fairly large dietary and housekeeping staff, because there is a great deal of work to be done, especially if you want to conduct a teaching program and a community education program-not so much community education program as a community activity program. We take our patients off the island for various activities, which means they would not be available for work programs at that time. So that the actual operation of the hospital cannot be totally transferred to patient care. Senator DANIEL. The total figure of employees you gave us, does that include your teaching personnel? Dr. GAMSO. No, that does not. Senator DANIEL. It does not include the teaching personnel? Senator DANIEL. How many? Dr. GAMSO. Fifteen. Senator DANIEL. Doctor, do you have any recommendations to make for us? I am sure that from what you have given us and from what has been filed for the record we will have the complete story on the operations of your hospital. Do you have any recommendations that you would give to us on this entire matter of treatment as far as our Federal hospitals are concerned? Dr. GAMSO. Well, I think that rather than my giving you recommendations with regard to Federal hospitals, we might wait and see what the Federal people have to say about the total picture. As you know, there has just been a study, which is still in process, done by the Public Health Service of our operations. They are interested because of various reasons: One is they do want to see what can be done in a local area with the type of staff that we have, and I am sure that their report will give a rather clear idea of how they feel about our method and how they could possibly use it. Senator DANIEL. Well, have you ever formed an opinion concerning the proposal of legalized drugs through clinics or through personal physicians for the purpose of keeping drug addicts comfortable and maintaining their addiction? Dr. GAMSO. I have given a good deal of thought to it. Senator DANIEL. What is your opinion concerning that proposal? Dr. GAMSO. I do not think it is practicable. Senator DANIEL. You do not think it will work? Dr. GAMSO. I do not think so. Senator DANIEL. Is it your experience that you must have more control than you would have under a clinic system in order to help him at all? Dr. GAMSO. Yes. I am afraid if an addict had access to free drugs that he would take that and still want more. Senator DANIEL. And supplement it? Dr. GAMSO. There is no way of stopping that; they would supplement it. Senator BUTLER. As a matter of fact, in your hospital you went from a voluntary to an involuntary basis to accomplish your results. Dr. GAMSO. That was necessary. Senator DANIEL. Did you find that absolutely necessary in order to accomplish the intended result? Dr. GAMSO. I was not at the hospital at that time when this change was made, but I was aware of it, and I would feel that that would be necessary, yes. Senator DANIEL. I think your experience there is important information for this committee. Mr. GASQUE. Doctor, I should like to make this point. Now, do you take all the juvenile addicts in New York City? Dr. GAMSO. No, we do not. Mr. GASQUE. Or in New York State? Dr. GAMSO. We would accept addicts from any part of New York State. Only one city has used that, and I do not know why, because we are perfectly willing to accept them. I suspect that the reason would have to be that they will have to pay the difference in the cost. Senator DANIEL. Is Buffalo the only city that has used it? Dr. GAMSO. Yes. Senator DANIEL. That is the only city in New York that has a narcotics problem among juveniles? Dr. GAMSO. It has the largest problem. But we know recently in Long Island there were some arrests because of narcotics use. Mr. GASQUE. They have used it on only 1 occasion, I believe, in Buffalo involving 1 patient. Dr. GAMSO. That is correct. Mr. GASQUE. Doctor, is it a fact that numerous patients, perhaps totaling even greater than in your hospital, are treated at other hospitals, who are adolescent users, for example, at Bellevue, at Kings County Hospitals? Dr. GAMSO. No. I believe that we get almost all the adolescent drug users who are treated right at our place. Mr. GASQUE. I was referring to a letter written by Dr. Basil C. MacLean, commissioner of the department of hospitals to Deputy Mayor Henry Epstein, in which he indicates that a number of adolescent users were treated at psychiatric division of Bellevue Hospital. Dr. GAMSO. That was during the interim period prior to the establishment of Riverside Hospital. Mr. GASQUE. That may be true. Mr. Chairman, if we could make this a part of the record at this point, I would like to submit it. Senator DANIEL. This letter is dated February 11, 1955, and the portion that the counsel refers to, I assume, is here: Our records