National Health Service Act, 1946 Local Authorities' Schemes for Under Section 20 (2) of the National Health Service Act, Local Authorities are required to serve copies of their Schemes for carrying out the duties imposed on them, to every voluntary organization providing in their areas services of the kind concerned. Copies of the Schemes dealing with the Mental Health Service (Sections 28 and 51) were therefore submitted to the National Association for Mental Health, and have been closely examined by the Association's officers and staff. Observations were then sent to the Minister, at his request. The chief points on which comment was made are here summarized.
a
Mental Health Service
of Local Authorities have little understanding of the functions properly belonging to each group. Nor is there any adequate appreciation of the distinction between administrative work and social work concerned with individual cases. The Association fully recognizes that under present conditions, authorities cannot hope to secure fully trained personnel to cover the whole field, but it is suggested that an effort should at least be made to employ as the head of the team, an experienced Mental Health worker (if a psychiatric social worker cannot be obtained). 3. Mental Deficiency Work
1. Medical Personnel The majority of the Schemes propose that the Medical Officer of Health should be responsible for the general direction of the Mental Health Services with the part-time help of Assistant Medical Officers who have taken a short course in Mental Deficiency, and general practitioners approved as Certifying Officers. In addition, joint-user arrangements with the Regional Hospital Boards' psychiatrists are proposed, when decisions have to be made on doubtful and difficult cases. The Association urges the use of psychiatrists in a wider consultative capacity and particularly for supervising social case work. Such a provision is stressed as being of the*utmost importance in view of the fact that Local Authorities must at present be dependent for such case work largely on a non-medical staff often with little or no specialized mental health training or experience. 2. Non-Medical Personnel The use of psychiatric social workers, general social workers, mental welfare officers with mental deficiency experience, Public Assistance Officers and Health Visitors is indicated in the Schemes under this heading, but it is evident that the majority
For the supervision of mental defectives, on which of personnel is to be used, it is urged that the Minister should take steps to ensure that Local Authorities are aware of the need for some special training in order that the requirements of this group may be fully understood. Many authorities propose to establish, or increase the number of Occupation Centres, and attention is drawn by the Association to the Year's Training Course for Occupation Centre workers for which early application should be made. a
variety
4. Community Care and After-Care of persons suffering from mental illness, including neurotics, socially maladjusted and epileptics (Section 28)
Only
a
few
progressive
authorities
are
proposing
to take any immediate steps under this Section, in so far as it relates to the neurotic and socially
maladjusted group. In view, however, of the shortage of the necessary trained personnel, and of the proportions which this work rapidly assumes once it is begun, the Association is of opinion that no purpose would be served by pressing for its development at the present time. It is nevertheless important for authorities to realize that the need exists and that it is waiting to be met.
MENTAL HEALTH 5. Training of Personnel for the Mental Health Service The attention of the Minister is called to the Courses for Relieving Officers transferred to the Mental Health Service, which are being organized by the National Association (see page 101) and it is suggested that Local Authorities should be encouraged to explore the possibilities of such courses in their own areas.
97
6. Mental Health Education
Only a minority of Schemes mention Health Education and of these a minority again refer to education in mental health. The attention of the Minister is drawn to the importance of this aspect of the subject and to the facilities offered by the National Association as well as by the Central Council for Health Education.
a
Mental Health Service
of Local Authorities have little understanding of the functions properly belonging to each group. Nor is there any adequate appreciation of the distinction between administrative work and social work concerned with individual cases. The Association fully recognizes that under present conditions, authorities cannot hope to secure fully trained personnel to cover the whole field, but it is suggested that an effort should at least be made to employ as the head of the team, an experienced Mental Health worker (if a psychiatric social worker cannot be obtained). 3. Mental Deficiency Work
1. Medical Personnel The majority of the Schemes propose that the Medical Officer of Health should be responsible for the general direction of the Mental Health Services with the part-time help of Assistant Medical Officers who have taken a short course in Mental Deficiency, and general practitioners approved as Certifying Officers. In addition, joint-user arrangements with the Regional Hospital Boards' psychiatrists are proposed, when decisions have to be made on doubtful and difficult cases. The Association urges the use of psychiatrists in a wider consultative capacity and particularly for supervising social case work. Such a provision is stressed as being of the*utmost importance in view of the fact that Local Authorities must at present be dependent for such case work largely on a non-medical staff often with little or no specialized mental health training or experience. 2. Non-Medical Personnel The use of psychiatric social workers, general social workers, mental welfare officers with mental deficiency experience, Public Assistance Officers and Health Visitors is indicated in the Schemes under this heading, but it is evident that the majority
For the supervision of mental defectives, on which of personnel is to be used, it is urged that the Minister should take steps to ensure that Local Authorities are aware of the need for some special training in order that the requirements of this group may be fully understood. Many authorities propose to establish, or increase the number of Occupation Centres, and attention is drawn by the Association to the Year's Training Course for Occupation Centre workers for which early application should be made. a
variety
4. Community Care and After-Care of persons suffering from mental illness, including neurotics, socially maladjusted and epileptics (Section 28)
Only
a
few
progressive
authorities
are
proposing
to take any immediate steps under this Section, in so far as it relates to the neurotic and socially
maladjusted group. In view, however, of the shortage of the necessary trained personnel, and of the proportions which this work rapidly assumes once it is begun, the Association is of opinion that no purpose would be served by pressing for its development at the present time. It is nevertheless important for authorities to realize that the need exists and that it is waiting to be met.
MENTAL HEALTH 5. Training of Personnel for the Mental Health Service The attention of the Minister is called to the Courses for Relieving Officers transferred to the Mental Health Service, which are being organized by the National Association (see page 101) and it is suggested that Local Authorities should be encouraged to explore the possibilities of such courses in their own areas.
97
6. Mental Health Education
Only a minority of Schemes mention Health Education and of these a minority again refer to education in mental health. The attention of the Minister is drawn to the importance of this aspect of the subject and to the facilities offered by the National Association as well as by the Central Council for Health Education.
