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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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It is evident, therefore, that insanity, if it is ever to be conquered, must be attacked along lines not commonly followed to-day. As to the method of attack to adopt there can be no argument, for the masters of medical education in every country on the continent of Europe have proved the practicability and value of the plan in question. What is needed in order to reach the root of the problem of insanity is the establishing of so-called Psychiatric or Psychopathic Hospitals in connection with our Medical Schools, -- hospitals wherein nervous and mental diseases may be treated in the most scientific manner, not only for the benefit of the patients, but also for the benefit of physicians and students. What a leap forward in humanitarian endeavor it would be if each university, so situated and organized as to warrant it, should have under its everlasting protection a modern Psychopathic Hospital! (Have not seats of learning outlasted seats of government?) And what could be more appropriate than the restoration of lost reasons under the hospitable protection of the very institutions wherein reason itself is trained to do its right work? Thus will it become possible to instruct the medical profession generally in psychiatry or psychopathology -- a branch of medicine about which thousands of physicians know little, -- or, in many instances, nothing at all. In addition, numberless persons threatened with mental collapse, or actually insane, will then receive the benefit of prompt and scientific treatment at a time when the mental life of the afflicted one hangs in the balance. Further, Psychopathic Hospitals will enable scientists to study insanity; and such institutions, by setting a high standard, will soon raise the standard of treatment throughout the country.


The necessity for such modern hospitals may be appreciated when an accredited authority in this country on matters pertaining to medical education (Dr. William H. Welch of Johns Hopkins University) can say, as he did to the writer of this book: "The most urgent need in medical education in America, to-day, is the need of Psychiatric Clinics (Psychopathic Hospitals) where medical students, and physicians as well, may benefit by instruction in psychiatry, and where scientific research into the cause and cure of insanity may be carried on unceasingly."


When the fact is considered that each university in Germany, France, Italy, Switzerland, Austria, Russia, Norway, Sweden, Denmark, Holland, Belgium, Brazil, Argentine Republic and Japan, at the present time, has a psychiatric clinic under its own control, and that no physician in most of these countries may practice medicine until he has passed a satisfactory examination in psychiatry, the disgraceful state of affairs existing in this, the richest nation in the world, may be the more readily appreciated. In Germany a system of state-supported sanatoriums has long been in successful operation. These institutions, however, are not open to those afflicted with a developed mental disease. They are designed for the exclusive use of those threatened with mental collapse. The Germans engage in the rescuing of those threatened with insanity because they have been wise enough to realize that it is cheaper to help the individual back to health than to let him break down completely and live, perhaps for years, a burden on the State.


In the light of such embarrassing facts, it is indeed high time that the United States of America should prove itself the vauntedly progressive nation it is supposed to be, by taking hold of the neglected problem of insanity, and, through its several State Legislatures, bringing into existence Psychopathic Hospitals of the type described in the interesting U. S. Consular Report on the Munich Clinic, quoted in full in Appendix II. That the movement toward the erection of such model hospitals is already under way is a fact, and those who know the field predict that within five years a majority of the States will be operating institutions of the desired type, and that within a decade no State will be without at least one Psychopathic Hospital of its own. (19) Thus far, Michigan is the only State in the Union to erect a modern Psychopathic Hospital. New York, however, has taken steps toward the erection of one, a well-meant though totally inadequate appropriation having been voted for the purpose. (20)

(19) In the year 1906, at a cost of about $75,000, a hospital of this type was brought under the control of the University Hospital at Ann Arbor, Michigan. Because of the close relations existing between the State authorities and those of the University (of Michigan), this new institution, though virtually a part of the University, is at the same time a part of the system of State Hospitals.

(20) If this State will appropriate, say, $1,000,000 instead of the comparatively paltry $300,000 already voted, New York City will have what it so richly deserves -- a modern hospital as good as the one at Munich.


As the location of this particular type of hospital is of vital importance, I shall here venture to emphasize an underlying principle which cannot be safely ignored when the selection of a site for such an institution comes up for decision. After discussing this subject with alienists, superintendents and assistant physicians of hospitals for the insane, and with certain recognized authorities on the needs of the insane, I am led to the sure conclusion that Psychopathic Hospitals erected at the expense of the State should be made a part of the existing hospital system. No State Hospital can hope to fulfil its functions properly until it has under its control, and within easy reach -- that is, within the hospital confines -- a separate building erected for the purpose of treating acute cases of insanity, either newly-admitted ones, or so-called chronic cases during recurrent, acute periods of depression or excitement. Patients of the latter class are numerous in our large hospitals, and when a management, because of inadequate equipment, has to treat such cases in the wards with patients less disturbed, a great injustice is done not only to the "acute cases" but to all other patients who are forced to live in the same ward with them. Failure on the part of those in authority to provide each State Hospital for the Insane with a Psychopathic Hospital or Pavilion (by which is meant a separate building, or group of small buildings) will bring about a result which it is painful even to contemplate; for the moment the Psychopathic Hospital is set apart as a favored type of institution, that moment will the State Hospitals or asylums, so-called, sink -- in the estimation of the public -- to a level far below the level of the worst managed asylum at present in existence. To adopt a policy which would widen the already great gulf that exists between general hospitals and asylums would undo in a day the work of a century. I have criticised with a considerable, yet merited, severity, our State Hospitals for the Insane; nevertheless, these two hundred and odd hospitals, erected at a cost to the Nation of over one hundred millions of dollars, constitute the nucleus of what will, in time, -- if rightly managed -- become the most perfect hospital system in the world. Continue to force the several managements to minister to the insane with hospitals which lack that most essential remedial feature, the Psychopathic Pavilion, and the dread of insanity and asylums which of late years (I am thankful to be able to record) has grown noticeably and hopefully weaker, will not only be perpetuated -- it will be cruelly and needlessly intensified! But let the many States in the Union which shall erect Psychopathic Hospitals during the ensuing decade make a beginning by adding to our existing asylums adequate treatment divisions, and the present dread of insanity, and the dread of asylums, will, in a relatively short time, be reduced to an intelligent minimum. Then ordinary asylums, instead of continuing to rank as mere prison-houses, will rise to the level of the best of our general hospitals, and eventually they will become a source of justifiable pride to the Nation.

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