The care and treatment of the insane poor, with special reference to the insane in private dwellings / by Arthur Mitchell, M.A.

  • Mitchell, Arthur, Sir, 1826-1909.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: The care and treatment of the insane poor, with special reference to the insane in private dwellings / by Arthur Mitchell, M.A. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    at home, for whom a comfortable and safe provision can be found there, and whom asylums cannot benefit, should be left at home or should be sent there, whether their proportion to the whole number of the pauper insane be 10, or 15, or 20 per cent. And in practice it will always be found that the percentage is one thing in one country and another in another; one thing even in one parish and another in another; and such differences will be proper ones, arising sometimes from accidental causes, and sometimes from causes of more fixity or permanence, such, for instance, as may be involved in the habits or in the circumstances of the people. I have before me the published report of a country parish, liable for the maintenance of 18 lunatics, who are as 1 to 232 of the population. Of these patients 9 are in asylums and 9 in private dwellings, that is, 50 instead of 15 per cent. A variety of circum- stances combine to bring this about and to make things possible in that parish which are impossible in others almost adjoining.1 For example, 9 of the 18 patients happen to be suitable; relatives and friends of the patients, with comfortable homes, are found willing to be guardians; the Parochial Board takes a liberal view of its obligations in these cases; the medical officer and inspector of the poor are interested in making arrangements to satisfy the Board of Lunacy; and the circumstances and occupations of the people of the parish are favourable. All these and other things combine to give the result I have stated, but if any one or two. of them were changed, we should immediately have a different result, reducing the proportion, perhaps, even below 15 per cent. This same parish furnishes in another way an illustration of how widely the operation of the system may be influenced by local and other causes. One of the nine patients left at home was at first regarded as of doutful suitability, but a well-considered and liberal arrangement for her comfort and safety was made by the parish, and for many years she has done well. In other words, the very range of suitability seems capable of being widened by good man- agement. As yet, indeed, we know little of the extent to which the system may and should be worked; 15 per cent, may be found generally too high, while, on the other hand, it may be found safe to go as far as 30 per cent., or beyond it. Very much will depend on the spirit and way in which the trial is made. Where failure is desired there will not be much chance of success. It will be very easy, indeed, to secure failure, if that is wanted, for even the most earnest and honest desire after good results will assuredly encounter at the outset a multitude of difficulties and discouragements, which will neither soon nor easily be removed. Hitherto in no country has a full and fair trial been made. More, however, has been done in Scotland than anywhere else, though the difficulties and hindrances 1 In the very next parish, out of five patients in private dwellings, four were removed by the Board to an asylum.