indicate that during 1954 there were 72 drug addicts under 21 years of age given treatment in the psychiatric division of Bellevue; of these 29 were male and 43 female; 46 were admitted from courts, 13 from home and the remainder from other hospitals. (The document referred to follows:) Hon. HENRY EPSTEIN, Deputy Mayor, City Hall, New York 7, N. Y. THE CITY OF NEW YORK, New York 13, N. Y., February:11, 1955. DEAR MR. EPSTEIN: Please forgive the delay in replying to your letter of December 20 to which was attached two letters regarding the problems of addiction to narcotic drugs. Teen-age drug addicts per se are under the care of the department of hospitals in three of our institutions, namely Kings County Hospital Center, Bellevue Hospital Center and Riverside Hospital. Drug addiction, continuing to be a serious problem in this city as well as throughout the Nation, it was found necessary to open Riverside Hospital for the treatment of preadult narcotics users in July 1952, where persons under 21 years of age who apply, are accepted for admission. Our records indicate that during 1954 there were 72 drug addicts under 21 years of age given treatment in the psychiatric division of Bellevue; of these 29 were male and 43 female; 46 were admitted from courts, 13 from home and the remainder from other hospitals. During this same period, the psychiatric division of Kings County treated a total of 70 patients of which number 56 were male and 14 female. Riverside Hospital, located on North Brother Island, is specifically for the care and treatment of teen-age drug users and are so-called voluntary commitments. After admission and thorough study of these patients, a program is developed for each patient including psychotherapy, classroom work and vocational training using hospital facilities, paying particular attention to the development of a confidence of the patient in the treating staff. These patients need the advice and guidance of the hospital staff over a prolonged period of time which includes the period of hospitalization and afterdischarge from the hospital. For that reason a therapeutic leave program was instituted on August 2, 1954. This concept provides for continuous therapy and observation. Personnel of this institution and those not members of the staff but interested in the program have participated in several conferences. During 1954, 409 patients were admitted to Riverside Hospital, of which 342 were male and 67 female. A total of 499 patients were treated there during the year. Research activities during the past year included continued cooperation with the New York University Research Center for Human Relations; a study of the personality of the adolescent drug addict; a study of the family relations of the patients; a study of elecroence-phalography of patients is being conducted, as is also a study of the use of serpasil with regard to its effect on dependency on narcotics. A report on the vocational rehabilitation program at Riverside Hospital was accepted for publication by the Psychiatric Quarterly of New York State. Riverside Hospital in its annual report for 1954 states: The past year can be looked back at as a year of great accomplishment. The increasing coordination of the various professional disciplines within the hospital, the increasing use of hospital service areas (dietary, housekeeping, stores, and engineering) as training areas for the patients, the development of the Parents-Friends-Staff Association, the development of the patient council, the improved attendance of patients in the school (P. S. 619) and the increasing interest of the patients in the school program, the more positive attitude of the patients towards the hospital program, and increasing attempts on the part of the patients to benefit from the hospital program, are all achievements of which we can be proud. There is still room for greater improvement. There are many patients who are not adequately benefited by the many activities and many programs which are in effect at the hospital. We must look to the development of new methods and must be more persistent in the application of the old methods if we are to achieve a degree of accomplishment with which we will be satisfied. It will be necessary to work intensively with patients over a prolonged period of time. It would be important to develop group methods, whereby patients reinforce each other in their determination to abstrain from the use of narcotic drugs. The need for a half-way house to which patients might go after discharge rather than return to their disturbed former environment still exists. The increasing public awareness of the drug problem and the determination of public and private agencies to assist in meeting it will be of immeasurable assistance in the coming