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which were several large stone buildings that were ultimately renovated and converted for the use of patients. The state acquired in the same year from the United States the gift of Widows' Island in Penobscot Bay near North Haven. This property, now known as the Chase Island Convalescent Hospital, is used during the summer months for the entertainment and recreation of patients from both hospitals.
The Criminal On March 6, 1907, the legislature appropriated money for Insane the construction of a suitable building for the criminal insane. This building was completed in 1908 and pro- vides suitable accommodations for the criminal insane who were up to that time inadequately provided for in the state prison and in the wards of both hospitals.
Capacity Since the opening of the hospital in 1840, 15,438 patients
have been admitted. The normal rated capacity is 942 patients. The number in the hospital Jan. 21, 1920, was 1,121; 573 men and 548 women.
Valuation The value of the hospital property, viz., real estate and buildings, is inventoried at 1,894,740; personal property, viz., furnishings and equipment $202,133.66, making the total valuation of the entire plant $2,096,836.66.
Farm The total area of the hospital property including the farm and grounds is approximately 600 acres, of which 450 acres are under cultivation.
Cost of For the year ending June 30, 1919:
Maintenance
Augusta Bangor
Average gross weekly per capita cost
$5.924 $6.92
Less income (sources other than appropriation)
.876 .76
Average weekly per capita cost to the state.
5.048 6.16
Bangor This institution, formerly known as the Eastern Maine Insane Hospital, is located in the city of Bangor and occu-
State Hospital pies a prominent site on the northern bank of the Penob- scot River, east of the city, two miles from the railroad station.
Early History In 1889 the legislature passed a resolution which was presented by Hon. E. C. Ryder of Bangor, authorizing Governor Edwin C. Burleigh to appoint a commission to select an eligible site at or near the city of Bangor for a state hospital. Twenty-five thou- sand dollars was appropriated for the purpose, and Governor Burleigh appointed as commissioners Col. Joseph W. Porter, chairman; Col. Joseph Hutchins and Col. Daniel A. Robinson, M. D. This commission after a long and careful investigation of various sites, finally selected a site in the city of Bangor adjacent to the water works, which was approved by Dr. Bigelow T. Sanborn, superintendent of the hospital at Augusta.
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The commissioners, accompanied by George M. Coombs of Lewiston, architect, who had been engaged to assist in the preparation of plans, vis- ited many hospitals in other states in order to familiarize themselves with the latest ideas in modern hospital construction. The plans were submitted to the legislature, and a joint special committee was selected to consider a resolve for an appropriation to start construction, and adopted a resolu- tion that a new commission of three be appointed by the governor to take immediate steps to erect a building on the site selected and that the sum of $200,000 be appropriated. This resolve failed to pass owing to strong opposition in both branches of the legislature.
In 1893 another attempt was made to obtain from the legislature an appropriation which was successful, and Governor Cleaves appointed Albion E. Little of Portland, chairman, Samuel Campbell and Sidney M. Bird members of the commission, with Dr. Bigelow T. Sanborn, superin- tendent of the Augusta State Hospital, as an advisory member. They were directed to take immediate steps to erect not later than January 1, 1897, upon the site at Bangor already purchased by the previous commission fire proof buildings, after plans to be selected by them, for which purpose the sum of $75,000 was appropriated.
The commission after careful study, rejected the site selected by the previous commission and decided to erect the hospital on the top of the hill which made necessary a great amount of grading and blasting of ledge to obtain a level place large enough to accommodate the buildings. The plans were drawn by John Calvin Stevens, architect, of Portland who followed closely what is known as "The pavilion plan". The plant con- sists of a central administration building, kitchen, laundry and power house on a central axis which runs from north to south. On the east and west and connected to the central building by corridors are the wings contain- ing the wards. The buildings were completed and opened for the recep- tion of patients July 1, 1901. The first patient was admitted June 26, 1901. Two others had been admitted when on the first day of July a detail of 70 women patients was received from the hospital at Augusta, followed upon the sixth by 75 men from the same institution.
