STORAGE QX7<Q3 J 7&V COf>. 4 Demote The Value of the Library in the Hospital for Mental Disease By Edith Kathleen Jones. Librarian at McLean Hospital, Waverley, Mass. T HE Superintendent of one of our large private hospitals for the insane recently made the remark that if he were obliged to give up either the library or the handicrafts department, he would unhesitatingly choose to keep the former. His reason was this: That there are always many patients who cannot be roused to any great interest in arts and crafts work, while there are very few who will not read, or at least look at books of pictures The criticism may be and often is made, that while this may be true of the private hospital, where the patients come from the so-called “cultured class,” the state hospital is largely made up from the “uncultured” classes, —workers in mills and factories, aliens, and persons who presumably do not care for books and on whom a library would be wasted. To a certain extent this is so; but an examination of the case records of state hospitals show that they all have a large percentage of school teachers, librari- ans, college professors, ministers, and other persons of the same mental grade, whose finances do not allow them to be cared for in private institutions, but who are as used to refined and cultured surroundings as their more affluent ’neighbors in the more expen- sive hospitals. And these are the patients who suffer from the lack of the finer elements of life, and to whom books and pictures are the key to temporary oblivion of their condition and sur- roundings. Granted that the percentage of such patients is small compared with the number of mill and factory hands, even for these few, an up-to-date, well-selected library is necessary to their happiness and well-being, and happiness is a great factor toward recovery and health. Moreover, for the many— the uneducated— much may be done to interest them in good books and raise their mental standard. To be sure, one who has read only such trash as the lurid, mor- bidly sentimental dime novel type, cannot at once appreciate Thackeray, for instance; but he will read with pleasure certain “half-way” books, and thus insensibly may be lead up to a 2 knowledge and appreciation of the best in the great world of literature. That this education can be and has been accomplished, 'is evidenced in a letter received in the Fall of 1913 from a librari- an interested in the hospitals and prisons of an adjacent state. “One of our neighbors,’ ’ she writes, “has for the last eleven years read four hours a week to the women patients. She could see an improvement from year to year. She was reading the very best in literature to an audience which appreciated it, but the funds are not available and the work is stopped. If some of these politicians could only see the results secured by interest and personal enthusiasm, they might not take such a cold-blooded view of the questions regarding the wards of the state. It is so inhumane to dole out money as if they were cattle, —so much food, so many officers, so much medicine etc. These are founda- tional— people really live on top of this comfort line, where ed- ucation, employment, play, intellectual and spiritual life keep people happy, as well as merely comfortable.” y “T‘ This letter was written before Dr. Richard Cabot published the papers in the Atlantic Monthly recently expanded in book form and called “What Men Live By— Work, Play, Love, Worship;” but the thought is the same. If these are the essentials for the physical and mental health of normal persons, how much more should the principle be applied toward re-educating those who have fallen into wrong habits of thought and life! And what bet- ter means have we of inculcating these principles than a well- selected library of the best books in fiction, literature, travel, biography, history, art and science? Here we have not only relaxation and pleasure for the mind, but healthful stimulus to thought and feeling, food for the mental and spiritual life. Work has always been provided in the state hospitals, and a certain amount of entertainment; but the intervals, the so-called “recreation times,” are often left unfilled. Here is where books are useful. The writer visited a state hospital not long ago, just after the dinner hour. In a secluded corner of the great dining- room which was being rapidly cleared, sat a patient absorbed in a book. On being asked what she was reading she looked up brightly and said, “0 I have such a splendid story! I am just finishing it while I am waiting till the dishes are ready to be washed.” This patient had been on her feet all the morning, helping in the kitchen, and would soon be working again, but in 3 the meantime she was snatching her bit of color and romance to set in the midst of her gray and sombre life. In another state hospital, in a sunny window in the work-room, one patient was reading aloud to half-a-dozen others who were busy sewing. They had read several books together in this way. In the farm colonies, where the men and women work all day in the fields or the shops, the evenings pass much more pleasantly and health- fully if there are plenty of books and magazines and papers to look over after supper. Years of experience in one of the large private hospitals has proved the necessity of the library in such an institution. Books are always kept on the sitting-room tables of the wards in this hospital, changed every two weeks, so that the patients are on the lookout for new books. There are many instances of patients who have become interested in reading from looking at these books. New patients (unless too ill or too destructive) are al- ways provided with stories or pictures to suit their mood. While one cannot affirm that reading the right sort of books is in itself a factor toward recovery, certainly it is a great help in the pro- motion of comfort and happiness, and in bringing the mind into more normal relations with the world, and these are the things that make for recovery where recovery is possible. Here is an instance showing what the library meant to one patient:— the first coherent letter for weeks from one young man was written after reading a book very carefully selected to suit his individual