An efficiency study from this standpoint during 1912 leads to the conclusion that the average cost per patient (the complete treatment of a case) in class three is sixty cents; in class two, a dollar; in class one, four dollars. The medical service is given gratuitously by the physician. More extended studies in this and in other mental clinics should be made in order to work out the cost figures more accurately.
There can be no doubt, however, that even if the cost of medical service were added, it is cheaper to treat mental diseases in the early stages, when patients can retain their places in the community, wholly or partly self-supporting, than to let the disease reach a point where permanent damage is done, and the insane hospital is the only resource.
That out-patient clinics should fill an important place in the new nation-wide campaign for mental hygiene, there can be no doubt in the mind of any one who has given attention to the matter. That organized social service is not only a desirable accompaniment of such clinics, but an essential condition of their efficiency, is a demonstrable and measurable fact.
CIVIL WAR IN THE WEST VIRGINIA COAL MINES
[_The Survey has not had staff or means to send a special representative to the West Virginia coal fields to make an intensive investigation of the conditions in the strike area. That is the sort of social interpretation we shall hope to perform with the growth of the slender resources of the Survey Associates. We have done the next best thing--viz., turned to the most promising newspaper source._
_It has been current gossip among journalists that the press of West Virginia could not be relied upon to tell the truth about the situation in the Kanawha Valley. Of the metropolitan newspapers which up to March had had staff representatives in the field, the accounts of the Baltimore Sun stood out. They did not mince matters in telling of the brutal murder by the strikers of the mine guard Stringer; nor did they hedge in publishing what was done by the Cabin Creek and Paint Creek Colliery Companies. Mr. West was the representative the Sun had sent into the field, and from him The Survey requested an article, only stipulating that it be fair to both sides and tell not only the events of the strike but the conditions back of them._