Social Service Department
The Social Service Department of the University Hospital began with the passage of the Michigan Medical Care Acts, the first of which (Act No. 274), passed by the legislature in 1913, permitted judges of probate to send to the University Hospital children suffering from congenital defects or diseased conditions. Shortly afterward, a similar measure (Act No. 267) authorizing the care and hospitalization of adults, was passed by the legislature. These acts determined in large part the designation, number, and type of patients received for clinical teaching purposes. They came particularly from indigent or marginal groups for which such care was otherwise not available: children who were wards of the state, congenital cripples, psychopathic cases needing medical care or surgical treatment, children with curable maladies or deformities whose parents were unable to provide proper treatment, crippled children, sterilization cases, and tuberculosis cases.
These measures brought many new patients needing special services to the hospital. Efforts to provide some sort of social service for hospital patients had, as a matter of fact, begun almost with the opening of the old University Hospital. The University Hospital Circle of the King's Daughters was formed in 1892 to give assistance to patients. These efforts, however, were voluntary and not always continuous. Within the Hospital, moreover, the nurses' service in 1912 had designated a particular nurse to act as a part-time social worker.
Mary C. Merriweather was Supervisor of Social Service in 1918 and Imogene Poole in the years 1919-21. Offices were assigned the Social Service Department in 1919, and in 1920 Dr. Christopher Parnall, then Director of the Hospital, reported that the Rotary Clubs were interested in maintaining in the Hospital a social service worker who would care particularly for the welfare of children sent to the Hospital under Public Act 274. In 1921 Mrs. Elmie W. Mallory (Ph.B. Buchtel '97, A.M. Michigan '20) was made Supervisor of Social Service in the Homeopathic Hospital. When the Page 991University Hospital and the Homeopathic Hospital were combined in 1922, Miss Dorothy Ketcham was appointed Social Service Director to integrate the Social Service Division of the University Hospital. Mrs. Mallory became Director of Social Service in the State Psychopathic Hospital.
In his report for 1920-21, Dr. Parnall said: "The role of a University Hospital in a broad program of education is to teach people the means of protecting and restoring health and preventing disease, both directly and through those who by their preparation and calling are fitted to serve in this field." With a social service program thus recognized, the first few years were spent in defining objectives, in improving methods so as to increase the satisfaction of the patients, in selecting personnel, and in establishing an improved system of records.
The Hospital School. — Among the important objectives of the service was the Hospital School. The King's Daughters of Ann Arbor supported the first teacher and have continued to help the program. Through the Michigan Crippled Children Commission the state also made funds available for the instruction of crippled children. New activities directed toward constructive programs were introduced in 1918 by Claudia Wanamaker. Since 1925 the Ann Arbor Kiwanis Club has given financial support to the program. In 1928 Galens, a senior medical society, undertook the support of a hospital workshop. The hospitalized child has been able to continue his schooling in this way, advancing with others of his age and in some cases graduating from school at the proper time. Although state funds make no provision for teaching preschool children, who at times make up almost half the total enrollment, a definite program has been set up for them as funds have become available.
Occupational therapy. — At first, occupational therapy for adults was carried on through voluntary service. Miss Helen James was appointed in July, 1920, to take charge of social work among dermatological cases being treated by Dr. Udo J. Wile. The work was financed through the Michigan Department of Health. Miss James introduced basketry, sewing, and similar activities, and an early exhibit revealed the value of such employment.
The facilities for occupational therapy include a large central shop and supplementary ward units. Some work can be carried to the patient's bedside. The central shop, largely equipped through the Galens' support, is a large, pleasant room for wheelchair or bed patients. The shop is equipped with looms, sewing machines, a jigsaw, carpenter's benches and tools, leather and reed tools, rug frames, a knitting machine, hoops, hooks, needles, as well as art and craft magazines and instruction books. It is open all day and has an average attendance of one hundred. The type of work varies according to the patient's individual interests and the length of his stay in the hospital. Some accept the idea of occupation eagerly and engage in comparatively vigorous activity; others require a limited or graduated program.
An important part of the social program is the library service. In 1935 a regular library service was set up on a full-time basis, and books were distributed on schedule. This service covers every unit in the Hospital. Reading lists are provided, and awards in the form of reading certificates are made on the basis of achievement.
Social service in the Hospital grew up as a result of case work with the individual patient. The work concerns itself particularly with the patient and with his reinstatement, if possible, as an effective member of society. The program Page 992in the University Hospital has adhered closely to lines laid down by the American Association of Medical Social Workers, the American Hospital Association, and the American College of Surgeons. As standards for personnel have improved new methods have been adopted for handling the work of the department. These improvements include a system of case recording, staff and group discussions, statistical sheets developed for the use of the case workers and the consultant, plans for better student instruction, and better and more accurate medical data. A further function of social service has been the matter of follow-up, which often concerns physician, judge, patient, and family.