NOTES AND COMMENTS

NATIONAL COMMITTEE FOR MENTAL HYGIENEGEORGE S. STEVENSON, M.D.,

Medical Director

On April IS, 1939, Dr. George S. Stevenson, now and for years past an officer of thisorganization, became Medical Director of the National Committee for Mental Hygiene.Those who attended the February meeting will recall that Mr. Beers announced that Dr.Hincks was retiring as Medical Director in order to devote more time to the CanadianNational Committee, continuing in the capacity of consultant to our National Committee.At the same time Mr. Beers announced that Mr. Bullis was retiring to enter privatebusiness.

It is a pleasure to record the appointment of Dr. Stevenson to this position. By virtueof training, experience, ability and interest, he is without doubt the outstanding choicefor the position. (Cf. THE JOURNAL, Vol. IX, No. I, p. 251 for his biographical sketch as apast President.)

This position as Director of the National Committee is one of the most importantand yet one of the most difficult in the psychiatric field in this country. In the 30 years ofits history the National Committee, under eminent and capable Medical Directors, hasinitiated or carried through tremendously important projects for the improvement ofmental hospital service, the development of preventive work, especially through the childguidance clinics, in research, and in the general field of carrying mental hygiene andpsychiatry into the education of physicians, social workers, teachers and other professionalgroups. Yet at no time has the National Committee had a stabilized budget over a periodof years. An admirable start had been made toward this through the establishment byMr. Beers of the American Foundation for Mental Hygiene. The depression, however,slowed this up very considerably, but the Committee has continued to secure the supportof the state hospital groups as well as the financial interest of many foundations andindividuals. Times grow increasingly parlous for organizations of national or local scopewhich are dependent for support upon gifts of foundations and individuals. (Cf. noteelsewhere in this number on "Mental Hygiene as a Field for Philanthropy.") Recognizingthis and recognizing also that demands for service upon the National Committee haveincreased by leaps and bounds during the past 10 years, it behooves all members of thisorganization to express their good will toward Dr. Stevenson and the National Com­mittee by giving him every bit of support of which we are capable.

Congratulations and best wishes to Dr. Stevenson and the National Committee.

1940 MEETING

The President has announced the following Committees for the 1940 meeting.

COMMITTEE ON ARRANGEMENTS: Chairman: Frederick Rosenheim, M.D., 38~ Beacon St.,Boston, Mass.; Annette Garrett; Louise Wood; Frederick L. Wells, Ph.D.; Henry B.Elkind, M.D.

PROGRAM COMMITTEE: Chairman: David M. Levy, M.D., 136 E. 57th St., New York;George S. Stevenson, M.D.; Simon S. Tulchin.

AUDITING COMMITTEE: William C. Menninger, M.D., Menninger Clinic, Topeka, Kan.;Fern Lowry; William C. Ferguson, M.D.

COMMITTEE ON NOMINATIONS: Chairman: to be appointed; Martha MacDonald, M.D.;Bradford J. Murphey, M.D.

TIME AND PLACE COMMITTEE: Chairman: John C. Thurrott, M.D., 965 Fifth Ave., NewYork; Hyman Lippman, M.D. Charles Bradley, M.D.

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RESOLUTIONS COMMITTEE: Chairman: Spafford Ackerly, M.D., 610 So. Floyd St., Louis­ville, Ky.; Manly B. Root, M.D.; to be appointed.

PUBLICITY COMMITTEE: Chairman: Lauretta Bender, M.D., 324 E. 41st St., New York;Helen P. Langner, M.D.; Edward Liss, M.D.; David Shakow.All members desiring to present papers, arrange for round tables and those who have

suggestions regarding topics for the 1940 meeting, are urged to communicate with theChairman of the Program Committee at once.

