The Progress of Mental Hospitals. II

The transfer of control of mental institutions from local authorities to Regional Hospital Boards has, in most areas, been carried out with little difficulty or friction. In the majority of cases mental hospitals and M.D. institutions of 1,000 beds or more have been given Management Committees of their own, the personnel of which has been drawn from a wide field and in many cases includes a satisfactory medical representative, bringing in a considerable amount of new interest. Where the medical superintendent is himself a member of the Hospital Management Committee his right is ensured to be present at all deliberations concerning his hospital. There are other cases, I think unfortunately, in which even quite large mental hospitals or M.D. institutions are grouped with non-psychiatric hospitals and are under House Committees with Very limited powers (and these in some cases grudgingly granted) which involves difficulty in working with duplication of officials, some of whom can have a very limited knowledge of the sPecial needs of a mental hospital, resulting in a general feeling of frustration on the part of the medical superintendent and others concerned. Whatever may be possible or desirable m the future I am quite sure that the administratlQn of a large mental institution in the present Period of settling down under the Act must be more efficient under a Management Committee ?f its own. I would like to make it clear that this opinion is most certainly not aimed at keeping psychiatric hospitals isolated in their Work. There are many effective ways of integra1Qn given co-operation and goodwill. Among new factors which have arisen is the appointment of regional psychiatrists whose task it is 0 promote psychiatric developments in the |"egion, to keep in close touch with all mental nealth activities in the region, to co-operate all medical superintendents of mental Institutions and to act as advisers if called upon but , in no way to interfere with day-to-day hospital management. It is also looked upon as important that a regional psychiatrist should continue to do some clinical work, e.g. outpatients. I cannot but think that such appointments have been and will continue to be of great enefit to the mental health service throughout the country and that where such appointments have not been made, a valuable opportunity has been missed of furthering the cause of psychiatry and its service to the public in the area, for of the need of thorough co-ordination of all branches of the specialty in each region I have