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chemistryu perhaps can athrow some light[jon, the workings of the nervous tissue.

.eletiqeoil soft bae Viltis very likely that expenditures for that kind of researeh would be very high, and the kind of research that needs be done may demand a fairly high backing in order to supply sufficient funds. I lepolo

In general, I feel that this bill is a very reasonable and very forward Jooking one:1 101 locob JSOv zimst vlmistus 917 T211 16

I don't believe I have anything more, sir. Jf99019 :12 TOT 101 brie

Mr. Priest. We certainly thank you: We appreciate your appearing and testifying personally in behalf of the bill. HOLASA DIITATTY29 KO.IT10L...04.10 TITATA STATEMENT OF DR. FRANK, J. CURRAN, REPRESENTING THE

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Mr.PRIEST, Dr. Curratı, will you give your name and your official title torthe reporter? bod 300.001,210 IIA 61 tsil) elevha ni mis il 97 Drz:CURRANIO Franko Jb Curran, New York City, 500 West End Avenues icon Tong teori soft bus jus) si 120:41 98 11990 92Mr.7 PRIEST.. You represent the Joint Committee of Psychiatric Security? 2011 lo '

Else-MT) oli sono lo puoi ot yds ni 79 Dr. CURRANSIThe Emergency Committee tof-Neuropsychiatric Societies of New York Citýmigile 10 ,1119090 08 101 10), 9ved

Mr. Priest. Thank you, Docten; you may proceeding 01011 oy Dr. CURRAN-Dro:John Millett, the president of the Emergency Committee of Neuropsychiatric Socieites oft:New York City i asked mesto represents himlat, this hearing. bin yuvil. 101.

The Emergency Neuropsychiatrie Committee is an organization which was formed at the time of the Pearl Harbor attack and is made up of representatives from thei various psychiatric and neurological societies of New York City, including the New York. Psychoanalytic Society, the New York, Neurological Society, the New York Society for Clinical Psychiatry, the New York Society for Psychotherapy and Psychopathology, the New York Regional Division of ithe Amenascan Ortbopsychiatric Society, and the section of neurology and psychiatry of the New York Academy of Medicinerichment jouity

I am also here in my official capacity as secretary and treasurer of the New York Society for Clinical Psychiatry and have been asked by Dr. Clarence Bellinger, the president of this society to represent him. I am also speaking a research councils on problems of alcohol. ; 'zi, assist wieluid,729 009

' L" As a psychiatrists practicing in New York City, I feel that our problems are similar to those in most other large cities in the country. There are an insufficient number of hospitals and clinics now available to treat those psychoneurotio individuals in the community who are hard working and conscientious, but who unfortunately do not have sufficient income to pay for the prolonged care and treatment of psychoneuroses. Persons who develop such illness usually fear to visit a psychiatrist, thinking he will label them as insane, and when their symptoms become so marked that they overcome this feab and consulta psychiatrist, their-condition is such that they will often -require many months of treatment toleradicate their illness o There Ishould be clinics available for people of moderate means similar to those for persons suffering from medical and surgical disorders, and, this may be made possible if this bill becomes a law.1940JB91) lo abong

1.As a member of the research council on the problems of alcohol, I would like so emphasize jone point, (namely, that the treatment of chronic alcoholism is very definitely a part of neuropsychiatry: 5 I do not wish at this time to go into detail as to the causo, prevention, and treatment of alcoholism, but my personal experience in dealing with alcoholics for the last 15 years indicates that deep-seated emotionalt factors are at the root of most cases of chronic alcoholism. Special research facilities and clinics to deal with the problems of alcoholisma are needed in all sections of the country, and it is my hope that if this, bill is passed that a fair percentage of the money is to be devoted to the neuropsychiapric problems of alcoholism, ipinto di parol

At the present time in New York City there is no public hospital or clinic ayailable for the treatment of alcoholism per se, and the laws of New York State do not allow the commitment to State hospitals) of chronic alcoholics who are not psychotic, not-insane. won TM

H. W. Haggard and E. M. Jellinek; in their book Alcohol Explored estimated that there were 44,000,000 users of alcoholic beverages in the United Sgates in 1940. of these 2,400,000 were excessive drinkers, and 600,000 were chronic alcoholies. Dit bier me ew lid

