As improvement grew more marked, the doctor advised that she should work three hours each day outside her home. Three hours' work every day in a good restaurant was secured. The benefit was so marked that after a month the doctor suggested that the working time be doubled.
Mrs. R. now reports weekly to the clinic, but her depression has disappeared. She is cheerful, interested in life, and is looking forward to the re-establishment of her home this spring.
Recent conferences on mental hygiene have emphasized the fact that the traditional conception of mental disease, raving insanity, is far behind the times. We recognize today that there are in the community all classes of mental disorders, from the maniac or imbecile to persons who are "just a little queer," or who, like Mrs. R., have a definite and curable obsession.
The time has also gone by when we associated the treatment of mental disease with the straight-jacket. The hopelessly defective and insane must indeed be segregated in institutions. But it is public economy to diagnose and treat the great mass of incipient and curable cases of mental disorder, since these, if uncared for, mean the wrecking of lives, the breaking up of families, and material loss to the community. The psychopathic clinic, or clinic for mental diseases, is an agency the importance of which is now recognized by all who have given attention to this field. Such clinics have usually been conducted in hospitals or institutions which specialized in mental disorders. They have rarely been managed as adjuncts of general hospitals or dispensaries. There is a distinct place for them in this connection, however, for in this way they catch patients who do not know that their troubles are really symptoms of mental disease.
Mrs. R.'s case illustrates not only the service of such a mental clinic, but also the two chief agents in achieving the service, the physician--specialist in mental diseases--and his aide, the social worker. Mrs. R.'s case belongs to one of three classes of mental disease which such a clinic can benefit--the incipient type. The second class comprises cases of mental defect which require diagnosis and institutional care.
For example. Mrs. B., a middle-aged Irish woman, came to the clinic much excited, fancying that people were locking her into her rooms. Among other delusions she feared that she might injure her two children.