MENTAL HEATING

Taranaki Daily News, 7 April 1928, Page 8

MENTAL HEATING

HOW IT IS PERFORMED VALUE OF SKILL AND SYMPATHY. HOPE FOR MANY PATIENTS. A DAY AT PORIRUA. \ ’ ’ (Special to News). It is strange, but true, that even today there is a hesitancy in regarding mental disorder as a pathological condition and not as something to be ashamed of and hidden. So late as four score years ago, indeed, mental sufferers were herded like beasts and chained in cells, while their attendants made a little pocket money by displaying to sympathetic or morbidly inquisitive people the strange antics of their unfortunate patients. Though wiser and kinder methods have prevailed in the past half century the unfortunate reticence so often displayed has often led to delay in getting the proper treatment for tortured nerves or bewilderei brain, and so reduced the chance of complete recovery. Fortunately there are signs of a more sensible view prevailing. Already in some cities mental clinics have been established in connection with the public hospital to which the friends of overstrained or abnormal folk are urged to bring them. They find at the clinic a couple of doctors, and they seem to have an almost uncanny acquaintance with the worries and ideas that are making life such a mystery. NO FEAR OF OFFICIALDOM. The sympathy and understanding tells. The patient and his friends feel they can tell their troubles fully and without any fear of officialdom, So the doctor listens and advises and suggests another chat in a week’s time. In some cases the treatment he suggests, or the mere fact of getting the trouble discussed, gives the patient peace of mind, and Nature does :the rest. If not, and he comes to the clinic again, the doctor suggests he come to a hospital where rest and treatment can be assured. In increasing numbers such invitations are being accepted. Helpful advice as to arrangements are given and the way made easy for the patient and his friends. That is how the most hopeful sort of patient reaches the mental hospital. Others are sent there by medical men and public authorities, but from the moment they reach the institution they are, in the eyes of all Connected with it, just patients to be cured. No matter if their weakness has been due to their own folly. No matter if their lack of mental balance led them even to commit erime, all is regarded only in its relationship to the possibility , of curing them, Careful inquiry is ; madg in regard to a patient’s family ■ history, environment, employment, amusement and general mode of living. , Nothing ig too trivial to be weighed , in the consideration of his case as a , patient. i CHANGING METHODS. ]

“Like to see a big mental hospital,

would you?” said a doctor to a News’ reporter. “Well, you can do it now, but it won’t be many years before it will be impossible. There won’t be any.” This does not mean alas, that there will be no patients needing succour, but that different methods are prevailing. The News’ man confessed to a very hazy idea of what such an institution was really like. He had seen the approaches to them, delightful, flower-bordered drives leading to — what? in those buildings of which the roofs could just be seen away behind the trees. He said something of this sort to the doctor, an .expert and an enthusiast in mental work, and added that he was sure his haziness was shared by many others who felt, that restraint and the gloom that’ attaches thereto were inseparable from all such institutions. “I’ll show you what we are hoping to do with a new establishment,” said the doctor. He "unrolled a plan showing a plot of some 500 acres as the site of the institution." One looked in vain for the plan of the big central block of buildings. Lots of little squares and oblongs, representing separate buildings, were dotted about. And that is the secret of the new methods. They don’t want buildings or patients in bulk. “Success in treating mental patients is largely a case of careful classification,” said the doctor. “Now, in this new institution we start with a patient here,” pointing to the little square marked “receiving house” on the plan and tracing through the series of proposed buildings the methods of classification, so that always a patient may be given a chance of increasing any progress made towards recovery. “Now,” sasd the doctor, “that, of course, is only possible when you are starting from scratch. We have to do what we can with the buildings we have, for to scrap them all at once would be out of the question, for financial reasons alone. But if you go out and see for yourself how the new methods are being applied, I think you will find it interesting.” LACK OF FORMALITY.

The way was made easy', and the following day the News’ man joined a large number of people who were on their way to see patients at the' hospital. Surprise number one was the lack of formality in visiting patients. A few words to a tactful attendant, a simple form, to fill in for record purposes, and a message goes to the nurse in charge that a patient is required. A few minutes of waiting, and then patient and visitor are left alone, unless, of course, the patient’s condition is such that the excitement of seeing a visitor would do. harm. The administrative block is perhaps the least prepossessing portion of the institution. It is drab, bare and severely utilitarian. Just inside the entrance Hall is the medical superintendent’s room, and here he sees the friends and relatives

of the patients, and gives them information regarding those from whom separation is so necessary and yet so hard to bear. Inside the offices there are rows and row’s of record books, for it is here that is concentrated the records made by doctors and nurses every day of every patient in the institution. There are 1400 souls in this hospital, and everyone of them is seen each day by one doctor, and, if needs be, by more. Their records are kept most meticulously, and at stated intervals the prospects of reebVery, or even diecharge from libsbital, come ap

for review. After all the hospital records can show hag been considered, the superintendent makes his recommendation as to discharge or otherwise. This is again reviewed by the expert in charge of the department (Dr. J. M. Gray) and he in turn advises the Minister whether discharge should be granted, for it must be remembered that all these patients are wards of the State. Whatever their financial or social standing before they needed healing, they are, as hospital patients, wards of the State and therefore require the Minister’s approval for their discharge. PRETTY SURROUNDINGS. It was fully a hour before the superintendent was free of visitors, and could begin his explanations. Leaving the big block of buildings one came to a pretty cottage set on a rise above the well kept drive and surrounded with flowers. "This,” said the doctor, “is our receiving cottage. Here every patient comes on admission, and here classification begins. There are some 300 admissions yearly, and of these about 25 per cent are not very likely to recover. They fall into the class known as ‘institutional,’ i.e., those that must be helped and cared for and looked after, but for whose recovery there is not much hope. For the remaining 75 per cent classification takes longer, may take several days. During this period, though they do not know it, two doctors are making most careful examinations and tests.

