MENTAL PATIENTS.

Hauraki Plains Gazette, Volume XXXVIII, Issue 5197, 31 October 1927, Page 1

MENTAL PATIENTS.

incipient cases.

CARE IN TREATMENT.

In an editorial article in the New Zealand Medical Journal there is some criticism of the present method of dealing wita incipient mental cases; Inquiries made from the responsible authorities show that when the clinics at general hospitals for consultation .with reference to such cases were first established, all the medical practitioners in the district werei circularised by the medical superintendents of the general hospitals in the four main centres. Medical men frequently ask for consultations on cases where thqy have any doubt or in cases which are not regarded as suitable for treatment in a mental hospital. In quite a number of such cases advice is given as to alteration of mode of life, etc. Instead of patients being sent directly to a mental hospital, they make their first contact with the medical officer of the institution at a general hospital. In this way a considerable number of such patients are led to seek institutional treatment in the capacity of voluntary boarders. That these clinics are serving a useful purpose, and that that usefulness is becoming increasingly recognised not only by the general public but also by medical men, is revealed by the fact that last, year about 1000 patients were dealt with nt these clinics. Incipient and recoverable cases are chiefly dealt with at these clinics.

Dr. D. Macdonald Wilson, medical superintendent of the- Wellington Hospital says he is convinced that the public have a high regard for the advice and treatmenti given at the general hospital mental clinics. When the work was first started he informed medical practitioners of the aims and objects of the clinics, and he thought that had the fleet of keeping up a steady inquiry, as every week fresh patients and relatives came to the hospital to see the medical officer from the Mental Hospital Department. Speaking from the point of view of the general hospital, he found that as a rule there had been frequently one or more patients in the hospital for whom the honorary physicians or honorary surgeons in charge of the cases had been only too anxious to have a consultation with the medical officer from the Mental Hospitals Department. Thus the organisation of the clinic had been to the advantage of the general hospital itself. In vie>w of the weekly consultation it was very rarely that a patient was sent to the mental hospital without consulting the officers of that department. By making a practice of this, Dr. Wilson found that they got more co-opera-tion from the relatives of patients, and there was no feeling of injury being done to patients.

With reference to the complaint in the Medical Journal as to the detention of patients in police cells prior to committal, it should be noted that in his interim report on his visit *D American and European mental hospitalSj the recently appointed In-spector-General of Mental Hospitals, Dr. T. G. Gray, states that it, is imperatively necessary to have associated with the general hospitals! a small detached block for the immediate preliminary reception of prior to committal. The department has also now arranged with the Commissioner of Police that no prison vans are to he used in the conveyance of mental hospital patients, and that officers on escort duty shall not wear uniforms.

The present system with regard to admission of patients is this : When it is decided that a patient requires institutional treatment, the patient on arrival at th» institution goes to a reception cottage, ydbere the medical officer on duty meet him and carefully examines him with a view to deciding the best means of treatment. Unless distinctly contra-indicated by extreme mental disability, the patient goes to the neuropathic hospital, which is entirely separated l from the main institution. In Otago and Canterbury the neuropathic hospital is several miles away from the main institution. This has not been found possible at Auckland or PoHrua, but the neuropathic hospital is put of sight of the main building. Dr. Gray is a strong advocate of what is known as the “villa” system of detached cottages. It may be noted that there has been considerable development of the system under which patients; go to the institutions as voluntary boarders. This system was established in 1911. Ther« were 23 admissions in the first year; last year there were 171, of whom only 6.56 per cent, had to be committed. The rest were discharged recovered.