Mental health clinical services; a study of the children between 6 and 12 years of age examined by mental health clinics in Vancouver from 1945 to 1947 inclusive

There are 2 organizations in Vancouver, the Child Guidance Clinic and the Mental Hygiene Division of the Metropolitan Health Committee, which offer services to maladjusted children. No descriptive account of the work of these 2 clinics has been previously written, particularly from the viewpoint of the social worker. Accordingly, this study undertook a review of the clinic records of a particular group of patients, namely, children of elementary school age, to throw light on the problems and needs in this field. The criteria set for the selection of cases was threefold. (1) The examination took place within a 3 year period (1945 to 1947). (2) Patients were those between the ages of 6 and 12 years, with intelligence quotients of at least 80, who had lived with parents or relatives at least until the age of 5 years, or were still living with them. (3) The children were confined to those residing in Greater Vancouver. The number of cases which satisfied these criteria was 257. These cases were classified into 4 groups on the basis of "problems" or symptoms of maladjustment which led to clinical examination. The classifications adopted distinguished (1) socially unacceptable behaviour, (2) personality reactions, (3) habit disorders, (4) disabilities in specific school subjects. The proportion which this group of 257 cases bears to the total number of cases examined by the clinics is examined, and an attempt is made to demonstrate to what extent the clinical population is a cross-section of the general population, but gaps in information in the clinic records make this possible in part only. A further sample was selected (on a one-in-five basis) from each of the four classifications, in proportion to the number of cases examined by each clinic, as well as to the number of boys and girls in the total survey. More detailed information was obtained from the clinic records on the 52 cases which comprised this sample. An analysis of this material, with the use of case illustrations, throws light on the work of the clinics, and on the factors of disorganization existing within the family and the community which contributed to the maladjustment of the children. The clinical recommendations for the treatment of children are outlined, and so far as possible an evaluation of the outcome of treatment is made. There is evidence that emotionally disturbed patients might be better served by the clinics if more adequate community resources for mentally retarded children existed, thus reducing the number of clinical examinations of such children. More awareness on the part of parents of the availability of clinic services would undoubtedly lead to the earlier referral of many children requiring this kind of help. Improvement of the working relationships between the 2 clinics and between the Child Guidance Clinic and the schools would be beneficial. The enlargement of the Mental Hygiene Clinic staff to include social workers would result in a better integrated clinical service. A third psychiatrist on the Child Guidance Clinic staff would overcome some of the present lacks in clinic services. A treatment and observation centre for emotionally disturbed children is greatly needed in this community. In many instances, staff members of social and health agencies responsible for the preparation of social histories would benefit from brief clinical orientation and discussions with the members of the clinic team on the subject of history taking. The addition of a group worker to clinic teams would enhance the services to maladjusted children.Arts, Faculty ofSocial Work, School ofGraduat