MENTAL DEFICIENCY
1937
ADMINISTRATION,
The Board of Control's Report for 1937 has recently been published, and the following gives the salient facts with regard to mental deficiency administration during
summary
that year. Numbers under Care On January 1st, 1938, there was a total number of 86,510 defectives under care, of which 44,263 were in Institutions, 4,430 were under Guardianship or Notified, and 37,817 This represents an increase of 3,784 on the correswere under Statutory Supervision. ponding figures for 1936. Ascertainment "
In the number of defectives reported to Local Authorities (whether subject to be dealt " with or not) there was an increase of 4,830, the number being 121,977, viz., 2.99 per 1,000 of the population as against 2.88 per 1,000. In addition, 3,382 feeble-minded children between 14 and 16 were reported informally for voluntary supervision (compared with 3,584 in the previous year). Adding these two groups of cases together, the total number of defectives reported was 125,359 (viz., 3.07 per 1,000). The total number, subject to be dealt with, was
92,449.
The number of children notified by Local Education Authorities (under Section 2 (2) of the Mental Deficiency Act, 1913) was 3,910, representing a decrease of 81 on the 1936 figures. In commenting on this unsatisfactory situation the Board draw attention to the lack of uniformity of method which exists in the practice of Local Education Authorities (the number of children notified varies from 3.20 per 10,000 of the population in Plymouth, to none at all in Merthyr Tydfil and West Hartlepool) and urge a closer measure of co-operation between the Authorities concerned. Especially is this important in the case of feeble-minded children leaving school?a question which is deemed by the Board to be by far the most urgent in relation to ascertainment which Local Authorities have to
face."
14
MENTAL WELFARE
are also asked to study closely the table of Ascertainment Rates throughout the country, showing the proportion of defectives reported, the proportion found to be subject to be dealt with," the proportion sent to Institutions and those put under some form of community care. The variation in the relation between these different groups is, as in former years, a striking one. Thus one Authority (Cardigan) with the high rate of 7.69 cases "reported" finds only 1.27 "subject to be dealt with" and only actually deals with .25. Another Authority (Durham County) reports 2.62 cases notified, and 2.62 as being subject to be dealt with," while in 2.04 it takes action. In commenting on this anomalous state of things, the Board attribute one reason for it to ascertained" are still in receipt be that numbers of cases in certain areas reported as of Poor Law Relief, and no further action is taken.
Local Authorities
in the various areas
"
"
"
Accommodation The progress made during the year is noted as being "distinctly encouraging," though the total accommodation available is still far short of what is required. There has been a net increase of 1,831 beds, making a total on January 1st, 1938, of 43,552 beds available. Nine Authorities have
now from 1.42 to 1.81 defectives per 1,000 of the population in (Walsall) has 2.39, this exceeding the estimate of 2 per 1,000 on the evidence of the Wood Report. By far the largest increase in accommodation has been in Certified Institutions, although 266 more beds were provided in Institutions certified under Section 37, and 37 in Approved Homes. The Board note with regret the reluctance of some Local Authorities to appoint a Medical Superintendent at an early stage in the development of a new Colony and urge the necessity for one can be no the fallacy of postponing such an appointment until longer ignored."
Institutions, whilst made by the Board
one
"
There are
modation, but it
still 13 Local Authorities without any provision for institutional is stated that the majority have schemes under consideration.
accom-
Hostels The number of Institutions functioning solely as Hostels remain at 4 (Eagle House, Mitcham; Royal Fort Home, Bristol; Royal Hostel, Elstead, and The Old Rectory, Bath) and only 7 other Institutions have separate Hostel branches (The Manor, L.C.C.; Starcross; Farmfield, L.C.C.; Meanvvood Park, Leeds; The Hermitage, Fairwarp; Caterham; Monyhull). In 9 Institutions, arrangements are made for patients to go out to daily work.
Community Care On January 1st, 1938, the numbers under follows:? On Licence from Institutions Under Guardianship Under Statutory Supervision Under Voluntary Supervision ...
some
...
