MENTAL DISORDERS

Evening Post, Volume CIX, Issue 123, 27 May 1930, Page 10

MENTAL DISORDERS

HOSPITAL CLINICS

EARLY TREATMENT ADVISED

SPECIAL WAED NEEDED

The holding of hospital clinics and the sotting apart of a special ward in tho larger general hospitals for the observation and treatment of nervous and mental disorders at an early stage is advocated by tho Director-General of Mental Hospitals (DivT.'G. Gray). , . '^The preventive aspect of nervous and mental disorders," states Dr. Gray, "has been receiving much attention during recent years. '. . . One method immediately presents itself. ■ It has been found that early consultation and appropriate treatment can do a great dael to prevent the onset md "lessen the duration of mental disease, and it was felt that if we could only'induee persons afflicted with any- sort of mental difficulty to consult with our.officers a great advance would be made in this direction. > - "To that end we have established clinics for nervous affections, which arc held at the General Hospital in each of the four large towns. These clinics have been a great and immediate success and arc doing a fine work. ■ "Last year, at the Wellington Hospital alone, over 700 consultations took place between the Porirua Medical Officers and people who were drifting in the direction of mental illness. ■ "UNBTJEDENING THEIR TROUBLES." "Most of the patients attending them had-" apparently required only the opportunity of unburdening their troubles to the attending physician. The treat: inent may consist of little more than a friendly chat and the giving of advice as to, the observance^ of Nature's laws, but it is just that little.which makes all the difference. Psychologists frankly• recognise the therapeutic value of confession, and.the relief which results from,this outpouring of the soul\is-in sharp contrast to the disorders'of mind produced and accentuated by repression. ■ "The large majority of those who come to the clinic are in the earliest phase of mental breakdown, and are- far rcmoveYl from the stage of which certification and removal to a mental hospital would be necessary. They attend the clinic, for advice and treatment, but are still able to carry on their daily work. , "There are other cases,,, however, which require more detailed observation and treatment of a kind which cannot be given at an out-patient clinic, and many of these people enter the mental hospital as voluntary boarders. .. Some thero are, however, whq have a very strong objection to this procedure, and consequently their examination, diagnosis; and treatment arc less adequate than they might be, and they tend to drift to the stage when committal"becomes a necessary step. SYMPTOMS OF MENTAL ' BREAKDOWN. "Apart from tho use.of hospital wards as an adjunct to the / clinics, there is another aspect of this matter which makes a strong appeal to'us.. Let us. consider what happens in a home when a member of the family circle presents the early, symptoms of a mental breakdown. The family doctor is called in, and if lie knows his job and recognises tho importance of the danger signals, he will frankly inform the relatives, and jirobably the patient, as, to the most hopeful line of treatment. ; In the majority of cases this involves a change of environment, a. removal from these influences and circumstances which have proved inimical to the patient's health, or it is an accepted fact amongst alienists- that the emotional tension produced in friends and relatives by the exhibition of mental symptoms in a member of the family is in itself adverse to successful treatment and that such patients do best with strangers. ' , ' ■ FiiAR OF COMMITTAL. %| "The question arises as' to what can be done. At tho back of everyone's mind, but hardly daued to be expressed, lies the fear of committal to an asylum. In the case of the well-to-do this dread possibility does not at once become urgent. A cottage may be taken in the country or at the seaside, or even an oversea trip may be arranged, and in addition special nurses or companions may be engaged. Everything possible may be done in this way, and even if admission to the mental hospitals may ultimately become unavoidable, tho relatives have at least the satisfaction of knowing that this course was" inevitable.

"But what about those who; are not so happily circumstanced? The overwrought artisan's wi{:e with a largcfamily, the lonely ■helpmate of the struggling backblocks farmer, the ex-service man unable to earn a livelihood because -of war disabilities, and the best of ordinary people whose resources arc limited? Must these people, whose only fault is their, poverty, be stampeded unnecessarily into the mental hospitals even as voluntary hoarders, or allowed to avoid treatment until they reach the stage of certification? Can no alternative be provided for them as iirth'c case of the rich AN ALTERNATIVE. ' "It is plain that such an alternative could be provided by the provision of observation wards in our general hospitals. When it became obvious that the caso was- one in which a definite breakdown- was inevitable, and that its treatment was likely to be beyond the resources of the general hospital, further stepa could be taken. The relatives in this event would also have had' the satisfaction' of feeling that every consideration had been given to tho case. It is well known that great improvements have been effected in our mental hospitals- during recent years, and that a great deal of caro is exercised in regard to the classification and treat incut of patients. The growth of public confidence is reflected in the rapidly increasing number ' oi! persons who seek treatment as voluntary boardors —the number of whom has risen from 23 in 1912, when the system was started^ to 290 last year, but. it must be frankly recognised that people are naturally adverse to entering mental hospitals or to sending their relatives there unless and until they are assured by tho most competent medical advisers that such a course is inevitable. Under these circumstances it is inequitable that the less well endowed should labour under a disadvantage as compared with the more fortunate members of the community. Quite apart from the important economic preventive aspect of this question, the demand for observation 'wards is thoroughly justified by this consideration. • . "I have tried very hard," states Dr. Gray, "to have a special ward set aside in the general hospitals for the proper observation of thest cases, buf: unfortunately so far the boards of these institutions still cling to the belief that a mental case is something quite apart from a physical one, and that they should bo treated in a mental hospital. However, the day will come when some of our early cases will be afforded this facility." .