MENTAL HOSPITALS
SIR,-1 would like to be allowed to comment on Pharos's notes (of January 24) about mental de- ficiency hospitals. As a member of the public and of a well-known social service organisation, I have Made it my business over many years to know about some of these hospitals and their patients.
I think the talk about illegal detention is thread- bare, and the well-being of some of the patients who have been 'released' through public clamour is open to grave doubts. There is nothing to prevent any patient being discharged into the care of near relatives if they can offer a good home and kindly supervision. But hospitals are very properly reluctant to send a patient out into what may only too prob- ably be cruel and hostile conditions.
I do not believe that it is possible for a 'perfectly sane, and intelligent young man' to be 'trapped' in such a hospital. The conditions for entry are strictly
controlled, the pressure of demand for places is high, medical superintendents, nursing and teaching staffs are for the most part highly trained and devoted and are most unlikely to squander their skill and care on people who do not need them. There is also a system of regular investigation and examination of all patients by a Visiting Committee.
There is urgent need for a more liberal attitude to so-called mentally deficient people, for better hos- pitals, better food therein, more day and boarding schools and hostels, but I do not think any good is achieved by shrill and melodramatic outcries.
The popular idea of the mentally deficient person as a threat to the community who must be kept behind locked doors is quite false. In fact, he is usually a simple soul, always a pathetic one, and there are few locked doors in a good mental de- ficiency hospital. The gates stand wide open. (I be- lieve that Rampton Institution is not typical, being by repute a place of detention for people of weak mind who have fallen into wrongdoing.)
It is a pity that, the terms 'mental illness' and `mental deficiency' have become bracketed together. They are distinct and unconnected conditions. Mental illness is a disease or disorder of the mind. Mental deficiency is a failure in development of the embryo, resulting in a failure of the child to grow and mature. It is a disability, ranging from very slight to very severe, not a disease. The first step towards the im- provement of the lot of the mentally deficient person would be the abolition of this term, which has be- come almost a term of abuse, and the substitution of something more accurate, perhaps 'glandular de- ficiency' or 'impaired development' —and no deroga- tory initials. Finally, against the picture of harsh gaolers confining innocent people to a sort of prison, I would like to write of the thousands of doctors, nurses and teachers who have given, or are giving, a lifetime of service and love to those who are the most helpless and vulnerable, and often the most lovable, among us.—Yours faithfully, [Pharos writes : 'If Mrs. Marshall reads the biography of Peter Whitehead to which I was re- ferring, she will see how a 'perfectly sane and intelligent young man' was 'trapped,' and how im- potent Visiting Committees are in detecting such cases. I agree with her that the main trouble is a failure to differentiate between mental deficiency and mental illness; people who are immature in the sense she mentions are treated in the same way (and in the same institution) as psychopaths. But the fact that such institutions exist is itself an indication of the need for reform.'—Editor, Spectator.]
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