NEWS REVIEW Architects urged to take Architects
have been urged to resist Pressures to build increasingly 'arge hospital complexes of 1,000 beds or more in an article in a recent issue of the Architectural
ftev/'ew.
The article maintains that it is high time for the architect to take
an
absolute stand on size and scale to tell his medical clients where architecture based on human values |s being made impossible by. his brief?to re-establish his social role ln architecture.' a
special issue
on
welfare, the magazine Proposed reforms of
30 years from now does not matter at all. The world is not ours to spend, but is held in trusteeship for our
children and our children's children. That should be more important to us that we are to ourselves.' He hoped that much would be done to mitigate the dismal picture he had drawn?that our grandchildren would be able to point to the benefactions that this generation had bequeathed to them.
conditions, 'children in
our
society
also made aware every day by advertisements and television that they are deprived and different from other children. Even their school to books serve reinforce the message?"Janet and John" don't live in two rooms.' The paper was based on the National Child Development Study, which is following the progress of about 16,000 children in England, Scotland and Wales who were born in one week in 1958. It was found that children lacking the sole use of all the three basic amenities? indoor lavatory, bathroom and hot water supply?were also about nine months behind in their reading. are
a
stand
In
We shovel our radioactive wastes under the carpet, as it were, to produce long-term effects which are entirely unpredictable. We behave as if what the world will be like
health and
said that the
the National the social services local government could do r^ore than anything else to improve the quality of British life and lnstil compassion into society. 'But,' added the writer, 'there is a very danger that this unique opporUn,ty is going to be bungled.'
health Service,
ar|d
[eal
Enormous menace of
More and suicides
sleeping pills Doctors treating drug addicts are becoming increasingly concerned about the number of people dependent on sleeping pills. In a recent
contribution to the British Journal of Hospital Medicine, Dr. Thomas Bewley, consultant psychiatrist at Tooting Bee Hospital, said that the total may exceed 100,000. One surthat vey he referred to suggested more than a million people regularly took small amounts of barbiturates. Over the past 10 years there has been a marked increase in deaths from overdoses of barbiturates. The suicide rate from barbiturate poisoning had more than doubled and the number of people treated in hospital for this form of poisoning had trebled.
Reading age hampered by housing
more
potential
Over 60,000 potential suicides will be dealt with this year by the Samaritans' organisation, according to a statement by its general secre-
tary, the Rev. Forecasting that
Basil Higginson. the 105 Samaritan centres would deal with 10,000 more cases in 1970 than in 1969, he said that the number of 'potentially suicidal people is rising rapidly.' Mr. Higginson said that the recent Registrar General's figures showed that actual suicides had fallen to 4,584, the lowest total for 16 years. In the London area Samaritans handled 5,999 cases in 1967 but the total had risen to 11,641 in 1969. While advice and medical care has reduced the number of actual suicides, the number of people contemplating suicide in the London area may have doubled in the past two years.
poor
Accusation of environmental vandalism
9randchildren ^Ur ack on
us
as
a
likely to look generation that
are
..rec^ed their world without a ?ught for them, said Dr. Eliot
?.er, director 'c genetics
anHP?Slum tut
ll
of the MRC psychiaresearch unit, at a
on human differences SOCial issues held at the Insti?f Psychiatry in August.
rev/any6d changes
tat
biot
t0
would never be he said' We d0 not hesi* pour chemicals, whose
roP'c effects are unknown, into fonrta 0ceans and air, to enter the chain of which we are a part. e
Overcrowded homes
can
retard the
reading age of a seven-year-old child by about nine months according to a study carried out by the National Bureau for Co-operation in Child Care and reported at the British Association recent ference in Durham.
con-
Giving the report, Peter Wedge,
senior research officer, and Jane Petzine, research assistant, said
that poor housing was disturbingly and that overcrowding common
far more among children occurred frequently than census figures
suggested.
Besides having to face the real consequences of poor housing
Lancashire site to relieve Broadmoor A new special hospital to relieve at the desperate overcrowding Broadmoor is to be built at Moss Side, Maghull, near Liverpool.
