potential ability to
make easier the task of educating large numbers of school children
is not used. As a visiting psychiatrist, I am always pleased to
extend a welcome to our Clinic case conferences to any teacher, and
to modify my personal arrangements or rearrange my work in order
to make it possible for them to attend.
Since cases of mental ill-health amongst school children must
have a beginning, it is important that we should extend further a
generally little-known field of knowledge which concerns itself
with the beginning of these disorders. As mentioned in my last
year's report, we have already started on such work in an experimental
way, with the joint attendance of one Medical Officer and
the visiting psychiatrist for one half day a week at a special
Clinic, to which are referred mothers with a child under five years
of age with whom there is some difficulty.
The method we have tentatively adopted is for each Medical
Officer to work with the psychiatrist for three months. It has
also been decided that the children should be preferably less than
three years old, because above that age the problem is already
complicated and is usually suitable for a Child Guidance team to
assess.The interview has been conducted, if possible, by the
Medical Officer, but where it has been felt that the case requires
considerable psychiatric knowledge to unravel, the psychiatrist has
taken the lead in conducting the session. A very small number of
cases were actually seen, in order to allow time for observation
of behaviour and to leave time for a discussion and instruction in
the interval between one case and the next. This is not intensive
enough to be called a training programme, but it was thought that
it could be a valuable series of Clinic demonstrations of the
technique of the clinical management of the interview and of
finding ways to help the mother both to understand and manage the
child.
It is not possible to report much of the clinical material
because this might more appropriately be the subject of a scientific
Paper, but certain conclusions are beginning to make themselves
apparent.
I intend to mention only three categories of difficulty with
a brief comment, and hope that this will not involve too great a
frustration to readers of this report. The commonest problems
are feeding, sleeping, and general restlessness and over-activity.