CONCERNING INTELLIGENCE QUOTIENTS

..... One cannot assume with a reasonable degree of logic and success that a highOtis score presupposes an equally high Terman mental age. It may be true and veryoften is so. But one does not necessarily follow from the other any more than a grade of90 in sewing follows logically or educationally from a grade of 90 in cooking ... "

"In summarizing the above, let me emphasize the fact that from no other scale exceptthe Terman individual examination-a new revision of which is now available-can anIQ be derived because from no other is an actual mental age determined. And secondly,that conclusions which hold true for thousands of persons cannot be assumed as true foreach individual member of that group. Lastly, I do not wish to convey the impressionthat the Terman results are the final and irrevocable criterion of a child's intellectualequipment. There are errors to be eliminated and defects inherent in the tests to becorrected. But, to date, they are the most accurate, the most reliable, and the most validmeasure of general mental capacity which is available."

A. CAROLINE SCHMEHL,Mental Hygiene News, May 1939.

BUDGET REDUCTIONS IN NEW YORK STATE

On April I, 1939, there were 94,824 insane, feeble-minded and epileptic patients in thecare of New York State institutions; an increase of 2°78 from July I, 1938. State CharitiesAid Association estimates that there will be an increase of 2000 to 2500 patients in thenext fiscal year. The Governor has submitted a budget for 193~1940, for the StateDepartment of Mental Hygiene, of $35,656,587, which was $1,213,000 less than in thecurrent year. The Legislature thereupon further reduced the Governor's budget by$1,564,14°. The S.C.A.A. News states, "The per capita cost in these institutions is nowabout one dollar a day. The cost for food is six cents per meal, the amount allowed forfood per patient in the Governor's budget is below this and less than at any time in thepast ten years. The allowance for fuel is lower than for the amount required on the basisof present prices. The fixed administrative expenses cannot be reduced. Even with themost drastic economy, it seems to us doubtful whether the institutions can be maintainedon the amount allowed on the Governor's budget. Further reduction of $I,564,I10 canbe made only by reducing the number of ward personnel.

"There are already numerous vacancies in the staffs of mental hygiene institutionswhich cannot he filled under the Governor's proposed budget. At the present time oneattendant is left in charge of from 25 to 100 patients in these state institutions. Entirelyapart from the treatment of patients, there is a serious question as to whether the presentamount of staff is sufficient to maintain safety and order in these institutions." It isestimated that the additional cut on the part of the Legislature will necessitate reductionof some 160:> in the number of ward attendants and nurses.

We expect to see this problem cropping up in every state. For one thing, the care ofthese classes of public charges always assumes a very large place instate budgets, rangingfrom 10 to 25 per cent. Being the most helpless and, in general, the most inarticulate statewards, the budget for their care often seems to offer a safe place for cutting. Every cutin budget results in decreased adequacy of treatment which in turn means increasedretention of patients in the hospitals, thereby increasing the economic burden on the onehand and misery of the patients on the other.

NOTES AND COMMENTS 665

We are reminded of an editorial we wrote some years ago on the necessity for examin­ing our own work to make sure that it was conducted in the best possible fashion. Theindications are that, for years to come, those responsible for the public care of the men­tally disordered classes will need to examine with great care their procedures to be surethat they are getting the greatest possible return for the least possible amount of money.So far as we can see we are in for a long period of belt-tightening in the face of drying upsources of revenue and increased expenditures for super-luxuries which have come, or arefast coming, to be regarded by society in general as necessities.

CHANGES AT WORCESTER (MASS.) STATE HOSPITAL

Superintendent Bryan announces that Dr. Robert Penn Kemble assumed charge ofthe Child Guidance Clinic operated by the Worcester State Hospital, on May I, 1939.

Dr. Kemble is 33 years of age; married; has an A.B. from Princeton; B.S., Susque­hanna; M.D., Jefferson Medical College, 1933; Diplomate of the National Board ofMedical Examiners. Interned in the Pennsylvania Hospital for Mental and NervousDiseases and at the Payne Whitney Psychiatric Clinic. He was a Fellow at the Phila­delphia Child Guidance Clinic and then a member of the staff of the Clinic.

Dr. William Malamud of the University of Iowa will assume the Clinical Directorshipof the Hospital on July I, 1939.

