It is now almost universally conceded that not less than two hundred and fifty patients, nor more than three hundred, is the number which can be best accommodated in one Institution. These are generally divided into eight classes, of each sex, each of which should have sepa rate halls and suits of apartments, as they cannot, as a rule, be allowed to consort together. It is not thought advisable to have more than two stories occupied by patients. This arrangement makes necessary three or more wings on each side of the centre building, of two stories height each, besides the basement. In addition, is required a Chapel, infimaries, kitchen offices, gas works, engines for supplying water, and boilers, engine and apparatus for a thorough system of warming and ventilation, besides a great number of saller but costly fixtures. From a too rigid economy, and from want of proper attention to the numerous details, or the erection under incompetent persons, expensive alterations have been found necessary, in many of the Asylums in the United States, which, in some cases, have equalled the original cost of the building. A large part of the actual cost of the building might thus have been saved, had the subject been duly considered in the outset. Many of these Asylums were completed in several parts, at different times, and on different plans; of course, at an enhanced cost, besides destroying unity of plan, and heated and ventillated afterwards, at a cost of from five thousand to fifty thousand dollars. It appears by the returns of the late census, that there are four hundred and twenty-six insane or idiotic persons reported in this State. As such returns are known to be generally below the mark, it may be safely assumed, that there is one insane person for every one thousand of population. Some of the States have one to every six hundred; others, one to every fifteen hundred. This calculation would make the number of insane in this State to be not less than five hundred. The greater part of these are undoubtedly proper subjects of State care, and of cure, neither age nor social position interposing any bar. It will thus be seen, that if the Asylum were now completed, it would still be inadequate to the wants of the State. How many of these un fortunates would be brought to the State Institution, we have no means of knowing, but that every ward would soon be filled, we have good reason to suppose. Many insane from this State are now in the care of Institutions in other States, and many more would be under such care if it were possible to obtain it. But these Institutions are everywhere full, and in some of them no amount of compensation will procure admission for a patient out of the State in which they are situated. The demand, then, is most urgent, to carry on and complete the Asylum without delay. We esteem it to be the duty, as well as interest of the State, to make the most immediate and ample provision in its power, for all its insane, who are not in a condition to reside in private families, without distinction of nativity or social position. No insane person should be left to the care of a county house for paupers, still less of a jail, as is the case with many at present. No good results to such, from the treatment they are likely to meet with in such places, and the moral effect upon themselves, as well as those with whom they come in contact in such situations, is as bad as can well be imagined. It may be asked, whether a portion of the buildings may not be completed and occupied by patients, while the remainder is in progress. We answer that there are important objections. What portion shall be first completed and occupied? The centre building is intended for the offices, and residence of Superintendent and assistants, and is not at all designed for the reception of crazy people. The proper care of the insane makes necessary a eertain classification, aceording to mental condition, and the several wards are constructed with reference to this classification. Every part of the house is designed for treatment of insanity in some of its stages or phases, and no part can be dispensed with. Thus, the extreme wings are for the violent, who require to be as far as possible removed from the quiet patients, and so on. Moreover, the male and female patients must be in widely separate wards, and the building and grounds must accord with this principle of seclusion. The power of an Institution for the cure of insanity resides in a great degree in its facilities for this perfect classification, and with only a portion completed this cannot be effected. The object, therefore, of early opening the Institution cannot be realized, by completing and occupying a part only. Again, supposing a portion of the building adapted to this immediate occupation, subsequent changes in construction, by departure from the plans, besides the increased cost, may defeat the original thought contained in the plan. Furthermore, the erection of additions must always be attended with danger; accidents occur, and suicides; the attention of officers and attendants is diverted from the channel of duty; proper discipline cannot be maintained, and upon this the comfort and success of the Institution must generally depend. In a word, to open a part of the building, the officers must commence under the ⚫ most adverse and unfortunate circumstances. The result is, they are disheartened, the Institution is unsuccessful in operation, and the public confidence is not gained. Even a good workman can do but little with poor tools. Again, to conduct an Institution, a certain amount of materiel and personnel is required, whether there are few or many to care for; consequently the average cost per patient would be less with a sufficiently large number, than with a portion of the house in operation. An Institution with a small number would be a heavy public charge, while one with a large number would be self-supporting; or at least, with the requisite number for good classification and cure, the best means could be afforded, at less cost, than the mere custody where the number is small. A patient often has to pass through every class, before the cure is finally effected. By effecting cures which is the object sought-not only is suffering relieved, but the public is relieved from a great burthen. Placed under favorable circumstances for recovery, a case often ceases, in a few months, to be a public charge, that otherwise would be one for life. The want of this early and judicious treatment, fills our county houses with the incurable insane. The object of Asylums is defeated by the want of the proper facilities for treatment. It is a mistaken political economy which cheapens the ingredients of moral medicine, when success depends upon the quality. It may be laid down as a principle, that there is no such thing as a just and proper curative or ameliorating treatment of the Insane, in cheaply constructed and cheaply managed institutions. The simple erection of a building would be a small matter. The erection of an Institution, which, in every part of its structure, looks to the cure of this worst of human maladies, is of very great importance, and can neither be very cheaply nor easily accomplished. The trustees farther request the attention of the Legislature to the law which limits the compensation of the Superintendent to eight hundred dollars. This salary is far too small to secure the services of a Superintendent who is really qualified, by superior medical knowledge, and by those high acquirements and qualities which so important a position demands. He is not only the chief physician, but the chief manager of the Institution. Few possess these varied qualities, and these few can always command the highest price for their services. It is not too much to say, that the success of the Institution, in a very great degree, depends upon the Medical Superintendent-as that of a school upon its teacher. Similar Institutions elsewhere pay the Superintentendent salaries of from fifteen hundred dollars to four thousand dol lars per annuum. We can hardly hope to secure the best talent and services short of at least, the medium price paid elsewhere, say two thousand dollars per annum. The Board recommend, in regard to all our asylums, and the employees attached to them, the most liberal policy, as the best and the cheapest. That parsimony cannot be too strongly objected to, which diminishes the pay of those to whom such important trusts are committed, to the loss of the best services, and the diminution of the influence and success of the State Institutions. The State of Michigan, though a child in age, is not one in its resources. Build, then, Asylums for its manhood. So build them, that they may be handed down to posterity, not as pauper houses, but as Hospitals and Asylums, fitted with all that experience has devised, for the care and cure of all its unfortunate children. Let a just State pride urge us to make the very best provision for our Insane, and our Deaf, Dumb and Blind, that can be procured with the aid of modern science and experiSuch institutions, the Board believe, the State will have, if these suggestions are met in such a spirit of benevolent liberality as will enable us to complete the structures designed, according to the plans. For this purpose, the trustees unanimously ask from the State an appropriation of one hundred and seventy-five thousand dollars, for continuing and ence. |