Dr. MCLENDON. They felt they should carry out the program, I think, rather than it should be delegated to some organization which had no responsibility.

Congresswoman GREEN. Thank you very much.

Mr. ELLIOTT. The gentleman from New Jersey, Mr. Daniels.

Mr. DANIELS. Dr. McLendon, I was happy to see in your report that you point out that in the studies of these young men at our colleges they are not sufficiently oriented in the character development of the child and that also, in the training of doctors, that the programs are insufficient to give them a complete understanding of the personality of the parent as well as the child.

Dr. MCLENDON. Yes.

Mr. DANIELS. Today in the medical profession there seems to be a tendency toward specialization; is that not so?

Dr. MCLENDON. Yes.

Mr. DANIELS. It probably will be conceded by you that there are an insufficient number of pediatricians and psychiatrists to cope with this problem that we have today.

DR. MCLENDON. Well, I am certain, sir, that that is generally true. The question comes as to who does what. In other words, if you take your school system, for instance, your teacher is responsible for picking out these children who do not adapt well and who may be physically below par. Then your nurse has the same responsibility as well with some follow-up activity related thereto. Then the pediatrician or the physician who physically examines the child should be well enough oriented that he can evaluate not only the mental aspects of that child's behavior but his physical aspects. Therefore he then directs the child through its proper channels.

"Is this all physical?" and it goes to some physical clinic. Or, is that physical condition taken care of and should he have a psychological evaluation with further study and help?

When he reaches the psychiatrist he is pretty well gone. He is sort of at the point of no return.

Mr. DANIELS. Do you not deem it advisable that we not only have the teacher work in cooperation with the nurse and medical doctor as well as the pediatrician and psychiatrist?

Dr. MCLENDON. Yes, sir.

Mr. DANIELS. In other words, it should be a rounded-out program? Dr. MCLENDON. Yes, sir, it is a progressive program up to the consultant who is a psychiatrist or a surgeon.

If you can visualize calling your family physician then throughout whatever program is necessary for you to then see a surgeon for proper care or some other specialist."

Mr. DANIELS. Doctor, in view of this tendency of specialization do you not feel that the doctors are making a big mistake in failing to respond to the calls of their patients who desire treatment but refuse to attend unless the patient comes to their office? This may be apart from this question of juvenile delinquency.

Dr. MCLENDON. That is an awfully difficult question to answer, sir. I do not make as many house calls as I did at one time. I am guilty of part of your question. And yet, we see no answer to it. If a patient in Mount Rainier or Hyattsville calls me from over around Dupont Circle, it takes me an hour and a half to make that call, whereas if he comes to the office I can see that particular patient and

38436-59-pt. 1--14

two or three others. You may say, "That is commercial." Well, we do have to eat and have to have a roof the same as anyone else and I do not know of anyone who subsidizes me up to now. So there is a question of what is the efficient thing to do. You might relate it to something like this:

Why don't you come to the office and have a conference with me about juvenile delinquency? As a group you get much better effect by having us come to you.

That is true in all lines of work, I think. If we go to the store and we help ourselves in the so-called stores we have to do the work that the clerk did at one time.

Mr. DANIELS. I have heard numerous complaints of late and especially in the city where I came from and there are many, many doctors, I think we have a sufficient number to take care of the needs of our ill, but the average person seems to complain that if there is a need of a doctor especially at night it is most difficult to get a doctor to make a house call and I think that might bring about a situation which we would not like to see come about, especially myself, that is, socialized medicine. I object to it and just as much as I would object to the socialization of the other professions and that it is probably the reason why Mrs. Green has received so many complaints to this program of medical care and aid to the aged. I think that doctors themselves may bring that program about.

Dr. MCLENDON. Well, sir, I have only this comment to make, that I know most of us are pretty busy. I know that people demand a great deal of us due to the development in medicine over a period of several years and they demand in the matter of high cost of medical care which is being looked into by Senator Morse. We all agree that the situation exists but how are we going to solve it? I think one of the things that has hurt us most has been the fact that technological advances and the so-called high standard of living have disrupted us and we have not been able to think at the same rate that technological advances have taken place. We are far behind in the knowledge of social behavior.

Mr. DANIELS. Thank you, Doctor. I yield to Mrs. Green.

Congresswoman GREEN. A preceding witness cited the State of Indiana as having no tax-supported place for the emotionally disturbed youngster and having three private ones.