e So far as the patients are concerned ‘ they have charming quarters to occupy, ! good food to eat, cheery nurses who • take all worries, and doctors who really 0 do seem to realise that what some peor pie have laughed at, some people have '■ sneered at, and some people have re- ■ fused to listen to, are real troubles ■ to the poor soul whose brain has bee come aweary with striving to sort them e ali out. For some the verdict is happy. They are sure to recover. So a man patient leaves the pretty cottage, and goes to some quarters higher up on the hillside. From here he cannot even > sec the “big buildings,” and there isn’t 1 a lock or a bolt in evidence. The sun > soaks into each of the rooms, and on ! the verendah patients are resting or reading. There are lawns and games to 1 play on them, and at the end of the building the click of billiard balls shows 1 that provision is made for amusement 1 on rainy days. This ‘home’ is quite 1 self-contained. True there is no nurse for those patients requiring her as- > sistance, but in all other respects the 1 quarters are like those of a first-class ‘ “hydro.” It is no wonder that the percentage of recovery is high, and patients who come to this part of the hospital only, need never- see any other part if they so desire. LIKE A FIRST-CLASS HOTEL. Women patients of the same classification are even more fortunate. Their hostel has been up long enough for trees and shrubs to grow. More delightful a position or surroundings would be hard to find, while the rooms and the furnishings are those of a firstclass hotel. This building is also selfcontained. It has its own kitchen, and all that can be done to stimulate jaded appetites or sooth tortured nerves is here. In these fortunate “Grade A” cases recovery may be looked for after six months, and sometimes sooner. In the men’s quarters, and in the women’s there is accommodation for 12. Next to the most hopeful cases, which may be called “Grade A” for the purpose of these notes come those who are obviously more difficult though still hopeful. These also have their special quarters again out of sight of the “big building,” and where bolts and bars are no part of the accommodation. These quarters have men’s and women's quarters with special rooms for massage, physical drill, music, billiards, and other amusements to keep dullness at bay. Outside there are lawns, and usually a nurse to stimulate interest in games or walks, and here again the sunshine is everywhere. THE “DIG BUILDINGS.” From this, “grade B” patients either go to grade A and so to an early discharge, or may prove “institutional” cases and be transferred to the “big buildings.” There they are kept in different wards, which is as far as classification can go until the day comes when big buiidings go, and there is but a series of small homes where classification can be carried out to the last degree. Should a patient in a ward show signs of recovery, hack he or she goes to the grade B building, so that every chance shall be given by environment to' aid recovery aiid stimulate self help thereto; Passing the big farm yard of the institution and its acres of vegetable garden, in . which many overstrung nerves find rest and many a clouded brain gets clear again, there are still more “homes.” These are for patients “on parole.” Some of them are free to go even to the village adjoining the hospital; others may go anywhere within its grounds, while for the remainder, closer observation is necessary, and they are therefore only given partial liberty. It is a rule of the institution that all patients who are physically fit shall do some work. This is part of the curative work, for empty hours give time for morbidity to hatch and worries to regain their bitterness. There is no compulsion, of course, nor is any patient overworked, but a tremendous amount of work is done by them collectively, I work which saves a good deal of the cost of maintaining the hospital. In the. “big building” undoubtedly the institutional atmosphere remains. The beds are spotless, so ar© the walls, and the floors. There isn’t a bit of brass that can be polished that is not shining like gold. There are playgrounds outside, and a glorious view from the windows, There is efficiency, kindness and skill, but over it all lies the heavy hand of authority. And the doors are locked. However many you come to, each one must be unlocked and locked again after you have entered. Granted it is essential, granted it is only to prevent weak minds from harming the bodies that enclose them, the impression it leaves is not exhilarating. Through dormitory clean, cool and sunny, through dining room equally clean but indescribably official in atmosphere, through corridors that have polished floors and shining brass work, around . you are the saddest of patients, for there is little hope of their recovery, 1 and so with admiration for the con- t veniences of the equipment, and still k more admiration for those who actually I tend and succour these poor weaklings n of the Sate, one comes with thankful- o ness out into the sunshine, and beyond c those locked doors. e i< HOPE FOR ALL. t a As you leave, you see tlm lights he- n ginning to twinkle in the “little build- v inga” that are io form the mental v

hospitals of the future. There is hope there, hope for patient, hope for his kindred, and hope for the community. For every patient restored to balance means a unit returned to the ranks of the social order. When one thinks of that and of the observation, recording and analysing of every patients’ idiosyncrasies, when one remembers that all that science can do or give is at the disposal of all, rich or poor, who need it, that the whole staff is imbued with the idea that its mission is to heal where possible and in all cases to sue-

cour, one comes away with optimism triumphant. It ie a strange uncanny shadowland in which to live and work. All honour to those who are doing their best to lead weak souls out of the mists into the daylight of normal living and working and striving. For sufferers and those caring for them the teaching of the new healing is plain. It is that the earlier skilled advice is sought, the better the chance of complete recovery. Above all, that' hope need' never be lost.