Evening star., 1926-12-01

pital.
The lack of adequate provision in
the law governing admission to ST.
Elzaheths Hospital has long been
recognized by the hospital authorities.
and the superintendent has frequent
ly called attention in his annual re-
port to the need Of remedial legis-
lation which would place this hospital
in an advanced position-making pos
sible care and treatment of the men
tally sick at the earliest possible mo-
ment and with the least possible diff
flculty associated Herewith. Bills
have been introduced into Congress to
effect the necessary changes. but have
failed of passage.
1T Is incOnceivable that a mental
hospital. such as st. Elizabeth's. main
tanned by the United States Govern
ment and having a standard Of care
surpassed by none. should have it's
facilities available only for patients
whose mental disorder has progressed
so far that adjudication as insane by
jury is necessary.
Provision should he made where
by patients admitted to St. Elizabeth's
can be treated from the first symp
tom of the mental disorder rather
than when the disease is apparent to
every one.
THE District of Columbia with an
estimated population in 1925 of $685.
900 is the largest contributing unit
to the hospital No considerable in
crease in the admission from these
departments may be expected with
in the next few years.
Increment Is IS Year.
Taking into consideration the
larger number of admissions from the
growing population of the District of
Columbia and the number of admis-
sions from all sources during the past
10 years. after a liberal allowance
is deducted for the unusual condi-
ton of the war period. then deducting
therefrom the expected discharges and
the deaths. there is reasonable ex-
pectation of an annual increment of
Is to 100 patients during the next 10
years These can only he properly
cared for in new buildings.
The committee. after careful con
sideration Of all the above mentioned
facts and after thorough inspection
Of all buildings and quarters occupied
by patients, concludes:
"1-That the housing is made
quate.
"2-The sanitation is good in so far
a
ness can make it"
The committee found that a grave
fire hazard exists in the older build
ines at the hospital and lis an addi-
tional and strong argument in favor
of their reconstruction"
Restraint Charges Denied.
The interiors are largely wood, as
are also the porches and halls en-
frances and stairways in several in
stances are small. and in the event
OF fire removal of the patients, espe-
cially the infirm, would prove diff
cult, if not impossible. notwithsta nd
ing the excellent system Of fire fight
ing and protection which is we'll
maintained within the hospital"
Answering charges that patients
have been unnecessarily restrained
and that they are retained longer
than necessary. the committee said:
We are able to answer definitely
that no unnecessary mechanical re-
straint is used in this hospital. We
are informed and believe that there
are no strait jackets or camisoles in
the institution now and none has been
in recent years. Belts and wristlets
are rarely used in Howard Hall, where
the character of the criminal insane
ccasionally require such control.
"Seclusion, we find, is used where
conditions warrant it. This consists
Of confinement of patients alone in
a room with locked door for varying
periods between the hours of am
and pm. We find chemical restraint
used within reasonable limits and we'll
safeguarded. A rule is in force and
observed, requiring all prescriptions
for hypnotics and narcotics by ply
sicians to be countersigned by the
clinical director of the service.
mo evidence whatsoever was found
as result of our investigation. to
indicate that patients are retained
under treatment longer than neces
sary. This is an erroneous impres.
sion commonly entertained regarding
mental hospitals. The belief that pa :
tients are detained unnecessarily long
Is at distinct variance with the facts
and practice in every public hospital
caring for the mentally sick known to
the medical advisers
InaSmuch as mentally sick patients
should have the opportunity to secure
treatment at the hospital in the same
manner as patients suffering from
physical illness enter general hos
pital for treatment. the committee
said provision by law should be made
for the following forms of admission
without court procedure: Voluntary
admission. temporary care, emergency
admission.
The medical advisers briefly recon-
mend that changes in the provision
governing admission. detention and
discharge of patients be secured which
recognize insanity as a sickness and
insure treatment Of the individual on
that basis.
voluntary admission should be
provided for and commitment through
Il atom hr jury .rial after the
manner # a ..riminai no longer re-