Accommodation provided
at Moss
Side will make it possible to rebuild Broadmoor which is 107 years old. By deciding to go ahead with the hospital scheme on the Moss Side site, Peter Walker, Minister of Housing and Local Government, in consultation with Sir Keith Joseph, Secretary of State for Social Services, has overruled an inspector's
21
recommendation
not
build
to
at
Maghuli. The beds
i
f
i
! i
|
new
hospital
will have
410
with
violent, dangerous or criminal tendencies and, when fully operational, will enable Broadmoor to halve its population. Work is expected to start in 1972 although it is hoped that an interim unit for 80 patients at Maghuli will be ready by then which will also provide facilities for training staff in preparation for the opening of the main hospital. The whole scheme is expected to be complete by 1974-75. There is already a special hospital for the subnormal with dangerous or criminal tendencies at Moss Side and the plan for a similar for
men
security hospital for the mentally ill was opposed by local residents at a public enquiry last year as well as by the West Lancashire RDC. The planning authority, Lancashire County Council, had no objection in principle. A letter to the county council Minister's decision the giving agreed with the inspector's conclusion
that
there
were
planning objections :
i !
no
and
serious
accepted
his view that local residents' fears about the possible danger of escapes and the effect of this fear on the quality of their lives was 'a weighty factor' which had to be taken into account. 'The evidence shows that the number of escapes from Broadmoor have been small and have decreased in recent years (there have been none since 1966),' the letter continues. 'While it cannot be stated with certainty that no dangerous
patients would ever escape again from a special hospital it would be right to assume that a new special hospital incorporating up-to-date equipment and security measures developed as a result of the of the recommendations batten committee would more
effective
security
Mount-
provide than
an
establishment of the age and design of Broadmoor. And, it must be stressed, as the Department of Health's evidence at the enquiry
did, that adequate and suitably trained staff is at least as important
physical security.' Broadmoor, as
measures
ensuring
Crowthorne, Berkshire, has 807 patients at the moment, including 116 women. near
Rebuilding will begin as soon patients can be transferred to Moss Side hospital.
as
the
Emotional needs of the
dying
While 80% of dying patients know they are dying and would like to talk about it, 80% of doctors believe that the patients should not be told about it, said W. A. Cramond, professor of mental health at Adelaide University, writing in a recent issue of the British Medical Journal. He believes that 'the emotional needs of the dying patient have been largely ignored by the medical profession.' No mention is made of attitudes to dying in the standard text books for medical students or nurses.
Professor 'Yet death', says Cramond, 'is an ever-present reality in medical and nursing practice, and a time of crisis for the patient, the family and the medical and nursing attendants.' He believes that training to cope with death is essential in a modern technical hospital with its constant risk of
impersonal efficiency. The professor emphasised that discussion of the fear of death should take place only when there was a close relationship between doctor
and
He
and,
ignored
patient,
and
that
in medicine in 1918 year later, took the DPM at
|
qualified a
I
Cambridge University. A psychotherapist by inclination, he always remained convinced of the power of reason and gentleness. Dr. Miller was a pioneer of child psychiatry and was director of the first child guidance clinic set up in Britain. In 1959 he became co-editor and founder of the Journal of Child Psychology and Psychiatry. Another long standing interest was criminology, he was joint editor of the British Journal of Criminology. His own books and articles, quite apart from their medical and professional value, were remarkable
for their fusion
of science,
philc
sophy, liberality and aesthetics. Art and art therapy were amon0 his
numerous
enthusiasms and his
help in compiling an exhibition o' art therapy at the time of the 7th International Congress on Mental
in London in 1968 will &e remembered with some awe f?r
Health
many years. The NAMH was to number him among its
proud
vice-
presidents.
it
should always be handled carefully. He is sure that most patients are much more afraid of the process of dying than of death itself. But this It fear 'is very real and acute. includes the fear of pain, or not being able to cope with pain, or not obtaining enough relief from it. There is fear that their courage will fail if the process goes on too long.'
Miss S. Clement Brown the first director of the menta health course at the London School of Economics financed by the Con1' monwealth Fund for the training the first psychiatric social workers in this country. Because of her work Miss Clement Brown was in close touch with the beginnings of the In
1929
was
'
particularly
child guidance clinics, the one run by Dr. Miller in
Dr. Emanuel Miller At the end of July, Dr. Emanuel Miller died at the age of 78. Dr. Miller was honorary physician in child psychiatry at St. George's Hospital, emeritus physician at the Maudsley Hospital, honorary director of the East London Child Guidance Clinic and a member of the
Child Guidance Council. In dealing with disturbed
EaS
London. She writes:
and
unhappy people, psychiatry at times imposes severe strains on the patience, tolerance and kindliness of the doctors who practice it. Probably the outstanding characteristic of Dr. Miller was his ability to stand these strains, apparently effortlessly, and to remain throughout his life intensely interested, naturally courteous and very kind.
'Emanuel Miller brought to the first child guidance clinic a versa' tile, creative mind, moving easw and eagerly from sensitive respons the' to troubled children and parents to the culture which ha shaped them and the social philosophic values involved in the1
an.f
problems. The comprehensiveness of h's.ir1j terests and knowledge embodie the wisdom which, in the twentie we hoped would come from tn^ partnership in child guidance af1j psychiatrists, psychologists
?
workers. To be associate with him was not only illuminating in clinical terms, but an educat'0 in its widest sense.'
social
j
J I
|
22
I
k
have been urged to resist Pressures to build increasingly 'arge hospital complexes of 1,000 beds or more in an article in a recent issue of the Architectural
ftev/'ew.
