MENTAL HOSPITALS.

Evening Star, Issue 19326, 12 August 1926, Page 4

MENTAL HOSPITALS.

Many of the new developments outlined in the report of the Department of Mental Hospitals are highly desirable, such as special provision for child defectives, shelters for consumptive patients, and a separate institution for refractory criminal “ lunatics.” There is no doubt either of the necessity for comfortable homes for the nurses who have to work under such trying, conditions. The provision of village dwellings for the artisans and male attendants will remove a distinct hardship, as at present many of them have to keep up homes for their families in the nearest town. At first sight this programme seems to hold out a considerable prospect of bringing the department up to modern requirements, but on closer ex-

animation it becomes evident that sonic | necessary and long overdue reforms are : replaced merely by utterly inadequate ' sops to the clamancy of educated public opinion. The most urgent necessity j is a proper system of hospital treatment for early mental cases. : For 'our lecal requirements this could lie. most efficiently carried out by the establishment of a psychopathic hospital fit Wakari, where the patients would be in happy and pleasant surroundings, where their friends would willingly send them at the earliest and most curable stage, whore they would not be subjected to tho supposed taint of the asylum, and whore they would be cared for by trained nurses under hospital conditions. The generally accepted modern view is that such a hospital or halfway house should be part of the general hospital system, and not of the mental hospital. In place of these desiderata tho department offers a makeshift, in the form of so-called “ sanatoria ” attached to the largo asylums, without any real hospital provision. This is to I cost £IB,OOO, while four suitable, psychopathic hospitals would cost nearly ten times ns much, but would thoroughly justify the expenditure. A still more absurd attempt at modernisation is the offer of £SOO to each base hospital to provide wards for acute cases. 'This offer has led to nothing, for • the simple reason that tho money offered is ridiculously inadequate Plans for such f mental block attached to tho Dunedin Hospital were drawn up morti than twenty years ago, but the site is now occupied by the new X-ray building. There is a further proposal to send an expert Home to select medical officers for the mental hospitals. This is necessary, because there are no facilities for training mental specialists at tho Otago Medical School. Tho authorities of this school have shown a persistentand unfortunate apathy towards the question of mental or psychopathic training for medical students, which is in glaring contrast to tho attitude adopted in most modern schools of medicine. In Sydney, for example, a specialist was imported from Scotland at a salary of £1,500 a year to teach psychiatry to tho medical students, and in America the mental aspect of general diseases is fully recognised, and students, are trained to regard the study of personality and of psychotherapy as of at least equal importance in clinical medicine to a dilated stomach or enlarged heart. Some year or two ago a half-hearted attempt wins made, under pressure, to put the teaching of tho Otago medical students on a more satisfactory basis by instituting a lectureship in psychological medicine. The superintendent of Hanmcr Hospital was appointed to deliver a fortnight’s lectures, but he went off Homo soon after, no attempt was made to appoint a substitute, and the students—with the exception of those who have graduated in tho meantime—are still awaiting their course of instruction.

The importation of a number of medical officers, however highly trained, will bo of little use, because, as Government servants, they will immediately bo forced to bend their necks to the antiquated yoke. The first step towards the necessary reorganisation of this department should be the appointment of an expert of high standing and thoroughly skilled in modern methods—like Sir John Macpherson in Sydney. Ho should be unfettered by any financial or political consideration, and he should be given a free hand, not only in setting the whole Mental' Department on a sound, modern, and scientific basis, but also in laying down a system of training for our future practitioners of medicine, so as to enable them to grapple successfully with the most difficult problem in civic efficiency and social health that has to be faced to-day. In the meantime our rate of insanity is increasing, and the roll of suicides and child murders rs mounting np. If the State would even set aside a stun equal to the potential ■capital value of the young children who are destroyed each year by parents who should have been in the despised halfway houses there would soon be sufficient to endow a small hospital. Criticism of this department is a weary and thankless task, but it has already stimulated the Government to a considerable promise of reform, if not of actual accomplishment, and it is to be hoped that in the not too distant future this dominion will lose the reproach of being a hundred years behind the times in its way of caring for the mentally sick and of preventing insanity.