MENTAL HOSPITALS IN THE MADRAS PRESIDENCY              5

(4) proposals for the formation of a mental cadre. The report of
the conference has been submitted to Government.

In forwarding the Annual Report of the Mental Hospital, Madras, the
Superintendent remarks as follows : —

I would like to take this opportunity of drawing your attention to
two or three matters which I think require your immediate considera-
tion :—

(1) "As has been already pointed out, the population of this
hospital is in excess of the accommodation available by more than 300
patients. So, the necessity for increased accommodation has become very
urgent. Even when the proposed scheme for remodelling the hospital is
completed which I expect will not be for some years to come, the problem
will still not be solved, for the new scheme provides accommodation for
1,100 patients and already the present strength of the hospital has
practically touched this mark. I would, therefore, urge that the question
of providing increased accommodation in the other mental hospitals at
Calicut and Vizagapatam be seriously considered. It may even be that
a fourth mental hospital may be necessary in the near future in one of
the districts of the South."

(2)  " I believe that the time has come for starting a home for
mentally defective children. There are at present more than thirty such
children below 16 years of age in this hospital and I have no doubt that
there are many more outside. All such children should be kept and
cared for in a separate home and not in a mental hospital. Even if the
present financial position does not permit of a scheme involving a large
expenditure, I would recommend that a start be made on a smaller scale
in rented buildings by providing a day school at least for the high grade
mental defectives and a home for the idiots and imbeciles. There is a
medical officer available who is specially qualified for this work and
there is no reason why this question should be indefinitely deferred. "

(3)  " If the work of a mental hospital is to advance along the right
lines, it is very necessary that the medical and the nursing staff should
be both permanent and contented. From my experience of over six
years in this hospital, I have found that the present conditions of
service are not financially attractive enough to draw and retain the best
men and women in this kind of work which is not only considered
unpleasant and risky but also requires special knowledge and experience.
It is therefore necessary that a special cadre for mental hospitals should
be introduced as soon as possible. Only such medical officers and nurses
as have an aptitude and are willing to volunteer for this branch of
service should be posted to such hospitals, and when once found
satisfactory, should not be transferred elsewhere."

I am in agreement with the recommendations under each of his three
headings.

The formation of a cadre of medical officers and nurses for mental
hospitals was discussed at the Conference of Mental Hospital Superin-
tendents in 1930, but our recommendations on that point are hampered
by financial considerations. The return of Dr. Venkata Subba Rao after
special study in Europe and America allowed a suitable opportunity for
forming a psychiatric clinic at the General Hospital in Madras with the
intention of using this officer's services later in a school for defective
children. Financial stringency must, however, delay the latter for some
time and though it has not been possible to retain Dr. Venkata Subba
Rao at the General Hospital a suitable place has been found for him on
the staff of the Rayapuram Medical School where his special training has
already proved of use and a psychiatric clinic has been established at
the Rayapuram Hospital.