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fiction. Many times they get the same persons because the people come in in that order to pick up their mail. (Laughter.]
To me it is terrible that people should be asked to judge insanity without ability in that line. We would like to see, as I stated before, 2 psychiatrists in Fairbanks, 2 in Juneau, 2 in Anchorage, and 2 in Nome, 1 to stay in the city and the other to immediately go to the place where they have a case, look him over as a person who has been trained and if he needs it to bring him in for observation, not for trial, for observation. Then he can be put somewhere if he needs itI am using “he," I guess the female of the species gets it too—but if we could do that we give Alaskans a chance to act with pride on this mental health bill.
Before I get a question thrown at me I would like to say that we can get psychiatrists. That has been one of the things they say about Alaska, "Oh, you cannot get them up here.” We had over 500 teachers who applied for 20 jobs in the Fairbanks school system this year. Over 500 applicants for 20 jobs according to Superintendent Ryan. And if we can get that many first-class teachers we can get psychiatrists. All we have to do is pay them enough. No. 1, we have the glamour and everything else it takes to get them up here and a lot of people in this good old United States still like to feel they are doing a good turn for their fellow man.
To summarize: We can save money, we can make it pay for itself. We will have less days in jail for those who are supposed to be mentally ill and with psychiatrists we will actually put it on a plane where it should be, a medical plane, not a level of the run of the mill people who come to a post office.
Mr. O'BRIEN. There is, I assume, no voluntary commitments in Alaska. In order to get into a mental institution unless you have great means you have to be accused, in effect, of the crime of being mentally ill.
Mr. DERR. No, a member of the immediate family could ask that you be committed or an officer of the law, if he sees you endangering people or property and thinks you are doing it because of insanity, can bring you in. But then you get tried by these six jurors and, Representative O'Brien, they have to be unanimous to say that you are insane. We have had cases in the last 6 months where the same 2 people were tried twice and it was 5 against 1 and they are still loose.
And the 5 think they are crazy but that i holds out so we do not know. We do not know.
Mr. ABBOTT. Mr. Chairman.
Mr. Derr, you raised a question, of course, as to the ability or efficiency, under the present system, of United States commissioners in the Territory, is that correct?
Mr. DERR. Yes, I do.
Mr. ABBOTT. You appreciate that under the specific provisions of the bill reported with respect to hospitalization, that it will still be upon the filing of a written application with a United States commissioner
Mr. DERR. Yes.
Mr. ABBOTT. And, that there is provision made for appeal from the order of the United States commissioner?
MR. DERR. Yes.
Mr. ABBOTT. Now is it your position that with that appeal provision that the provisions in the present bill would nevertheless be satisfactory, absent some change in your present system of United States commissioners?
Mr. DERR. In part, that would solve the problem, but I feel that if our commissioner in Fairbanks, who is judged more sternly for the position than those in the outlying areas, could judge somebody else in another area to act as commissioner we would get a better commissioner staff. I think that would help.
Mrs. GREEN. You said that you would amend the present bill, that you would change it and your first suggestion was to require 2 psychiatrists in each of 4 places. Mr. DERR. Yes. Mrs. Green. There would be several questions in my mind about that. One, of course, the bill would provide hospital facilities in more than one place, which I think the majority of the members of the committee agreed on would be a better procedure. Mr. DERR. Does it say that in the bill?
Mrs. GREEN. Yes; it is hospital facilities. It does not provide for one hospital.
Mr. DERR. But it could be at one place. Mrs. GREEN. That is not the intent of the bill. Mr. DERR. We do not know what the intent is in the bill. Mrs. Green. The intent was to provide facilities in each of perhaps 3 or 4 different places, or maybe 2 or 3, whatever was decided afterward by the people in charge. But is it your opinion that it would be well to write into the bill that 2 psychiatrists shall be at Fairbanks and 2 at Nome or would it be better to leave that up to the judgment of people who are in charge? Maybe there would be a greater need for more psychiatrists in this place than over here.
Mr. Dern. We would certainly like to make sure that the people in charge would write it in. We are not telling them it is the best thing. We do not know. But, Representative Green, what the law says or the bill says as written, and what the intent is, are two entirely different things. We also read into that bill it said facilities but all the facilities could be in one community. We are a little worried about that phase of it, that it could be centered, let us say-may I be frank?-let us say it could be in Anchorage where you have a 600-bed hospital of which only 200 beds are being used now and then our natives from up in this country where we have two-thirds of the area would still be far from home in a mental hospital. That is the way the bill read to us in the committee.