In 1907 an additional wing for women was added that provided accom- modations for 150 patients and 19 nurses. The tuberculosis pavilion was added in 1910 which provides open-air treatment for 48 patients. In 1909 an appropriation of $175,000 was obtained for a new wing to accommodate 150 men and a bathing pavilion equipped with shower baths and dressing room. In 1913 a new cold storage plant and a new store room were con- structed over which was constructed in 1916 and 1917 a congregate dining room to accommodate 500 persons.
Capacity
The hospital has capacity for 600 patients. The number in the hospital on January 21, 1920, was 355 men, 329
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women, a total of 684 patients; 3,614 patients have been admitted to the hospital since it was opened, in 1901.
Valuation The value of the hospital property, viz., real estate, includ- ing buildings, is estimated at $956,882.48; personal prop- erty, viz., furnishings and equipment, $140,168.24, making the total value of the entire plant, $1,097,050.72.
Farm
The original hospital site consisted of 120 acres. The farm was enlarged by the purchase of 50 acres additional in 1905, and a second purchase of 50 acres in 1909. The farm now contains approxi- mately 250 acres, of which about 100 acres are under cultivation.
Management Both institutions are managed by a single board of trus- tees, consisting of seven members, the present personnel of which is Howard L. Keyser, president, Greene; Charles E. Smith, secre- tary, Newport ; Albert J. Stearns, Norway ; James W. Beck, Augusta; John B. Hutchinson, Eastport ; Frank E. Nichols, Bath ; Mrs. Arthur F. Parrott, Augusta. The board meets monthly at each institution. The superin- tendent of the Augusta State Hospital is Dr. Forrest C. Tyson; steward and treasurer, Mr. Samuel N. Tobey. Dr. Carl J. Hedin and William Thomp- son occupy similar positions in the Bangor State Hospital.
Admission of Patients The Bangor State Hospital receives patients who are resi- dents of the five eastern counties as follows: Penobscot, Hancock, Washington, Aroostook and Piscataquis. Resi- dents of all other counties are received at Augusta. Patients received in either hospital that have a residence in the district other than that assigned to the hospital may be transferred by order of the trustees. Patients are admitted to either hospital only on properly executed forms prescribed by statute. The blanks may be obtained on application from the superin- tendent.
Rate for Board The rate for board established by the trustees January 1, 1920, is $6.00 per week. Economically, patients are divided into two classes: first, reimbursing patients who pay all or part of the cost; second, state patients in which the state assumes the entire cost of maintenance. The expense of commitment and trans- ference to and from the hospitals is borne by the town making the com- mitment. The private wards with special privileges for a certain class of patients have been abolished. A statement of facts relative to the financial ability of the patient or relatives for his support is required in each case. Commitment All insane who are legal residents of a town are entitled to admission to the state hospitals. All persons should be committed in the regular manner by the municipal officers on the evi- dence of at least two reputable physicians given by them under oath. The complaint must be made in writing by any blood relative, husband or
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wife, or by any justice of the peace. At least 24 hours' notice must be given to the person alleged to be insane prior to the date of hearing. The commitment paper and the signed medical certificate must accompany the patient to the hospital. If the patient has no means or relatives liable for his support a certificate of inability should be filed at the same time. If a woman is committed she should be accompanied by a father, husband, brother or son. In the absence of these relatives by a woman attendant. All cases whenever possible should be accompanied to the hospital by rela- tives or friends. Officers of the law if obliged to accompany the patient in order to render assistance should dress in civilian clothes.
Emergency Commitment In cases of emergency when immediate restraint and deten- tion is necessary for the comfort and safety of the patient, the right of hearing may be waived and the patient may be received on the presentation of a copy of the complaint and physicians' certificate, which certificate shall set forth the reasons for the emergency. The municipal officers should proceed with the hearing, complete the com- mitment, and forward the certificate to the hospital within 10 days.
