BORDERLAND OF SANITY

Evening Star, Issue 18175, 16 January 1923, Page 8

BORDERLAND OF SANITY

HALF-WAY HOUSES. NEED OF GREAT REFORM. [From the Auckland ‘Star,’] There was onco a patient wiho was “ mental.” 'Oris patient, rightly treated, would soon have been restored to normal. Bo was a poor patient. His friends ooitld not afford to send (him to a 'private iiiati- , tution where ho could hawo received tiho personal and medical attention necessary 1 for his restoration to useful andl happy citizenship, so lie was committed to ao a asylum for tlie insane. Tie was no more insane than the main in the street, pee{j>tr ing for temporary delusions, due primarily to physical illness; hut the shock of realising that ho was in “a lunatic asylum’’ shattered his reason .permanently. He J 9 now what is brutally called “a madman.” The fact that his iplace of incarceration is nowadays soothingly termed a “mental hospital ” does net obliterate the more poignant fact that ho is a lunatic —driven mad by the knowledge that ho was confined in an institution that he had always known as “ tlie lunatic” iisylum. So docs our antiquated lunacy law sometimes make men mad. This, a ‘ Star ’ representatiivo was assured by a specialist in mental diseases, was only one ease of very many. The most, terrifying- thing to the average normal person is the thought of maib ness, that weird and goblin-like darkness, the contemplation of which in itself brings about mental distress, and an infinite pity fur the afflicted—save in tlie hearts of hardened officialdom, which puts the patient down as a, .number in tho grim, record of such, cases and leaves the rest to the system. There have been several cases In tho past, few months which have scoured officially unwelcome publicity in tho Press, and these have directed attention to the ,[ need for reform. Stories have been civcu'i luted of persons incarcerated in “mental J hospitals” (all the soft-soaping in tho jj world will nui. rub off the old name of (j “lunatic :is\lum ’’), who were not by any ■J means insane, but whom, as tho result | nf such incarceration “much melancholy jl hath driven mad!” Tho far-seeing Shakei| rpcare faw tho inevitable result of mcla.n----:j cluily. and the physicians of to-day see it- 1 - ; j and ! iicy strive in every way to wave tho I] magic, wand of cheerfulness and hope ovo'r d I ih‘>:i. who are mentally depressed. But j ' tim■ ir hands are tied in the case, of tho '■} | peer patient always, and in the case, of ■J I lhe atlluent. one very often, for they have not at their disposal institutions to which | such cases can 'bo sent fur tin: proper I*l iroatment. | There arc queer talcs told o' “mental •I hospitals,” mainly arising from public ij ignorance of ibeir adininisiralion and the (! horrible “ some ('king “ wloc.h snggesis | itself to the healthy need, in ropugtl nance to the coutemidaf.on of (ho un--3 healthy. Tim atmosphere of such a, place 'I is disturbing to the normal mind, anil hi 1 here is a fear of contagion which is T strengthened by tales of how nurses and T dodom at fumh in.-gi 1 1 J.ti(jn.-s go “queer •I by contact with their patients. These arc h| mostly baseless; stories, but they are prevail lent, and amid so much ignorance of the a | subject tire uncontradickihle: so the a.verr j age man says to himself; “if I were in % | t here I would go niad -with a-n emit | |>lns:s oil the “ would." ij And as tho medical man said to (he rj | pressman to-day, “ bumc of them do.” | j MAGISTERIAL VIEW, ft j Mi- I’oynton. S.M., one of our most ;; ’ c-tccmcd and widely experienced magis- ? traU-s, was asked his opinion on the mats ter of a■' halfway houseT as lias hecu sugt gested time and again by skilled opinions, X Including those m (lie medical profes- ? i sion. Said Mr Boynton": \ . •• Certainly such an c.-tablishmcntwould ■; I bo desirable, bn! can a small country l» like tills stand the expense of such rnsti(l tutions? If we have a ‘halfway house’ h| and tho homes we should, have in a peril feet state of society- we would have, for J instance, epileptics quite apart from ordinj- ary mental cases--wo would have specially bed homos, for different phases of mental trouble. But this is almost impossible in [j a, small country. Take epileptics: they 11 should have special homes for the reason hi that they take fils, shriek, and serious]} E disturb the other patients. Then there 0 is a. great want here for homes for o’d E people who are mentally upset. It nmal P be known to everybody that quite a niim- *| j her of old people go to the mental hos«j- pilals simply because they are senile. They if ’ are harmless, and do not endanger anyi| • body. The proper place for them is a I* suitable, institution for tho aged. p “Then there are those greatly to bo > pitied women who, often after child [! birth, or at a later and most momentous [ change in the affair of life, become men* 5l I tally deranged 1 for a temporary period. [' They should have a