Medical and general reports and accounts for the year ended 31st December, 1942 : (from Swaylands, Penshurst, Kent.) Present Address: Ash Hall, Bucknall, Stoke-on-Trent / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1943?]
Catalogue details

Licence: In copyright

Credit: Medical and general reports and accounts for the year ended 31st December, 1942 : (from Swaylands, Penshurst, Kent.) Present Address: Ash Hall, Bucknall, Stoke-on-Trent / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

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    In general, during his period of hospital treatment the patient will be under the. care of one physician who will carry his medical treatment as far as may be required. During his convalescence he will not need to have intensive medical treatment, or if he does he should be referred back to the psychiatrist who sent him. Clearly the convalescent home must be under medical guidance, but this does not mean that its medical superintendent will take over the function of the patient’s own physician. The bulk of the programme of rehabilitation at this stage should in fact be carried out by ancillary personnel who have been adequately trained in their special work. This work would represent a particular branch which might be undertaken by nurses, massage staff, or occupational therapists, according to the type of rehabilitation and the nature of the institution in which it was to be carried out. For example, in the short-term type of convalescent home, massage staff would probably play a considerable part, whereas in the longer-term reconditioning unit for neurosis, already discussed, a trained nurse with special interests would be the ideal person to take charge. If, for these ancillary workers, a special diploma in rehabilitation is available, and if this is intended by the authors of the Tomlinson Report, then this suggestion seems to be an admirable one. Role of psychiatric social worker. Experience in this hospital and elsewhere leads us to make one further suggestion. The trained psychiatric social worker can be a very valuable ally in plans for all stages of rehabilitation. She can enter into and attempt to modify difficulties which may exist in the home. She can interview employers and explain to them the medical point of view concerning a patient, she can discuss questions of suitable employment with the officials of the Labour Exchanges, and enable them to grasp essential medical and social points. In the after-treatment of neurosis she can undertake for the physician work that he has neither the time, nor usually the know¬ ledge, to do himself. At the Cassel Hospital the fact that patients have always come from every part of the British Isles has prevented the employment of a full-time psychiatric social worker. It will be necessary to ask the Committee to consider after the war whether the obvious difficulties can be overcome, particularly as regionalisation may reduce the geographically scattered nature of our intake. 3. SUMMARY. Experience at this hospital leads us to suggest that the present interest in rehabilitation might profitably be translated into the following concrete proposals for the better treatment of neurosis. Stage 1. “ Medical Rehabilitation.” A need exists for the better psychiatric education of physicians and nurses so that neurosis may be prevented at the onset. There must also be more adequate facilities for treatment in the early stages. There must be a greater emphasis upon useful and purposive forms of occupational therapy adapted to the patient’s needs. Occupational therapy at its best should always combine the sense of individual achievement with the sense of worth-while purpose. Stage 2. “ Post-hospital Rehabilitation ” or Convalescence. For certain patients a short period (e.g., up to four weeks) of “ active ” convalescence is needed, with emphasis upon a brisk invigorating psychological “atmosphere” and general physical “reconditioning” in a non-hospital environment. Such a centre need not be exclusively for psychoneurotic patients. For other patients a rather longer period of “recon¬ ditioning” should be arranged in an establishment designed to enable the patient to bridge the gap between a period of hospital treatment and a return to normal life. Costs at such an establishment should be kept at a minimum by arranging for patients to do most of the work. Stage 3. “ Resettlement.” A closer liaison between the physician, the Labour Exchanges and the Employers and Welfare Officers. The psychiatric social worker can play a large part in creating such liaison. Medical supervision of the patient at this stage must necessarily be very indirect. 4. SPECIFIC SUGGESTIONS FOR THE CASSEL HOSPITAL. Obviously many of the views expressed in this report would require national rather than individual planning. There are, however, certain lines of development which might now or at some future date be considered by the Committee of the Cassel Hospital as lying within the boundary of practical possibility for the hospital itself. At Stage 1. It is suggested that there is at the present time considerable scope for the development of occu¬ pational therapy along the lines discussed in this report. With the approval of the Committee patients have undertaken many more and more varied domestic tasks than ever before. Under the guidance of the kitchen supervisor they have prepared meals for staff and patients, they have been responsible for most of the gardening and some cleaning, dusting, etc. Among patients suffering from neurosis many problems arise when activities of this type are