...
...
...
...
...
...
...
...
form of Community Care
3,155 ( +132 4,157 ( +428 37,817 ( + 1,510 25,370 ( +322
on on on on
were
as
1936 figures) 1936 figures) 1936 figures) 1936 figures)
The total number represents 36% of defectives known to
Authorities, or, including those under Voluntary Supervision, 56.2%. In spite of the slow general increase of these forms of care it is pointed out that there are still many areas in which little or no use is being made of the sections of the Act relating to community care, and emphasis is laid on the fact that:? "
in addition to the failure on the part of many Local Authorities to take
advantage of these important sections of the Act, the organisation for supervision and training has also failed to keep pace with the numbers and needs of defectives living in the community." The Board regard the use of Licence as a "means of testing the fitness of mental and deplore any restriction of its use, as a result defectives to return to community life of the difficulties and risks involved. They emphasise, however, the urgent need of providing supervision that is really adequate and of the utmost care in the selection of "
MENTAL WELFARE
15
patients and the choice of homes, pointing out the vital importance of providing full reports for the guidance of the Superintendent of the institution concerned. In the absence of such information, no wise judgment can be formed as to the moment when discharge becomes justifiable, or on the other hand, when it is desirable that the defective should be recalled.
Occupation Centres The growth of Occupation Centres continues to be disappointingly slow, and on January 1st, 1938, there were only 2 more Centres (making a total of 191 in all) than on ^he corresponding date in 1937, and only 89 more defectives on the registers. Of the 191 Centres (including Industrial Classes and Clubs) 121 are provided by Voluntary Associations and 70 by Local Authorities: 81 of the Occupation Centres and 11 Industrial Centres are open for whole-time sessions.
New Centres were opened during the year at Biddulph Moor (Staffordshire), Ilkeston (Derbyshire), Exeter and Sheffield, and three Centres (Newport, Worthing and Newcastleunder-Lyme) now occupy their own specially built premises.
1937
ADMINISTRATION,
The Board of Control's Report for 1937 has recently been published, and the following gives the salient facts with regard to mental deficiency administration during
summary
that year. Numbers under Care On January 1st, 1938, there was a total number of 86,510 defectives under care, of which 44,263 were in Institutions, 4,430 were under Guardianship or Notified, and 37,817 This represents an increase of 3,784 on the correswere under Statutory Supervision. ponding figures for 1936. Ascertainment "
In the number of defectives reported to Local Authorities (whether subject to be dealt " with or not) there was an increase of 4,830, the number being 121,977, viz., 2.99 per 1,000 of the population as against 2.88 per 1,000. In addition, 3,382 feeble-minded children between 14 and 16 were reported informally for voluntary supervision (compared with 3,584 in the previous year). Adding these two groups of cases together, the total number of defectives reported was 125,359 (viz., 3.07 per 1,000). The total number, subject to be dealt with, was
92,449.
The number of children notified by Local Education Authorities (under Section 2 (2) of the Mental Deficiency Act, 1913) was 3,910, representing a decrease of 81 on the 1936 figures. In commenting on this unsatisfactory situation the Board draw attention to the lack of uniformity of method which exists in the practice of Local Education Authorities (the number of children notified varies from 3.20 per 10,000 of the population in Plymouth, to none at all in Merthyr Tydfil and West Hartlepool) and urge a closer measure of co-operation between the Authorities concerned. Especially is this important in the case of feeble-minded children leaving school?a question which is deemed by the Board to be by far the most urgent in relation to ascertainment which Local Authorities have to
face."