Could you tell me the approximate cost of the monthly care of a youngster, an emotionally disturbed youngster in a private institution? Dr. MCLENDON. Private institutions as we know them, Mrs. Green, I do not think cost under $500 a month, though there may be occasional ones. That may be a little high, say $300 a month. It costs a State, or the District of Columbia, we will say about $2,000 a year for each one in the institutions that we have at Laurel.

Congresswoman GREEN. $300 or $500 would be the minimum and it could go up in private institutions to a couple of thousand?

Dr. MCLENDON. Yes, and that would be where they got very special attention, a lot of educational advantages, and so on.

Congresswoman GREEN. What is the charge for a psychiatrist― average charge? Am I right that it is $15 to $20 for a half hour?

Dr. MCLENDON. I think it is about an hour. They usually figure on an hour. I would not like to be quoted but I would feel pretty certain that the minimum is $15.

Congresswoman GREEN. Well, I am sure that Indiana is not alone. in not having tax-supported institutions. What other source does the parent of an emotionally disturbed child have, one that cannot even afford to feed the child, what can he do when the costs are this high?

Mr. MCLENDON. And he had to be institutionalized; he could not be kept at home?

Congresswoman GREEN. Yes. Where this is desirable, and where there is an inability to put the child in a private institution. I can see no solution, except to appeal to the juvenile court to have the child committed. That would be the only way I could see out of such a dilemma. But in most of the States the juvenile court judge could not pay to have the child taken care of in a private institution, there would not be funds for it.

Dr. MCLENDON. No.

Congresswoman GREEN. It would be just a reform school or some place like that if he had to be institutionalized?

Dr. MCLENDON. That is true.

Congresswoman GREEN. Is this not a pretty sad situation?
Dr. MCLENDON. It is.

Congresswoman GREEN. And does it not point up the need for some Federal action?

Dr. MCLENDON. Yes. And the problem is that prevention is where activity must take place and not at that, using again, that term, waiting until they reach the point of no return.

Mr. ELLIOTT. Dr. McLendon, you are a member of the school board · of the District of Columbia. You are chairman of the committee on juvenile delinquency of the American Academy of Pediatrics, and are you not in addition the professor of children's diseases at one of the local medical schools?

Dr. MCLENDON. Yes, at George Washington.

Mr. ELLIOTT. Is that the correct title of your professorship?
Dr. MCLENDON. Yes.

Mr. ELLIOTT. You are a professor of children diseases?
Dr. MCLENDON. They call it the professor of pediatrics.

Mr. ELLIOTT. May I say to you that I thank you very much for your kindness. Your time is very valuable to you when you get to use it for yourself, and it is very valuable to us. We appreciate it very much.

Dr. MCLENDON. Thank you, sir.

Mr. ELLIOTT. The next witness is Mr. Irvin Lechliter, executive -director of the American Veterans Committee.

STATEMENT OF IRVIN LECHLITER, EXECUTIVE DIRECTOR, AMERICAN VETERANS COMMITTEE

Mr. LECHLITER. Thank you, Mr. Chairman and members of the committee. I have submitted a brief statement. In the interest of time I think I should like the committee, with your permission, to insert that statement in the record and then, if I may, briefly sum

marize it.

Mr. ELLIOTT. Without objection, immediately following Mr. Lechliter's oral presentation his written statement will be made a part of - the record.

Mr. LECHLITER. Thank you, Mr. Chairman.

I should like first of all to express the thanks of the American Veterans Committee to this committee for giving us an opportunity to present our views on juvenile delinquents. Our support is directed toward Mrs. Green's bill, H.R. 772.

I certainly do not come before you as an expert in the field of juvenile delinquency, but our National Affairs Commission, the National Affairs Commission of AVC, has studied the question and they recommended to our national board an endorsement of Mrs. Green's bill and at the last quarterly meeting of the board H.R. 772 received our board's unanimous endorsement.

We are interested in AVC in the question of juvenile delinquency because in AVC we are citizens before we are veterans and as citizen-veterans many of us are now fathers and mothers and we have a great deal of interest in what we consider to be the greatest resource of our country, and that is its youth.

I can direct my remarks only to title 2 of Mrs. Green's bill which calls for grants for training of personnel.

It seems to us in the experience that we have had and in the information we were able to get together that there is a great shortage of trained personnel in the field of psychiatry and in the field of child psychology, even among teachers and probation officers, all people that are concerned with problems arising in connection with juvenile delinquency.

In addition to that of course we endorse title 3 which provides grants to States for the carrying on of special projects for the purpose of demonstrating or developing improved techniques and practices for the treatment of the problem of juvenile delinquency.

With that I shall stop because I do not want to take too much time, but you have my statement in the record.

Mr. ELLIOTT. Thank you, Mr. Lechliter.

