The Washington herald., 1914-01-18
4 Movement for Treating
Mental Diseases at Home

| early cases. but those conyalescinS in
State hospitals who eagerly await their
discharge and return to their families.
With out-patient departments able TO ex-
tend into the communities the skilled OBJ
| serVauon and care now possible only in
hospitais, many more such patients can
be safely paroled, and at the expiration
| oi SIX months or year a large proper
tien OF them permanently discha rged
Inc expense of an out-patlent depart
ment for each State hospital will be
Insignificant compared with the cos, ~
maintaining in hospitals patients who
| can be returned to their homes
| Inc out-patient department can be
| operated as integral parts of the hos
| pitals to which they are attached. and
the physicians, being supplied with all
the clinical notes of patients during
| their hospital residence, can make treat
| ment absolutely continuous. Under sucr
circumstances. many hundreds of pa
| tients can be paroled annually, with the
| Understanding that regular visits, at
nrst 1reQuent-even daily-and later less
| frequent, will be made to the out-pa-
tient department where the physicians
can advise both patients and relatives
ana closely observe the progress of the
mental disease.
These are some of the immediate needs
which out-patient departments of the
State hospitals will meet. 1t Is DIM
cult to predict just what the future de-
Velopment ot the clinic for mental dis
eases will be. and yet II seems not too
visionary to conceive of their growth
into mental hygiene institutes in our
larger centers of population in which
many cases Of mental disease will be
successfully treated without the necessi-
ty Of removal from their homes.
An institute with several departments
would be capable OF dealing with much
more efficiently with its cases than the
ordinary out-patient clinic. It would
have examining rooms fully equipped for
modern psychological examinations, oc-
cupation rooms with skilled instructors
in the manual arts. and facilities for ali
kinds of special treatment
Beside being a center for the diagnosi,
and early treatment OF mental diseases
and continued treatment of conyalescent
patents, the mental hygiene institute |
would have to meet some very broad |
social responsibilities. 1t would be a
center for preventive work and for the
education not only Of physicians, nurses
and occupation instructors. but of social
WORKERS In various fields teachers and
parents-those upon whom preservation
of mental health and recognition of III.
hrst signs Of mental disease must always
largely depend.
To such an institute, as to the ortinarvl
mental clinic, would come from schools
homes and juvenile courts those queer"
and different children.
There would also come to the Institute
or be sent by friends or intelligent mar
istrates some of those individuals like
Schrank. in whose defective brains polIti-
cal ideas become 30 strangely trans
formed that they find expression in the
of men in public life. II is
a fact that most such persons are Thought
by friends or relatives to be unbalanced
but harmless cranks',, long before thev
commit crimes. No more striking lin
stration of the present futile means oil
dealing with such cases could be found
than the defective man who murdered a
little girl in New York few months aro
He had been arrested some time befor.
for an offense, which. to every psycbi-
artist. plainly disclosed his mental state
and the probability of his final reyoltinr
crime, but he was dealt with by the
courts. who did not need the aid oil
psychiatrists, and he was ignorantly re-
leased to follow the course which his de-
fective mind had inexorably set for him
Efforts have been made by the State tol
keep down the number in the State bo.-
pitals by the deportation of aliens, and
discharge of nonresidents and otherl
means. but the establishment of OUT
patient departments is the first atternntl
made by the State to deal with mental
diseases before they have resulted in ad-
missions TO the institutions This new
plan Of attacking the problem of mental
diseases In the communities in which tbevI
originate marks the end of a long period
If inactivity, during which the State has
watched apprehensively the rising tide In
Is institutions without making a single Y
Mort to check 'at their sources any Of =
he streams which feed it =