The article maintains that it is high time for the architect to take
an
absolute stand on size and scale to tell his medical clients where architecture based on human values |s being made impossible by. his brief?to re-establish his social role ln architecture.' a
special issue
on
welfare, the magazine Proposed reforms of
30 years from now does not matter at all. The world is not ours to spend, but is held in trusteeship for our
children and our children's children. That should be more important to us that we are to ourselves.' He hoped that much would be done to mitigate the dismal picture he had drawn?that our grandchildren would be able to point to the benefactions that this generation had bequeathed to them.
conditions, 'children in
our
society
also made aware every day by advertisements and television that they are deprived and different from other children. Even their school to books serve reinforce the message?"Janet and John" don't live in two rooms.' The paper was based on the National Child Development Study, which is following the progress of about 16,000 children in England, Scotland and Wales who were born in one week in 1958. It was found that children lacking the sole use of all the three basic amenities? indoor lavatory, bathroom and hot water supply?were also about nine months behind in their reading. are
a
stand
In
We shovel our radioactive wastes under the carpet, as it were, to produce long-term effects which are entirely unpredictable. We behave as if what the world will be like
health and
said that the
the National the social services local government could do r^ore than anything else to improve the quality of British life and lnstil compassion into society. 'But,' added the writer, 'there is a very danger that this unique opporUn,ty is going to be bungled.'
health Service,
ar|d
[eal
Enormous menace of
More and suicides
sleeping pills Doctors treating drug addicts are becoming increasingly concerned about the number of people dependent on sleeping pills. In a recent
contribution to the British Journal of Hospital Medicine, Dr. Thomas Bewley, consultant psychiatrist at Tooting Bee Hospital, said that the total may exceed 100,000. One surthat vey he referred to suggested more than a million people regularly took small amounts of barbiturates. Over the past 10 years there has been a marked increase in deaths from overdoses of barbiturates. The suicide rate from barbiturate poisoning had more than doubled and the number of people treated in hospital for this form of poisoning had trebled.
Reading age hampered by housing
more
potential
Over 60,000 potential suicides will be dealt with this year by the Samaritans' organisation, according to a statement by its general secre-
tary, the Rev. Forecasting that
Basil Higginson. the 105 Samaritan centres would deal with 10,000 more cases in 1970 than in 1969, he said that the number of 'potentially suicidal people is rising rapidly.' Mr. Higginson said that the recent Registrar General's figures showed that actual suicides had fallen to 4,584, the lowest total for 16 years. In the London area Samaritans handled 5,999 cases in 1967 but the total had risen to 11,641 in 1969. While advice and medical care has reduced the number of actual suicides, the number of people contemplating suicide in the London area may have doubled in the past two years.
poor
Accusation of environmental vandalism
9randchildren ^Ur ack on
us
as
a
likely to look generation that
are
..rec^ed their world without a ?ught for them, said Dr. Eliot
?.er, director 'c genetics
anHP?Slum tut
ll
of the MRC psychiaresearch unit, at a
on human differences SOCial issues held at the Insti?f Psychiatry in August.
rev/any6d changes
tat
biot
t0
would never be he said' We d0 not hesi* pour chemicals, whose
roP'c effects are unknown, into fonrta 0ceans and air, to enter the chain of which we are a part. e
Overcrowded homes
can
retard the
reading age of a seven-year-old child by about nine months according to a study carried out by the National Bureau for Co-operation in Child Care and reported at the British Association recent ference in Durham.
con-
Giving the report, Peter Wedge,
senior research officer, and Jane Petzine, research assistant, said
that poor housing was disturbingly and that overcrowding common
far more among children occurred frequently than census figures
suggested.
Besides having to face the real consequences of poor housing
Lancashire site to relieve Broadmoor A new special hospital to relieve at the desperate overcrowding Broadmoor is to be built at Moss Side, Maghull, near Liverpool.
