TEACHING AND RESEARCH IN STATE HOSPITALS

In this paper we have discussed the present status of teaching and research in state hospitals. We have outlined the teaching programs in various state hospitals and have attempted to evaluate these programs. We have discussed research in state hospitals from the viewpoints of its present status and its rôle in the solution of mental disease, and we have mentioned a few problems of special importance. We have considered the need for, and the advantages of, some central organization for research, and we have listed some of the functions of such a central council. Finally, the importance of the psychopathic hospital as a liaison between state hospitals and medical schools and as an almost indispensable unit in the teaching of psychiatry has been stressed.

We have found that some very worthwhile work in teaching and research is being carried on at the present time; that some hospitals are alert to the need of teaching and research in a progressive program; that such work in state hospitals is often carried on under great handicaps as to personnel, finances and equipment. However, we have noted that in far too many institutions, the physical conditions and the attitudes and interests of the staff are unfavorable to the development of teaching or the prosecution of research. While in many cases this lack of a teaching and research program is due to insufficient funds, in some it is certainly due to a mistaken adherence to the idea of the purely custodial function of the state hospital. We believe that the state hospital has much to gain from, and much to offer to, an extensive organized program of teaching and research.

We are mindful that state hospital administrators may object that our program is too ambitious; that it is beyond the realm of possibility. Also we are mindful that some will emphasize unduly their financial and personnel handicaps. While we are cognizant of these and other criticisms, we abhor taking a temporizing position in this discussion by merely patting everyone on the shoulder and pleading for more and better work. We beg instead for cooperation by all those concerned to develop their teaching and research programs in order that they may make a worthwhile contribution to the solution of mental disease. No one can question that within a short time, if indeed it is not already true, state hospital administrators will become more cognizant of their position as directors of teaching and research institutions. This means changes in personnel and organization, and a shifting of the emphasis on the functions of a state hospital. Naturally the state hospital must take the lead itself in initiating and developing these changes.