New Britain herald., 1918-04-23

LFnIlOn Wnlcn Will promote cure. AT
first these institutions were looked
uron merely as asylums where the
insane could find refuge from the
ignorance and Indifference which had
previously characterized their treat
| n.ent. With the general advance of
| medical and nursing knowledge and
standards and the further enlighten-
Tent of the public it has become
Possible to elaborate them into truly
curative agencies. These institutions
are usually of large size and widely
separated and there are still many
states in which they do not furnish
provision for all tho cases which re-
duire hospital treatment. In several
of the states. however. the number
OF which is steadily increasing. the
whole burden OF providing institu-
ucnal care and treatment for the in
So ne has been assumed by the state
government. Wherever this has oc-
CURED, the result has been a better
level of intelligence and humanity in
dealing with the cases under insti-
tutional care. State care is properly
regarded. therefore, as a goal to be
reached in the progress towards an
efficient public system for deal
ing with mental disorders. II &C
com plishes much more than tho
mere transfer to the state Of
tho responsibility of providing insti
tutlonal care. 1t raises the prevalence
OF mental disorders with their causes,
prevention, and manageme into the
dimensions of q state problem of the
first class. And while after state
care has been adopted, the first task
to be accomplished is to bring all
cases which require institutional
treatment into state hospitals it is
soon found that this by no means &C
complishes all that is required for
dealing adequately with the needs.
Unless the vital issues occasioned by
mental disorders in the homes the
schools, the industries. and in social
relations are inte1ligcntly grasped and
dealt with by means Of the state sys
tenn, state institutions are liable to be
looked upon 1s a resource which is
only to be appealed to when complete
separa ton of the patient from his
usual environment has become i'm
perative. They will still be regarded
as asylums. In such case, their de-
yelopment is likely to Se in the dl-
rection of great custodie centers, and
economic and so-called business con-
siderations in their mana cement are
likely to prevail over those dictated
by science and humanity. This has
happened in more than one state in
which state care has been adopted
under conditions of great promise a
state care system must, to be effec
tive, not only be adopted but it nust
be planned and developed with ref
erence to the known needs of the Suf-
ferers from mental disorder. a we'll I
defined policy Is essential and care |
fully prepared plans. The best plan |
is probably to divide the state into
districts containing not more than |
500 900 inha btants each, and to pro-
vide Il state hospital for each district. |
This hospital should be SO conducted |
as to- serve the needs of the district
in dealing with mental disorders to
the fullest extent possible. With this |
in view. the necessity of educating !
the public to a proper understanding |
of the purpose and advantages OF !
such an institution should be consid |
cred. Unless steps are taken to this |
end, the process of subtitutins, for |
the prevailing views and methods the |
newer conceptions and resources, viii |
require a generation. This necessity |
is all too frequently lost sight Of and |
progress is thereby greatly retarded. !
The state hospital is to be regarded |
a social welfare agency and GEN. !
ter of information and useful service |
which can be confidently appealed to |
in dealing with the problem Of men
tai disorders in the district which 1t |
serves. In states where a state sys- |
tenn of care of. the insane has been |
most fully developed, the lines of pro- /
gress have been towards the applica- !
ton Of this view. Developments have |
hpnn q bring
ing the district hospital into moro |
intimate relation with the needs of |
the various communities in the dis !
trict. In some states nurses from the |
state hospital and sometimes a physi- i
clan are sent to the communities to |
bring the patient to the hospitals. Out |
patient departments are conducted in |
various parts of the district where |
persons who wish advice concerning |
mental disorders may apply. Social |
service workers are employed to Wis |
it, at their homes, patients who have |
been discharged from the hospital or |
who may have applied at an out pa |
tent department. These contacts |
with the communities have an educa- |
tional value and furnish means by |
which the hospital may contribute to !
the management of the problem Of !
mental disorders as they occur in the |
home in the school and in the COM |
mercial. industrial and social life of |
the people. Instructive literature re- !
lating to the naure, causes and treat |
ment of mental disorders, and to the |
utilization of the resources of the hos |
pital, is widely distributed The ply |
sicians of the hospital aim to inform |!
the medical practitioners of the dis !
trict and the public, by means of !
scientific papers and addresses, con- |
corning the conditions met with in !
their patients and the purposes and |