Evening star., 1948-10-27
Helping the Alcoholic
To the Editor of The Star:

Permit me to comment on your editorial,
Some Progress Due,' of October II. The
editorial, which devotes itself to the establish
ment OF clinic service for alcoholics in the
District OF Columbia, states that, practically
nothing has been done to get the work start
ed." feel that 1t Is very unfortunate to leave
the reader OF your paper with the impression
that nothing has been done toward the estab-
lishment Of a clinic for alcoholics here in the
District which you refer to as new de-
parture." Historically, it may be of interest
to the reader to know that psychiatrc ap-
proach in the treatment of alcoholics is moth
ing new ana has history of more than so
years practice back of it, Here in the Dis
trict, the local Health Department, through
its Bureau of Mental Hygiene, has dealt with
the alcoholic for more than three years. 1t
has rendered service to more than 1000
patients and has apparently achieved cures
or good results in at least go per cent of these
patients.
So far as the establishment of the particular
clinic for alcoholics under the Hebert Act is
concerned the difficulty in establishing this
arises from the Interpretation which certain
people are putting upon the meaning Of this
act. The recommendation that the clinic be
developed, as your editorial says, as q "sepa-
rate entity" is, manifestly, unsound. It would
Immediately identify the locale for the clinic
service for the purpose for which it exists
and, In that way, identify those that come
to the clinic as alcoholics; that is, to say the
least, bad psychjatric service. We have had
ample experience with clinics SO housed as
for example, in the treatment of venereal
disease patients. The matter became crying
scandal and certainly is a procedure that
should not be repeated. On this point it
might be interesting to the public to have
the opinion of such well-known authorities in
the field OF psychiatry as DR.. William Men
ninger, formerly head of the psychiatric pro-
gram Of the Army, who writes me as follows:
From my point of view it would seem
highly important that you have one mental
hygiene service and that the alcoholic clinic
be section or a part of this. {. 1t seems
extremely unwise to me to set up so-called
alcoholic clinic as separate and apart from
another division of psychiatric outpatient
work. think this does an unfairness to the
patients concerned because obviously alcohol
ism is merely a symptom and even though
common one, the nature of the diagnosis
and treatment of the underlying personality
disorder is the same as in any other psy-
chiatric case Therefore, to me it seems an
artificial division. Furthermore, it would seem
to me that for the advantage of the patient
1t would be much wiser to have him go to
psychiatric clinic rather than to an alcoholic
clinic"
Gallinger Cooperation Needed
The commissioners, fortunately have recog-
nized the unwisdom Of setting up the clinic
Tor alcoholics as separate entity because
administratively, such clinic service needs the
cooperation of Gallinger Hospital psychiatric
service, OF the Hospital Permit Bureau, of the
Laboratory. Of the Public Health Nursing Serv-
ice, OF the psychiatric service, of the account
ing and personnel service, all in the Health
Department. An independent clinic requiring
all these services would represent needless
duplication and increased cost to the taxpayer.
However, while 1t has been decided that the
clinic should be established in the Health De-
partment, the director of the clinic is still
described as a person who should function
with absolute independence of the Health De-
partment. Such setup would be extremely
awkward to say the least. However, honest
effort has been made to secure director for
the clinic service as defined. Not only was
the local Civil Service appealed to- but also
Saint Elizabeths Hospital, the Public Health
Service, the Army, the Navy, the Veterans
Bureau, Is leading universities having PSYCHE
atric service, the American Psychiatric Associa-
tion, the local Medical Society. in addition
to the advertisements placed in the medical
journals Outstanding in the reaction was,
OF course, the point which your editorial also
mentions, the inadequacy of the salary offered
However, some local psychiatrists whom we
hoped to secure for the service, declined to
have anything to do with it when they learned
of the proposed limitation of the service to
alcoholics only.
In this connection it may also be of interest
to your readers to learn that the Connecticut
Commission on Alcoholism ("Yale Clinic')
is suffering from the same handicap that we
are here, namely, that 1t has not yet found
a director for ITS clinic. In fact, the director
of the District Health Departments mental
hygiene clinic service, who is also in charge
of the clinic work for alcoholics here, has
been offered the dictatorship of the Connecti-
cut service which he has, however, declined to
accept.
The suggestion which you say has been made
that the standards for the dictatorship be
lowered in order to fill the position is, to say
the least, of doubtful value. The ahsurdity
in the local situation is that the funds that
have accumulated for the care of the alcoholic
are denied to an existing and functioning
clinic on the basis of an unfortunate and
impractical bit Of legislation, at least as this
Act Is presently interpreted.
From the above it should be clear that really
quite a good deal has been done to help the
alcoholic. More of course, could be done by
simply repeating the impractical stipulation
in the present Act so that funds available
under it could be applied to the psychiatric
clinic service in the Health Department.
GEORGE G. RUTLAND, M. D,
Health Oficer.
Sympathy for Mercy.Speeder
To the Editor OF The Star: