WELLINGTON LUNATIC ASYLUM.

Globe, Volume XXIII, Issue 2226, 16 April 1881, Page 3

WELLINGTON LUNATIC ASYLUM.

[PEBaa ASSOCIATION TBLEOBAM.] WELLINQTON, April 14. Tho Report of the Royal Commission appointed to inquire into tho management of tho Mount View Lunatic Asylum, Wel« lington, was sent in to - day, and is as follows : May it ploase your Excellency I# We have the honor to report that, in -accordance with the terms of the Commission addressed to us, bearing date February 15th, wo have made inquiry into the charges contained therein, and into various other matters and things connected therewith, brought under our notice. 2. Offing to the number of the witnesses who presented themselves, and the length of their examinations, it became necessary on two separate occasions to ask for an extension of the time originally fixed for the return of the Commission which your Excellency was pleased to grant. Seventeen public and seven private sittings have been held, and seventy witnesses examined upon oath. Of these thirty-eight were called by tho complainant, and thirty-two on the other side. Of these latter, some twelve were more or loss implicated in charges laid. 3. In addition, your Commissioners have felt it necessary from time to time to visit the Asylum together or separately, so as to make themselves acquainted by personal inspection with the buildings and their surroundings, and the internal economy and administration of the institution. 4. Appended to this report will be found a transcript of a shorthand writer’s notes of the sworn testimony, occupying 1156 closely written pages of foolscap. This may bo conveniently classified as follows: —(a) The evidence of persona formerly patients in the Asylum j (b) the evidence of persons formerly on the stall of the Asylum ; (c) the evidence of persons at no time in any way connected with Asylum; (d) expert evidence bb to treatment of lunatics generally j (b) evidence of persons at present upon the staff. 6. With regard to a groat mass of evidence given by the first class of witnesses, i.e., former patients, we have felt very considerable difficulty in estimating its worth. Wo have boon conscious that, though the witness before ua might be truly anxious to state correctly what had occurred, his story might bo the memory of distorted maniacal delusion, which recovered sanity had not dispelled. On the other hand, it might be a recollection of actual facts, and in some instances has been confirmed by independent testimony. We feel it safer, therefore, not to accept such evidence unless when corroborated by_ other witnesses or by admissions or entries in the books of the Asylum. It may be that by adopting such a resolution we are dismissing from our consideration narratives of wrongs really endured, but we must decline to accept the responsibility of finding a number of attendants guilty of acts of violence upon unsupported evidence of a witness insane at the timo of an alleged occurrence. 6. We propose firstly to deal with tho specific charges enumerated in complainant’s statement, and secondly with a number of other matters brought under notice affecting the general management of the Asylum and the comfort and well-being of the patients. 7. Tour Excellency will observe the Commission recites seven specific charges, six of which are made against tho superintendent, Mr Whitelaw, and one against his subordinates. Reading the first two charges as one, alleging violent and tyrannical conduct towards patients and others, wo are of opinion that the charge of violence towards one patient has been established.—Vide evidence of William Mclntosh, given on 21st February; of Timothy O’Oarroll, of 7th March j and of Alfred Do Nerville, on February 22nd. 8. The violence practised on this patient, Wm. M‘lntosh, took this shape. He was, by direction of the Superintendent, and in his presence, dragged from bis bed at ten o’clock on a midwinter night, stripped, conducted across an exposed yard, placed in a confined shower bath, twenty inches by eighteen inches, and kept nnder a continuous shower of cold water for ton minutes or thereabouts, without any possible escape, the superintendent himself handling the tap which regulated the water, until upon the door of the bath being opened (to quote the description of an attendant present at tho time—J. Carroll) 11 He staggered out into my arms.” Tho whole record of this patient’s treatment will bo found detailed in his evidence (pages 19 to 56, of 21st February. However startling and improbable his statement appears, it is our duty to report that we find it in all salient points confirmed and verified by other and independent witnesses. It is needless to rewrite the story. Upon whom the responsibility fastens we shall have occasion to discuss in another branch of our report. 9. With regard to the alleged tyrannical character of the superintendent, if by the word “ tyrannical ” we are to understand an overbearing demeanor and a hasty and irascible temperament, unfitting him for his position as superintendent, wo are compelled to say plainly we consider that the evidence amply substantiates the truth of this charge. It is impossible, believing as we do the evidence of entirely independent witnesses, such as ( inter alia ) Mr Blackmore (page 1, 22nd February), J. W. White (page 14,18bh February), A. Compton (page 44, 24th March), and of the complainant, Mr J, H. Shaw (page 11, Bth February), to come to any other conclusion than that Mr Whitelaw from his constitutional infirmity of temper, is wholly unsuited to take charge of those bereft of reason, whoso care demands such a constant tax on the patience and kindly forbearance of their keeper, and who are so helpless in his hands.

10. With regard to the third charge, that the superintendent’s bad example is followed by his subordinates, wo find a number of facts of cruelty alleged against various attendants. Wo don’t feel satisfied beyond doubt in any one case, but the tenor of the evidence and numerous other reasons have led us to the conclusion that, generally speaking, the male attendants have been in the habit of using unnecessary force in handling the refractory patients, and that anoh roughness has not been sufficiently discountenanced.

2. By way of illustration, wo submit your 'Excellency’s attention to the subjoined extract from Inspector Skae’e book :—Extract February 23nd :—“One of the secluded men, D. Fearon, has a contused face and a little blood in one oar, and the attendant in charge (Duggan) admits to having, in self-defence, given him a blow in the face. I reprimanded him severely, but did not dismiss him, as he is reported to be a very efficient and hardworking attendant, and it is difficult to say how far he acted really in self-defence.”

12. We submit that the recurrence of such an entry as this should be made impossible, and that a system which tolerates a blow from a warder upon the face of a patient, even in self-defence, is not consonant with the humane or Christian treatment of totally irresponsible beings. It appears to us that if in the mind of the Inspector the blow was a resource of the warder to protect himself a severe reprimand was uncalled for ; for if not so, the entry is practically a condonation of (ho offence.

13. As to the charge contained in paragraph 4, the facts upon which it is based are admitted. There is no question that the Superintendent, sometimes with Dr. France and sometimes alone, visited the female wards unaccompanied by any female attendant or matron. There is not the slightest suspicion that such visits were made for any immoral purpose, or arose from any other cause than a mistaken sense of duty. The practice is, as we think, unwisely defended on insufficient grounds, and ought in our opinion to be discontinued. The condition of nakedness to which some female patients reduce themselves ought not to bo witnessed by any male, except if absolutely necessary by a medical attendant.

14. Upon the fifth charge we find that the Superintendent did obtrude himeelf upon the private interview referred to, but that such obtrusion was not caused by any desire to overawe the patient, but from what he conceived to be his duty. 15. The sixth charge opens up a large and not serious question. It has been admitted by the Inspector, a medical attendant, and the Superintendent that the averment contained therein is enbstantially true as far as the facts go, and that Mr Bobert Sinclair Shaw, a paying patient, was employed In the work described. 16. In alloting various descriptions of employment to inmates, wo think regard ought to be paid to the sex and history of a patient. In this instance a man has been sot to a woman's work, and a man from his antecedents presumably quite unfamiliar with any menial occupation has been selected to act as a scullion. 17. The seventh charge is not in any respect affirmatively proved, but doubtless there is a good deal of inferential evidence deducted

from the Superintendent’s personal character and the ungentle treatment of the patients generally, but at the most it only speaks as to the probability of such a complaint being true. 18. This, as far as we are aware, disposes of the charges contained in the complainant’s memorial. There remains, however, a list of accusations, varying both in nature and degree, directed not only against the attendants and the Superintend ant, but challenging the Medical Officer and the Local Inspector. The gravamen of these charges is the perfunctory and unsatisfactory discharge of the duties entrusted to these gentlemen, and their consequent responsibility for the serious maladministration and the apparently unskilful and inhuman treatment of the patients. 19. The evidence in support was elicited chiefly by the cross-examination of_ Dr. France and Inspector Skae, and was introduced as being auxiliary to the charges laid by the complainant. For some time we felt uncertain whether the administrative conduct of these officers was by the terms of your Excellency’s Commission a question within the issue submitted for our consideration, but we are now of opinion that if our report stops short at this point your Excellency will not be properly advised as to the whole of the circumstances which have led to the unsatisfactory condition of the Asylum, as already indicated.

20. It is necessary to state that, observing many defects and grievances, we have already addressed ourselves to the consideration of this question, “ What person or persons are responsible for such a state of things P ” and here a grave difficulty presents itself. We have the responsibility to out up and divide among a number of authorities that are in the present system of organisation, and it is quite

feasible for any official to throw the liability of his share in the proper treatment of the lunatics in this colony upon the shoulders of the nominal head of the Department —Your Excellency’s responsible adviser, the Colonial Secretary. Such a line of defence as this—that this Minister is to be responsible for misfeasance of all officials appointed by him for the charge of lunatics—appears to us to be an argumentum ad absurdum ; but having been gradually advanced, and containing as it does, in our opinion, through a defect in the legislative enactment, a substratum of truth, we are bound to notice it. Under the Lunatics Act, 1868, the keeper is made responsible for the safe custody and proper feeding and clothing of the patients committed to his charge. The medical attendant has charge of their physical and, as we shall shortly remark, their mental health. The duties of the local inspector, as defined by the Act, are inquisitorial. He is at stated intervals to visit and inspect and report generally, to the Colonial Secretary. The law, as it at present exists, clothes him with no more power to administer the affairs of the Asylum, excepting only the power to release an inmate on probation, than any other official or unofficial visitor who may address a complaint to the Colonial Secretary’s Department. It only throws upon him the duty of making icriodical reports, fully expressing his satisfaction or dissatisfaction with the state of the Asylum and its patients, as revealed by his inspection. We submit to your Excellency’s consideration the following illustration of how this system works. 21. A reference to the medical journal and the official records of the Mount View Asylum shows that from August, 18S0, till March, 1881, a patient named Albert Hall was confined in the back wards day and night, with a trifling intermission of a very few days, in a straight jacket, euphemistically described as a “camisole.” This mechanical instrument of restraint, os shown to us, consists of a stout canvas jacket, reaching from the throat to the hips. It is laced down the back, and has sleeves about four or five feet long, which constrain the patient’s arms and hands folded across his breast, and are thence led round towarda the back, so as to effectually prevent any movement of the arms. Occasionally, in addition, the elbow is pinioned by an iron clasp to the jacket whore it covers the ribs. Seven months’ ligature by day and night culminated in the patient stumbling when at exercise in the brick-paved yard. Falling without a hand to save himself, his collar-bone was fractured, and necessarily the jacket was removed in order that he might receive surgical treatment. We have to report that from frequent personal inspection, confirmed by the report of his attendants, from that date last February until the present, this patient, instead of exhibiting the most destructive and violent tendencies which had previously been attributed to him, has occupied his time seated on a chair by day, in front of the Asylum, reading and examining illustrated books, and conversing in a thoroughly quiet condition, and with a comparative degree of intelligence. Since the appointment of this Commission, it is to be remarked that the use of the strait-jacket has diminished. At that time six patients were more or less continually confined. At the present there is not one, and the attendants report to us that they find the patients more tractable, and easily managed without mechanical restraint.

22. Anxious to obtain some account of Hall’s case, we examined Inspector Skae upon it. His answers will be found on pages 92 to 96 of the evidence taken on the 18th of March, and amounts to this—That he was aware of Hall’s particular case, and generally of the amount of restraint practised at the asylum ; that he, on three different occasions, verbally remonstrated with the Superintendent as to the treatment of Hall and another patient named Ryan, as excessive and unnecessary; that such intimation or remonstrance was not port of his duty, and was altogether disregarded by the Superin. tendent; that, notwithstanding his expressed verbal disapproval, and the continuance of what in bis opinion was a most improper method of treatment, he did not on the occasion of any official visit to the asylum from August to the present date, numbering in all some twelve visits, minute a complaint in the Inspector’s book or report the occurrence to the Colonial Secretary, as required by the Act under which he is appointed (vide the Lunatics Act, 1868, section 58 Herein we find Inspector Skae clearly omitting to perform a duty cast upon him by hie appointment, namely, to use bis special knowledge and experience to discover faults in the condition and treatment of lunatics at this and other Asylums in the colony j and upon discovery to put in motion such machinery as was available to have the matter rectified. One line from him to the Colonial Secretary in August last, expressing his disapproval of the Superintendent’s inordinate use of mechanical restraint in Hall’s case might have saved that patient at all events from seven months of what was in our opinion totally unjustifiable torture. 23. With various modifications the same remark applies to Inspector Skae’s neglect with regard to a number of other patients.

24. On a visit lately made by one of the Commissioners to the Asylum it was discovered that a shed occupied by the carpenter, assisted by from two to six convalescent patients, was situated in a backyard on the female side in which the worst women patients are confined. Thus several lunatic men are daily brought into direct contact with the wildest and most intractable female patients. To this same back ward also have access all the male attendants of the asylum by means of a pass key supplied to each of them. The irregularity and indecency of this continuous mixing up of the sexes within the walls of the Lunatic Asylum is not on any occasion reported by the Inspector, although to us he appeared to disapprove of it.

25. With regard to Inspector Skao’s recommendation of Mr Whitolaw for the post of Superintendent, we have to remark that we are unable to understand the grounds on which ho proceeded. Mr Whitelaw was admittedly totally inexperienced in the management of lunatics. On page 11 of the evidence taken on March 21st, Inspector Skae defends his appointment on that very ground, while in another portion of his evidence he lays particular stress upon experienced officers only being employed in important positions in any well-regulated Asylum, and states that special and technical training is a most powerful factor in the proper treatment of lunatics. We cannot but feel that suspicion is cast generally upon his recommendation of Mr Whitelaw, from the fact that no effort was made to obtain applications from persons possessing experience or other special qualifications.

26. The present medical attendant of the Asylum is Dr. Fiance. No charge of any lack of professional capability or industry has boon preferred against him, but we are regretfully compelled to say that, in his habitual treatment of patients, we can discover no trace of any attempt to cure mental disorder. He has confined his duties, as far as we can ascertain, to a most careful diagnosis and treatment of physical ailments reported to him from time to time. We conceive that

I modern science refuses to look upon me diseases as incurable, except in certain if >r “ > but the shaken reason of the bulk of inmates of this Institution was left to reco ™ r itself, if it could, unassisted. In fact the Mount Yiow Asylum has been, and is, a sate keeping-place for the insane and that is al . 27. The matron lately was a Miss Bngdon. She obtained her appointment originally as attendant upon a foolish false pretence that she was a relation of Mr Whitelaw and his moiher, and this of course with their connivance. Since undertaking the post, she has performed her duties very satisfactorily, and we are glad to notice the general kindness and good feeling evinced by the female patients at present in the Asylum. A chargahad been laid against this lady and Mr Whitelaw for combining to defraud his mother of moneys accruing to her. We believe that, acting under the influence of Whitelaw, Mies Brigdon did commit certain irregularities, from which she has derived no pecuniary benefit whatever. In his case, however, wo can find no palliation for his harsh and unfilial conduct, and are sorry to be quite unable to accept hia explanation of his financial dealings with his mother.

28. Since the commencement of this inquiry, interlineations had been effected in the Medical Journal of 1878, by Mr Whitelaw in a matter concerning his own conduct, thus to a great extent impairing the yalue of the records.

29. Speaking generally of the Asylum records, we notice that no book entitled “ The patients’ book ” has been kept, as required by the Lunatics Act, 1868, nor has Inspector Skae in any appreciable degree fulfilled the duties required of him in respect of the “ Inspector’s book.” For example, the interval between the year 1876 and 1878, is recorded by one brief mention of a single visit, whereas the Act requires a full entry of the result of an inspection at least every three months. There is no entry between the 19th of April and the 9th of August, 1880, the entry under the latter date being simply—“lnspected Asylum and found it in very good order, ” No report appears to have been made for the thirteen months between February, 1879, and March, 1880, excepting the briefest possible minute of the Inspector’s visit—not containing any of the particulars required by section 58 of the Lunatics Act of 1868, with the exception of an entry relating to the confinement of two patients. 30. It would bo desirable if the medical attendant entered daily upon his journal the proscriptions ordered by him for the use of the patients, each prescription to be distinguished by the patient’s name and number, such number to be entered into the cash book for reference.

