MENTAL PATIENTS' LOT LETTERS TO THE EDITOR [Correspondents are requested
to keep their letters as brief as is reasonably possible. The most suitable length is that of one of our " News of the Week" paragraphs. Signed letters are given a preference over those bearing a pseudonym, and the latter must be accompanied by the name and address of the author, which will be treated as confidential.—Ed. Tim SPECTATOR.] [To the Editor of Tim SPECTATOR.] SIR,—The Board of Control's current Report, Part II, gives account of some useful medical research and treatment, together with the deplorable conditions which make them ineffectual. Beside the usual complaints of inattention to the Act of 1930, of cold plates and unvaried diet, of nightshirts in common, of women's antiquated underclothing, of the promiscuous use of brushes to scrub food tables, floors and lavatories (especially where dysentery is endemic), of the mixture of fouled with ordinary linen (which results in garments returning boiled beyond recognition but still brown), there are notes of origin- ality. One Commissioner was sharp enough to discover " small " black beetles in a kitchen, and one investigated a " slight " black eye. One suggested ecclesiastical hangings would be more appropriate than coat hangers in the mortuary viewing-room, and another thought the medical officers' billiard room hardly suitable for Roman Catholic services. One discovered that 67 women at Wakefield slept on mattresses on the floor and were apt to step on each other in the night. One commended a Superintendent for attending lectures on mental treatment and another ventured that slippery floors do not always account for broken wrists. In a large licensed house the absence of broken bones is noted as showing a high level of nursing care, although fractures apparently result always from accidental falls or altercations with other patients.
Overcrowding still occurs in nearly every hospital. At Denbigh there are 212 too many beds, at Sunderland (a small hospital) 183. At Derby, Severalls, Rainhill, Burntwood, Cheddleton, there are more than 150 extra beds. Overcrowding of day-space is sometimes greater and amounts to 293 at Burntwood, 264 at Cheddleton, 273 at Upton, Chester, 244 at Durham, 217 at Severalls, 215 at Chartham, 557 at Rainhill. In most places building is in progress to overtake the deficiency, and many beds are unsuitably occupied by defective children who ought to be elsewhere.
Associated with overcrowding is inadequate sanitation. At Denbigh there are three W.C.'s and three basins for 83 diffi- cult patients, at Derby two W.C.'s for two whole wards, at Northampton five for 130 patients, at Colney Hatch three for 50-6o. At Colney Hatch, too, one room was used as a bath- room, bootroom, W.C., place for cleaning dirty patients, store- room for dirty linen and toothbrushes. Very commonly no hot water is laid on to the basins for the use of patients or staff, and
nurses sometimes have no separate bathrooms. - Half a sick ward may have to be used as a day-room. T.B. cases cannot always be isolated—or are isolated with the dysenteric and debilitated patients, who are most prone to catch infection. Inadequate ventilation increases the incidence. However, one hospital is giving its T.B. patients butter instead of margarine.
The Board hopefully recommends " leisurely interviews " as most important in treatment. But it finds in most places
that each doctor has care of about 400. (At Denbigh each has 600 to 700 patients.) In Northumberland, lack of laboratory prevents treatment of malaria or study of the cause of dysen- teric outbreaks. Without X-ray appliances, also, T.B. and fractures are not always detected. At Devon, patients under- going narcosis treatment have nowhere to sleep in peace.—
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