Accommodation provided
at Moss
Side will make it possible to rebuild Broadmoor which is 107 years old. By deciding to go ahead with the hospital scheme on the Moss Side site, Peter Walker, Minister of Housing and Local Government, in consultation with Sir Keith Joseph, Secretary of State for Social Services, has overruled an inspector's
21
recommendation
not
build
to
at
Maghuli. The beds
i
f
i
! i
|
new
hospital
will have
410
with
violent, dangerous or criminal tendencies and, when fully operational, will enable Broadmoor to halve its population. Work is expected to start in 1972 although it is hoped that an interim unit for 80 patients at Maghuli will be ready by then which will also provide facilities for training staff in preparation for the opening of the main hospital. The whole scheme is expected to be complete by 1974-75. There is already a special hospital for the subnormal with dangerous or criminal tendencies at Moss Side and the plan for a similar for
men
security hospital for the mentally ill was opposed by local residents at a public enquiry last year as well as by the West Lancashire RDC. The planning authority, Lancashire County Council, had no objection in principle. A letter to the county council Minister's decision the giving agreed with the inspector's conclusion
that
there
were
planning objections :
i !
no
and
serious
accepted
his view that local residents' fears about the possible danger of escapes and the effect of this fear on the quality of their lives was 'a weighty factor' which had to be taken into account. 'The evidence shows that the number of escapes from Broadmoor have been small and have decreased in recent years (there have been none since 1966),' the letter continues. 'While it cannot be stated with certainty that no dangerous
patients would ever escape again from a special hospital it would be right to assume that a new special hospital incorporating up-to-date equipment and security measures developed as a result of the of the recommendations batten committee would more
effective
security
Mount-
provide than
an
establishment of the age and design of Broadmoor. And, it must be stressed, as the Department of Health's evidence at the enquiry
did, that adequate and suitably trained staff is at least as important
physical security.' Broadmoor, as
measures
ensuring
Crowthorne, Berkshire, has 807 patients at the moment, including 116 women. near
Rebuilding will begin as soon patients can be transferred to Moss Side hospital.
as
the
Emotional needs of the
dying
While 80% of dying patients know they are dying and would like to talk about it, 80% of doctors believe that the patients should not be told about it, said W. A. Cramond, professor of mental health at Adelaide University, writing in a recent issue of the British Medical Journal. He believes that 'the emotional needs of the dying patient have been largely ignored by the medical profession.' No mention is made of attitudes to dying in the standard text books for medical students or nurses.
Professor 'Yet death', says Cramond, 'is an ever-present reality in medical and nursing practice, and a time of crisis for the patient, the family and the medical and nursing attendants.' He believes that training to cope with death is essential in a modern technical hospital with its constant risk of
impersonal efficiency. The professor emphasised that discussion of the fear of death should take place only when there was a close relationship between doctor
and
He
and,
ignored
patient,
and
that
in medicine in 1918 year later, took the DPM at
|
qualified a
I
Cambridge University. A psychotherapist by inclination, he always remained convinced of the power of reason and gentleness. Dr. Miller was a pioneer of child psychiatry and was director of the first child guidance clinic set up in Britain. In 1959 he became co-editor and founder of the Journal of Child Psychology and Psychiatry. Another long standing interest was criminology, he was joint editor of the British Journal of Criminology. His own books and articles, quite apart from their medical and professional value, were remarkable
for their fusion
of science,
philc
sophy, liberality and aesthetics. Art and art therapy were amon0 his
numerous
enthusiasms and his
help in compiling an exhibition o' art therapy at the time of the 7th International Congress on Mental
in London in 1968 will &e remembered with some awe f?r
Health
many years. The NAMH was to number him among its
proud
vice-
presidents.
it
should always be handled carefully. He is sure that most patients are much more afraid of the process of dying than of death itself. But this It fear 'is very real and acute. includes the fear of pain, or not being able to cope with pain, or not obtaining enough relief from it. There is fear that their courage will fail if the process goes on too long.'
Miss S. Clement Brown the first director of the menta health course at the London School of Economics financed by the Con1' monwealth Fund for the training the first psychiatric social workers in this country. Because of her work Miss Clement Brown was in close touch with the beginnings of the In
1929
was
'
particularly
child guidance clinics, the one run by Dr. Miller in
Dr. Emanuel Miller At the end of July, Dr. Emanuel Miller died at the age of 78. Dr. Miller was honorary physician in child psychiatry at St. George's Hospital, emeritus physician at the Maudsley Hospital, honorary director of the East London Child Guidance Clinic and a member of the
Child Guidance Council. In dealing with disturbed
EaS
London. She writes:
and
unhappy people, psychiatry at times imposes severe strains on the patience, tolerance and kindliness of the doctors who practice it. Probably the outstanding characteristic of Dr. Miller was his ability to stand these strains, apparently effortlessly, and to remain throughout his life intensely interested, naturally courteous and very kind.
'Emanuel Miller brought to the first child guidance clinic a versa' tile, creative mind, moving easw and eagerly from sensitive respons the' to troubled children and parents to the culture which ha shaped them and the social philosophic values involved in the1
an.f
problems. The comprehensiveness of h's.ir1j terests and knowledge embodie the wisdom which, in the twentie we hoped would come from tn^ partnership in child guidance af1j psychiatrists, psychologists
?
workers. To be associate with him was not only illuminating in clinical terms, but an educat'0 in its widest sense.'
social
j
J I
|
22
I
k
