Local Authorities and the Mental Health Act

One of the main principles of the Royal Commission of 1957 and of the Mental Health Act which followed it was a reorientation towards community services. This has given local authorities the function of caring for most of the mentally ill who are not being treated within hospitals and will allow them to play as big a part ?n mental health as they have done in physical health. The opportunity has been created to provide a truly comprehensive mental health service, through the cooperation of local authorities with hospitals and general practitioners. In this article, an attempt is made to consider the main features ?f local authority action in mental health and the directions in which this is likely to be developed. As an observer, rather than a Participant in local authority services, the author trusts that those of greater experience will be indulgent of the views expressed. No comprehensive review can be given here of the earlier functions of local authority services for the mentally ill, the changes rnade by the National Health Service Act, not the Royal Commis-sion's recommendations, except to note that when the part played hy Justices of the Peace in certification ceases, it will end a link between the Justices and the care of mental illness, which is of great antiquity. It may be convenient to consider the development of local Authority services under several main headings?referring both to types of staff concerned and the problems they face. Social Workers "The effectiveness of community care will depend directly on the quality of staff, which in turn depends on the training available ," (Donaldson 1960). There can never be enough fully trained Psychiatric social workers to cover all the social work required in community mental health, nor in fact would this be necessary. As the general practitioner has his place in the care of the psychiatric Patient, so should the general social worker. A long-term answer to the problem of social work should come with the implementation of the Younghusband Report, whose main principles have recently heen accepted by the Government. Meanwhile, however, there seems little doubt that in-service training with the help of hospitals ls the best available solution.