Born in Rumania in 1896, he received his M.D. from McGill University, 1921;interned at Montreal General and Royal Victoria Hospitals; medical interne at BostonPsychopathic Hospital July 1921 to September 1922; Junior Assistant Physician at Fox­borough State Hospital, September 1922 to May 1923. Then one year as resident neurolo­gist at Mount Sinai and a year abroad, covering neuropathology at Hamburg University,psychology under Prof. William Stern, psychoanalysis with Prof. Paul Schilder in Vienna,individual psychology with Dr. Alfred Adler, neurology at Heidelberg University, psy­chiatric work with Prof. Bleuler at Zurich, and a clinical clerkship with Dr. Holmes atQueens Square Hospital. From July 1926 to July 1929 he was Senior Assistant Physicianat Foxborough State Hospital. Since that time Dr. Malamud has been Assistant Directorof the Iowa State Psychopathic Hospital and Professor of Psychiatry at the State Univer­sity of Iowa Medical School. He is a Diplomate in both Psychiatry and Neurology of theAmerican Board; Fellow of the American Medical Association, American PsychiatricAssociation and a member of the American Neurological Association.

ROCHESTER GUIDANCE CENTER

On June first the staff of the new Rochester (N. Y.) Guidance Center will be completedby the addition of a full time psychiatrist, and the clinic will be fully equipped for itstask. The Guidance Center, a mental hygiene clinic for Rochester and Monroe County,opened January I, 1939, after a year of careful planning by a committee representingcommunity agencies. The full staff of the Center is as follows: director, Carl R. Rogers,Ph.D.; psychiatrist, Chester L. Reynolds, M.D.; clinical psychologists, Gordon L. Riley,M.A., Virginia W. Lewis, M.A., Chester C. Bennett, Ph.D., Annette L. Gillette, Ph.D.,Natalie A. King; psychiatric social worker, D. Elizabeth Davis, M.A., M.S.S.; in­take secretary, Mrs. Constance Obourn, M.A.; psychological interne, Mrs. Dorothy I.Wronker, M.A.

The Guidance Center will accept, for diagnostic study and treatment, children referredby agencies or parents because of behavior or personality disorders. It will also makestudies of juvenile delinquents, children entering foster home or institutional care andinfants being considered for adoption. The age limits for acceptance are from infancy to21 years of age. Special consultation service will be given to the Family Welfare Society.

The Clinic will also endeavor to promote community education in mental hygiene.Both Dr. Rogers and Dr. Reynolds will have university affiliations, the former in thedepartment of psychology, the latter in psychiatry, in addition to their clinic work. The

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Guidance Center is financed jointly by the Rochester Community Chest and MonroeCounty.

DEVELOPMENTS IN NEW YO'RK

The New York State and City Committees on Mental Hygiene recently reported toDr. Tiffany, the State Commissioner of Mental Hygiene, its estimates as to the numberof beds which would probably be needed for young, low-grade, infirm and epilepticpatients in the new State School to be built on Long Island. Data from the Departmentof Education and Children's Court show that some 1600 children with IQ below 50 arenow known and not in institutional care. Among these are 250 epileptics, at present ondischarge from public schools and receiving only such care and education as relativesprovide. The Department of Hospitals alone has recommended for commitment 146children, 6 years of age or less, of whom 123 have IQ under 50. They estimate that in1941 there will be about 2500 low-grade children and adults, 400 young and infirm and400 epileptics constituting a kind of waiting list for the new institution. It would appear,therefore, that even before the new institution is under construction, it has a potentialpopulation of 3300. Further, it is estimated that the great need and demand will befor beds for low-grade, that is, IQ under 50.

At this writing, it appears that the Lunacy Commissions in New York State will beabolished. This system has been under attack for a long time but the proponents of ithave been too strongly intrenched politically. However, some time ago an investigationby Commissioner Herlands revealed widespread discrepancies in the use of commissionsin the different boroughs. Furthermore, it appeared that certain judges made muchgreater use of commissions than did others and it still further appeared that there werefavored physicians, lawyers and laymen involved in the appointments. The substituteproposal would replace these commissions appointed by the judges by commissions as­signed from the staff of the Department of Hospitals in New York City and from the StateHospitals elsewhere in the state. The plan has its defects and has encountered a certainamount of opposition because it is felt by many that the judges should have access to apanel of qualified psychiatrists aside from the hospital group. However, it is a sharp stepin advance and has the support of most of the organizations in the field.