I wish particularly, to emphasize the portion of the bill which deals with the organization of clinics and with the training of psychiatrists, nurses, and other therapists who are to deal with the emotional problems of children and adolescence. I have been treating juvenilo: , delinquents for many years and know that since the war started there has been a gradual but very progressive increase in the number of juvenile delinquents appearing in the New York City courts. I have been reviewing recently the statistics of the domestie relations court, children's division, and have found that in 1940 there were 4,379 juvenile delinquents in the New York courts; in 1941, there were 4,379 cases; in 1942,6;109. delinquents; in 1943, there were 6,640; and in 1944 there were 6,774, juvenile delinquents. Thus we see that in 1943 and 1944, there was over 50 perqent increase over the 1940: figures iso assoablid 07 2:1), lo stess kits

According to Acting Presiding Justice Bruce Cobb of New York City Domestic Relations Court, there was no marked increase in juvenile delinquency in the United States, -and particularly in New York, after the First World War. There was, however, a very marked increase in juvenile delinquency in most European countries and gangs of boys ran wild and were labeled as ifpacks of wolves" and they were very destructive and unmanageable for years.be

Inasmuch as the present' war has been on a much wider scale, it appears quite likely that unless preventive measures are taken there will continue to be a marked increase in juvenile and adult delinquency in our country. 00:28; 1. 1039. lit vis, ** 123

At the present time there are very few places in this country where physicians can be trained to handle the emotional problems of children, and adolescents. Specialized techniques are needed for the understanding and correct treatment of these unfortunate children, consi

Moreover, there are inadequate hospital and clinic facilities for the treatment of such patients. It has been my own personal experience that the majority of delinquents of adolescent age if given intensive: examination along physical lines and given an intensive examination

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along intellectual and emotional lines, and given the benefit of short periods of treatment in a psychiatric hospital or in a clinic, will show marked improvement and they will not return to their antisocial behavior. Those children should not be treated as cirminals and should not be herded into jails or correctional institutions but instead should be first treated in hospital or clinic set-ups. It is true that a small percentage may require prolonged care in a correctional institution, but the largest group may be salvaged without such placement. The hope of our future lies in our children and adolescents, and if they can be given adequate help when they first manifest signs of emotional instability or antisocial tendencies, the majority can be made into honest, worth-while citizens.

Please permit me to thank you for the privilege of addressing you today.

Mr. PRIEST. We thank you for your statement. Are there any questions?

Mr. Brown. I might ask this question. Is it your thought the shortage of hospital and treatment centers should be met by the Federal Government?

Dr. CURRAN. No. But I understood one of the purposes of the bill was grant-in-aid funds for research and treatment purposes in places that are now established in other sections of the country.

Mr. BROWN. It is your feeling the place of the Federal Government in this picture is to do research, and furnish information and advice, and perhaps certain training, and in that way aid the State and local communities?

Dr. CURRAN. That is right. For example, when I first got into this juvenile-delinquency work in Bellevue Hospital in 1937, when we opened a ward for adolescent boys, I was warned on all sides, not only by nonprofessional people but even by professional people, that I was tackling a problem that could not be solved, that juvenile delinquents were incurable and they were going to continue in their antisocial behavior the rest of their lives. In spite of that we opened the ward; cases were referred to us by the courts of New York and by other agencies—as a matter of fact, the New York Children's Court only sent us the worst 7 percent of their juvenile delinquents, including those who had been tried on probation one to five times, including those who commit major crimes; for example, I had four boys under the age of 16, in a period of 6 months, who were sent to the hospital because they had killed others.

I did follow a study made of the boys that we kept under observation and treatment for 30 days, and found that 2 years later, of all of those most severe delinquents in New York City, only 10 percent were in correctional institutions.

Mr. BROWN. Were or were not?

Dr. CURRAN. Only 10 percent of the 300 I had studied were in correctional institutions; the rest, with the exception of a small group who were in feeble-minded institutions or in State hospitals, were adjusting satisfactorily in the community.

Other centers should be opened to do similar work, in my opinion, to prove to people in the community that it is not a wortħless task, that instead it is a very constructive task, to help in the diagnosis and treatment of problems of the adolescent period.

Mr. BROWN. Now, Doctor, I think this is a very important question. It is your thought that hospital facilities should be furnished by the States, or by local subdivisions, for the normal care of psychiatric cases; is that correct?

Dr. CURRAN. That is right.

Mr. BROWN. And that the Federal Government has no place in the routine care of those individuals?

Dr. CURRAN. My understanding, and my feeling, was that if there were a national center, such as has been proposed at Bethesda, that this could be used as a trying out, or trial place, to demonstrate the efficacy of treatment which could then be done in other parts of the country by the local communities.

Mr. BROWN. But you would have so many cases at whatever center you might name, of course. But what I am attempting to learn from you is whether it is your opinion the Federal Government should go into the States and local communities and establish hospitals there, or take over, the routine care of the ordinary mental cases, or whether it should be the policy of the Federal Government to establish a main center where research studies are made, and then perhaps send out experts to aid in the way of ideas, plans and equipment to be used, and methods to be followed, and perhaps put research men in these State or local hospitals to do research work, and to aid in the training of staffs, but not actually to staff any hospital for 'normal routine work, or to maintain beds therein, or to meet other costs that otherwise the State would carry.

Dr. CURRAN. I personally feel that each individual community should take care of its own problems.

Mr. Brown. This proposed institution would be a great center from which we could get experts to give advice and help.

Dr. CURRAN. To point out the possibilities and to demonstrate, as it were, test cases for people all over the country.

Mr. BROWN. And then from this central institute there should go into the State and local institutions the latest information, the latest methods, the latest types of equipment, and perhaps also specialists who would do research work on particular problems that the State would not be equipped to handle, but not to do so as a permanent service, but rather as a temporary thing until the States could take care of their own problems.

Dr. Curran. I feel it should be more in' an advisory capacity and as a proving center for certain new techniques of treatment.

Mr. Brown. In other words, they are the specialists?
Dr. CURRAN. That is right.

Mr. Brown. I think our minds meet. I know of your work, and I want to congratulate you on your statement.

Mr. PRIEST. Are there any other questions? Mr. MARCANTONIO. Are there mental hygiene clinics in New York City?

Dr. CURRAN. There are mental hygiene clinics in New York City; yes.

Mr. MARCANTONIO. How many are there, do you know? Dr. CURRAN. Yes; there are four New York City mental hygiene clinics, one of them for each of the four largest boroughs, Manhattan, the Bronx, Brooklyn, and Queens; there is no city mental hygiene clinic in Staten Island.

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Mr. MARCANTONIO. These hygiene clinics are located in health centers?

Dr. CURRAN. No; each of them is located in city hospitals. In Manhattan the hygiene clinic is located in Bellevue Hospital; in Queens County, it is located in the Queens General Hospital; in the Bronx, in the Morrisonia Hospital; in Brooklyn, in the Kings County Hospital,

Mr. MARCANTÓNIO. If a physician feels that a patient requires some treatment, and the patient cannot afford it, what does he do, recommend him to one of these clinics? Let us say he resides in Manhattan, Dr. CURRAN. A treatment for neurosis, you mean?

. , Mr. MARCANTONIO, Yés.

nisins . Marcantonio Dr. Curran. There is a place for treatment of psychoneurosis in the four boroughs of New York .

Mr. MARCANTONIO. Do you know anything about how it operates in Bellevue? Dr. CURRAN. Yes.

... via @r799110 voorleze, Mr. MARCANTONIO. I wish you would tell us about it. !!! 101

Dr. CURRAN. Well, usually there were three to six full-time phymental-hygiene clinics operate 5% days a week

at we nygiene clinic. , These

are seen on an appointment basis. We service most of the social agencies of New York. For example, the board of education and the various foster-home bureaus are constantly referring in children for examina– tion, 'particularly to determine whether they are or are not feebleminded, whether they do or do not have organic diseases of the brain, such as epilepsy, or if these children are showing emotional problems, they are examined to determine whether or not the emotional problems are of a minor or of a severe character. In other words, they want to find out whether these children, most of whom are neglected, can be taken care of adequately in the community, or whether they need special treatment in institutions. So they come to the clinic for such examination, primarily, then, for diagnosis. There is a small percentage of these children who are taken on for treatment purposes.

Mr. MARCANTONIO. That is the point. Where are they treated, at Bellevue?

Dr. CURRAN. A few are treated' at Bellevue. Some of the other agencies have their own psychiatrist to treat patients. For example, the bureau of child guidance of the bureau of education has a rather large psychiatric 'staff, but because of the fact that there are over 1,000,000 school children, they cannot handle all of the problems which are asked to take care of the group that the board of education cannot

e askered to them, and therefore the city mental hygiene cllinics gamine MÁRCANTÓNIO. From the standpoint of treatment; isn't it the usual practice to have these children and adults who come there finally committed to a State institution?

Dr. CURRAN. From Bellevue Hospital, from the mental hygiene clinic?

Mr. MARCÁNTONIO. 'No.' 'I just wanted to get that straight for the record.

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