Ellen Winston

Integration of Services in a Public Welfare Program

THE PUBLIC WELFARE AGENCY of today is called upon to offer a comprehensive program of public social services. Clearly, the objective of the agency is to develop the most effective program possible for serving the wide range of individuals and families who turn to the agency for help. To reach this objective, the agency must have as its central focus the co-ordination of all its discrete services to form an integrated program of public social welfare. Throughout its history the public welfare program in North Carolina has reflected close co-operation between public assistance and child welfare services at both the state and the county levels. The State Board of Public Welfare has taken a leading role in implementing a philosophy of strengthening family life and protecting the welfare of children, irrespective of financial need.

Indices of Adequacy of State Care of Mental Patients

A T THE PRESENT stage in the study of mental disease it is relevant to explore the possibilities in measuring provisions for state care of mental patients and in setting up indices of the adequacy of this care. The problem of institutional adequacy has been generally considered an individual one in each state. Statements of relative provisions for care expressed in quantitative terms give a reasonable basis, however, for comparisons among states. Analysis of rates of mental disease is a decidedly complex problem. In studying such rates for the 48 states, one has to take into account the fact that provisions for the care of the mentally diseased vary so widely from state to state that social explanations of differences in rates of hospital admissions are not sufficient. It was thought feasible to explore the data available on capacity, personnel, and expenditures of state hospitals and to study them without regard to the characteristics of the patient population. The measures developed show to an important extent what each state has accomplished in these respects in comparison with other states. The interrelated purposes of the present analysis may be summarized as follows: