MENTAL DISEASE

Hokitika Guardian, 13 November 1930, Page 7

MENTAL DISEASE

MARRIAGE BAN AND STERILISATION.

The British Board of Control in its report for 1929 states that the principal event of the year was the passing in to law of the Mental Treatment Act, which for the first time authorises the reception of voluntary patients into public mental hospitals and defines the conditions under which they may be treated on a voluntary basis. They express the earnest “hope that local authorities will realise that, from the point off view both of humanity and econofy, treatment cannot begin too early, and will see that any charge made for the reception of voluntary patients shall not be such as to discourage admissions in the incipient stages of the disease.” Attention is drawn to a still more important feature of the new Act in the provision of temporary treatment of non-volitional patients on the recommendation of two medical practitioners and without the intervention of any judicial authority. This provision ‘marks a striking advance in the assimilation of the treatment of mental illness to that of physical illness.” The board explains that the new provision for the reception of voluntary and non-volitional patients are not limited to public mental hospitals, but they have power to approve other institutions or hospitals for this purpose and that there are many cases which could with advantage bo treated in teaching hospitals which are large, enough to have wards for patients faring from nervous and mental disorders. In the case of the teaching hospitals such an arrangement would be of special value, not only from the point of view of the patient but in the interests of medical education and research.

A LOW INCREASE. The number of persons off unsound mind under all forms of care increased during the year by 1307, as compared with an average of 2167 for the last five years, while the total number of notified cases in England and Wales on January 1, 1930, was 142,387, or nearly 3.6 per 1000 of the population. There is no reason to suppose that the abnormally low increase for 1929 reflects any real diminution in the incidence of mental diseases. It is mainly due to an increased death rate during the year, but to some extent the explanation is to be found in the increasing shortage of beds in public mental hospitals. The mjirgin of accommodation is perilously small, and any increase in the admission rate may easily produce a position of the utmost gravity. The board discusses the effect the Local Government. Act 1929, is likely to have on the nation’s provision for the care and protection of the mentally defective, and expresses its belief that it gives great and valuable opportunities for development, improvement, and economy. Up to the present" local authorities have provided only 7697 beds, Eighty-six of the 124 local authorities have not made institutional provision yet, although a considerable number are in process of making provision. At the end of 1929 the total number of mental defectives ascertained by local athorities was 71,439, or 1.81 per 10Q of the estimated population,STERILISATION. The board remains of opinion that an Act prohibiting the marriage of defectives while under statutory care would be a preventive measure of great social utility. Not only would it draw public attention to the unwisdom of allowihg defectives to marry, but it place local authorities in a far stronger position by enabling them to insist on proper precautions , being taken by the persons to whom defectives are licensed, and by their parents and guardians. On the subject of sterilisation, the board concludes: — “Sterilisation will not solve the many problems of the prevention of mental defect; indeed, it is doubtful | whether it will appreciably reduce its incidence. In any case it would be absurd to suggest that its adoption would obviate the need for the institutional care and training of those defectives whose social inadaptability makes it impossible to leave them at. large, But there are, in our opinion cases in which it might be advantageous, and if the claims of its advocates are often exaggerated the condemnation of ' its opponents rests on an equal unsubstantial foundation.” The board remarks that with the increase in the number of mental deficiency colonies it is becoming increasingly difficult to find superintendents with any specialised experience of mental deficiency work. It would, in its view, be a gain to medical education and it would certainly be a gain to mental deficiency colonies if arrangements could be made for short postgraduate courses at one or two colonies within easy reach of a teaching hospital.