Mrs. Green. The language in the bill is this: Such facilities shall be scheduled for construction in accordance with a comprehensive construction program developed by the Territory in consultation with the Public Health Service and approved by the Surgeon General. Projects shall be constructed in accordance with such approved program and in accordance with plans and specifications for the project approved by the Surgeon General. Which, of course, would allow the people of the Territory to have a strong voice in where those facilities shall be located.
Mr. Bartlett. The committee was told time after time during these rather prolonged hearings that modern practice recommends that there be different treatment centers at different places rather than one big institution.
Mr. DERR. Wonderful.
Mr. BARTLETT. And we believe, the committee believes if this bill is enacted that is what will occur under the guidance of the experts.
Mr. DERR. That is wonderful.
Mrs. GREEN. Of course, too, I think there would be a serious question of whether or not we would have two psychiatrists for each one of these places. You have one psychiatrist in the entire Territory at the present time.
Mr. DERR. Yes,
Mrs. GREEN. And, of course, at Morningside at the present time there is the one psychiatrist who is placed there by the Department of the Interior who does not really perform psychiatric work. Then there is a person who has had some training in psychiatry. He is not a recognized psychiatrist and he spends half of his time on administrative duties.
It would seem to me that saying 2 psychiatrists in each of 4 places is fine in theory, but a little bit hard in actual practice. I was also interested in your statement that 67 had been brought in in a period of 20 months. Can you tell me if any of those 67 were children? Were there any under 10 years of age? Were there any under 5 years of age? Mr. Derr. May I pass the buck to the gentleman coming up next,
I the commissioner for this district, and I believe he can state definitely. Am I right in that assumption, Mr. Stevens?
Mr. ABBOTT. Mr. Stevens, the United States district attorney.
Mr. DERR. He would know what percentage of children. I think he would.
Mr. O'BRIEN. May I ask you this: From your own observation up here, do you think because of the degrading procedure that there are instances where people conceal mild mental disturbances in their family, a disturbance which could become worse and does become worse and could be cured if it was corrected in time? Do you think that would be concealed by a husband, for example, in the case of his wife because he would not want to go through this degrading procedure, trial by jury and jail and so forth?
Mr. DERR. Speaking for myself, Chairman O'Brien, I certainly would if I thought my wife—God bless her, there is nothing wrong with her slaughter]—but I certainly would hesitate to have her put in a jail such as we have in Fairbanks.
Mr. O'BRIEN. That is one of the things that made me most interested in this legislation, and I assure you, too, that my wife is in pretty good shape slaughter) even though she is playing golf on this afternoon up in Fairbanks.
But that is my concern. It is not only the people who are mentally ill who may sometimes not realize what they are going through but it is people who have mental illness in their family and who have to put their children, their wives, their husbands through that. I think it is barbaric and people with whom I have talked in my district were completely unaware that anywhere under the American flag we allowed such a thing to go on.
Mr. DERR. It certainly is not American.
Mrs. GREEN. Mr. Abbott posed this question to a witness this morning in regard to this amendment that was offered and accepted making it possible for trial by jury. What is your opinion in regard to that?
Mr. DERR. By trial by jury, do you mean that the person
would come up to be judged to be insane or sane? Would it be a public hearing? I missed that question.
Mrs. GREEN. One of the members of the committee---in fact, two of them, felt very strongly that the individual's rights must be protected and if he demands a trial by jury that that should be written into the bill and he should be allowed it. I think everybody agreed it was not the best procedure, it would be much more desirable to have psychiatrists do the examining, the observation.
Mr. Derr. Actually, Mrs. Green, that is what they are doing now with these six people. I understand that these six people that are pulled out of the post office sit there and then a man or someone from the office comes up and tries to show them just like you would a jury that this man is either sane or insane. So it is a trial.
Mrs. GREEN. I am in complete agreement with both you and Congressman O'Brien. I think the commitment procedures are out of this world. But my question is, do you feel that a citizen's rights must be protected by giving him the opportunity to demand a jury trial?
