The insane Improved methods of treatment. Provision for a comprehensive inquiry as to the best methods of treatment has been made by Pennsylvania ['01 ch. 36]. Three senators and four members of the House are appointed a commission to inquire into the exact condition of the insane now confined in state institutions, and as to the policy and effect of the present practice of removing them to the different county institutions. Also to inquire into the most modern methods of treatment in reputable institutions of other states, and to obtain the official views of experienced superintendents, physicians and officers as to any improved methods of government or economy. This commission is to report at least one month prior to the meeting of the next Legislature. Separate provision for chronic insane. Indiana ['01 ch. 195] provides that counties having a population of 150,000 or more may establish asylums for the chronic insane. These institutions shall be governed by the counties, and the county council shall make all appropriations for buildings and maintenance. It is made the duty of the sheriff of the counties establishing such county hospitals, to transfer thereto all pauper insane who are regarded as incurable, whether in the state hospitals for the insane or any other place. No provision seems to have been made by this law for supervision on the part of any state board. Transfer as a curative measure. Maine ['01 ch.235] authorizes the trustees of the insane hospitals to transfer from one insane hospital to another, any patients who are now or may hereafter be committed to any state hospital, whenever, in their judgment, the welfare of the patients will be promoted thereby. The expense of such transfer falls upon the person or municipality liable for the board of such patient, or, if the patient be public, this charge is to be paid out of the appropriation for insane state beneficiaries. Liability for support. New Jersey ['01 ch.186] provides for securing reimbursement from the estate of individuals and from legally liable relatives, for outlay incurred for maintenance in a state hospital. It is also provided where the insane person committed to the hospital did not, prior to such commitment, obtain a settlement in any one county of the state, the cost of The insane his maintenance shall fall upon the state at large. South Dakota ['01 ch.92] has provided that counties from which insane persons are committed to the state hospital, and which allege that such persons have not obtained a legal residence in such county, are authorized to file with the state auditor proofs of such nonresidence, and if the state auditor shall find that such patient is not a proper charge against any county in the state, such patient shall thereafter be regarded as a proper charge against the state at large. Commitment, discharge and restoration to capacity. Vermont ['00 ch.47, 48] has amended its law regulating the commitment to and discharge from institutions for the insane. The trustees of the Vermont hospital are authorized to prepare, at the expense of the state, blank forms of commitment to that institution, and to the Brattleboro Retreat, and these are to be supplied to the several county judges, and only such forms are hereafter to be used. The supervisors may conditionally discharge from any asylum or hospital such persons as in their judgment may safely and properly be cared for in the place from whence they were committed, and such discharge shall become final at the expiration of 60 days. But the supervisors may revoke this order within 60 days, and this shall authorize the recommitment of the person to the asylum or hospital. Indiana ['01 ch.129] has provided a more perfect form of medical certificate of commitment and requires the findings of the medical examiner and justice of the peace to be filed with the clerk of the Circuit Court. The necessity of periodical examination to determine by outside authority the mental status of inmates of institutions for the insane is recognized by Wisconsin ['01 ch.163], which provides that either personally or through his guardian any inmate of an institution for the insane may petition any Court of Record for a retrial of his mental condition. Should no jury trial be demanded the State Board of Control is to act as a commission in lunacy. The act does not apply to the criminal insane. Wisconsin ['01 ch.77] also provides that superintendents of hospitals may require the return of a paroled lunatic The insane at any time within two years of the date of issuing such parole, unless the patient has been formally discharged by the court from his original commitment. Unless such return is ordered within two years the jurisdiction of the hospital shall be regarded as at an end. Inquiry into the capacity of persons adjudged insane and who desire to regain control of their estates is provided for by North Carolina ['01 ch.191], California ['01 ch.121] and Wisconsin ['01 ch. 15]. The statute of North Carolina provides that the Superior Court may, by order, appoint a jury of six freeholders to inquire into the sanity of any person whose sanity is questioned, for the purpose of determining whether such person has become of sound mind and memory, and if so found, he shall be authorized to manage, sell and control his property. The California statute provides that persons properly committed to state hospitals and who are absent on parole from the institution, or who have been discharged therefrom, may