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DEPARTMENTS OF LABOR AND HEALTH, EDUCATION,

AND WELFARE APPROPRIATIONS FOR 1967

HEARINGS

BEFORE A

SUBCOMMITTEE OF THE
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES

EIGHTY-NINTH CONGRESS

SECOND SESSION

WINFIELD K. DENTON, Indiana
DANIEL J. FLOOD, Pennsylvania
D. R. (BILLY) MATTHEWS, Florida
ROBERT B. DUNCAN, Oregon
BILLIE S. FARNUM, Michigan

SUBCOMMITTEE ON DEPARTMENTS OF LABOR AND HEALTH, EDUCATION, AND

WELFARE AND RELATED AGENCIES APPROPRIATIONS
JOHN E. FOGARTY, Rhode Island, Chairman

MELVIN R. LAIRD, Wisconsin
ROBERT H. MICHEL, Illinois
GARNER E. SHRIVER, Kansas

ROBDBT M. MOYBR, Stal Assistant to Subcommittee

PART 5
Testimony of Members of Congress, Interested Individuals

and Organizations

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61-753

0.8. GOVERNMENT PRINTING OFFICE

WASHINGTON : 1966

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GEORGE H. MAHON, Texas, Chairman ALBERT THOMAS, Texas 1

FRANK T. BOW, Ohio MICHAEL J. KIRWAN, Ohio

CHARLES R. JONAS, North Carolina JAMIE L. WHITTEN, Mississippi

MELVIN R. LAIRD, Wisconsin GEORGE W. ANDREWS, Alabama

ELFORD A. CEDERBERG, Michigan JOHN J. ROONEY, New York

GLENARD P. LIPSCOMB, California JOHN E. FOGARTY, Rhode Island

JOHN J. RHODES, Arizona ROBERT L. F. SIKES, Florida

WILLIAM E. MINSHALL, Ohio OTTO E. PASSMAN, Louisiana

ROBERT H. MICHEL, Illinois JOE L. EVINS, Tennessee

SILVIO O. CONTE, Massachusetts EDWARD P. BOLAND, Massachusetts ODIN LANGEN, Minnesota WILLIAM H. NATCHER, Kentucky

BEN REIFEL, South Dakota DANIEL J. FLOOD, Pennsylvania

GLENN R. DAVIS, Wisconsin WINFIELD K. DENTON, Indiana

HOWARD W. ROBISON, New York TOM STEED, Oklahoma

GARNER E. SHRIVER, Kansas GEORGE E. SHIPLEY, Illinois

JOSEPH M. McDADE, Pennsylvania
JOHN M. SLACK, JR., West Virginia

MARK ANDREWS, North Dakota
JOHN J. FLYNT, JR., Georgia
NEAL SMITH, Iowa
ROBERT N. GIAIMO, Connecticut
JULIA BUTLER HANSEN, Washington
CHARLES S. JOELSON, New Jersey
JOSEPH P. ADDABBO, New York
JOHN J. McFALL, California
W. R. HULL, JR., Missouri
D. R. (BILLY) MATTHEWS, Florida
JEFFERY COHELAN, California
THOMAS G. MORRIS, New Mexico
EDWARD J. PATTEN, New Jersey
CLARENCE D. LONG, Maryland
JOHN O. MARSH, JR., Virginia
KOBERT B. DUNCAN, Oregon
SIDNEY R. YATES, Illinois
BILLIE S. FARNUM, Michigan
BOB CASEY, Texas 2

KENNETH SPRANKLE, Clerk and Staff Director
1 Deceased Feb. 10. 1966.
2 Elected Mat. 8, 1966.

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DEPARTMENTS OF LABOR AND HEALTH, EDUCATION,

AND WELFARE APPROPRIATIONS FOR 1967

MONDAY, MARCH 21, 1966.

MENTAL HEALTH

WITNESSES

MIKE GORMAN, EXECUTIVE DIRECTOR, NATIONAL COMMITTEE

AGAINST MENTAL ILLNESS DR. FRANCIS J. BRACELAND, PSYCHIATRIST IN CHIEF, INSTITUTE OF LIVING, HARTFORD, CONN.; CHAIRMAN, COMMISSION ON CURRENT ISSUES IN PSYCHIATRY, AMERICAN PSYCHIATRIC

ASSOCIATION DR. DANIEL BLAIN, PHILADELPHIA, PA.; CHAIRMAN, COMMISSION

ON MANPOWER, AMERICAN PSYCHIATRIC ASSOCIATION REV. ROBERT TATE, D.D., AUSTIN, TEX.; REPRESENTATIVE, NATIONAL ASSOCIATION FOR MENTAL HEALTH

Mr. FOGARTY. The committee will come to order. We are starting today with outside witnesses on mental health.