81._ Certain structural changes in the buildings are urgently required. One excuse for the abnormal and excessive use of mechanical restraint offered to us has been that the exercise yards are not secure against attempts at escape on the part of an active patient. Again some provision should bo made for artificially heating the padded and single cells, where the most demented patients are confined. Their tendency often is to tear off and destroy their clothing, and to meet this strait jackets are now used. In England the room would be well heated, and ths patient thus made independent of bed or body clothing, 32. An immediate necessity arises for the demolition of what are known as the back wards of the asylum. On the male side we find a number of patients varying from twenty to thirty, confined during the day in a room 23ft by 15ft, with access for exercise purposes in fine weather to a brick paved yard adjoining, 50fb by 28ft. From 6 p.m. until 7 a.ta. patients are shut up in solitary calls without artificial light or heat, in winter and summer alike. It is difficult to imagine a worse fate for any human being than incarceration in this part of the asylum, overcrowded and surrounded by a most repulsive and degrading spectacle of idiotoy and demented patients. The recalcitrant or the disobedient are placed here for punishment—incongruous as the term must seem applied to an irresponsible subject, it remains a fact that there were to be found Mclntosh, Gannon, Buchanan and other comparatively sane patients confined for their disaffected conduct or their delusions. As to tha behaviour of the attendants, we have been forcibly struck by the indescribable difference between the lot of a patient treated in comparative comfort and luxury in the front wards of the Asylum and one doomed to the back ward with its degrading and miserable surroundings. A change was not unfrequent. A hasty word or act might call forth the fiat of the Superintendent, and a lunatic was punished for his lunacy. 33. It ia to be remarked that during the thirteen years’ existence of the present Lunatics Act, no rules for the proper regulation of asylums have been framed. In accordance with its provisions we can conceive no reason to justify any further delay, and much to recommend the framing of a definite code of instructions, restraining and binding the hands of those employed in the asylums. 34. One recommendation we earnestly press upon your Excellency’s attention : As already indicated, wo have been forced to the conclusion that divided responsibility has been to a great extent the root of the mismanagement of this Asylum. We would suggestthe appointment of an offioercombining the duties of medical attendant with those of superintendent, upon whom should rest the responsibility not only for the physical health and custody of the patients, but from whom should be expected a constant effort at curative treatment of the mental diseases of those within his charge. Such an officer might, in « our opinion, bring practical experience and technical training to aid him in his task, and should be entrusted with the most ample discretionary power, accounting only for the discharge of all his duties to one general inspector, who should himself possess the highest qualifications at the command of the colony. 35. Last October two official visitors were appointed for the Mount Yiew Asylum. One of these has been selected by your Excellency as a member of this Commission. With reference to their appointment we have to report that one visit has been paid by them to the Asylum, a minute of which, in the inspector’s book, states that they were well satisfied with what they saw “ on the outside,” and that they left “ more minute inquiries to subsequent visits.” The appointment of official visitors appears to us open to this objection—that thoir functions, aa defined to them by law, are conterminous with thoss of the local inspector, and the division of the inspectoral duties might probably lead to unpleasantness between them and that officer. 36. Many changes involving an amendment or alteration of existing law, appears to us desirable, but the terms of your Excellency’s Commission do not seem to require from us suggestions for future legislation. In the event, however, of the Executive Government recommending the advisability of the introduction of a Lunatics Act Amendment Act, we would desire to call attention to the limited functions of the local inspectors, as at present appointed, and to the anomaly presented by the re capture and ro-committal of escaped lunatics without the intervention of any judicial authority. 37. In conclusion, while lamenting that the duty intrusted to us has been necessarily painful and anxious, we are glad to be able to report to your Excellency that there are many bright features in connection with the Mount View Asylum in the cleanliness, general order, and discipline of the front wards. Almost nothing is left to be desired. The corridors have been tastefully embellished by pictures, ferns, and flowers, and the dayrooms supplied with books and illustrated periodicals to divert the patients’ attention. Eor the men two billiard tables are provided, and for the women a croquet lawn and conservatory. Country walks are taken, concerts and theatrical entertainments are from time to time given, and divine service ia hold regularly once a week. Not a single complaint has reached ua ot the conduct of any female attendant at present in the Asylum, and we have had many instances afforded us of their quiet and gentlo guardianship. Nevertheless, what in our opinion is a total misconception of the true aim and design of such an institution, runs through its entire management. For the orderly and quiet, restraint has been made as easy as the circumstances of the case will admit; for those suffering from acute mania, and those who do not yield readily to discipline, this Asylum is a prisonhouse furnished with every appliance for punishment. Wo are indebted to the complainant, Mr J. H. Shaw, for the careful and conscientious discharge of duty voluntarily undertaken by him. We believe he has been animated by a sense of public duty in seeking for the investigation which has been made by us, and wo have to report that, without his or similar aid, our efforts would have been comparatively futile. We are unable to make any recommendation as to the payment of the, costs of this Commission. As has been

already intimated, we censure not only particular acts or shortcomings of those entrusted with the charge of lunatics in this asylum, but the system under which they are appointed and continue to act. We attach to this report the whole of the evidence taken by us during the inquiry, together with various exhibits tendered and accepted by us as relevant. This report is understood to have been drawn up by Mr Shaw Ross, R.M., and fully concurred in by hie fellow Commissioners. The accompanying evidence was reported by Mr Mitchell, of the “ Hansard ” staff, and occupies 1156 foolscap pages.