MENTAL DISORDERS

Evening Post, Volume CXII, Issue 59, 7 September 1926, Page 9

MENTAL DISORDERS

NEW CODE FOR LUNACY

MEDICAL MEN AND CERTIFI-

CATION.

(From Our Own Correspondent.) LONDON, bist July. A Royal Commission on Lunacy and Mental Disorders was appointed after the sensational Harnett case, and it has now issued a report in which drastic alterations are suggested in the Lunacy Laws. Diseussing the complicated task of those charged with the administration under the Lunacy Act, the Commission state that the liability Ao actions at law to which the medical profession is at present exposed has resulted in so marked a reluctance on the part of medical practitioners to be concerned in certification that a breakdown of the system is threatened. The stigma of pauperisation, and also of certification is commented upon, but the Commission have come to the conelusion, that the evidence before them does not support the suggestion that the present safeguards ■ against wrongful certification, if properly observed, are inadequate. It does, however, point to the need for some provision whereby certain classes of case may be placed under care and treatment without the necessity for full certification. The present facilities for treatment without certification are on a very limited scale, and need extensive development.

CERTIFICATION A LAST RESORT,

"We, therefore, recommend," says the Commission, "that tho lunacy code should be recast with a view to securing that the treatment of mental dis-, order should approximate as nearly to the treatment of physical ailments as ia consistent with the special safeguards which are indispensable when the liberty of the subject is infringed; that certification should be the last resort, and not a necessary preliminary to Treatment; and that the procedure for certification should be simplified, made uniform for private and rate-aided cases alike, and dissociated from the Poor Law.''

For the more effective protection of medical men and others, it is proposed that the law should be amended so as to provide that any such person shall not be liable to civil or criminal proceedings unless he has acted in bad faith and without reasonable care, and any proceedings against such a person shall btf stayed upon a summary application to the High Court or a Judge in Chambers unless the Court or Judge is satisfied that there is substantial grounds for alleging that such act was done in bad faith or without reasonable care.

NOMENCLATURE SHOULD BE ALTERED.

In any new legislation is is suggested that careful consideration should be given to the nomenclature recommended by the British Medical Council. The term "lunatic" should be discarded, and persons might be classified as suffering from mental disorder, while the terms "asylum" and "pauper" might with advantage be superseded by the term "mental hospital" and "rate-aided" lyThe Commission were satisfied that in practice instances of sane persons being wrongfully certified or improperly detained must be of the rarest occurrence. In order to ensure effective visitation it is recommended that the staff of the Board of Control should be substantially increased while additional visits by the local visiting authorities are also suggested.

PATIENTS WELL CARED TOR.

After visiting twenty-five institutions the Commission state that they "are satisfied" that the patients are on the whole well cared for, and that the wholesale allegations of neglect and ill-treat-ment which are sometimes made in regard to tho present system are unjustified. "We are impressed with tho skill, devotion, and self-sacrifice of the nursing staffs who in circumstances peculiarly exacting are rendering great service to Buffering humanity," proceeds the report. "We have come to the conclusion that there is no foundation for the suggestion that ill-usage is deliberately or systematically practised in mental institutions." It is recommended that in future mental hospitals should" be designed to accommodate, not more than 1000 patients, and that in the design of the hospital the villa system should bo adopted. The Commission are of opinion that there is room for improvement in the facilities for outdoor recreation, particularly on the female side.

PRIVATE INSTITUTIONS.

Licensed houses in which mental patients aro taken for financial gain should receive more rigid financial supervision. It ia suggested that the Board of Controf'should bo made smaller to allow of the' appointment of fifteen assistant commissioners who would visit mental homes under tho board. The aid that women can give to mental patients is omphasised, and it is proposed that there should be a woman commissioner on tho main Board of Control. More women iiurset «re needed*