Mr. Mike Gorman, you have been here many times before. You may proceed.

Šír. GORMAN. Mr. Chairman and members of the committee, on February 5, 1963, President John F. Kennedy, in the first Executive message ever delivered to the Congress on mental illness and mental retardation, called for a revolutionary war upon these twin afflictions of mankind in these stirring words:

Mental illness and mental retardation are among our most critical health problems. They occur more frequently, affect more people, require more prolonged treatment, cause more suffering to the families of the afflicted, waste more of our human resources, and constitute more financial drain upon both the Public Treasury and the personal finances of the individual families than any other single conditions * * *. Every year, nearly 1,500,000 people receive treatment in institutions for the mentally ill and mentally retarded. Most of them are confined and compressed within an antiquated, vastly overcrowded chain of State institutions.

Sounding a clear trumpet call for a “bold new approach” to these diseases, he told the Congress that "if we launch a broad, new mental health program now, it will be possible within a decade or two to reduce the number of patients now under custodial care by 50 percent or more.”

The trumpet sounded clearly enough in 1963, but in subsequent years its sound has been fading away.

I do not contend that we are not making progress. Over the past decade we have reduced the number of patients in State mental hospitals by 15 percent—from 558,000 in 1955 to the current low of

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475,000 in 1965. This unprecedented reduction in State mental hospital populations has saved the States an estimated $2 billion in patient care costs and $4 billion in construction costs over the 10-year period.

However, I must in all candor point out to this committee that we are not meeting the goals set by President Kennedy—the average annual reduction in State hospitalized patients over the past decade till has been only 1.5 percent.

Why are we failing? The answer is quite simple. We are not meeting any of the long-term budgetary goals which President Kennedy submitted in connection with his historic 1963 message.

According to several recent newspaper stories, the Bureau of the Budget has asked every department and agency in the Government to submit 5-year plans for program development. Mr. Chairman, President Kennedy did this in the field of mental health in 1963. We have the carefully documented projections which would make obsolete within a decade or so the dreary human warehouses which now house hundreds of thousands of our mentally ill and mentally retarded. But we lack one thing—the money to implement these projections.

For example, psychiatric manpower is at the very core of any significant increase in the treatment potential of these institutions. Placing the greatest emphasis upon this area, President Kennedy reminded the Congress in 1963 thatwe must increase our existing training programs and launch new ones; for our efforts cannot succeed unless we increase by several-fold in the next decade the number of professional and subprofessional personnel who work in these fields.

President Kennedy proposed in that year, and the Congress voted. a $17 million increase in the training programs of the National Institute of Mental Health for fiscal 1964. However, in both the fiscal 1965 and 1966 budgets, we fell considerably below this level of increase, and the fiscal 1967 recommendation of the administration really holds these training programs at a standstill level.

Pointing out that more than half of the mentally ill and mentally retarded in State and county institutions were receiving no treatment whatsoever, President Kennedy proposed a hospital improvement plan program starting at $12 million in fiscal 1964 and reaching $36 million in fiscal 1966. In the current year, we have only reached half of this target level, and the administration proposes the same inadequate sum for the coming year.

President Kennedy also placed great emphasis upon the upgrading of the skills of personnel working in public mental institutions. He submitted projections which would permit these inservice training grants to reach a level of $11 million in fiscal 1966. The hard money has never caught up with the projections; the sum the administration proposes for these vital grants in fiscal 1967 is little more than half of the amount President Kenendy envisaged for the current year.

Mr. Chairman, we therefore propose a realistic budget of $287,358,000 for the National Institute of Mental Health during the coming year-an increase of approximately $34 million over the administration recommendation. This overall figure is solidly predicated upon two sets of documentation : the detailed, 5-year budgetary projections which accompanied the 1963 Kennedy message and the current level of scientifically approved applications in all areas which cannot be

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