be restored to legal capacity upon application to the medical superintendent of the hospital, who may require such proof as he may reasonably deem necessary to determine whether or not such person is sane, including the presence of the patient at the hospital. If satisfied as to the person's sanity, the superintendent shall issue a certificate that such person is sane, recovered and restored to health, and shall forward a copy of the certificate to the commission in lunacy. If the superintendent is unwilling to make such certificate, application can be made by the patient or his friends to the Superior Court of the county where such person resides, or the question of the sanity of a person may be tried by a jury as in civil cases; in the latter event, the case against the insane person shall be represented by the district attorney of the county. If three fourths of the jury fail to declare said person insane, or the court and jury find him to be sane, proceedings shall be dismissed and no new application to declare said person insane shall be made for six months thereafter. Similar proceeding is to be followed in the case of a person adjudged to be insane, but not committed to a hospital. Before any of the proceedings are had, the person demanding a certificate shall make a deposit or give a bond guarantying the payment of the cost The insane of such trial. Wisconsin ['01 ch.15] provides that " on a proper showing" to the county court a previously adjudged incompetent may be adjudged competent. State care of insane. Pennsylvania ['01 ch.340] appropriates $1,700,000 for the state care of the indigent insane, for the two years beginning June 1, 1901. It is made the duty of the secretary of the Board of Charities to certify to the correctness of all accounts rendered by counties maintaining their insane, before any financial assistance is extended by the state. Directors or managers of state hospitals must also submit statements under oath to the auditor general, showing the actual number of indigent persons receiving maintenance during each quarter. State Board of Control. Following the lead of Iowa and Wisconsin, Minnesota ['01 ch.122] has established a State Board of Control. This board is to fix salaries of officers and employees, award contracts and have general management and control of all state institutions, including prisons, normal schools, reformatories and hospitals for insane. The boards of managers now in control of these institutions, excepting normal schools, are legislated out of office. Requisitions for supplies must be approved by the board before purchases can be made. Plans for buildings and improvements must also be approved by the board. The board also keeps a complete record of all persons admitted to or discharged from the institutions. The salaries of the members of the Board of Control are $3500 each. Inspection of state institutions. North Carolina ['01 ch. 424] has established a board of three inspectors of state institutions, who are to examine into the condition of public institutions every two years and report to the Assembly the requirements of these institutions; they are also directed to examine thoroughly into the internal management of institutions, and summon witnesses, etc., as may be necessary. The board must give no notice of impending visits. Each inspector receives $4 a day and expenses. The term of office is two Investigation of public institutions is also provided years. Feebleminded and epileptic for by Wisconsin ['01 ch.403]. The governor is authorized to appoint any suitable person to make an investigation of any institution or of the conduct of any employee in such institution. FEEBLE-MINDED AND EPILEPTIC1 J. C. CARSON M.D. SUPERINTENDENT SYRACUSE STATE INSTITUTION More than 50 years have elapsed since New York and Massachusetts began the training and education of the feeble-minded; Massachusetts, in 1848, by a small appropriation for the support and education of a few feeble-minded children at the school for the blind, and New York, in 1851 [ch. 502], by the establishment of the New York state asylum for idiots, more recently named the Syracuse state institution for feeble-minded children ['91 ch.51]. Following the lead of New York and Massachusetts, about 20 other states have in some manner provided for their feeble-minded. During all this period New Hampshire has made no provision for the feeble-minded, except for a few annually at the State school for feeble-minded in Massachusetts. In 1901, however, a decided step forward was taken in New Hampshire by an act ['01 ch.102] providing for the establishment and maintenance of a school for the care and education of the idiotic and feebleminded. This act creates a board of 5 trustees, 1 of whom shall be a woman; the governor, who is required to visit and inspect the school annually, is made a trustee ex officio. The law appropriates $30,000 for the purpose of purchasing a suitable site for the school and for erecting thereon appropriate buildings. To this school only feeble-minded children between 3 and 21 years shall be admitted. No provision seems to have been made in the law for the care and maintenance of custodial cases. This feature is further emphasized by the fact that pupils are not to be retained after reaching the age of 21. Pupils may be admitted at either public or private expense; those at public expense are made a charge upon the cities or towns 1 See also Comparative Summary and Index, 1901, no. 4139–47. |