Evening star., 1942-05-04
District Would Reduce
Cost of Mental Cases
Writer Discusses Expense
Of Maintaining Patients
At St. EIizubeth's
By John w. Thompson, Jr.

Bobblng back into the news Is tne
perennial problem of what to do with
the Districts insane.
The Commissioners, trying to plug up
some of the leaks in the city purse. are
wondering If there is not some way to
cut down the 100000 spent annually
to maintain local patients at sprawling
ST. Elizabeths across the Anacostia.
At the Federal institution officials
point to the use of the $4,000, 900 estab-
lishment accorded District patients at
maintenance cost and want to know
what the District is complaining about.
There have been rumors that the Dis
trict government has contemplated es-
tablishing it's own mental hospital in
the belief that it might be operated more
cheaply than the s18o a day paid for
patients at st. Elizabeth'S. There also
have been rumors of plans to construct
with funds in the 1943 budget an addi-
ton to Gallinger Hospital, where certain
mental patients OF an advanced age
might be cared for more cheaply. But
it seems probable that war production
and priorities will provide an effective
negative answer to these possibilities,
whether the funds are provided by the
budget or even, as has been suggested,
by Lanham Act ALLEGATION.
Washington has somewhat of an un-
usual problem in insanity. In the first
place it is urban and apartment dwell
ing in nature and for this reason alb
normal conduct is not tolerated to the
extent it might be in the country. In
the second place in many families both
the husband and wife work, thus being
unable to stay home and look after
aged members of the family who might
be harmlesSly senile. Thirdly, being
the Nations Capital, it has its share and
more of crack pots" who drop into town
to give the President or his cabinet
advice on how to run the country.
Fourth, st. Elizabeth's has a national
reputation for high standards of care
so that District fanilies-to whom an
institution ordinarily might be last
resort-do not object to having relatives
committed there.
At the moment there are about 1900
District patients among the 1000 or
more at the Federal hospital. They are
committed by District Court on recon-
mendation by the Commission on Mental
Health. The bills are paid by the Board
of Public Welfare, which does not enjoy
having $4,000 900 of its money spent for
commitments over which it has no
jurisdiction. To the board also belongs
the task of collecting what money the
families of patients can give toward the
maintenance of their committed rela-
tives as well as investigating the resi-
dences Of the inmates to see that they
are properly District charges.
1t has been suggested that establish
ment of mental hygiene clinic and an
expanded venereal disease program
under the Health Department might be
good source OF attack on the large
number of commitments. 1t also has
been pointed out that this would only
add another agency to further confuse
jurisdiction.
Because of the material factors which
probably will intervene in any building
program, the moves to reduce the cost
OF neutrality-suspicious. with the in
creasing cost Of food and supplies-are
limited, but there appear to be at least
two that can be given immediate con-
sideration. These are: Cd Boarding
out Of certain types of patients to Sc
lected families under the auspices of the
hospital; and CD tightening up on COL
lections.
1t has been estimated IS a week per
patient might be saved under boarding
out conditions, over and above the cost
OF providing inspectors to keep constant
check on the homes. There would seem
to be little argument that the hospital
Is the agency best fitted to say what
patients and what types of homes should
be used in such a program
At the present time the Welfare Board
has not sufficient personnel to give
thorough investigation to the financial
condition Of patient or to keep it
under constant check Patients and
their families inherit money or have
other changes in their income which
probably could be tapped to increase
considerably the collections. Whether
this should be done by the Welfare
Board, which is now doing partial in
vestigations, or through a new unit in
the tax collectors office, as has been
proposed, is something administrative
specialists should decide In either event
1t Is probable that the law here would
have to be strengthened to open sources
OF information on the affairs of patients
and their families.
1t should be added that any changes
in procedure involving change of insti-
tuition will involve a further change In
the lunacy law which recognizes only st.
Ellzabeth's. Even if the District were
to build its own institution, there is
nothing in the present law either to au-
thorize or compel st. Elizabeth's to turn
over any patients committed there. 1t
Is further reason why the boarding-out
OF patents-for whom the hospital is
responsible upon commitment-would
have to be treated as an extension of
the hospital and done under hospital
auspices.
During the past 10 years the District
has paid more than s25 900. 900 to st.
Ellzabeth's for the care of patients.
There has been evident from time to
time at the Capitol some sentiment to
charge the District interest on the capi-