This difference, too, is most strikingly shown by the fact that the average weekly cost per patient in the acute asylums was $5.29, while in the Willard and Binghamton asylums for the chronic insane it was less than half that amount, or about $2.60. The ratio of physicians to patients in the acute asylums was 1 to 110, while in the chronic asylums it was 1 to 272. The recovery rate on average daily population was twenty per cent in the acute asylums, while in the chronic it was two per cent. The average recovery rate on admissions was about thirty-three per cent in acute asylums and about five per cent in chronic asylums.
In spite of the fact that the State had built many new asylums, the number of insane patients in the State increased more rapidly than the accommodations provided for them. The counties also found it more economical to abuse, under the guise of care, many of their own chronic insane. The result, therefore, was that the number of these unfortunates in county houses had in 1889 increased to 2,200. Their condition was most pitiable, and the recital of what they were subjected to carries one back to the barbarities practiced in the middle ages and by savage tribes. The Charities Aid Association, President Craig of the State Board of Charities, and Dr. Stephen Smith, then State Commissioner in Lunacy, kept for three years nobly at the work of making public this disgrace and blot on our civilization. Finally, in 1890, the present State care act, the consummation of their endeavors and those of the present commission in lunacy created in 1889, became a law. This State care act calls for the removal of all the insane patients from county houses to State hospitals and their care therein. New York and Kings (Brooklyn) Counties are exempted from this act, as they are considered to furnish suitable accommodations distinct from their poorhouses for their insane. The State has been divided into districts, and each hospital has its own district, from which it draws all the patients, both acute and chronic, thus making all the State hospitals of the same character—that is, mixed hospitals for the care of both the acute and chronic insane, instead of hospitals for the acute cases and asylums for the chronic incurable cases.
In order to furnish accommodations for this large increase to the State hospital population, it has been designed and is now being carried out to erect cheap buildings as annexes to the present State hospitals on the hospital grounds at a cost of 8550 per patient. These buildings are intended for the more easily managed chronic cases, and will enable the State to care for the 2,200 insane patients who were inmates of county houses before this
- Many of the recoveries in chronic asylums were of acute cases of insanity in persons living in the immediate vicinity of the asylum.