year." This drug addiction treatment program at Riverside Hospital is an experiment in the care of drug users. It is still too nearly to evaluate the results obtained. It is suggested that additional information in regard to drug addiction care and treatment may be obtained from the welfare and health council committee on narcotic addiction; the office of the chief magistrate which supervises the narcotic term court; the correction department for figures on cases in jails and prisons; Dr. O'Brien of the department of education and the mental health board. Very truly yours, BASIL C. MACLEAN, M. D., Commissioner. Dr. GAMSO. Well, some of those were referred there from our hospital for further study at Bellevue, not all of them, but some of them, and returned to us. Senator DANIEL. Because you felt Bellevue could more properly treat those addicts than you could? Dr. GAMSO. During their acute stage. Most of them were returned to us or transferred to a State hospital. They were not kept for definitive treatment for drug addiction. Mr. GASQUE. A number of juveniles are referred directly to jails and never get to Riverside; is that correct? Dr. GAMSO. That is correct. Senator DANIEL. What juveniles would they be? Dr. GAMSO. They would be persons whom the courts did not refer to us, in most cases. Senator DANIEL. On account of their criminal records? Dr. GAMSO. Because their antisocial behavior was such that they would be better in a locked facility. Senator DANIEL. Do you have any figures as to what the number was as compared to those committed to Riverside? Dr. GAMSO. I have not seen the 1954 reports. As I recall the 1953 report of the bureau of prisons, it was not very great. Senator DANIEL. I suppose you can assist us in getting those figures later on? Dr. GAMSO. Yes. Mr. GASQUE. Dr. Gamso, when the patients come to your hospital on an average how long have they been on drugs? Dr. GAMSO. The average has been about a year and a half. Mr. GASQUE. About a year and a half? Dr. GAMSO. About a year and a half. Mr. GASQUE. What is the age of the youngest addict you have ever known to be on drugs at Riverside? Dr. GAMSO. The youngest we have admitted to the hospital- Dr. GAMSO (continuing). Has been 13. Mr. GASQUE. Thirteen? Dr. GAMSO. Thirteen and three-fourths. Mr. GASQUE. I believe that when I visited Riverside I was told that you had one patient who had gone on drugs at the age of 8 years of age. Dr. GAMSO. I have not run across that patient. We have had patients who have gone on drugs at the age of 11, but they didn't come to Riverside Hospital until they were 13 or 14. Senator DANIEL. There was only 1 patient 13 years of age. Is that right? Dr. GAMSO. That is correct. Senator DANIEL. Then we will place in the record at this point a letter from Dr. Gamso giving us the breakdown from the records at Riverside, showing the total number of admissions from July 1, 1952, to June 30, 1955, being 1,183; total number of patients during the same period, 777. (The document referred to follows:) (AURBEY GASQUE, Esq. THE CITY OF NEW YORK, RIVERSIDE HOSPITAL, New York, N. Y., August 24, 1955. General Counsel, Subcommittee on Narcotics, DEAR MR. GASQUE: Attached is a breakdown of admissions to Riverside Hospital according to age at the time of first admission. I have been informed that you had requested this breakdown. If there is any additional information you desire, kindly contact me. Sincerely yours, Submitted by record room August 22, 1955: 1. Total number of admissions from July 1, 1952, to June 30, 1955, 1,183. Total number of patients from July 1, 1952, to June 30, 1955, 777, 2. Average age of patients on first admission, 17.7. 3. Average length of stay in hospital excluding those whose stay was 30 days or under. (These figures are based on ward discharges and transfers to therapeutic leave.) They represent all discharges for the period, July 1, 1952, to June 30, 1955. Average length of stay for all discharges, excluding those whose stay was 30 days or under, 93.7. Senator DANIEL. What is the distinction between admissions and· patients? Dr. GAMSO. Some patients were admitted more than one time. 777 represents the total number of actual persons. About 40 percent had more than one admission. Senator DANIEL. In other words, they have gone back on the drug? Dr. GAMSO. Not necessarily. They may have been transferred to another hospital for another type of care, like Bellevue or Lincoln Hospital, and returned to us, and considered a new admission. Senator DANIEL. Then your breakdown of patients shows the average age of patients on first admission is 17.7. Dr. GAMSO. Correct, sir. Senator DANIEL. And the breakdown of patients by ages shows them running from 13 to 27 years of age. I see you list 5 patients or 4 patients over 21. 71515-56-pt. 5- -18 |