CONDITIONS IN MENTAL HOSPITALS [To the Editor of THE SPECTATOR.]
SIR,—AS a "Visiting Justice" (Magistrate) under the Lunacy' Act, 1890, for many years past, I have been interested in the correspondence on this subject. More especially have I been interested in the letter signed " Expertus " owing to my intimate official connexion with at least one private mental institution (in this case a hall), and my sense of justice does not permit me to pass by unanswered some at least of the damning allegations made by this correspondent in respect of private mental institutions generally.
The private mental institution which I visit officially several times a year (I wish I could name it) has very deservedly and consistently Merited and received most excellent reports from my colleagues on their quarterly, unannounced visitr and from the three or four separate Commissioners of the Board of Control on their biennial and previously unannounced visits of inspection. Unless my experience and the reports of my colleagues and these Commissioners on the management and work done at this hospital in no way apply to other similar institutions, this really vicious attack made by " Expertus " on private mental institutions generally would seem to show a singular want of personal inside experience and a callous disregard for the feelings of your readers who may have relatives under treatment in such institutions, and is a libel on their owners, medical and nursing staff. Presuming that " Expertus " has such personal knowledge of some private mental institutions that warrant him in making such allegations he should certainly make it his business to bring his facts to the notice of the authorities concerned. My complaint is that he should tar all private mental institutions with the same brush.
He commences his diatribe by an allegation that because private mental institutions are admittedly run for profit, therefore their owners' first care is not for those who commit themselves or are committed to their care, but the making of money. Such an allegation applied to the owners of the institution I have in mind is merely ridiculous and wholly untrue. (I am not one of the owners.) Setting aside the inhumanity on the part of the owners that such an allegation suggests, does it not strike " Expertus " as a very poor business proposition to neglect "the Goose that lays the Golden Eggs " ? One can conceive the owners of such an institution as has possibly, by such bad management, got into low water, being obliged to cut expenses, merely to make ends meet (not to make profit) to such an extent as to interfere with the welfare and amenities of their patients. If and where such astute of things exists and it cannot very well escape the notice of Commissioners and magistrates, I entirely agree that such an institution should be closed or pps into other hands.
Another o. your cprrespondents signing himself " Black- burnian " in a letter dated April 23rd makes the astonishing and sweeping statement that "Private Mental : Homes usually discourage relatives' visits, and even if. they come they seldom get further than the visitors' room." Here again quite apart from the humanitarian point of view and the sugges- tion that the owners have something to hide, is such a policy likely to inspire confidence ? Is it businesslike ? At the private institution I am speaking of, visitors are welcomed at almost any time, and except when the patients' welfare entirely forbids it, they see their friends, in the visitors'rooms, in the gardens, or if the patient is unfit for this, in the wards, or dormitory. They were at one time given tea with the patient free of cost, but this was so much abused, parties of three, four and five coming frequently and staying for tea in the visitors' room or gardens, that a small charge had to be made. " Expertus " tells us that no new private mental institution should be licensed. Am I not right in saying that none have been licensed since 189o, nearly fifty years ago ?
He goes-on to say that all existing ones should be closed as soon as possible. Judging from my own observations in regard to the particular institution I have in mind, such hospitals if properly run are wanted, and until all public insti- tutions are able to cater for mental patients of all classes, and this will not be for some years to come, will continue to be wanted. If any exist that are not properly run, or which compare unfavourably with public institutions, they should be closed or the owners compelled to bring them up to date. This is in the hands of the Board of Control and the Visiting Magistrates and through them the Licensing Authority. These Inspectorates, The Board of Control Commissioners and the Visiting Justices—the latter accompanied by a medical and legal specialist—write reports six times a year, these reports are before the Licensing Authority every time an application for renewal of licence is made, and it is then up to the Authority as to whether that renewal is granted or refused. These inspectors on their visits see every patient, grant private interviews to any that request one. They go very thoroughly over every part of the institution, sitting rooms, bedrooms, kitchens (see the food being served) bathrooms and lavatories. They take note and report on the condition of these, of the state of the furniture and decorations. They note the number and qualifications of the nursing staff, everything in fact that the Licensing Authority requires to know when the merits or otherwise of such an institution for the renewal of licence comes before them. If the allegations made by " Expertus " are true of any existing private institution, the blame for their continuance rests with the Licensing Authority, on the reports put before them by the Commissioners and Visiting Justices. So far as the private institution in which I am officially interested is concerned, the reports on its work and management are in every way excellent, and entirely refute the allegations put forward by "Expertus " against private mental institutions in
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