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3rd March 1966.
Sir,
Psychiatric Care
Some important observations on the matter raised in Professor Hill's letter (23rd February) have been made (Dr. Guy Mitchell, Mr. Robert Humphreys). Among other issues relative to the lack of mental hospital provision for the adolescent are the following:
I have been involved and have watched this problem over several decades and there is no reason why there should ever be any outcome. Partly the difficulty arises out of the peculiar nature of mental disorder in the adolescent period, this being difficult to distinguish clinically from the difficulties inherent in the adolescent phase of growth towards independence, and partly the difficulties arise out of there being no professional body that feels responsible. In other words, child psychiatry must urgently become a discipline with its own autonomy since experience has proved that neither paediatrics nor psychiatry (of adults) has the will or the specific knowledge necessary for professional involvement in this vast area of care. In fact, the treatment (and prevention) of emotional disorder in childhood has been done and will be done by psychiatric social workers, child care officers (Children's Committee), and Probation Officers, and the whole community of residential workers in boarding schools for difficult (ill) children. It is now too late for either psychiatry or paediatrics to claim an interest in our specialty. We must go ahead with only a friendly liaison with the two established disciplines, and plan according to the needs which only we know.
In a detail, we need and have needed now for thirty years an experimental hostel or boarding school for half a dozen children to be located in the area in which psycho-analysts live and work. Only in this way can a beginning be made to the problem of the treatment of those children of any age who need treatment of two kinds at once, treatment by specialised management and treatment by intensive personal therapy.
To what Ministry can on