Observation In addition to cases sent to either hospital for observation by the supreme court provision is made for other cases as follows: "If a person is found by two physicians qualified as examiners in insanity, to be in such mental condition that his commitment to an institution for the insane is necessary for his proper care or observation, he may be committed by any judge or any other officer authorized to com- mit insane persons to either of the state hospitals for the insane, under such limitations as the judge may direct, pending a determination of his insanity."
Voluntary Commitment The superintendent in charge of either of the state hos- pitals to which an insane person may be committed may receive and detain therein, as a boarder and patient, any person who is desirous of submitting himself to treatment and who makes written application therefor, and whose mental condition in the opinion of the superintendent or physician in charge is such as to render him com- petent to make the application. Such superintendent shall give immedi- ate notice of the reception of such voluntary patient to the board of state hospital trustees. Such patient shall not be detained for more than ten days after having given notice in writing of his intention or desire of leav- ing the institution. The charges for support of such a voluntary patient shall be governed by the laws or rules applicable to the support of an insane person in such institution.
Temporary Care
Provision is made for the temporary care of patients who by reason of sudden mental disorder need care pending other arrangements for the disposition of the case. It is applicable to transients and non-residents particularly, and in those
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instances when officials authorized to make commitments cannot be assem- bled immediately. The act is as follows: "The superintendent of either of the state hospitals, to which an insane person may be legally com- mitted, may, when requested by a physician, a member of the board of health, a health officer, a police officer of a city or town, receive and care for as a patient in such institution for a period not exceeding fifteen days, any person who needs care and treatment because of his mental condition. Such request for admission of a patient shall be in writing and filed at the institution at the time of the reception of the patient, together with a statement in a form prescribed or approved by the board of state hospital trustees, together with a statement giving such information as said board may deem appropriate. Such a patient who is deemed by the superin- tendent not suitable for such care, shall upon the request of the superin- tendent be removed forthwith from the institution by the person requesting his reception, and if he is not so removed, such person shall be liable for all reasonable expenses incurred under the provisions of this act, on account of the patient, which may be recovered by the institution in an action of contract. Such superintendent shall cause every patient to be duly com- mitted according to law, provided he shall not sign a request to remain as a voluntary patient or to be removed therefrom before the expiration of such period of fifteen days. All reasonable expenses incurred for the examination of the patient, for his transportation to the institution and for his support therein, shall be allowed, certified and paid according to the laws providing for similar expenses in the commitment and support of the insane."
Minors
Parents and guardians of insane minors if of sufficient
ability to support them in the hospital must within 30 days after an attack of insanity, without legal examination send them to one of the hospitals and give to the treasurer the bond required within this period.
The Medical Service
The medical service in both hospitals is under the direc- tion of the superintendent who is assisted by a staff of trained physicians. The chief feature of the medical serv- ice is the daily staff conference at which all new cases are presented in turn by the assistant physicians for diagnosis and suggestions for treat- ment. Cases for parole or discharge are also considered.
New Cases All new cases are received by the assistant physicians in rotation. The record of examination contains the anamne- sis obtained at the time or later, a general physical and neurological exam- ination with urinalysis, vaccination, and an examination of the blood for the Wassermann reaction. Special tests are performed when indicated. The mental status is ascertained by a carefully recorded examination.
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The patient is now presented at staff conference for classification. The subsequent clinical course of the case is noted from time to time on the record.
Treatment Special features in treatment consist of rest in bed, regu- lation of diet and bodily habits, judicious application of various hydrotherapeutic measures such as wet packs, douches, and con- tinuous warm baths, selected occupation under a trained industrial worker. The physically ill are cared for in sick wards where the principles of gen- eral medical practice are used.
Amusements
Patients are entertained by weekly dances, moving pic- tures, concerts, lectures, athletics and various other out-
door activities.
