[To the Editor of THE SPECTATOR.] Sta,—The letter of "Expertus
" certainly does not exaggerate the conditions in some of the licensed houses for mental patients. The monopoly for keeping certified patients was, in some cases, acquired a hundred years ago, and methods of treatment and interior decoration often seem equally antiquated. The Royal Commission advocated in 5924 that these houses should either be abolished or their numbers increased to do away with the monopoly. Neither course has been followed.
Only the metropolitan licensed houses are inspected six times yearly by the Commissioners, as "Expertus " suggests. The provincial ones get two visits, and four from the licensing justices, who walk through as quickly as possible, averting their eyes. A patient who wishes to write a complaint has great difficulty in obtaining their names from the authorities.
Reports on rate-aided institutions, if shocking, are at least candid and thorough. But those on licensed houses briefly remark that the patients seemed comfortable. No particulars of food, occupation, number of X-ray examinations, post-mortems, malarial or psycho-therapy, prolonged immersion baths, violet ray or narcosis treatment are ever given, since few remedial methods are ever used. We are seldom told how many —if any—of the nursing staff are fully qualified, or given individual discharge or death-rates. The general death-rate is higher in private than in public institutions.—I am, Sir, &c., T. POOLER.
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