Mental Health in 1958 The Second Part of the Ministry of Health's Annual Report, "On the State of the Public Health", has now been published.
statistics, given in Part I, are here considered in a wider and the chapter devoted to Mental Health begins with an context, introduction stressing the process of integrating general medicine and psychiatry which has gone on since the introduction of the National Health Service and is reflected in various new developThe
ments.
Thus the original policy of appointing a Regional Psychiatrist for every Regional Hospital Board area?necessary for the purpose 146
of re-organisation involved after the passing of the National Health Service Act?has since given place to a scheme under which the day to day administration of Mental Health Services is placed in the hands of an administrative medical officer responsible to the senior administrative medical officer of the Board concerned. When specialist psychiatric knowledge is required, it is provided by a consultant adviser or a psychiatric advisory committee. Again, it is pointed out that in 1958 there were over 500 psychiatric out-patient clinics and that fewer than 100 of these were in mental hospitals, and that whereas in 1949 the number of new patients was 93,800, in 1958 it was 152,107?indicating the gradual disappearance of the "unnatural division" between mental and physical illness and the growing acceptance by general hospitals of responsibility for making provision for psychiatric patients. Jt has now been amply proved that patients can be adequately treated in this way even in some cases in which hospitalization would formerly have been considered essential. The fall of 10,500 in the number of patients in mental hospitals which has taken place since 1954, is another striking phenomenon one cause of which is the rehabilitation and discharge of chronic patients formerly regarded
hopeless. With regard to staffing, the Report, whilst stressing the need created by the new services for workers of every kind and grade, notes as an encouraging fact, that consultants in psychiatry have increased since 1949 by more than 50%, which is considerably higher than in other specialities, and that recently the intake of senior registrars has also increased. Moreover a growing interest in psychiatry on the part of general practitioners has become apparent, and more time is now given to the subject in the training of medical
as
students. on "Community Services", brief but useful sumgiven of the comprehensive schemes in force in Oldham, Nottingham, York, London and Birmingham, and of the arrangements made in Liverpool for after-care and employment of patients discharged from mental and mental deficiency hospitals. The chapter ends with a survey of present trends in the mental deficiency field, and it is envisaged that in future more children will remain in the community and fewer will need to be admitted to hospital. The need for a comprehensive service for trainable mentally handicapped children and for certain types of defectives in hospital who are capable of some form of "education", is discussed. In
In
maries
a
section
are
this connection a reference is made to the scheme at Cell Barnes Hospital, St. Albans, whose Occupation Centre is used also by the local health authority, and it is suggested that new Hospital "Schools" might be sited away from other hospital buildings with entrances and ultimately transferred altogether to the
separate
147
4
local health authorities concerned. At the same time, appreciation is expressed of the teaching activities of many mental deficiency hospitals at the present time. "Whatever may be ahead, it would not have been reasonable to try to prevent these excellent developments. But they will have to be taken into account and used so far as possible to the benefit of patients if the swing of the pendulum brings the community more closely into the picture."
this survey is one dominant theme?that of mental health service, reaching far beyond the boundaries of services dealing with the treatment of mental illness and mental deficiency, and involving the discovery of methods of fostering good mental health. In such a service there must be taken into account: a
Running through truly comprehensive
"the schools, industry, the universities, families, voluntary workers and the great general public; in fact, good mental health in a nation involves everybody in the nation. No such comprehensive service exists as yet in this or any other
country." The spreading of such a concept is of tives of World Mental Health Year.
course one
of the
objec-
statistics, given in Part I, are here considered in a wider and the chapter devoted to Mental Health begins with an context, introduction stressing the process of integrating general medicine and psychiatry which has gone on since the introduction of the National Health Service and is reflected in various new developThe
ments.
Thus the original policy of appointing a Regional Psychiatrist for every Regional Hospital Board area?necessary for the purpose 146
of re-organisation involved after the passing of the National Health Service Act?has since given place to a scheme under which the day to day administration of Mental Health Services is placed in the hands of an administrative medical officer responsible to the senior administrative medical officer of the Board concerned. When specialist psychiatric knowledge is required, it is provided by a consultant adviser or a psychiatric advisory committee. Again, it is pointed out that in 1958 there were over 500 psychiatric out-patient clinics and that fewer than 100 of these were in mental hospitals, and that whereas in 1949 the number of new patients was 93,800, in 1958 it was 152,107?indicating the gradual disappearance of the "unnatural division" between mental and physical illness and the growing acceptance by general hospitals of responsibility for making provision for psychiatric patients. Jt has now been amply proved that patients can be adequately treated in this way even in some cases in which hospitalization would formerly have been considered essential. The fall of 10,500 in the number of patients in mental hospitals which has taken place since 1954, is another striking phenomenon one cause of which is the rehabilitation and discharge of chronic patients formerly regarded
hopeless. With regard to staffing, the Report, whilst stressing the need created by the new services for workers of every kind and grade, notes as an encouraging fact, that consultants in psychiatry have increased since 1949 by more than 50%, which is considerably higher than in other specialities, and that recently the intake of senior registrars has also increased. Moreover a growing interest in psychiatry on the part of general practitioners has become apparent, and more time is now given to the subject in the training of medical
as
students. on "Community Services", brief but useful sumgiven of the comprehensive schemes in force in Oldham, Nottingham, York, London and Birmingham, and of the arrangements made in Liverpool for after-care and employment of patients discharged from mental and mental deficiency hospitals. The chapter ends with a survey of present trends in the mental deficiency field, and it is envisaged that in future more children will remain in the community and fewer will need to be admitted to hospital. The need for a comprehensive service for trainable mentally handicapped children and for certain types of defectives in hospital who are capable of some form of "education", is discussed. In
In
maries
a
section
are
this connection a reference is made to the scheme at Cell Barnes Hospital, St. Albans, whose Occupation Centre is used also by the local health authority, and it is suggested that new Hospital "Schools" might be sited away from other hospital buildings with entrances and ultimately transferred altogether to the
separate
147
4
local health authorities concerned. At the same time, appreciation is expressed of the teaching activities of many mental deficiency hospitals at the present time. "Whatever may be ahead, it would not have been reasonable to try to prevent these excellent developments. But they will have to be taken into account and used so far as possible to the benefit of patients if the swing of the pendulum brings the community more closely into the picture."
this survey is one dominant theme?that of mental health service, reaching far beyond the boundaries of services dealing with the treatment of mental illness and mental deficiency, and involving the discovery of methods of fostering good mental health. In such a service there must be taken into account: a
Running through truly comprehensive
"the schools, industry, the universities, families, voluntary workers and the great general public; in fact, good mental health in a nation involves everybody in the nation. No such comprehensive service exists as yet in this or any other
country." The spreading of such a concept is of tives of World Mental Health Year.
course one
of the
objec-
