the hearings are concluded so that we may ask them the proper questions.

You know and I know that very often we go in with legislation of this kind. People who have remained on the sidelines start waving cash registers and reading statements at us, ignoring all of the pertinent matters which are before the committee.

So, I would like to more than invite, Mr. Chairman, I would like to challenge those who are opposed to this legislation to come before this subcommittee where they can be heard and properly questioned. Mr. ROBERTS. I think that is an excellent suggestion. I might say that while we are very anxious to get this bill out, if there are people who are opposed to it we certainly would be willing to schedule additional time to hear them, but I am so pleased with the unanimous support that the bill has had up to this point that I do not know whether I want to take a searchlight and go out and look for oppon

ents or not.

Mr. O'BRIEN. I do not either.

It becomes a little frustrating at times when the committee, which has the greatest knowledge of the legislation is not confronted with the opposition, the opposition suddenly appears before some other group which has not listened to any of the testimony.

I think that if they are going to attack it later on, that there is to time like the present. I have no knowledge of any people who do, but my questions throughout have been devoted to answers to possible attacks later on.

I have become convinced from what I have heard here, if I did not have a single humanitarian instinct in my makeup, that I could make a case for this legislation from a strictly economic viewpoint.

Mr. ROBERTS. I think you could well demonstrate that these two bills would save a great deal of money, certainly a lot of money at State level. It all amounts to the same thing, it is the same group of taxpayers that is paying the bill. Certainly I think, as far as the testimony we have had, that it would not only mean perhaps a lot more activity as far as the private practice of medicine is concerned, but it would mean that the custodial care will probably be decreasing all the time and you will have this done at a community level where you can do something about it, more than simply a case of providing custodial care.

Mr. O'BRIEN. I just do not want this to become a cost item in an unbalanced budget. I think it stands on its own feet and should not be swept aside by any concern about its impact.

If we are going to make cuts, Mr. Chairman, this is the last place that I would suggest it.

Mr. ROBERTS. I certainly agree with you.

Mr. O'BRIEN. I do not want to prolong my statement here but we did have one statement from one witness who suggests that these public hearings be slowed down considerably and extended for at least a year. I understand we are going to hear that witness testify. I am pleased to hear that because maybe we can have some answers. Mr. ROBERTS. Mr. Harold Edwards of the Pure Food Association.

STATEMENT OF HAROLD EDWARDS, EXECUTIVE SECRETARY OF THE PURE FOOD ASSOCIATION OF AMERICA, WASHINGTON, D.C.

Mr. EDWARDS. I would like to preface my formal statement with just a few remarks, particularly in regard to the availability of teachers, instructors and interested people who will do the handling of the mentally retarded.

I happen to be very closely associated with a gentleman that is doing a wonderful job in trying to answer this problem. He is trying to get educational facilities set up in at least one nationally known university and his problem, of course, his great problem is money, getting the funds.

Then, his second problem is selling the size of this great problem to the university heads and others that would have the final word on whether such training facilities for instructors could be set up.

So, although I have some opposition to certain facets of this legislation I want to say emphatically that I know at first-hand that modern facilities are needed. I think my formal statement that I will read will bring out the basis of my appearance here today a little more clearly.

Mr. Chairman and members of the committee: It is indeed a generous thought to provide modern facilities for the treatment and housing of mental patients. You, Mr. Chairman, and members of the committee deserve praise for your admirable concern.

There is great danger, however, that this kind of giant Government plan with all its attendant publicity may interfere with solving the toughest problem of all, and that is, the neglect of mental patients by their relatives and friends.

It is rather well established that such widely heralded proposals can lull the public further into its chronic neglect of a duty, of kindly acts that only individuals can fufill.

Money, buildings, drugs, science, cannot replace this great human need which, we believe, has historically been the biggest factor of all. The continued interest of one individual from the outside supplies more rehabilitating influence than all other factors combined.

I am presently working to get one young man released from a State hospital. His greatest resolve, once he is released, is to organize groups of ex-patients who will know from long experience how to supply this essential human ingredient.