14
MENTAL WELFARE
are also asked to study closely the table of Ascertainment Rates throughout the country, showing the proportion of defectives reported, the proportion found to be subject to be dealt with," the proportion sent to Institutions and those put under some form of community care. The variation in the relation between these different groups is, as in former years, a striking one. Thus one Authority (Cardigan) with the high rate of 7.69 cases "reported" finds only 1.27 "subject to be dealt with" and only actually deals with .25. Another Authority (Durham County) reports 2.62 cases notified, and 2.62 as being subject to be dealt with," while in 2.04 it takes action. In commenting on this anomalous state of things, the Board attribute one reason for it to ascertained" are still in receipt be that numbers of cases in certain areas reported as of Poor Law Relief, and no further action is taken.
Local Authorities
in the various areas
"
"
"
Accommodation The progress made during the year is noted as being "distinctly encouraging," though the total accommodation available is still far short of what is required. There has been a net increase of 1,831 beds, making a total on January 1st, 1938, of 43,552 beds available. Nine Authorities have
now from 1.42 to 1.81 defectives per 1,000 of the population in (Walsall) has 2.39, this exceeding the estimate of 2 per 1,000 on the evidence of the Wood Report. By far the largest increase in accommodation has been in Certified Institutions, although 266 more beds were provided in Institutions certified under Section 37, and 37 in Approved Homes. The Board note with regret the reluctance of some Local Authorities to appoint a Medical Superintendent at an early stage in the development of a new Colony and urge the necessity for one can be no the fallacy of postponing such an appointment until longer ignored."
Institutions, whilst made by the Board
one
"
There are
modation, but it
still 13 Local Authorities without any provision for institutional is stated that the majority have schemes under consideration.
accom-
Hostels The number of Institutions functioning solely as Hostels remain at 4 (Eagle House, Mitcham; Royal Fort Home, Bristol; Royal Hostel, Elstead, and The Old Rectory, Bath) and only 7 other Institutions have separate Hostel branches (The Manor, L.C.C.; Starcross; Farmfield, L.C.C.; Meanvvood Park, Leeds; The Hermitage, Fairwarp; Caterham; Monyhull). In 9 Institutions, arrangements are made for patients to go out to daily work.
Community Care On January 1st, 1938, the numbers under follows:? On Licence from Institutions Under Guardianship Under Statutory Supervision Under Voluntary Supervision ...
some
...
...
...
...
...
...
...
...
...
form of Community Care
3,155 ( +132 4,157 ( +428 37,817 ( + 1,510 25,370 ( +322
on on on on
were
as
1936 figures) 1936 figures) 1936 figures) 1936 figures)
The total number represents 36% of defectives known to
Authorities, or, including those under Voluntary Supervision, 56.2%. In spite of the slow general increase of these forms of care it is pointed out that there are still many areas in which little or no use is being made of the sections of the Act relating to community care, and emphasis is laid on the fact that:? "
in addition to the failure on the part of many Local Authorities to take
advantage of these important sections of the Act, the organisation for supervision and training has also failed to keep pace with the numbers and needs of defectives living in the community." The Board regard the use of Licence as a "means of testing the fitness of mental and deplore any restriction of its use, as a result defectives to return to community life of the difficulties and risks involved. They emphasise, however, the urgent need of providing supervision that is really adequate and of the utmost care in the selection of "
MENTAL WELFARE
15
patients and the choice of homes, pointing out the vital importance of providing full reports for the guidance of the Superintendent of the institution concerned. In the absence of such information, no wise judgment can be formed as to the moment when discharge becomes justifiable, or on the other hand, when it is desirable that the defective should be recalled.
Occupation Centres The growth of Occupation Centres continues to be disappointingly slow, and on January 1st, 1938, there were only 2 more Centres (making a total of 191 in all) than on ^he corresponding date in 1937, and only 89 more defectives on the registers. Of the 191 Centres (including Industrial Classes and Clubs) 121 are provided by Voluntary Associations and 70 by Local Authorities: 81 of the Occupation Centres and 11 Industrial Centres are open for whole-time sessions.
New Centres were opened during the year at Biddulph Moor (Staffordshire), Ilkeston (Derbyshire), Exeter and Sheffield, and three Centres (Newport, Worthing and Newcastleunder-Lyme) now occupy their own specially built premises.
