Library Collections: Document: Full Text

Out Of Sight, Out Of Mind

Creator: Frank L. Wright, Jr. (author)
Date: 1947
Publisher: National Mental Health Foundation, Inc.
Source: Available at selected libraries
Figures From This Artifact: Figure 2  Figure 3  Figure 4  Figure 5  Figure 6  Figure 7  Figure 8  Figure 9  Figure 10  Figure 11  Figure 12  Figure 13  Figure 14  Figure 15  Figure 16  Figure 17

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45% supplied insufficient quantities of bed sheets.


35% failed to provide adequate clothing.


None were highly selective in employing attendants, although the attendant "exercised effective responsibility" on the ward in every case, and was reported as giving medications in 95% of the replies.


Attendants' salaries ran as low as $45 per month, plus maintenance; nurses were paid as little as $50 per month; doctors, $150; hours were as long as wages were low.


In only 15% of the hospitals were doctors readily available for individual consultation with patients, and doctors spent more than half their time on "book work" in 60% of the cases.


Only 30% provided games and reading material on the wards.


Only 60% used hydrotherapy, and half of these had an untrained attendant in charge.


Tuberculosis patients were not properly isolated in at least 35% of the hospitals.


Food was unsanitary in 20%, poorly served in 50%.


90% used patients for work in a work-centered rather than a patient-centered manner.


30% acknowledged that doctors and nurses did not always maintain a therapeutic attitude toward their patients.


95% indicated that attendants, who have most contact with patients, often violated rules of good treatment and care.


From this survey, as well as innumerable surveys in the possession of the National Committee for Mental Hygiene, the United States Public Health Service, and the American Psychiatric Association, it is plainly evident that deplorable conditions not only exist, but exist generally throughout the country, in many different hospitals.


This fact is further supported by a list of the states from which the actual incidents reported previously in these pages were drawn. One or more of these incidents actually took place at a hospital in each of the following states: Connecticut, Delaware, Illinois, Indiana, Iowa, Maryland, Michigan, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and Wisconsin. Some of the states listed are among the most progressive. There is every reason to believe that incidents similar in their effect on patients could have been selected from any state in the country. Those used have been selected for their clarity and ease of presentation. They are neither the best nor the worst cases on record.


(Some of the most flagrant examples of mistreatment were omitted because of the impossibility of making them seem plausible. Could anyone believe that a doctor would resort to Jew-baiting a poor refugee, offer to assist in suicide, or force a sick man to take an ice cold shower? Or could anyone believe that hospital patients would be forced to sleep on a wet tile floor with no mattress or covering but a piece of rubber sheeting? Only seeing is believing such things.)


Incidents similar to those reported in the first chapters of this book occur in every hospital in every state. They are not rare, unusual occurrences -- they happen daily. There is no mental hospital in the country that lives up to its possibilities, that stands in need of no improvements or changes.


An important corollary of this fact is that there is no hospital that is all bad, that has no redeeming features. Some hospitals are blessed with active and progressive medical staffs, but are hamstrung by "economy-conscious" politicians, or incompetent nurses and attendants. Others are equipped for all the latest therapies and treatment methods, but are burdened with unconcerned doctors or inadequate buildings. In some hospitals, the admission wards are consistently conducted on a high level, but the continued treatment wards grovel in degradation.


These variations exist in practically all hospitals. You may have noticed that there were usually redeeming factors in the incidents and cases in this book. There are always redeeming factors in every hospital. The proof of this is that our state mental hospitals discharge, as recovered or improved, thousands of patients every year. For this reason, at the same time that you acknowledge that conditions are intolerable and must be changed, you must also acknowledge the good work of the hospitals. You must encourage people in need of psychiatric treatment to seek it through early admission to a hospital.


The patient who is admitted to the hospital before his disturbance becomes chronic and ingrained is almost certain to find help. Doctors, nurses and attendants rally to the opportunity of cure; the best conditions and the best personnel gravitate to the patient with a chance. The redeeming features, even in the worst mental hospital, often make it a much more healthy place for the mentally ill than can be found elsewhere -- at home, in a "nursing home," or in a general hospital not equipped to care for mental patients.


This fact does not in any way deny that the conditions of which we have been speaking are representative of mental hospitals generally. The redeeming features, the shafts of light in the general darkness, are only the exceptions which prove the rules. They support the thesis that the conditions herein pictured are generally true, and representative of all hospitals everywhere, by proving that they are not universally true. The conclusion is undeniable; these conditions are representative.

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