This young man's experience with his doctor in charge points up another serious shortcoming which calls for extended investigation by Congress. We refer to the general caliber of doctors directly in charge of patients. In this instance the stodgy, old-fashioned-type doctor conducts himself in the manner of a tyrant.

He has almost completely undone the good work that has taken 212 years to achieve I should have explained, with this one individual. It is well known that the caliber of doctors in this work leaves much to be desired. They are all too often misfits, incompetents, or alcoholics.

We are going to try to list briefly as possible the several salient features of our remarks intending them as constructive information to aid your honorable members in their determinations.

(1) We earnestly suggest that these public hearings be slowed down considerably and extended for at least a year. Mental health and

retardation seem far too serious, far too comprehensive to be decided in this short space of time. We are thinking particularly in terms of mental retardation and certainly there were an awful lot of unanswered points raised and an awful lot of unanswered questions raised in regard to this rapidly exploding matter of mental retardation.

(2) It is our sincerest conviction that an entirely separate set of public hearings be instituted for the retardation bill. Too little is known and there is far too much ground to cover to limit the retardation issue so briefly.

As an aside I do believe these bill were introduced on February 11 and the Senate has already completed public hearings on them and now we are drawing to the close of these hearings. I think emphatically that more time should be requested on this issue of mental retardation, Mr. Chairman.

(3) That in line 7, page 1, of H.R. 3689, be amended to eliminate the words, "And related aspects of human development," and that in lines 19, 20, 21, and 22, the words, "or research and related purposes, relating to human development, whether biological, medical, social, or behavioral, which may assist in finding the causes, and means of prevention, of mental retardation," since they are vague and irrele

vant.

(4) The concept of psychiatric beds in general hospitals will compound the "hospital treatment" atmosphere that has long handicapped efforts toward reform. Homelike facilities are a must for both mental health and retardation facilities proposed here.

(5) Too little has been brought out to date on the results of continued tranquilizing drugs. While simplifying one of the major problems in daily control of patients they have contributed little in reducing the number of patients. This is brought out in the high readmissions.

(6) The forward looking suggestions of State mental health tribunals must be incorporated into any legislation of this broad, comprehensive plan. Such entirely independent patient appeal boards are quite indispensable to an improved outlook. A description of the British system is included in the body of this statement.

(7) Provision must be made for religious belief, religious practice, which occupy so important a place in mental health. The newer homelike facility can contribute importantly here.

(8) To help solve this gargantuan retardation problem about which so little is admittedly known, a separate medical organization must be conceived of. This should be entirely separate from the present, traditional concept. Retarded youngsters do not respond to psychiatry like adults, nor to drugs-they do respond so wonderfully to love, affection, kindly interest, and human warmth.

These cannot be considered products of a modern medical school. Yet, a limited medical training should be available to a minority of workers in this brandnew field. Although the word "nutrition" has been suggested in this present instance, nothing is being carried through.

So, let us begin from the ground up where a short term medical training shall be on an even footing with advanced, modern nutritional training for workers. Obstacles to this should be few since it is admitted on all sides that little or nothing is known as to the cause of the condition.

Dr. Tom Spies, famous nutritional researcher, made a most thorough study of the mental-nutritional relationship at the University of Alabama and again at Northwestern. The pattern established at these great universities are still readily available despite Dr. Spies' untimely death some 2 years ago.

Over 30 years ago Henry Ford was quoted in one of his famous interviews on the subject of intelligence and morals, and worth noting here. Mr. Ford states, "First discover the vital connection between food and attitudes of mind, between food and the images of mind and body, then experience a proper course."

Although he was far from a scientist, Mr. Ford's views were ably seconded by the famous Dr. Royal S. Copeland, at that time, a U.S. Senator from New York.

We may look to Great Britain for admirable progress in mental health. It is true we have a few notable institutions here, such as the great Massachusetts Mental Health Center in Boston. In Britain they believe there should be no formality about entering a mental institution, and that the number of people in mental homes has been higher than it need be.

