MENTAL WELFARE
Mental Health Workers
=
An
65
Appreciation
At the request of the Association of Mental Health Workers and by kind permission of Mr. Brock (Chairman, Board of Control), we have printed the following account of his reply to the toast of the guests at the Annual Dinner of the Association held on 25th April, 1931.
When you did me the honour to ask me to come and dine with you to-night I had no intimation that I should be expected to talk, but I had a sort of idea that I might! But as I had no indication as to whether I should, I was in rather a difficulty. It seemed to me incredible that you should want to propose the health of the Board of Control?that kind of thing only happens once in a blue moon! I
thought perhaps
the best
thing I
could do would be
to
talk
to
you about
appreciates more than I do, or my Board, how much our work on the depends co-operation of the local workers all over the country. Ours is not a popular service. I sometimes think that it is the one Health
yourselves, because
no one
Service which is
I envy the people who not popular, perhaps never will be. realises the for Child Welfare?everybody necessity for that? responsible there is no need, in Miss Blake's phrase, for a chief preacher. But unfortunately everybody does not realise the need for care of defectives. They are not an attractive class. I know there are exceptions. I see someone at the far end of the table to-night whom I have heard enthusing over what she called a little jolly Mongol." I am very glad that Mrs. Pinsent, to whom defectives owe so much, can enthuse over jolly little Mongols. I know others who find defectives much less attractive, and we cannot expect that the County Councils or that the Public generally will be ready to enthuse over them. People often try to persuade themselves that they can save money by pretending that the defective is not there, very much as our Victorian forebears thought they could get rid of anything by never mentioning it and pretending it did not exist.
are
"
Your
to educate public opinion. No Local Authorin far advance of public opinion among its constituents; go very not to do so: if it be doing something which is really it would ought did, alien to the whole of Local Government. principles
ity
most
can ever
The Board
important task is
can do very little without your co-operation. We can preach afraid we do; we can issue circulars?I \now we do, but even if we were as wise as we look (I am far from saying that my colleagues are not as Wise as still we could not do much if it were not for what you are they look) to create a better instructed doing public opinion in your various areas. It ls a stiff task?it will take time. You see it is so easy to suggest that this long Service is not urgent. I know that times are hard, and Local Authorities cannot develop all their Health Services as fast as we should like to see them eveloped. Neglect of the mental deficiency service only seems cheap because cost of leaving mental defectives at large cannot be estimated. We cannot Wor& out any definite figure to show what it really costs. If we could calcu-
"I
am
MENTAL WELFARE
66
late the real cost to the community, not merely in money, but in social wellbeing, if we could calculate the cost of all the crime, the disease, the unemployment which is due to neglect of defectives, the result would be simply appalling. You know better than anyone what it costs to neglect defectives and you know how difficult it is to persuade other people of that cost. Educating public opinion is perhaps the most important of your tasks, but it is far from being the only one. Ascertainment is a work full of rather special pitfalls. When I first came to the Board, and when I thought I knew more about mental deficiency than I do now, it fell to my lot to go to a prizeat a large girls' school. In front of the platform there was a long row giving of vacant looking girls in white frocks, with curiously blank faces, and I thought they must be the Morons, selected and put close to the platform so
kind of intellectual violet ray treatment from us might pass to them. One face in the middle seemed to bear the obvious stigmata of defect and I thought I had found a good specimen of a rather low-grade. She later came up to receive five prizes and an Exhibition! After that I abandoned ascertainment. You must have suffered as we have at the Board from the singular vagueI remember one in which it was stated as ness of Medical Certificates. she becomes irritated if kept to the point." evidence of mental defect that " Well?doesn't She always! Another common entry is Cannot give change." Well?neither can I. If I go to buy an ounce of tobacco I know from experience just what change I shall receive. But if my wife asks me to buy 5 yards of ribbon at 61/^ d., I just accept whatever handful of coins I am given. Indeed, my chief trouble with medical certificates, is that they read so much like the description of one's friends. that
some
"
Now I
equally important part of your work, and that is the of organisation supervision. Two-thirds of the total number of defectives can be left to what is euphemistically called community care. Very particularly to-night I feel that if it were not for the supervision which the local associations under your guidance provides, the defectives would come off badly. The poor are, we know, in general kind to the poor. But I doubt if that kindness extends to defectives, especially to those of a lower grade. They would suffer many hardships were there no organisation to secure for them effective supervision, and regular and sympathetic visiting. It would be difficult to find any class of the community so unfortunate as the mentally defective; not only are they born without a fair chance in life, but many people, perhaps it would be correct to say, most people, shrink from them and I have the greatest admiration for those who visit constantly the homes, often wretched and miserable, from which these defectives come. turn to an
was very glad to hear to-night from Miss Blake that you have among number of workers at Occupation Centres. It is a branch of the work you to which I attach very great importance, because there will always be a number of defectives whose families can look after them at night, and can look after
I
a-
MENTAL WELFARE
67
them on Sundays, but who cannot give them the necessary care during the normal hours of work, and for those cases Occupation Centres are of utmost value. If we are to make the Occupation Centres a success it means a great deal of hard work. It is not enough to open a Centre and expect the defectives to roll up. If it is to be a success you have got to put in a great deal of hard work in finding the right cases to come to it, and when you have found them, in arranging for their regular attendance and transport. Progress is bound to be slow, but it is worth while, because I believe it is hardly too much to say that every regular attendant at an Occupation Centre means a bed saved in a Colony or Institution. You have stirred the public conscience and we are advancing. Authorities of whom I sometimes despaired have, within the last twelve months, begun to move. We are making progress; I can make that claim because the credit does not belong to me, and I believe that we owe it more than anything to the self-sacrificing work which you and the Local Associations have done, and that is why I am glad and proud to be your guest to-night.
