ASYLUM REFORM.
[To the Editor of the SPECTATOR.]
Sia,—Amid the outcry for reform of the lunacy laws, the suggestion is made that if only the English laws could be modelled on those of Scotland, that would be progress indeed. It is true that the Scottish laws are better than the English ones, but they are even older, being based on an Act of 1866 --whereas we in England are using those of 1890 and 1891.
At least it is possible in Scotland, if a member of the great middle class has a mental breakdown and only about £3 a week can be afforded for his keep, to have a private bedroom and not to be herded in a ward with thirty or forty others in a rate-aided institution. In a private asylum in England a patient must pay at least £6 6s. a week for a room to himself, however small ; while very few amenities of his usual station in life are available under about £10 10s. a week, and if he has a horror of sharing the public sitting-rooms, the charge goes up to nearly £1,000 a year or so. You can pay up to £1,500 a year if you choose, both in England and Scotland alike, the main difference being that whereas in England the private asylum is run as a business enterprise for the Medical Superintendent's private profit, though registered and subject, of course, to Board of Control regulations ; in Scotland all the private asylums save one (that of New Saughton) are part of the public or royal asylums, and the same Medical Superintendent presides over both, though they may be a mile apart.
For this he receives a salary, and is therefore not financially
dependent on keeping the private portion of his asylum full of patients, as the English doctor is. A generation or so ago unscrupulous medicoes in this country actually used to get commissions from private asylum doctors for supplying them with patients !
Professor Sir George Robertson is the Physician-Super-
intendent in charge of Edinburgh Royal Asylum, and Morn- ingside, the private part of it, is one of the best known models of what such an institution should be. Alienists in almost every land have heard of it, and seek to emulate it. Professor Robertson believes in giving the maximum of freedom and the minimum of coercion. Morningside is an open-door institution. In it there are dukes, marquesses, and women aaembers of the Scottish nobility. When I visited it, its lodge gates were open wide, and there was no one to direct me. Up the drive I walked, seeing patients at their airing and being pursued by one of them, a perfect stranger, who yet shouted after me my Christian name ! " Hullo, — t" she cried repeatedly. It was only my second visit to a similar spot and never before have I so much desired to run
Arrived at the central building, even the hall door stood wide open, and a doctor and the woman superintendent took me round. I was told that the slightest harsh touch
on a patient meant dismissal for a nurse (they are all women nurses at Morningside, by the way), yet, as I walked down that drive, I heard a woman screaming and saw her knees dragging along the ground while two young uniformed women impelled her forward. Everything else I saw there was excellent, and but for this incident I was favourably impressed, save that even at Morningside it is not possible to get a private bedroom for less than £4 4s. a week,- and it is not permanently available even for that,
Professor Sir George Robertson and other eminent Scottish alienists are continually decrying the absurdity of the Scottish lunacy laws which make preventive work impossible except in comparatively few cases of rich voluntary patients. Nothing short of a Royal Commission will runedy matters, but meanwhile those who are distressed by the hard cases of mentally broken ex-Service men in the asylums- can sub- scribe to the funds of the Ex-Services Welfare Society which is opening homes for them where they will at least be free from the asylum stigma and harsh rules.—I am, Sir, &c., RAY Mum.
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