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A Mind That Found Itself: An Autobiography

Creator: Clifford Whittingham Beers (author)
Date: 1910
Publisher: Longmans, Green, and Co., New York
Source: Available at selected libraries

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Page 115:




Verbatim quotation from the 14th Annual Report (October 1, 1901 -- September 30, 1902) State Commission in Lunacy of the State of New York, including a report on abuses in private, run-for-gain sanatoriums, written by M. Allen Starr, M.D. -- Professor of Nervous and Mental Diseases at Columbia University.




THE number of private licensed institutions for the insane is now twenty-three. No new licenses have been granted during the year. It is not desirable that the number should be increased; on the contrary, a decrease would be welcomed.


The Commission feels that there should be a more adequate system of visitation of these private retreats. An inspection twice a year by the medical member of the Commission is not sufficient. While most of them are admirably conducted, there are some which do not reach the standard of the state hospitals in point of sanitary conditions and means of care and treatment of patients. In some of them patients are at times isolated for unconscionable periods and restraint with muffs and camisoles is employed to an unreasonable degree. In certain of them bathing facilities are insufficient and protection from fire inadequate. In some the proportion of attendants is too small, and even in some of the best of them the quality of the nursing leaves much to be desired. The following letter by Dr. M. Allen Starr to the "Medical Record" is presented as an evidence of the low standard of nursing existing in some of the private institutions:




To the Editor of the Medical Record:


SIR: -- The first steps towards the correction of any abuse or evil are publicity of the facts and the awakening of public interest; after this the pressure of public opinion is sufficient to bring about a reform.


I desire to call the attention of the medical public, through your columns, to an abuse which should surely be remedied. I refer to the lack of proper nursing and care of patients in private lunatic asylums in the vicinity. First as to the facts:


Case I. -- A lady of wealth and refinement, who became insane in Germany, was brought home by her family, attended by skilled nurses, and, for a time, was kept in her home. She was then sent to Asylum A, where she remained for three years. During this time her nurses and companions were women obtained from the Young Women's Christian Association of this city at a cost of twenty dollars per month -- decent persons, but wholly untrained in the care of lunatics, and incapable of giving the mental direction and help which a good trained nurse can give. Subsequently, on her removal to her home and on being put in charge of two skilful nurses, a marked improvement occurred up to the time of her death, which took place from an intercurrent disease. She was charged $100 a week at the asylum, though the food was that of a ten-dollar boarding house.


Case II. -- A young lady, who became acutely maniacal, was sent to Asylum B for care. Her nurses were dismissed and she was placed in charge of an Irish servant and a young French woman, who had failed as a teacher and was willing to take a place as nurse. Neither of them had experience, and the days were passed in constant struggles between them and the patient. For months this condition went on, though the family were anxious to have extra nurses and were ready to pay for them. They were charged seventy-five dollars per week. The patient had to be fed on milk and eggs only.


Case III. -- A lady suffering from chronic mania has been ten years in one institution, Asylum C. She is happy and able to be diverted. By accident I discovered that she was regularly locked into her room by her companion at 8 P. M., the door into this companion's room being thus closed till 8 A. M., while she was often absent. Considerable extra expense to the family was incurred, because the attendant had a large adjacent communicating room.


Case IV. -- A lady suffering from melancholia had been well cared for by two trained nurses and was improving, when it was thought best to send her to Asylum D. On her admission her nurses were discharged, as the physician "preferred his own nurses." Two weeks later I found her locked in a room with a good-natured, ignorant Irish girl, who informed me that she had come to the asylum within a week and had never done any nursing before. As proper companionship is essential to recovery in melancholia, I remonstrated with the physician, but no attention being paid to the protest, I removed her, and at home, under proper care, she recovered.


Case V. -- A gentleman of means and high mental ability, who had an attack of mild melancholia, was sent to Asylum E. He has had a most faithful male nurse, intelligent, sober, and capable of managing him perfectly. Three days after his admission to the asylum this man was unexpectedly discharged at night, and the patient was put in the care of a rough, dirty Swede, who had been hired that very day, and had never before acted as a nurse in an asylum. To my protest the physician replied that he "could trust only his own trained nurses -- others were liable to drink and disobey orders." Two weeks later my patient was found completely terrorized by this man and complained bitterly of his treatment and lack of companionship. He saw the doctor for fifteen minutes daily, but was with the attendant all the time. The man's habits were filthy, and he was better fitted for a stableman than for a nurse. The patient offered to pay for the services of his former nurse, and to pay his board in addition to the fifty dollars per week which he paid for his single room. This proposition was declined. Hence I removed him to another institution, where he is being properly nursed, and is recovering rapidly.

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