WHO SAID CRIME DOESN'T PAY?

It ought to be consoling to the tax payers of New York City to learn that crime, inits lesser degrees, is fast becoming self-supporting. During 1937 total fines imposed inthe Courts were only some $159,000 short of the Courts' expenses for that year, whereasin 1934, deficit was over $875,000. (Total budget for 1937, $1,595,421; total fines col­lected, $1,436,374.) This happy circumstance is "due ... to the suppression of favoritismand an insistence on the equality of all men before the Law." Total of 1,010,380 arraign­ments is an increase during ten years of more than 200 per cent; increase in female casesnearly 300 per cent.

F.W.P. reporter notes a few crimes becoming less popular; homicide has decreased25 per cent; larceny (felony) has decreased among males over 40 per cent, but for womenonly about zo per cent; total robberies have decreased, but the number of female robbershas increased.

The efficacy of prohibition gets something of a wallop from the decrease in casesarraigned for intoxication, the 1937 total being something less than 25 per cent of thetotal for 1928. Speeding and reckless driving have dropped from 51,019 to 18,252. Prosti­tution has decreased, but vagrancy other than prostitution has more than doubled­possibly because so many people have nothing much to do.

The only crime in which women outnumber men is shoplifting-e-aaf to 74. In thematter of disorderly houses, women rate about 50 per cent. In general, the male miscre­ants outnumber the female almost 10 to I.

Sixty-one magistrates are required to administer justice in greater New York's 41

NOTES AND COMMENTS

Magistrates' Courts. Punishment is meted out as follows: of 836,319 convictions, 737,638fines were imposed (that is not to say that all of these fines were paid, as a number ofsuspended sentences are included in this figure); 9,742 received workhouse and straightsentences; 144 were sentenced to both fine and imprisonment; others were sent to reforma­tories, city homes, hospitals, or received suspended sentences.

Federal Writers' Project, N.Y.

MISCELLANEOUS

Refugee physicians are beginning to create a problem of some importance in relationto the practice of medicine, particularly in cities along the eastern seaboard. There hasbeen considerable agitation in New York City and State Medical Societies because ofvarious kinds of unethical and unsatisfactory incidents in the practice and approach ofthese men to patients. The matter has been discussed in the U.S. Senate and, while thereare some debatable elements in the situation, it would seem that the stand taken by theA.. M. A. should have general endorsement.

The Psychological Bulletin, which has been edited by Professor John A. McGeoch atWesleyan University, is being transferred on June 15 to the State University of Iowa.It is requested that books for review or notice in the Psychological Bulletin be sent, afterJune 15, to the editor, Professor John A. McGeoch, Department of Psychology, StateUniversity of Iowa, Iowa City, Iowa.

The Child Research Clinic of the Woods Schools at Langhorne, Pa., held its Fifth SpringConference on Education and the Exceptional Child, Tuesday, April 25. The papersgiven at the Conference in 1938 have now been issued as a special bulletin under thetitle, The Challenge of Progressive Education. Copies may be had by addressing Miss IreneS. Seipt, Woods Schools, Langhorne, Pa,

We have received an announcement of the Silver Bay Summer School, which is locatedon Lake George in New York. Group education, life philosophy, recreational activities,and personal-social problems of childhood and adolescents are among courses offered forcollege credit in what seems to be a very attractive setting. For further information,address the Director, Silver Bay Summer School, 263 Alden Street, Springfield, Mass.