Mr. Derr. If those rights are according to the law he should have them. Mr. Dawson. Will the lady yield? Mrs. GREEN. Yes. Mr. Dawson. I served on the Welfare Commission of the State of Utah in charge of our mental hospital in our State and had a little experience with this bill. And I do not agree with your idea that he should have this trial by jury. I think the bill as it was written is right and it will be proven so, because once you get into that with a person that is mentally ill you are going back to your old system. I was one member of the committee that did not propose that change. I know some of the lawyer members did. It sounds good on the surface but the experience shows the only way you are going to really do justice to these people is to have trained people there who know their business to examine them and to make their recommendations. And I do not go along with this amendment that was adopted.
Mr. DERR. Mr. Dawson, I want to be sure of one thing. If I understood Mrs. Green correctly, she said if they demanded and it is a part of the law, who are we to deny it? Mr. Dawson. We are making the law. Mr. Derr. It is not a law as yet. Mr. Dawson. No. Mr. Abbott. May I read the amendment, which is very brief. It occurs in section 108 of the bill, as Mrs. Green indicated, amended in the committee.
If not less than five days prior to the date fixed for the hearing, the proposed patient, his counsel, or any member of his immediate family files a written request with the United States commissioner
therefor, the commissioner shall summon and empanel a jury of six adult residents to hear and consider the evidence concerning the mental condition of the proposed patient.
Then, of course, reflecting that amendment, the following subsection
which is (g) of 108:
If, upon completion of the hearing and consideration of the record the United States Commissioner or in the event the right to a jury has been exercised pursuant to subsection (f) hereof, the jury find that the proposed patient (1) is mentally ill and (2) because of his illnesss is likely to injure others and * * * the United States Commissioner shall order his hospitalization.
It is a provision that was adopted by the committee with, as Mrs. Green has indicated and Mr. Dawson has indicated, some varying views. The statement of Dr. Oberholzer of the Public Health Service who is in charge of St. Elizabeths Hospital, District of Columbia, was to the effect that the very person who would be able to beguile a lay jury in a lucid moment and thus appear to be mentally capable is the very person who would take advantage of this provision; thus, he would defeat, in the view of some people who are versed in mental health matters, the very purpose which you are seeking to achieve to help and assist these people return to the part of society in which they find themselves unable to maintain a balance. So there is a strong division of opinion. It is my understanding, I might add, that Mr. Stevens, the United States attorney for the division here-in fact I have his prepared statement-has some views on that which are his personal views in light of his experience here in the division.
Mr. DERR. In that respect I would agree with Mr. Dawson because many insane people are really brilliant in disguising their insanity and in that respect they are terribly dangerous and they could fool a jury of lay people and they would ask to be tried by jury.
Mr. Dawson. They usually would, yes. I agree with Mrs. Green too, in her suggestion that these two psychiatrists in each one of these cities would run out of business. They would be pending their time looking at you and some people around the street here and seeing if they could not find somebody they could work on. You have only got 360 patients in Alaska, mental patients, as I understand it. In the State of Utah we have 1,400 in our mental institution. We have two psychiatrists. And yet you are going to have two in each one of these cities,
Mr. DERR. It is a division.
Mr. Dawson. That is right. But even with your total population—what have you got, 160,000—if they were all prepared to go to an institution. And covering your whole district you have still got
. just about the right number for everybody if you figure the average in the various States.
My colleague from California was saying in Orange County, Calif., 400,000 people are in that area and have 2 psychiatrists.
Mr. DERR. But they all go to Los Angeles there so they are not known in their own locality.
Mr. Dawson. Do you know what they pay these psychiatrists?
Mr. DERR. It is rather high but could we not put them on a parttime basis? I believe they would wear out couches galore up here. I am serious.
Mr. Dawson. At the present time you do not have a single psychiatrist in the Territory as I understand it.
Mr. DERR. No, sir; not a one.
Mr. Dawson. And to bring a psychiatrist up here the minimum you would have to pay him would be $15,000 a year. That would be the minimum.
Mr. DERR. Yes, I presume so.
Mr. Dawson. As you figure it there would be 8 psychiatrists at $15,000 a year to handle 360 patients; that is too many psychiatrists. I just want to suggest this to you people that are interested in this bill; The bill as it was originally drafted is what is known as the model bill. It is a bill that was drafted by the American Psychiatric Association