Annual report of the Board of Control : 12th, 1925.

Date:
1925
Catalogue details

Licence: In copyright

Credit: Annual report of the Board of Control : 12th, 1925. Source: Wellcome Collection.

    60/482 (page 50)
    (4) That the patient’s death was due to natural causes and was not in any way affected by the administration of drugs or any other influence suggested at the Inquiry. Out-Patient Treatment of Mental Cases. Reference was made to this subject at some length in our Ninth Annual Report, and it is with satisfaction we can record some progress in the provision of arrangements for out-patient treatment. Although it is realized that either an unwillingness or a real inability on the part of patients to recognize the presence of mental illness often constitutes a serious obstacle to early treatment, the fact that many patients do recognize the nature of their symptoms and are eager for treatment are encouragements to undertake work in this direction. For a number of years we have lost no favourable opportunity in directing attention to this matter, but it is only in a com¬ paratively few areas that the subject has received practical attention. Out-patient Treatment at Mental Hospitals.—So far as we have knowledge, the earliest attempt in this country to provide out-patient treatment for mental cases at Mental Hospitals was made at the instigation of Professor Bevan-Lewis when, in 1890, while Medical Director of the West Riding Mental Hospital at Wakefield, he and his colleagues arranged to see out-patients in a room at the entrance of the hospital. This service has been steadily maintained; cases are seen twice weekly; and, during 1925, 61 male and 82 female patients were treated. In former years, many of those attending were cases of epilepsy or persons who had previously received treatment in the hospital as in-patients, but we understand that latterly there has been a remarkable increase in the number of borderland and early mental cases. Professor Shaw Bolton feels that the usefulness of the department is considerably curtailed by the existing legal inability to take into the hospital as voluntary boarders certain of these cases who are in need of fuller observation. Similar out-patient departments were established soon after at the other West Riding institutions, viz. : Wadsley, Menston and Scalebor Park; and the work has never been relinquished. At Scalebor Park, where the number of fresh cases, and especially of adolescents, is increasing, a considerable proportion recover without resort to certification. It is instructive to learn from Dr. Gilmour that in the course of this out-patient treatment, patients appear to lose “ asylum fear ” and, if in-patient treat¬ ment is advised, they would be willing to enter the Mental Hospital as voluntary boarders. As public mental hospitals are not empowered to receive patients without certification, patients can only obtain in-patient treatment on a voluntary looting in some registered hospital or licensed house and this entails dislocation in the continuity of treatment.