Child Psychiatry in Great Britain

Abstract

Over the past twenty years the rapid development of child psychiatry in England was something which the author watched but, at the same time, took more or less for granted. On surveying the Canadian scene after a lengthy absence, one may be excused for disappointment that the rate of development of child psychiatry has not been faster, while admiring the rate of development of psychiatry in general. History, of course, shows that adults have often been relatively well cared for in contrast to children. It is not long, in fact, since paediatrics became a special branch of medicine, and it is a very short time since child psychiatry began to develop in its own right. Sources of stimulation for child psychiatry in our country may be glimpsed if one lists those events of the last 50 years which have stimulated child psychiatry in Britain. The beginning of a psychological service in schools in 1913; The foundation of a Medical Section of the British Psychological Society; The psychobiological psychiatry of D. K. Henderson and W. H. Gillespie; The post-World War I Child Guidance Movement; The psychoanalytic work fostered by Melanie Klein and Anna Freud; The evacuation of children from cities in World War II and the establishment of hostels for children with emotional difficulties; The Blacker Neurosis Survey and the resulting recommendations; The Education Act of 1944 and its provision for maladjusted children; The National Health Act of 1948 which stimulated the provision of both out- and in-patient services for children, and placed child psychiatrists on the same economic footing as adult psychiatrists; The foundation of an active Child Psychiatry Section of the Royal Medico-Psychological Association after World War II. To equal achievements in Britain, Canada would require 100 child guidance clinics and facilities for the in-patient or full-day care of over 1000 children. Great Britain, with a population three times the size of ours, has now seen the stimulating effect of an insurance scheme which provides a child psychiatric service. We have much to learn by keeping in close touch with developments across the water. Perhaps eventually our Executive may be able to increase contacts between our Society and our counterpart in Great Britain, the Royal Medico-Psychological Association, and, when we eventually have a Child Psychiatric Section, it should be possible for us as a Society to foster the practice of child psychiatry and teaching and research in child psychiatry, and to thrash out professional differences within the Society so that we may speak with a united voice to administrative bodies, to other professions, and to our colleagues in other branches of medicine.