place for the volunteer in mental health
Northern Local Associations Annual Conference By Walter Fieldhouse
Voluntary work in the mental health field can be used effectively if it is organised by full-time professional staff. Authorities who, for any reason, cannot appoint an organiser should find out if any member of their staffs is willing to organise and, if necessary, most
train volunteers for such work. These were two of the which emerged at the annual conference of the namh Northern Local Associations held at the University of York on October 1. The chairman of the conference, Mrs. E. E. Irvine, ma, aapsw. Reader in Social Science at the University, said that the conference had recognised as an important principle that the volunteer should not be used to dilute professional services (even by providing a secretary for matron) nor to dilute the role of the professionally trained person. It was the responsibility of the community to look after its injured members and it was legitimate to ask if the community was entitled to depute this responsibility to a professional when there was a shortage of professional workers? 'It is up to every professional to ask himself or herself "How much work am I doing which could be done equally well by someone without professional training?"' said Mrs. Irvine. 'We know that there are many people in hospital not because they need to be there but because they have nowhere else to go. I wonder how many stay in hospital because they have no friends or contacts in the outside world. I wonder how many mental welfare officers spend time visiting patients in their homes merely because they are friendless and lonely; this is where volunteers might be involved.'
emerged during the conference that volunteers felt more secure working in hospitals than in the outside world, partly because the hospital retained complete responsibility for the patient. The difference between working as a group and as an It
individual had also been discussed. It had been shown that if volunteers worked individually with patients, very deep feelings and dependencies might develop. Any disruption could have extensive consequences
and it appeared that these factors could be minimised if the volunteer were part of a group. In group working, it had been suggested that the strength of the individual was not so important and training was not so necessary. The use of volunteers to assist in prison after-care work was discussed and the conference endorsed namh efforts to consider how volunteers could meet the need for after-care. Mrs. E. M. C. King, namh Local Associations Officer, described her experiences at Fulbourn Hospital, Cam-
the volunteer in mental health
bridge, where she had formerly been organiser of voluntary services. She said that while she was at the hospital she organised an experiment under the sponsorship of the Nuffield Provincial Hospitals Trust to
find ways in which volunteers could be used in the hospital, and how they could be recruited. Volunteers were allocated to the various care units in the hospital?admissions, intensive nursing, rehabilitation and geriatrics. The question arose not only of finding work for volunteers but of finding the right volunteers for the different tasks.
Seldom failed Mrs.
of the best ways of obtainfor work in the geriatric unit,
ing help, particularly
was found to be by arranging volunteers in groups. The group leader undertook to supply two volunteers at a certain time on a certain day. This system brought in the volunteer who could not guarantee to be available every week. The number of volunteers had risen from 40 to 400, all used in different ways, but, said Mrs. King, she had seldom been let down. It was understandable, she added, that hard-pressed staffs did not always accept offers of help. 'Hospitals often refuse offers of help because there is no one there with the time to think about what volunteers can do.' But if the need was first defined and then volunteers recruited to fill them the staff were glad to
accept them. In stressing the title of the conference, 'Volunteer beware! An uneasy partnership?' Dr. P. J. G. Quinn, Mrcp, dpm, Physician Superintendent, Clifton Hospital, York, took up a 'cautionary point of view'. Mental hospitals, he said, were still, maybe, a little bit sensitive. A small detonation could touch off an
and remind them of the from the old asylum
continuing obligation, dating days,
to shield and
protect their patients.
Revolutionary thinking The attitudes of some hospital staff to voluntary helpers derived from the past, but many of the older staff members had responded superbly to the call for acceptance of revolutionary thinking and policies. 'The capacity for change is there?painful though it may sometimes be?and I personally see no prohibitive reason why part of the change should not include the introduction of voluntary workers. Having said that, may J add that if you roll up to the wards expecting to be greeted with ecstatic enthusiasm and uninhibited joy your morale will sink rapidly,' said ^r. Quinn. 'There is nobody better at achieving that than a strong-minded ward sister, zealous of her authority and determined to protect her patients from the rash manipulations of an amateur.' ^r. Quinn went on to outline some of the criticisms ?f voluntary workers, the kinds of hostility they might meet, and the reasons which lay behind them: 'Any scheme of voluntary help which involves working with professional staff needs careful planning to in-
elude (a), a the scale of
satisfactory appraisal of the needs and voluntary help required; (b), preliminary
with the relevant staff and the encourage-
ment of a favourable
attitude; (c) adequate briefing, preparation, and, if necessary, training of the volunteer; (d) careful selection to fit the volunteer to the job and not only to the job but to the professional
staff with whom he will be associated and under whose jurisdiction he will work.' In Dr. Quinn's view no senior officer could devote adequate time for more than a limited project and he agreed with Mrs. King's contention that it should be the full-time responsibility of a paid professional member of the staff.
During the morning the conference, comprising about 100 representatives from local associations, hospitals, the probationary and after-care services, Marriage Guidance Counsellors, Telephone Samaritans, Councils of Social Service and local authority health services, divided into four discussion groups. Subjects considered during a general discussion in the afternoon ranged over the attitude of patients towards volunteers, the inclusion of former patients in volun-
tary work and the work of local associations in the co-ordination of other voluntary organisations.