To implement this view they have set up practical mental homes, and hostels. As an example, there is Cassel Hospital at Richmond, outside London; here "depth psychology," or "talking treatment” is practiced.

Drugs are hardly used. The average monthly drug bill for the entire hospital, including tranquilizers, is $4.20. Instead, treatment at Cassel concentrates on helping the patient cope with his ordinary day-to-day problems.

At our St. Elizabeths, here in Washington, tranquilizers are a must three times a day. A patient who might try to avoid the drugs has them administered forcibly.

At Cassel mothers are encouraged to bring their newest born with them, to avoid the difficult readjustments resulting from neuroses already present. Husbands spend weekends with wives and vice versa. These innovations do much to ease the lost and lonely feeling that is so much a part of mental depression.

Once released, patients are encouraged to come back for periodic talks with their doctor whenever things get out of hand for them, even to spending a night or two at the hospital.

Cassel patients do most of the day-to-day running of the hospital. They prepare menus, serve meals, and arrange the social activities. There is a special playroom for the children. Nurses wear ordinary clothes, to make the atmosphere as much like home as possible.

Over there, in general, patients suffering from mental illness can consult their family doctor or receive specialist advice at hospital outpatients' clinics, as they would for any other kind of illness, and if they need to enter a hospital for treatment they can do so without formalities.

If patients or their relatives are unable or unwilling to make the necessary arrangements for admission to a mental hospital, it is the duty of a mental welfare officer of the local health authority to do

So.

Where necessary in the interests of society or of the patients themselves, mentally disordered patients can be compulsorily de

tained. However, compulsion is regulated in England and Wales by the Mental Health Act which supplies clear-cut guidelines.

The patient, or his relatives, may appeal against detention to a mental health tribunal, an independent body appointed not by the Minister of Health but by the Lord Chancellor, a top government official who is Chancellor of the House of Lords.

In Scotland, the system of safeguards and legal responsibility are even more extensive. When a patient is to be compusorily admitted, or held, or placed under guardianship, an application is made to the hospital management board, and this must be approved by a judicial authority, or sheriff.

A patient with a grievance can appeal to the sheriff or complain to the Mental Welfare Commission. This commission is an independent, central body. It has a right to discharge patients from detention at any time, or to investigate wrongful detention or improper treatment.

This system has happily governed the British approach to mental health administration for more than 50 years. It has materially lessened the entire mental burden over there, and it illustrates the charitableness and human understanding that has long guided their thinking. (Any letter or appeal sent to the commission is not subject to censorship.)

I would like to add here, Mr. Chairman, I cannot think of any reason why it could not be stipulated in this present legislation that guidelines and safeguards in these present plans be set up because we do not have anything here in this country.

The real authority over a patient, and I am thinking of this young man that I mentioned earlier, the authority and the only authority that he can appeal to directly is the doctor that is immediately in charge of his residence where he lives.

Resuming the formal statement, in contrast, we most often treat Americans, with ordinary neurotic problems, the same as common criminals. The sheriff moves in with the warrant, the mental suspect is locked in the county jail, behind bars, alongside jailbirds of every stripe.

It is not that these people are considered dangerous, we simply do not have any better system of handling them while they await probate court action on their commitment.

Furthermore, it has been the almost universal practice of administering shock treatment of some type once detention begins, although there has been a lessening of this since the advent of the tranquilizer drugs. However, this is still the system in general.

At this point, some way must be found to change public understanding of the mental problem. A highly organized system of public information, and a cult of so-called science writers is greatly responsible for creating an almost failure-proof health image.

With the development of the tranquilizers and the drive for ever bigger, annual Government research budgets, the public relations expert has built up a concept of scientific mental health treatment and competence all out of proportion to the ability to deliver. Truly the American public has been sold a bill of goods-that medical science, psychiatry, and modern drugs have eliminated mental health as a serious problem.