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81
Child Guidance Centres
In Tottenham, the Medical Director, Dr. William Craike continued to see an
increasing number of cases and he stresses the importance of case conferences involving
all the members of the Child Guidance Team During the year such a conference was held
on a special case, in which the mother was psychotic and had been discharged from
mental hospital. There were two young children and the head mistress was concerned
about their safety. Arrangements were made to call together the Headmistress, the
Psychiatric Team, Mental Welfare Officer, School Welfare Officers and the Child Care
Officer, in an endeavour to find a satisfactory method of helping this family. It is to be
anticipated that more cases of this type will arise with the policy of early discharge of
psychotic patients to their homes, where they still live in the community, having home
treatment from their general practitioners though still under hospital supervision. It is
likely that stresses and strains will be thrown on the child, which may be reflected in
school and general behavour. From past experience it would seem that the adolescents
are more likely to be disturbed than the younger children; but this is one of the side
effects of the Mental Health Act which was not anticipated and which may cause
considerable concern in future years.
Dr. Craike has proposed an evening clinic for the Consultant Psychiatrist to meet
working parents and adolescents who cannot miss time from school or employment
Dr. Nina Meyer, writing about her work with the under-fives, comments that the
work has grown markedly in the last year Most have been cases of severe disturbance
of sleeping in the under-twos In many it emerged that it was a problem of the
inability of the mother to let the young child separate from her. For many mothers it is a
difficult problem to make the transition from infancy to the toddler phase, and this can be
one in which disturbed patterns of behaviour and personality are laid down.
At many of the diagnostic interviews, the health visitor concerned with the child
came with the mother; this was most helpful to the psychiatrist and Dr. Meyer hopes
that it will be increasingly so to the health visitor. Suggestions were made of the
sort of information the health visitor can look for which may be helpful in psychiatric
consultation. Dr. Meyer suggests the health visitor will be able to act increasingly as a
liaison between psychiatrist and family. The under-five clinic has no psychiatric
social worker and this is an aspect where the unique knowledge and experience of the
health visitor is so valuable in her helpfulness to the mother.,
A further innovation was a monthly discussion group comprising medical officers in
infant welfare and toddler clinics and the Consultant Psychiatrist Here problems and
points of view in relation to disturbances of the under fives were freely discussed with
great benefit to the psychiatrist and the medical officers.
The under-five clinic is now firmly established what is most encouraging is the
interest of fathers who often accompany their wives with the children. It seems that
young children arouse and hold fathering instincts more easily than when they are
beginning to become independent. This fostering of fathering is of benefit to the family's