Evening star., 1954-10-17
Mental Therapy Plan
For District Strikes
S'nag on Legal Ruling
CONTINUED From First Page.)

Georgetown and George WASH
ington Universities got together
to see what could be done about
providing psychiatric treatment
at, District General Hospital,
They began by sending in psy-
chiatrists as consultants.
The big change came in
March. Georgetown University
relinquished DR.. John D. Schultz.
associate professor and director
of the medical schools OUT
patient clinic, to head the psy-
chiatry department at District
General. Georgetown agreed to
contribute part of his salary.
"Manacles" Were Used.
Here's what DR.. Schultz found
when he began work:
When a patient was brought
into the psychiatric department.
he was examined to see If he
was of unsound mind. If he was.
the legal machinery unwound for
his commitment to st. Eliza
beths Hospital. If he wasn't, he
was. promptly discharged-us-
ually without referring him to
any other place that could help
him. He got no treatment.
DR.. Schultz found "manacles"
Leather straps to hold down
disturbed patients-in frequent
use. He found no use being made
of such means of quieting a
patient as sedatives. soothing
tub baths and personal atten-
ton.
A machine for electric shock
treatments had been bought
years before but had never been
used because nobody knew how
to use 1t.
"It was a clearing house." he
said, mot a hospital"
Increase in Staff.
The changes began to come.
Fourteen consultants. all on the
Georgetown University teaching
staff, began to visit the PSYCHE
atric division about once week.
Four resident physicians, one of
them paid by Georgetown on a
public health grant. were added
to the staff. An average of five
senior medical students were put
on the wards, beginning April.
On the one hand, the visiting
staff interviewed patients, super
vised their, treatment and con-
Quoted case conferences at the
hospital. On the other hand, the
university arranged to conduct
seminars for the staff and resi-
dent physicians. In this close
tie-up, DR.. Schultz continued to
teach at Georgetown and DR..
Robert P. Nenno. assistant di-
rector of Georgetown's psychia-
trio department, devoted at least
one day a week to the District
General patients.
With the emphasis on treat
ment, patients began to get seda-
tives, continuous tub baths, in
terviews under sodium amytol. a
lot more personal attention.
Leather straps became the e1-
ception rather than the rule.
In this atmosphere of treat
ment, nurses who had previously
been reluctant to take a psychi-
atric assignment now began
asking for it. The hospitals oc-
cupational therapy department
began planning a program for
the mentally i'll. Community
groups began to come in to offer
entertainment. Social agencies
began to get referrals from the
psyehiatfic sdiyision for follow
UP treatment.
Shock Treatment Begun.
And DR.. Schultz began using
electric shock treatment. At that
point, Hospital Superintendent
Philip A. E. Stebbing decided he
needed a legal opinion on what
safeguards the hospital should
use to prevent suits. He asked for
a ruling on who should give con-
sent in different types of cases
those where the patients came in
voluntarily and those where they
were brought in by police.
Mr.. West issued his ruling on
August 26 in an 11-page opinion:
He ruled out electric shock
treatment for all but the volun-
tary patients. But the ruling
didn't stop there.
Patients brought in by police
or sent by the courts. he said,
"are detained for purposes of
observation and examination
only. as opposed to being ad-
mitted for the correction of a
psychiatric disorder He said
there was no law authorizing
their psychiatric treatment. "ex-
. cept for such treatment as may
be actually required in connec-
ton with their detention, obser-
vation and examination"
"To Detain Not to Treat"
At(one point, he made it clear
he was talking about psychiatrit
treatment either by means OF
e,ectro-shock therapy or other
WISE"
In these cases." he said, "the
function of District Genera
Hospital is merely to detain. OBJ
serve and examine-not to treat.
He recognized there might bt
instances where the patient was
not found of unsound mind but
would be benefited by treatment
In such cases, he said, it was the
hospitals duty to discharge the
patient forthwith. But, he added
the hospital might advise tht
patient that he could come ba6s
as voluntary patient and ge
treatment.
Quentioned about the ruling
yesterday, Mr., West said:
"The doctors concern wa