Training School Each hospital maintains a training school for nurses under the direction of a superintendent who is a registered grad- uate nurse. The course is of three years' duration. Appli- cants must be over 19 years of age and present satisfactory references as to good moral character and physical health. Preference will be given to those candidates for the training school who are high school graduates or who have acquired more than a common school education. Pupil nurses are assigned to positions offering the best opportunities for experience in nursing all forms of nervous and mental diseases, as well as acute medi- cal and surgical cases. The reception wards have adequate modern equip- ment for giving prolonged baths, packs, and other hydrotherapeutic treat- ment. While the hospitals are mainly for nervous and mental diseases they are large enough to give ample opportunities for experience in gen- eral medical and surgical nursing. The training school opens in October and closes in June. Lectures are given by the physicians. Practical instruction and demonstrations are given daily on the wards by the super- intendent of nurses, supervisors, and charge nurses. In addition to the theoretical instruction the physicians also give practical demonstrations in the ward clinics, laboratory, dispensary, and autopsy room. The Augusta training school affiliates with that of the Maine General Hospital in Port- land, the Bangor training school with Bellevue hospital in New York city. The affiliated course is of not less than six months' duration after which the graduate is eligible for registration in Maine.
General ยท No patient can be received at either hospital until cor- rect commitment papers are presented.
Information
Patients' relatives are requested to furnish a good supply of plain, suitable clothing.
Money, jewelry and other valuables should not be brought with patients, and the hospital will not be responsible for anything left later in possession of patients. Things necessary or suitable for patients can be left with hospital officers.
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Visiting daily from 9 to 11.30 a. m .; from 1 to 5 p. m. Definite times for visiting are required to avoid serious interference with hospital work. Visiting on Sundays not allowed except in cases of critical illness, or by pre-arrangement.
Visitors are requested to ask for any desired information concerning patients of the physicians at the office.
Inquiries by telephone, concerning patients should be made, if possible, between the hours of 1 and 2 p. m. The persons making call should always give the name of patient for whom inquiry is to be made, and not call for the physicians. This will insure prompt reply and the proper person will be notified to answer call.
Written inquiries should always contain name of patient, name and address of writer, with relationship, if any, to patient. Reply stamp should be enclosed.
Letters and express packages sent to patients should be directed to them in care of the hospital.
The name and address of sender should be given on outside of package in order that acknowledgment of same may be made. To insure delivery, all charges must be prepaid.
All letters concerning patients should be addressed to the superin- tendent.
All letters concerning the financial condition of the patient should be referred to the treasurer.
Community
The public is entitled to the benefits of the knowledge and resources of the state hospital organization which should
Service be extended to the community through the services of mental clinics and after care agents. Both hospitals conduct mental clinics in Portland, Lewiston and Bangor. Social service workers are employed to visit the homes, obtain and impart information, and help in restoring paroled and discharged patients to economic independence. The require- ments of such extra institutional activities in general are as follows:
First: The supervision of patients who have left the institution with a view to their safe care at home, suitable employment and self-support under good working and living conditions, and prevention of their relapse and return to public dependency.
Second: Provision for informing and advising any indigent person, his relatives or friends and the representatives of any charitable agency as to the mental condition of any indigent person, as to the prevention and. treatment of such condition, as to the available institutions or other means of caring for the person so afflicted, and as to any other matter relative to the welfare of such person.
Third: Whenever it is deemed advisable the superintendent of the institution may cooperate with other state departments such as health,
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education, charities, penal, probation, etc., to examine upon request and recommend suitable treatment and supervision for
(a) Persons thought to be afflicted with mental or nervous disorder.
(b) School children who are nervous, psychopathic, retarded, defect- ive or incorrigible.
(c) Children referred to the department of juvenile courts.
Fourth: The acquisition and dissemination of knowledge of mental disease, feeble-mindedness, epilepsy and allied conditions, with a view to promoting a better understanding and the most enlightened public senti- ment and policy in such matters. In this work the department may coop- erate with local authorities, schools and social agencies.
