The Bridgeport evening farmer., 1914-01-19

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 A bill was passed. practi icallyg un- noticed, in the closing days Of the last session of the New York legislature which marked as Important aastep in the care of the insane as has been taken in generation. This bill, which is now a law and in effect, per
 nits each state hospital for the in sane to establish an out-patient de- partment.
 ment, in the earliest stages, Of persons i'll with mental diseases and at the same time makes it possible to dls- charge conyalescing. patients who pre- viously had to be kept from the friends and families because It was impossible to provide skilled ohserva- ton and advice after they had left The records of 5000 patients admit ted for the first time to New York state hospitals for the insane in 1911 show that in nearly a third of all cases the mental diseases had existed at least year before admission Thus the state spends, more or less willing ly. several million dollars a year for the care and treatment of insane pa- tients whose chances of recovery have been already very seriously impaired, while it ignores entirely provision for their treatment. e.g The treatment of mental diseases in out patient departments is not an untried experiment. There are al ready fl.ree such clinics in New. York and very few widely scattered in other states.
 To these clinics come cases rarely seen by physicians in institutions for the insane-a child brought by a mother whose quick Intuition has told her that he is stdiferentss from the others Ia man who has found his ac7 custofaed work grown uddenIy di fiji cult and is conscious of loss of mem 1 ory and rapidly rising irritabiIity; a depressed old lady who realizes thai some small naisfoTtunes cannot be wholly vres ppn sdbie for the new 5anxie- ty which is doninating her life a youth who fears that he is hopelessly lentangled in some sexual difficulty but thinks that there is just possibility f that a good mind doctor might help him see 3, way out of it; the anxious wife of man wI1oY was always a. | good husband although he drank a bit,'' but has lately bedorne morose a$nd suspicious and has lost four jobs in quick succession Because fspe9pIe are all againsts him tl- a brother of | a patient in a state hospital who anx fously inquires if it is sabsofue ely sure'' that he will become insane be- cause his brother did and who has worried So much about it that he can think of nothing else. S4sf It would be unfortunate, howeKer, to give the iIdpfessions that early diagz nosis and early treatment insire re- oovery in all eases of mental diseases or even In the greater proportion of I There ars several large groups of men al sahteh early alag rlosfss and fIzseiat t are quit DOW CT l less to in{luence h any way an in z eyItab1y 1lnfav orable outcome. The. most irnportafat gsneraI paresis, q
 
 one sixth of ali adr izsions fo hos: pitfalls for tase insaal from Anae1dcanI cities. Sssa
 Four hundred and 11inety ty-1lirls per sons died from typhoid fever inSGreat-; CT New York in 1912 but more than 500 eases of general paresis. all scer-
 tain to die of their disease, were ad- I naitted to the State hospitals from fhe same population in the sam period The history of the early stages of general paresis is often a pitiful story lof family estrangement, business en- ltanglenent Eor persofa1 disgrace and yet the diagnosis of this disease can 1usually be made by the trained psy- chiatrist at a very early period and 1 it is aided by very accurate labora- i tory test 1 ! know Of. the cashier of a bank, whose business life had been ire lproachabIe who became careless and luntidy in his dress and wasteds fhe
 funds in his custody in the most fool I fsh ways He was convicted of en- lbezzlement and died in disgrace a 'ii short time afterward. Fortunately i his family, recognizing that his com duct could be accounted for only by 1 mental disease, had the courage and lgood sense to demand necropsy and the necropsy showed conclusive1y that
 he died of general paresis. Even all though such eases may be incurab1e their existence should be recognized in order that. serious social troubles 1 may be averted
 Establishment Of out patient depart ments by the state will benefit not I only early cases but those conva1esc- ling in state hospitals who eagerly await their discharge and return to their families. With out-patfent de-
 partments able to extend into the lcommunitiesl the skilled sobservatiop and care now ppssib1e only in hos- lpitals, many more such patients can be safely paro1ed, and at the expira,- tion of six months or a year a large proportion of them permanently dis charged.
 l The expense of an o,lt-patient de- I partmeht for each State hospital will be insignificant compared with the cost of maintaining in hospitals pa
 tients who can be returned to their homes.