separate place for s' snecia-list treatment. Wo have power now 1 to admit to probation inmates of hospitals j for tho insane, but they can only bo L retained for further observation for one week, andi this, of course, is not. euffiti dent in many cases to determine their fc recovery or otherwise. This is right, in f; i a way, as far as tho .safety of tho patient l| | and the community is concerned, but if I: j w© had 1 a. ‘ halfway house ’ tho term of || probation could bo extended to a few It months. The present law is very careful | as- to tho liberty of tho subject, and) as |l to preventing wrongful comxnitals. Of til course, as I said, there aro people in. the 5 '3 hospitals for tho insane who ought not to bo there if there is any other suitable—or, I should gay, more sufratdc—place for them. On tho other band, there are many r people at largo who ought to bo—well, f’ in some suitable place. | “Tho epileptic is often quite sane, and • ; in such cases a mental hospital is not £ tho place for him. Yet ho cannot bo al- | lowed to go about without anyone to look I' after him and to tho risk of his life or serious injury—and perhaps to the risk lof others. In large communities they hav© i special establishments for these people. ! For us, I suppose it is a matter of j growth. No doubt that in time we will 1 have these things. “ I would like to say a word or two, lif I can, for the private homes. Some i of those do wonderful work, taking in all j sorbs of pitiable, cases and doing them good. Private work is accomplishing very ' much more than the public know of. I would) especially mention in this connection the. home for incurables at Wellington. I Indeed, too much could not bo said in praise of what this grand institution is doing. MEDICAL VIEW. “I take It (says a medical man) that ■ there is no question people aro put into j} mental hospitals who are quite unsuited y for such institutions. The surroundings in |; euch places have a very bad effect, and || I I most certainly say that, as the result of putting them there, their position is ■ going to become aggravated. There is no i’ question that a considerable .number of |S; what we term 1 borderland ’ c-asies are thus J sent over the border. At tho present ~ time these ‘borderland* patients outsido ;1 have to bo treated under two conditions I-* ■ —some at homo and some at special prill vate hospitals. There were two _ cases | under my notice, which in a suitable > place ami under suitable treatment would <1 havo rapidly improved, but no place could | bo found for them. They had to remain. (1 at home and they a.re not improved, uns fortunately. It ia very undesirable that it such cases should be kept at homo, in my | opinion. Homo treatment is undesirable !f for tho following reasons; \ THE RIGHT SURROUNDINGS. | “ First, the persistence of the old sur- | roundings with which, not infrequently I the mental associations commenced. I Friends, however anxious, aro quite null equal to the task of nursing .such patients, i as the patients impose on them to an | almost unbelievable extent. It is my exit perienoe that ‘ borderland ’ mental cases, 5 aa long aft they remain with friends, will I not got better, and will ultimately be re--3 moved to a mental hospital. By keeping 28 up the same conditions wo can establish a sa permanent mental case. Discipline and authority in cases of this kind arc akso- • lutoly necessary, as well as helpful surln roundings from tho point of view of mental and physical rest and the development

of all ‘ atmosphere of cure. I lace get hold of these people under right conditions and their cure is begun. A special private hospital is barred in nine-tenths of the cases, simply because it in too expensive, probably requiring, in addition to ordinary hospital expenses, a special nurse and fees which run the _ patient. for an indefinite period to anything between ten, and twenty guineas a week. Ibyeln. therapv ban tong been recognised and practised' by alienists in tho treatment ul | recognised cases of mental disorder, and * now it is becoming increasingly applied by i doctors everywhere and eonsidered to be: tho only adequate lino of treatment for all I cases of serious functional nerve disorder, many of which have the elements that, if not rc.slnunod, would develop into mental disorder. “An institution of this kind must, of course, bo under qualified medical control, because tho alleviation of organic causes of ill-health and tho return of the vital processes to tho physiological state calls for tho best resources of modern medicine, and is an essential preliminary to tho treatment of any nerve condition. “Hv own opinion is that a special institution, adequately staffed, is an urgent need which could probably best be met bv the establishment of a Department of Psychological Medicine in connection, with the general hospital, and there should be with it arrangements for dealing with inpatient and out-patient groups.”