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least part of the tremendous personal, social, and economic burdens now borne by the individuals, by their families, and by the public as a whole.

From the foregoing, it can be seen that the National Society for Crippled Children and Adults believes the problem of crippling in general, and crippling as a result of neurological diseases in particular, to be a tremendous one requiring all the energies of public and private agencies to meet. Additional funds and additional numbers of trained personnel are critically needed to provide and staff services and facilities which will bring to the crippled of our country all of the techniques of rehabilitation of which we now have knowledge. Similarly, there is an urgent need for vastly increased research efforts in fields where we already have reason to believe heartening results can be realized and in fields not yet explored.

Speaking as a voluntary agency whose strength lies in the local communities where direct services must be provided to reach the individuals in need of them, the national society pledges its financial support to research, to the limited extent to which it has funds available, while increasing its programs of care and treatment, and education to keep pace with research developments which we believe will be made possible through adequate appropriations for the National Institute of Neurological Diseases and Blindness,

(Whereupon the committee adjourned.)

(Mental Illness)



Washington, D.C. The committee met, pursuant to adjournment, at 10 a. m. in the committee room of the House Committee on Interstate and Foreign Commerce, Hon. James Dolliver (acting chairman) presiding.

Mr. DOLLIVER. The hearing will come to order. As a preliminary matter, let me state that the present occupant of the chairman's seat is not the regular chairman of this committee. Mr. Wolverton was called to his home late yesterday afternoon and will be here today during the course of the hearings. He asked me to get this hearing started in his absence.

The hearings of the Committee on Interstate and Foreign Commerce on the problems of chronic illness facing our Nation will be devoted today to mental illness and tuberculosis. We will start with a discussion of mental illness.

The committee is extremely concerned about the problem, the suffering that the diseases in this category visit upon so many of our citizens and their families, and the tremendous economic factors involved in caring for and treating the mentally ill.

More than half of all the hospital beds in this country are occupied by the mentally ill. Despite this, there are not enough mental hospital beds to accommodate all of the people who are in desperate need of treatment. When you add together the cost of caring for mental patients in long-term public mental hospitals and the money spe by the Veterans' Administration in hospitals for the mentally ill, on outpatient care, and on pensions for veterans suffering from neuropsychiatric disorders, the dollar cost is staggering-probably as much as a billion dollars or more a year.

These few figures only begin to tell the story. What we are going to try to do today is to find out about the scope of the problem of mental illness, the facilities and resources that are available for dealing with the problem, and what more needs to be done to help us meet it.

The pattern that the committee has followed in conducting these hearings has been to invite a group of people who are authorities in the field under discussion to come here and testify. The witnesses have all appeared voluntarily and have conducted what, in effect, may be described as an informal symposium. The committee wishes to thank those who have come today to discuss the problem of mental illness. I understand that Dr. S. Bernard Wortis has agreed to serve as discussion leader for the group.

An agenda has been prepared, and the discussion will follow the general outline of that agenda. However, since the purpose of this hearing is to place before the American people the maximum amount of information relating to this disease, I hope that the witnesses will bring everything they consider important to the attention of the committee, regardless of the agenda. The committee members will ask questions of the witnesses, and I hope that the witnesses, in turn, will ask questions of each other when they consider it appropriate.

I understand that a number of prepared statements have been submitted to our committee by the organizations represented here today. At this time, I would like the prepared agenda and the list of participants to be made a part of the official record of this hearing.

(The information is as follows:)


I. Scope of problem:
A. Disease areas to be covered:

1. Psychoses.
2. Severe emotional disturbances-psychoneuroses.
3. Personality disorders.

4. Mental subnormality.
B. Numbers affected.
C. Costs :

1. Tax money expended.
2. Loss of income.

3. Cost to family.
D. Manpower losses.
E. Effects on society:

1. Dislocation of families.
2. Juvenile delinquency.

3. Addiction to alcohol and drugs.
II. Facilities and resources for dealing with the problem :
A. Current state of knowledge in the field :

1. What is known about epidemiology, diagnosis, causes, treat

ment, and rehabilitation,
2. Research currently being conducted :

(a) Areas of research.
(b) Scientific disciplines involved.
(c) Volume of research.

(d) Organizations sponsoring research.
B. Professional manpower available for dealing with the problem.
C. Services available for diagnosis, treatment, and rehabilitation:

1. Mental hospitals.
2. Clinics and community services.
3. Private psychiatrists.
4. Institutions for mentally subnormal.
5. Rehabilitation services.
6. Dissemination of professional and scientific information.
7. Prevention services, including public education and control

D. What the Federal Government is doing :

1. Research.
2. Training

3. Technical consultation. III. Needs to help meet the problem:

A. More research :

1. Types and specific examples.

2. Manpower and facilities required.
B. More professional manpower :

1. Vumber and types needed for treatment services.
2. Methods for obtaining required personnel.

C. Extended and improved services:
1. Institutional:

(a) Mental hospitals.
(6) Psychiatric services in general hospitals.

(c) Institutions for mentally subnormal.
2. More concentrated use of therapies.
3. Outpatient facilities.
4. Rehabilitation.
5. Prevention, control, and public education.


Dr. S. Bernard Wortis, professor of psychiatry and neurology, New York Uni

versity College of Medicine. Dr. Francis J. Braceland, psychiatrist in chief, Institute of Living, Hartford,

Conn. Charles Schlaifer, cochairman, National Mental Health Committee, New York

City. Dr. Seymour S. Kety, Associate Director in Charge of Research, National Institute

of Mental Health. Dr. Fillmore H. Sanford, American Psychological Association. Dr. George S. Stevenson, National Association of Mental Health. Dr. Robert H. Felix, director, National Institute of Mental Health. Dr. Richard Willey, executive assistant, the American Psychological Association. Dr. Daniel Blain, American Psychiatric Association.

Mr. DOLLIVER. In order for the recorder to identify the witnesses and so that they can be known to the members of the committee, I would appreciate it if they would stand and introduce themselves in turn, starting with Dr. Wortis.

When the introductions have been concluded, will you, Dr. Wortis, proceed to lead the discussion, following the general lines of the agenda or as you see fit.

Dr. WORTIS. My name is Sam Bernard Wortis. I am professor of psychiatry and neurology at the New York University College of Medicine and director of the psychiatric and neurologic services of the university hospital at the New York University Bellevue Medical Center.

I am consultant to several Federal agencies and several hospitals in the general metropolitan area of New

York. I have also served as the president of the American Board of Psychiatry, the American Neurologic Association, and several other medical and neuropsychiatric organizations in America.

I have also had the privilege of serving a 3-year term as a member of the National Advisory Mental Health Council to the Surgeon General of the United States Public Health Service.

My colleague to my left is Dr. Braceland.

Dr. BRACELAND. I am Francis J. Braceland, director of the Institute of Living, Hartford, Conn. I am a clinical professor of psychiatry at Yale University. I have been the dean of a medical school, and in wartime was chief of psychiatry for the United States Navy. I was head of psychiatry at the Mayo Clinic. I am secretary and president of the American Board of Psychiatry and Neurology.

At present I am psychiatric consultant to the Surgeon General of the Navy and of the Army and am a member of the National Advisory Committee to Selective Service which was set up by Congress, and chairman of a committee to determine the competency of mentalhospital superintendents.

My colleague on my left is Dr. Robert Felix.

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