Winston-Salem (N. C.) Mental Hygiene Society and Parent-Teacher Associations heldtheir annual meetings jointly on May I of this year. The evening meeting had a surpris­ingly large attendance from all over that section of North Carolina. Dr. Lawson G. Lowreyaddressed the meeting on "Some Parallels Between Parent-Child Relationships and SocialOrganization." In addition to this meeting, Dr. Lowrey also addressed the parents' group ofa private school, a joint meeting of the various Civic Clubs and a meeting of the JuniorLeague which is supporting the work of the Child Guidance Clinic. There is an openingfor a psychiatrist of proper training with the State Board of Public Welfare, giving parttime service to clinics at Winston-Salem and Charlotte.

The Rorschach Institute has published a record blank for the Rorschach test, preparedby Bruno Klopfer and Helen H. Davidson. They may be secured at JO cents per copywith a reduction in unit price when 10 or more are ordered from Miss Davidson, 601West 115th Street, New York.

The Symposium on "Visual Fatigue" of the National Research Council was held in,Washington, May 20, 1939.

The Girls Service League of America (N. Y.) has issued an attractive bulletin describingtheir work during 1938 under the title, "The Girl-A Community Trust:'

The Kansas Mental Hygiene Society held their Annual Conference April 2J-22, 1939at Wichita. They announced a most interesting program covering a wide range of topics.

668 THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY

In fact this program, by virtue of its variety, the size of the directorial board and theinteresting comments in its Bulletin, reminds us forcefully of the meeting at which wewere the only speaker in 1921. Interestingly enough, it was only the other day that thenotes for that speech were accidentally encountered in one of our old note books.

Congratulations to the Society upon its healthy growth in the intervening years.

The Charity Organization Bulletin, ably edited by Claire M. Towseley, came to an endwith number 1044 on April 3, 1939. That is because on April 12 the Charity OrganizationSociety and the Association for Improving the Condition of the Poor (the latter being theoldest social agency in New York City) were merged. The new organization is calledthe Community Service Society, but there have already been indications in the new Bul­letin, which continues the format and the editorship of the old, that this name is notregarded as completely satisfactory. These two organizations have a long and distin­guished record of achievement. It was the Charity Organization Society which organizedthe first professional school of social work in this country-the New York School of SocialWork, begun in 1899. Our best wishes for continued growth and development.

The Henry C. Frick Educational Commission of The Pennsylvania College for Womenoffers a Social Service Course for teachers. Last year Dr. Ralph P. Truitt, Professor ofPsychiatry at the University of Maryland, presented a series of lectures on MentalHygiene, This year, during the week of July roth, Dr. Ira S. Wile will discuss the followingtopics:

I. The Child as a Person2. Home Problems as they Affect the Child at School3. Mental Hygiene and the Teacher4. Mental Hygiene and the Curriculum5. Sex Education as a Problem in Mental Hygiene6. Adolescent Heat and Friction7. Mental Hygiene and the School Administrator.

The general.field oj orthopsychiatry should receive more attention as a result of therecent Presidential address of Dr. Rock Sleyster, President of the American MedicalAssociation. His interesting discussion, entitled "The Mind of Man and His Security,"appeared in the May sorh number, J.A.M.A.. The broad appeal to the medical professionas a whole to think in terms of mental competence is timely, and the psychiatric possibil­ities can by no means be ignored, although orthopsychiatry is referred to only by impli­cation. Every advance along the broad front of mental welfare, however, confers advanta­ges upon every collateral branch of the work.

FRAGMENT

I have always conceded that Institution people know how to run institutions: thatteachers know how to teach; that judges know how to judge; lawyers how to press suitsand policemen how to police; that doctors and dentists know how to diagnose and treatdisease; that the military know how to fight; that preachers know how to minister; bossesto boss and laborers to toil: but I categorically deny that any of these and many otherbackgrounds of training and experience (including psychiatry and psychology), in and ofthemselves prepare for or insure successful management of human relations, either forthe self or, more importantly, the individuals and groups ruled or served. All of thesetypes of training tend to give knowledge regarding specific aspects of human living anddying, but they pay far too little attention (save for certain specific types of psychiatrictraining) to the individual person as a whole and the total environments in which hefunctions. We don't know all there is to know about personality and individuality-notby a long shot. And how much less do we know about and understand societal groupingsand theories of social organization?