Evening star., 1939-06-25

order, based on the findings of tn.
board, is issued by the court anc
proper notification given to the in.
dividual. This causes Today delay
after the hearing by the commits.
sion.
There is provision for volun.
tary commitment by a patient him.
self who, knowing himself in neec
of psychiatric treatment, obtains 6
permit from the District health of
flcer. Relatives or friends may OBJ.
tain this permit for the patient il
he is unable to go to the District
Building himself.
Some Leeway Allowed.
This provision affords leeway, but
it cannot be used in cases of emerg-
ency for holding persons against
their will.
After person has been declared
OF unsound mind by the board he
has the right of appeal from their
decision to a trial by jury.
1t is universally admitted that
the new system is, in at least one
respect. superior to the old. II
does away with the compulsory an.
pearance of an insane person be-
fore jury where he was tried
in public like an ordinary criminal
Psychiatrists long have protested
against this. Mental disease, they
maintain, no more constitutes q
person a criminal than any other
kind of disease and it is high time
that the stigma was taken away.
Also the final verdit was rem
dered by laymen most of whom
knew little of the complicated fac
tors of mental disease. Juries, ir
fact, usually followed the recon-
mendations of the District alienist
where case was uncontested. The
majority fell in this category. Un-
fortunately the persons most likely
10 put up a fight and also to pre-
sent the best appearance before q
jury OF laymen were the most dam
gerous of all psychotics- para
nolacs. These are persons, usually
OF good intelligence and often OF
marvellous cunning, who have de-
luslons OF persecution. Their stories
sometimes fool experienced psychia-
trlsts. But all of them, when turned
loose, are potentially dangerous. So
1t was in the very worst cases of
all that a jury was apt to override
the doctors.
Eminent Physicians.
or course, under the new system
the paranoiac has the same oppor-
tunlty, but it is one step further on.
Inc psychiatric members of the
board are eminent physicians,
trained to judge mental conditions
expertly and sympathetically. They
are far less likely to make a mistake
than jury. The unfortunate pa
tlent is not paraded before the
stares of the public.
Why, then, have conditions be-
come worse?
Ihe chief reason seems to be the
various delays inherent in the
new system. Gallinger has be-
come plugged psychiatric bottle
neck. whereas it used to be an open
bottleneck through which there was
free flow of the insane into st.
EliZabeth's.
DR.. Gilbert, who is both District
alienist and chief psychiatrist at
Gallinger, says frankly that the
municipal hospital has no facilities
for handling the suicidal and the
homicidal. A great many brought
In by police are of this type. For
merly he could shift them to St.
Elizabeth's, with its excellent facili.
ties, almost as soon as they arrived.
The transfer could be made in a
single day.
Patients Pile Up.
Now they must be allowed to pile
up in Gallinger until all legal red
tape is complied with and then for
10 days more, at least, while the
legal technicalities are being COM
pleted.
This means that blood mad killers
and persons with fixed resolves to
take their own lives must be kept
in the same ward with gentle old
senile dementia patients who would
not injure anybody and who ARE in
the hospital only because the years
have taken away their ability to
care for themselves.
Modern psychiatry is an advanced
science. It has come long way
from the time of handouts and
padded cells. It is recognized that
physical restraint is cruel and about
the worst psychiatric treatment i'm
aginable. There is very little re-
straint on even the most violent at
st. Elizabeth's. The padded cell is
considered a relic Of the dark ages.
Kinder and more scientific
methods are used. Manical furies are