Mrs. Green.

Congresswoman GREEN. Well, I am delighted that a veterans group has come to appear before the committee. I think this is the only veterans group that has testified in favor of this legislation. It always pleases me when organizations go beyond their own special interests and are concerned about other national problems.

I might also say to you, Mr. Lechliter, that I have had in preceding years contact with the American Veterans Committee in regard to veterans legislation.

Mr. LECHLITER. Yes.

Congresswoman GREEN. And I have learned to turn to them as a group that have spoken with the voice of reason in regard to veterans' matters.

Mr. LECHLITER. We have a very active chapter in your district and we are very pleased to count you among our friends.

Congresswoman GREEN. Thank you, and thank you for coming. Mr. ELLIOTT. The gentleman from New Jersey, Mr. Daniels. Mr. DANIELS. No questions, although I desire to thank Mr. Lechliter for his contribution here today.

Mr. ELLIOTT. Thank you, Mr. Lechliter.

Mr. LECHLITER. I should like to express the thanks of AVC again for an opportunity to present our point of view.

(The statement of Mr. Lechliter is as follows:)

STATEMENT OF THE AMERICAN VETERANS COMMITTEE (AVC) ON H.R. 772 PRESENTED BY IRVIN LECHLITER, EXECUTIVE DIRECTOR, AMERICAN VETERANS COMMITTEE

I am Irvin Lechliter, national executive director of the American Veterans Committee. AVC's membership is composed of veterans of World War I, World War II, and the Korean War. Our national headquarters are located at 1830 Jefferson Place NW., here in Washington.

I should like to express on behalf of AVC our thanks to this distinguished committee in affording us an oppotrunity to present our views in support of Congresswoman Green's bill, H.R. 772, which provides for assistance in strengthening and improving State and local programs for the diminution, control, and treatment of juvenile delinquency. Upon the recommendation of our National Affairs Commission, AVC's national board at its last quarterly meeting unanimously endorsed H.R. 772.

I should like to request that my prepared statement be included in the record of these hearings. And then, with the permission of the committee, I should like briefly to summarize the contents of that statement.

I am sure that AVC's interest in this legislation occasions no surprise on the part of the members of this committee. With considerable pride, we in AVC label ourselves as "citizens first, veterans second." Most of us are today citizens-veteran fathers and mothers who are genuinely concerned for the wellbeing of our country's greatest resource-its youth. We are alarmed by the fact that the incidence of juvenile delinquency in this country is increasing yearly. We think that juvenile delinquency has become a problem of such dimensions that States and local communities can no longer cope with it, and that the Federal Government must be called upon to assist in the solution of the problem.

Every community in the United States is, I am sure, making available its full resources in an effort to arrest the unrelenting increase in juvenile delinquency year after year. But the increase does continue. This suggests that local resources are inadequate at present to meet the emergency thus created. It suggests also he need for additional trained personnel and the introduction of new methods in this field. I suppose all would agree that in many instances our youth problems are aggrevated by lack of trained personnel and archaic methods of dealing with offenders.

Title II of Mrs. Green's bill calls for the appropriation of funds to be used as grants to States and to approved nonprofit institutions of higher learning to cover the cost of training personnel employed, or who may be employed, in programs dealing with the problem of juvenile delinquency. Those who are experts in this field tell us that there is an acute shortage of personnel adequately trained for the handling of youth problems. I know that in the county in which I live, our school offices and other offices dealing with the youth of the country are pathetically understaffed. I recently attended a citizens group meeting which was devoted exclusively to the exploration of ways and means of remedying this situation. The plain fact is, however, that there are not enough trained people in such fields as child psychology, sociology, social work, psychiatry, juvenile court work, probation and parole services, recreation work, and community organization work, to meet the needs of my county. This is true in varying degrees in both urban and rural areas throughout the country. H.R. 772 in its provisions for training grants faces up realistically to this shortage of adequately trained personnel, and we respectfully urge this commitee to report a bill containing this provision.

AVC also unreservedly endorses title III of H.R. 772 which provides for grants to States and to public and private nonprofit institutions of higher learning or research for defraying the costs of special projects for the purpose of demonstrating or developing improved techniques and practices for treatment of the problem of juvenile delinquency.

We believe that this combination of demonstration projects and the training of additional personnel provided for in Mrs. Green's bill, if enacted into law by the Congress, would constitute a substantial contribution toward bringing juvenile problems in this country under control.

Mr. ELLIOTT. We have in the audience here Dr. Maher Kamel who I understand is from Jersey City Teachers College, which college is