A PSYCHIATRIC SOCIAL WORKER ABROAD By
Robina S. Addis,
Deputy
General
Secretary,
hoU/j
over-driven.
Attendance at the Federation's a. nual conferences and at the Bo& meetings themselves involves worklfl: together with experts from other cOlli tries and many different disciplin? You learn to consider the training background of the speaker bef?. being able to appreciate the ficance of what he says. The same applies to conferences of nationals,K when the meeting is internatioi1 great allowances have to be made different structures of services, ferent histories and approaches, ^ above all, of cultural differences.
Big adventure
That is an old story now, but it influenced me in accepting the invitation to join the Board in 1961 for the initial four-year period. The first meeting was to be in Peru, which seemed a big adventure, but a few days before my departure it was cancelled because of an untimely revolution. Our sessions were transferred to Florence, and Italy was a country where I knew something of the Rome resources through Professor Carlo de Sanctis. His great work for the subnormal and for the Italian League for Mental Hygiene showed me how similar aims to ours might be translated into different terms according to the setting. Long before we grouped mental deficiency and mental illness under the term of "mental disorder", there were examples in Italy. When there was no tradition of voluntary help in the mental health field, experts had to give their time voluntarily and thus was created a different but
viable pattern.
meeting was in Amsterreview of the proceedings elsewhere in this journal.1
Our next
dam, and appears 1
a
See "Book
N.A.M.H.
Berne, in 1964, has just been P11. lished2 and there we were amofl? our friends the Swiss and in a coud'.( where I have paid many visits. In sp1. of prosperity, the Swiss remain har. working?shops and offices are oPe. by 8 a.m. and people work long This pattern is repeated in the cP ren's homes I visited, and a full Pr! gramme of work is accepted as tc, normal. Had I been visiting in Englat1' I might have thought the childfe
of the Board of the World Federation for Mental Health has stimulated but not created my interest in international work in the mental health field. Almost the first beginning pre-dated this by 16 years. Called to Switzerland by "Sepeg" immediately after the war, I learned vividly there the moral support and comfort which colleagues from other countries could give in dealing with such problems as "child victims of the war". Together we worked out principles which alone we could, not have achieved. membership
^
^
Cultural The
background
significance ground in looking
of cultural at mental
ba On a previous visit I had seen must be the only mental hospital ,j( have an open-air Greek theatre W by the patients where they perfo^,
Reviews", p. 178.
156
services
_
ti^j
2
Industrialisation and Mental Health, ings of the 17th Annual Meeting (W.F.M.H.. $3).
*^ddis >?:ai &ctlns &ct,n*
by 4tbybeing
?
5??r the
pf
AssoPPin.es C|ation for M nt*l Health
?f
ple
tragedies. t^assical glorious
The influence past pervaded even
e
Hil?ary Sessi?ns in the air-conditioned In the land where 0e,?n Hotel. surely mental health Wo lPUs was must have a
yk*Slting
$er
a
es
legendary flavour.
