The Work of a Residential Child Psychiatry Unit

consultant child psychiatrist at the Uffculme Clinic, Birmingham. He wrote this article while in charge of the Dundee child psychiatry service. Before the start of the National Health Service there were very few units for the residential treatment of children with psychiatric disorders (other than mental subnormality). Since then the number of such units has been steadily increasing. In the area of the Eastern Regional Hospital Board in Scotland (Dundee, Angus, Perth and Kinross) a children's in-patient unit has been in operation since May, 1964. Liff House Children's Unit is a large converted house within the grounds of Royal Dundee Liff Hospital. A new building, next to the existing one, was recently completed. A full programme is arranged for the children, including periods of school work, occupational therapy , visits to the swimming baths and the children's cinema show in Dundee. There are also periods of free play under the guidance of the nursing staff. The aim is to create a relaxed and accepting atmosphere in which the child can feel secure in a regular but flexible routine. The attitude of the staff has to be tolerant, accepting and understanding but it is important that they must always be, and appear to the child to be, in control of the situation. The atmosphere is generally permissive but it is necessary to have definite limits to the behaviour which is permitted and children often 'test out' the staff in order to find out what these limits are. Living experience We try to provide an environment suited to the needs of the children in the unit. The overall living experience which the child has is considered to be the most important aspect of treatment. For this reason it is essential for all members of the staff?psychiatrists, social workers, psychologist, nurses, occupational therapist and teacher?to be fully informed about each child's case. The unit is organised so that there is as much informal contact as possible between all members of the staff. Regular weekly staff meetings are held at which each child's case, and plans for future treatment, are discussed. Once they are settled in the unit the children, often quickly, show evidence of their psychological problems and can then start to work through these problems in the context of their relationship with the unit staff as a whole and with individual staff members. Individual psychotherapy is carried out and occupational therapy is …