Mental Health Workers
=
An
65
Appreciation
At the request of the Association of Mental Health Workers and by kind permission of Mr. Brock (Chairman, Board of Control), we have printed the following account of his reply to the toast of the guests at the Annual Dinner of the Association held on 25th April, 1931.
When you did me the honour to ask me to come and dine with you to-night I had no intimation that I should be expected to talk, but I had a sort of idea that I might! But as I had no indication as to whether I should, I was in rather a difficulty. It seemed to me incredible that you should want to propose the health of the Board of Control?that kind of thing only happens once in a blue moon! I
thought perhaps
the best
thing I
could do would be
to
talk
to
you about
appreciates more than I do, or my Board, how much our work on the depends co-operation of the local workers all over the country. Ours is not a popular service. I sometimes think that it is the one Health
yourselves, because
no one
Service which is
I envy the people who not popular, perhaps never will be. realises the for Child Welfare?everybody necessity for that? responsible there is no need, in Miss Blake's phrase, for a chief preacher. But unfortunately everybody does not realise the need for care of defectives. They are not an attractive class. I know there are exceptions. I see someone at the far end of the table to-night whom I have heard enthusing over what she called a little jolly Mongol." I am very glad that Mrs. Pinsent, to whom defectives owe so much, can enthuse over jolly little Mongols. I know others who find defectives much less attractive, and we cannot expect that the County Councils or that the Public generally will be ready to enthuse over them. People often try to persuade themselves that they can save money by pretending that the defective is not there, very much as our Victorian forebears thought they could get rid of anything by never mentioning it and pretending it did not exist.
are
"
Your
to educate public opinion. No Local Authorin far advance of public opinion among its constituents; go very not to do so: if it be doing something which is really it would ought did, alien to the whole of Local Government. principles
ity
most
can ever
The Board
important task is
can do very little without your co-operation. We can preach afraid we do; we can issue circulars?I \now we do, but even if we were as wise as we look (I am far from saying that my colleagues are not as Wise as still we could not do much if it were not for what you are they look) to create a better instructed doing public opinion in your various areas. It ls a stiff task?it will take time. You see it is so easy to suggest that this long Service is not urgent. I know that times are hard, and Local Authorities cannot develop all their Health Services as fast as we should like to see them eveloped. Neglect of the mental deficiency service only seems cheap because cost of leaving mental defectives at large cannot be estimated. We cannot Wor& out any definite figure to show what it really costs. If we could calcu-
"I
am
MENTAL WELFARE
66
late the real cost to the community, not merely in money, but in social wellbeing, if we could calculate the cost of all the crime, the disease, the unemployment which is due to neglect of defectives, the result would be simply appalling. You know better than anyone what it costs to neglect defectives and you know how difficult it is to persuade other people of that cost. Educating public opinion is perhaps the most important of your tasks, but it is far from being the only one. Ascertainment is a work full of rather special pitfalls. When I first came to the Board, and when I thought I knew more about mental deficiency than I do now, it fell to my lot to go to a prizeat a large girls' school. In front of the platform there was a long row giving of vacant looking girls in white frocks, with curiously blank faces, and I thought they must be the Morons, selected and put close to the platform so
kind of intellectual violet ray treatment from us might pass to them. One face in the middle seemed to bear the obvious stigmata of defect and I thought I had found a good specimen of a rather low-grade. She later came up to receive five prizes and an Exhibition! After that I abandoned ascertainment. You must have suffered as we have at the Board from the singular vagueI remember one in which it was stated as ness of Medical Certificates. she becomes irritated if kept to the point." evidence of mental defect that " Well?doesn't She always! Another common entry is Cannot give change." Well?neither can I. If I go to buy an ounce of tobacco I know from experience just what change I shall receive. But if my wife asks me to buy 5 yards of ribbon at 61/^ d., I just accept whatever handful of coins I am given. Indeed, my chief trouble with medical certificates, is that they read so much like the description of one's friends. that
some
"
Now I
equally important part of your work, and that is the of organisation supervision. Two-thirds of the total number of defectives can be left to what is euphemistically called community care. Very particularly to-night I feel that if it were not for the supervision which the local associations under your guidance provides, the defectives would come off badly. The poor are, we know, in general kind to the poor. But I doubt if that kindness extends to defectives, especially to those of a lower grade. They would suffer many hardships were there no organisation to secure for them effective supervision, and regular and sympathetic visiting. It would be difficult to find any class of the community so unfortunate as the mentally defective; not only are they born without a fair chance in life, but many people, perhaps it would be correct to say, most people, shrink from them and I have the greatest admiration for those who visit constantly the homes, often wretched and miserable, from which these defectives come. turn to an
was very glad to hear to-night from Miss Blake that you have among number of workers at Occupation Centres. It is a branch of the work you to which I attach very great importance, because there will always be a number of defectives whose families can look after them at night, and can look after
I
a-
MENTAL WELFARE
67
them on Sundays, but who cannot give them the necessary care during the normal hours of work, and for those cases Occupation Centres are of utmost value. If we are to make the Occupation Centres a success it means a great deal of hard work. It is not enough to open a Centre and expect the defectives to roll up. If it is to be a success you have got to put in a great deal of hard work in finding the right cases to come to it, and when you have found them, in arranging for their regular attendance and transport. Progress is bound to be slow, but it is worth while, because I believe it is hardly too much to say that every regular attendant at an Occupation Centre means a bed saved in a Colony or Institution. You have stirred the public conscience and we are advancing. Authorities of whom I sometimes despaired have, within the last twelve months, begun to move. We are making progress; I can make that claim because the credit does not belong to me, and I believe that we owe it more than anything to the self-sacrificing work which you and the Local Associations have done, and that is why I am glad and proud to be your guest to-night.