country
to
study its social
still moreand resources brings home clearly the integral importanc e ?f the cultural setting. Last year I as
asked to go to Malta to make .Emendations on a child guidance $er lCeAttendance at most of our Int fer r~Clinic Child Guidance Con(almost the whole 21 which vUces ? rej taken place since 1933) and the re
have kept me in the work of the clinics, it is a long time since I was one- ^ was familiar with Ve.d the k ?asic principles and the training H for the staff team. tetfi Pted brief visit to the island, I atto see something of the servic
t?U
4'scussi?ns
K
aituC?u?hw'th j^ssary
chiln
^0r maladjusted
?ren,
or
handicapped
and my many questions were by kind Maltese friends. I d the Education Authority was a]r ady providing occupation centres a
f?u^red
(with staff trained by the N.A.M.H.) and classes for maladjusted children, while the leading paediatrician had excellent facilities in his children's wards. The Roman Catholic Church, which plays such a large part in the life of Malta, run almost all the children's homes. A voluntary body, the Malta Welfare Society for the Mentally Handicapped, a young but vigorous organisation, was the instigator of my visit, which was then supported by the British Council. All these factors had to be taken into account and affected the recommendation that a child guidance service for Malta should include the subnormal as well as the maladjusted, and be served by a fully qualified team of Maltese. The organising committee should represent Education and Health Departments, and the Social Welfare Department (which is concerned with emigration, and this is seen as a solution for some young patients' problems). A leading part should also be given to the Church. Such recommendations were specially designed for Malta, but some colleagues in this country have been
157
interested in the suggestion that the child guidance clinic should also provide a diagnostic and treatment service for cases of special difficulty amongst the subnormal, and the paediatric department should be closely involved. Not only the circumscribed size of the island and its recent independence, but the nature of its people all conditioned necessarily the results of the
study. Even more startling is the effect of the background when visiting a strange continent. Attending the first Pan African Psychiatric Conference in Nigeria in 1961 opened my eyes to the variation necessary in applying mental health principles in a different culture. Professor Lambo, the eminent Nigerian psychiatrist, had found that even a modern mental hospital was not suited to the African way of life and he created a scheme of com-
munity care whereby patients lived as "paying guests" with a responsible relative in charge of each in the villages round the hospital. A visiting team based at the hospital brought
treatment to them and enabled them to remain part of the community, instead of having to face a foreign way of life in a hospital. The emphasis on group living and the strong ties of the family make it more appropriate to treat the patient and relative together in the village than to apply a Western form of individual treatment. This is apparent also in training, and the English matron told me that she had to revise her methods because young nurses responded better to correction in front of others than when she called them to her room on their own. In discussing training for Nigerian social workers, it was clear that they needed to have their basic course in their own country, related to their own experiences of life and geared to return to work in Nigeria. An advanced course might then be profitably taken abroad. Our concepts of family relationships, of relationships between individuals and with other groups all would have to be revised before working in Nigeria. Removing deaf and blind children, or adults for that mat-
ne^*'
from home for training re-thinking in a country where responsibility is so high. Respect a" privilege for the aged again gives different background for geriatric $ vices. Surprisingly I found that ter,
grey hair gave me a status unknov\ to me in my own country. The of change and industrialisation need" profound and extensive study.3
effeCj
Behind the
facade
horf ba
Robina S. Addis,
Deputy
General
Secretary,
hoU/j
over-driven.
Attendance at the Federation's a. nual conferences and at the Bo& meetings themselves involves worklfl: together with experts from other cOlli tries and many different disciplin? You learn to consider the training background of the speaker bef?. being able to appreciate the ficance of what he says. The same applies to conferences of nationals,K when the meeting is internatioi1 great allowances have to be made different structures of services, ferent histories and approaches, ^ above all, of cultural differences.
Big adventure
That is an old story now, but it influenced me in accepting the invitation to join the Board in 1961 for the initial four-year period. The first meeting was to be in Peru, which seemed a big adventure, but a few days before my departure it was cancelled because of an untimely revolution. Our sessions were transferred to Florence, and Italy was a country where I knew something of the Rome resources through Professor Carlo de Sanctis. His great work for the subnormal and for the Italian League for Mental Hygiene showed me how similar aims to ours might be translated into different terms according to the setting. Long before we grouped mental deficiency and mental illness under the term of "mental disorder", there were examples in Italy. When there was no tradition of voluntary help in the mental health field, experts had to give their time voluntarily and thus was created a different but
viable pattern.
meeting was in Amsterreview of the proceedings elsewhere in this journal.1
Our next
dam, and appears 1
a
See "Book
N.A.M.H.
Berne, in 1964, has just been P11. lished2 and there we were amofl? our friends the Swiss and in a coud'.( where I have paid many visits. In sp1. of prosperity, the Swiss remain har. working?shops and offices are oPe. by 8 a.m. and people work long This pattern is repeated in the cP ren's homes I visited, and a full Pr! gramme of work is accepted as tc, normal. Had I been visiting in Englat1' I might have thought the childfe
of the Board of the World Federation for Mental Health has stimulated but not created my interest in international work in the mental health field. Almost the first beginning pre-dated this by 16 years. Called to Switzerland by "Sepeg" immediately after the war, I learned vividly there the moral support and comfort which colleagues from other countries could give in dealing with such problems as "child victims of the war". Together we worked out principles which alone we could, not have achieved. membership
^
^
Cultural The
background
significance ground in looking
of cultural at mental
ba On a previous visit I had seen must be the only mental hospital ,j( have an open-air Greek theatre W by the patients where they perfo^,
Reviews", p. 178.