CHAPTER LV
SCHOOL FOR THE FEEBLE-MINDED
History The Maine School for Feeble-Minded was established by an act of the legislature of 1907. In accordance with this provision, the state purchased about 1200 acres of land in the towns of New Gloucester, Gray, North Yarmouth and Pownal, in Cumberland County. The institution is located one mile from Maine Central Railroad and one mile from Grand Trunk Railroad, Gray and Pownal being respec- tively their nearest stations. The school is twenty miles distant from Portland, and sixteen miles from Lewiston.
Who Are the In the group called feeble-minded, we include all those Feeble-Minded? individuals who are mentally deficient from birth, or early childhood; and whose defect is due rather to an arrest of development, than to a disease process in later life. These individuals are incapable of managing their affairs with ordinary prudence under ordinary circumstances.
Number of On the basis of one feeble-minded person in three hundred Feeble-Minded of the population, which is a conservative estimate, there are, according to the census of 1910, 2,226 feeble-minded persons in Maine, and 275,844 in the United States.
Admission The act establishing the School for Feeble-Minded provided for the care and education of the idiotic and feeble-minded six years of age upward. The law has since been amended, so that at present only males between the ages of six and forty, and females between the ages of six and forty-five are eligible for admission to the School for Feeble-Minded.
Commitment Feeble-minded persons are committed to the school by judges of the probate court, after they have first been examined by two physicians who certify that they are fit subjects for the School for Feeble-Minded.
Management Maine School for Feeble-Minded was opened for inmates in 1908, and is under the general management and super- vision of the hospital trustees, who also have charge of the two insane hospitals. One or more of the trustees must visit the institution as often as once in each month. The board of trustees must have an annual meet- ing, and present a yearly report to the governor and his council, contain- ing the history of the school for the year, and a detailed report of all accounts and disbursements.
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Cost The School for Feeble-Minded accommodates 282, and has a waiting list of 180 applicants. Applicants for admission must first apply to the board of trustees, and are accepted for admission from the various counties in the state in proportion to their population. The approximate total expenditure for permanent construction and build- ings up to date is $275,000. The average per capita cost for maintenance, including board, clothing, care and medical treatment, and training is $4.00 per week.
Methods On admission, the inmates are given a physical and mental examination, and classified according to their physical and mental condition. All teachable and trainable boys and girls are grouped in classes according to their mental age and given instruction and training adapted to their mentality. The higher grades are taught to read, write and do simple number work. In the manual training and industrial rooms they are taught to work at various simple occupations. The many house- hold duties and the large farm furnish many of the boys and girls with useful occupations.
Care of the Feeble-Minded Every feeble-minded child should have an opportunity to learn whatever he is capable of learning and thereby be able to think better, do better, and be able to live a happier and more useful life.
All feeble-minded cases who show criminal tendencies, sex offenders, and those who distribute venereal infection, live in filth and tend to degrade the neighborhood, should be provided for in an institution.
Every feeble-minded woman between the ages of fifteen years and forty-five years of age, who cannot look out for her own moral welfare, should be segregated in an institution. There are probably more than five hundred of these child-bearing mentally defective women in Maine, who are rapidly multiplying the feeble-minded variety of the human race.
ADMINISTRATION BUILDING-STATE SCHOOL FOR BOYS
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CHAPTER LVI
STATE SCHOOL FOR BOYS
Location The State School for Boys is located in South Portland, about four miles from Portland City Hall. The nearest trolley line is at Stroudwater, one and one-half miles from the school build- ing. The post office address is 264 Westbrook Street, South Portland, Maine.
History The school was established by act of the state legisla- ture of 1853, and after a careful investigation by a legis- lative committee appointed to select a site the present location was most happily chosen, and by the liberality of the City of Portland a farm of 160 acres was purchased at a cost of $9,000 and presented to the state to be used for purposes connected with the institution, which was then known as the State Reform School.
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