Law 89-105, which authorized financial assistance to help the centers meet the cost of professional and technical personnel.

We supported the legislation because we were aware that the treatment of the mentally ill in state hospitals was handicapped because of the size, location and staffing patterns of these institutions. Too frequently care has been custodial rather than therapeutic largely due to the lack of professional personnel. This resulted in frequent, long, or permanent hospitalizations. Additionally, the isolated location of most state hospitals deprived patients of close, supportive contacts with family, friends, and community life. This situation also made recruitment of qualified personnel more difficult.

The establishment of community mental health centers is a relatively new approach to the prevention and treatment of the mentally ill. Many communities already have available diagnostic and treatment facilities, inpatient and outpatient psychiatric services, and provisions for emergency care and rehabilitation. In most instances these are not coordinated to the extent that continuing supervision of patients is provided from the onset of symptoms through to complete rehabilitation. One important function of the community mental health center was to stimulate coordinating of these various efforts to improve services to patients and families.

The availability of services in localities where people live can result in early recognition of illness and intervention at a time when treatment is likely to be more successful and lastng. For patients who may still require hospitalization away from their homes, the community mental health center is a resource for providing follow-up care and rehabilitative services. The hospital stay would, therefore, be shorter enabling the individual more quickly to resume his proper role in society.

In addition to providing direct services to patients and families, the mental health center also has an educational function in the community. Because of lack of knowledge and understanding of the pathological process by members of the family and community, the mentally ill were all too frequently rejected. The support and understanding of relatives is vital to full recovery. Because hospitals for the mentally ill are generally in isolated areas, an effective sustained plan for interpreting mental illness and the patient's needs to his family is frequently impossible.

Closer collaboration is necessary between mental health personnel and other health workers in public and private community agencies, and with practicing physicians, nurses and social workers. Although their major function may not be directly related to mental health and mental illness, they too have a responsibility in prevention, in follow-up care, and in rehabilitation. The staff of the community mental health center becomes a resource for helping these allied professional groups broaden their understanding and knowledge of mental health and therefore, provide more effective service. The centers provide clinical facilities where doctors, nurses, psychologists and social workers can gain first hand experience in working with psychiatric patients and their families. In addition, consultant service is made available to those coping with the behavior problems of the child and adolescent.

The success of programs to combat mental illness depends in large measure on the availability of well-qualified professional manpower. We have stated repeatedly that buildings alone cannot constitute a program. They provide only facilities for treatment. The provision of treatment and the quality of care is dependent on personnel. We, therefore, urge your Committee to approve the extension of the provision for meeting the costs for staffing mental health centers. Your bill H.R. 6431 will continue the assistance to states to help them deal effectively with the problem of mental illness and further relieve them of the tremendous financial burden they carried so long. Establishment of the mental health centers is providing a means, not only for helping patients in their own communities, but also for developing new types of programs that are less costly than the traditional confinement in a longterm institution.

We urge the favorable consideration of H.R. 6431 and request that this communication be made a part of your Committee's record of hearings.

Sincerely yours,

JUDITH G. WHITAKER, R.N.,

Executive Director.

Hon. HARLEY O. STAGGERS,

NATIONAL ASSOCIATION OF SOCIAL WORKERS, INC.,
Washington, D.C., April 6, 1967.

Chairman, House Interstate and Foreign Commerce Committee,
House Office Building, Washington, D.C.

DEAR MR. STAGGERS: In behalf of the 47,000 members of the National Association of Social Workers, may I express support for H.R. 6431-the Mental Health Amendments of 1967.

Our organization supported this legislation when it was enacted. Our many members who are involved in the carrying out of the programs have told us of the changing patterns of services meaning more effective care which are now possible.

In most communities the programs are really just getting under way and not only continued but increased appropriations are needed to sustain the effectiveness of the community mental health approach.

We should like to make a final comment in support of Section 5 of H.R. 6431— establishing a contingency fund. We see this as insurance for sustaining important programs which otherwise might become bogged down or cut off because of unforeseeable administrative complexities.

Sincerely,

MELVIN A. GLASSER, Chairman, Social Action Commission.

(Whereupon, at 2:25 p.m., the subcommittee adjourned, subject to the call of the Chair.)