156
services
_
ti^j
2
Industrialisation and Mental Health, ings of the 17th Annual Meeting (W.F.M.H.. $3).
*^ddis >?:ai &ctlns &ct,n*
by 4tbybeing
?
5??r the
pf
AssoPPin.es C|ation for M nt*l Health
?f
ple
tragedies. t^assical glorious
The influence past pervaded even
e
Hil?ary Sessi?ns in the air-conditioned In the land where 0e,?n Hotel. surely mental health Wo lPUs was must have a
yk*Slting
$er
a
es
legendary flavour.
country
to
study its social
still moreand resources brings home clearly the integral importanc e ?f the cultural setting. Last year I as
asked to go to Malta to make .Emendations on a child guidance $er lCeAttendance at most of our Int fer r~Clinic Child Guidance Con(almost the whole 21 which vUces ? rej taken place since 1933) and the re
have kept me in the work of the clinics, it is a long time since I was one- ^ was familiar with Ve.d the k ?asic principles and the training H for the staff team. tetfi Pted brief visit to the island, I atto see something of the servic
t?U
4'scussi?ns
K
aituC?u?hw'th j^ssary
chiln
^0r maladjusted
?ren,
or
handicapped
and my many questions were by kind Maltese friends. I d the Education Authority was a]r ady providing occupation centres a
f?u^red
(with staff trained by the N.A.M.H.) and classes for maladjusted children, while the leading paediatrician had excellent facilities in his children's wards. The Roman Catholic Church, which plays such a large part in the life of Malta, run almost all the children's homes. A voluntary body, the Malta Welfare Society for the Mentally Handicapped, a young but vigorous organisation, was the instigator of my visit, which was then supported by the British Council. All these factors had to be taken into account and affected the recommendation that a child guidance service for Malta should include the subnormal as well as the maladjusted, and be served by a fully qualified team of Maltese. The organising committee should represent Education and Health Departments, and the Social Welfare Department (which is concerned with emigration, and this is seen as a solution for some young patients' problems). A leading part should also be given to the Church. Such recommendations were specially designed for Malta, but some colleagues in this country have been
157
interested in the suggestion that the child guidance clinic should also provide a diagnostic and treatment service for cases of special difficulty amongst the subnormal, and the paediatric department should be closely involved. Not only the circumscribed size of the island and its recent independence, but the nature of its people all conditioned necessarily the results of the
study. Even more startling is the effect of the background when visiting a strange continent. Attending the first Pan African Psychiatric Conference in Nigeria in 1961 opened my eyes to the variation necessary in applying mental health principles in a different culture. Professor Lambo, the eminent Nigerian psychiatrist, had found that even a modern mental hospital was not suited to the African way of life and he created a scheme of com-
munity care whereby patients lived as "paying guests" with a responsible relative in charge of each in the villages round the hospital. A visiting team based at the hospital brought
treatment to them and enabled them to remain part of the community, instead of having to face a foreign way of life in a hospital. The emphasis on group living and the strong ties of the family make it more appropriate to treat the patient and relative together in the village than to apply a Western form of individual treatment. This is apparent also in training, and the English matron told me that she had to revise her methods because young nurses responded better to correction in front of others than when she called them to her room on their own. In discussing training for Nigerian social workers, it was clear that they needed to have their basic course in their own country, related to their own experiences of life and geared to return to work in Nigeria. An advanced course might then be profitably taken abroad. Our concepts of family relationships, of relationships between individuals and with other groups all would have to be revised before working in Nigeria. Removing deaf and blind children, or adults for that mat-
ne^*'
from home for training re-thinking in a country where responsibility is so high. Respect a" privilege for the aged again gives different background for geriatric $ vices. Surprisingly I found that ter,
grey hair gave me a status unknov\ to me in my own country. The of change and industrialisation need" profound and extensive study.3
effeCj
Behind the
facade
horf ba