needs and s , ent from the library; he wrote his sister an analysis of the plot and a good criticism of the book as a whole. This book was the very first thing in which that patient had taken any in- terest whatsoever. Following this clue, he was given other books of the same sort, well- written, thoughtful, with enough adventure to hold his attention. They were not always easy to find, for this sort of book is the ideal achievement; but only such would he read. As the process of his recovery seemed to date from that first story, his family are firmly convinced that to the library they owe his ultimate recovery. In all probability something else might have aroused him in time, but as a matter of fact it was a book. Patients often tell us that they owe more to the library than to any other one department; the reason for this probably lies in the fact that it is uninstitutional and homelike as it is possible to make it, and that in these rooms, s-urrounded by the familiar backs of 4 the books they have known and loved, they feel freer, less restrained, in a more normal atmosphere. But to achieve such an effect requires constant attention. New books must be bought, and they must be displayed where the patients will find them; the library must be placed on open shelves, for your true book- lover loves to browse. To really get the very best and most out of a hospital library requires all the time and thought of one person, for here, fully as much if not more than in any other department, enters in the personal equation, the knowledge of individual tastes, the intuitive perception. The central library seems to be essential. It has been proved over and over again that patients will not read the books in the ward bookcases unless they are frequently renewed. Ward bookcases, filled with books which have been there for years might as well be in the attic so far as their use is concerned. They are more or less decorative, but they will never be looked at unless a patient is perfectly desperate for something to read. It is also true that in the central library, any hospital can get better results from two hundred well chosen, readable books, * classified if not catalogued, than from two thousand, or even ten thousand books which no one wants to read, placed on the shelves helter-skelter by shelf-and-book or accession number. The first step toward organization is ruthless elimination and the furnace fire. The next is classification. The third is to take off the paper covers so that the library may* present some individuality. If the books get much soiled, they may be shellaced. The question has often been asked if it is worth while for a state hospital to try to have a library if it cannot afford a librarian. Surely it is, if by a librarian is meant one trained to the business. Such a librarian will, without doubt, get about ten times as much out of the books as an untrained one, will do things more easily and in less time, and will succeed in interest- ing the patients to a much greater degree; but failing a trained librarian, there are usually patients who can do the work and who would take great pride in developing existing possibilities, and who might be capable, with a little guidance, of organizing a really up-to-date library out of a mere collection of books. In allowing the patients to have a hand in this, the state hospital achieves a two-fold purpose; these patients are employed in doing useful, creative work and other patients reap the benefits. 5 Beside the patients, there is another class of people in the hos- pital, to whom the library may be of great value, —namely, the nurses. Many of them have had few advantages, some of them have had only a grammar school education, though perhaps more have graduated from High Schools, and a few have been to college. These young men and women come to the hospitals to receive a training which shall enable them to earn a living. Some of them are tremendously in earnest and eagerly seize every bit of help which comes their way. The hospitals, general as well as mental, have long given them training along special lines, but now the de- mand is for more cultured, better educated, more companionable nurses for private patients. ‘‘We can get all the nurses we want for physical ailments,” is the cry of the modern physicians, “but the nurse who can go into a cultivated home and be a friend and companion is hard to find.” The fact is, the college-trained man or woman does not often select nursing as a profession. The hospital training-schools have had to take what material they could get and make the most of it. If the demand is for better educated nurses, the training-schools must either raise their standard for admission (which would de- bar many of their best nurses,) or they must give their students an opportunity to meet the new demand. With a good library at hand and someone willing and able to guide them in their choice of books, they can get a certain amount of education and a degree of culture in a surprisingly short time merely from reading systematically, but every one knows how hard it is to undertake a course of study by one’s self. Recognizing this, in many hospitals during the last year or two, literature courses have been talked of, and in at least one, McLean, such a course has been organized with very satisfactory re- sults. Most of the nurses have been eager for the lectures, have read as many as possible of the books mentioned, and have made good comments on them. Some of them have frankly said that a new world of books has been opened up to them. An experimental course in the history of Fine Arts is now being tried in the same hospital. Both these courses, however, would be impossible without an adequate library to draw T on. Yet even without these culture courses, those nurses who are at all inclined may make good use of the books at their [ 6 disposal. One physician with a large city practice recently told a former patient of the hospital in which the physician had received training as a nurse, that he owed all his success to the library of that hospital; that he had gone there, a poor boy from an isolated farm, with no advantages, but hungry for knowledge; in the hospital library he found books of science which he read with avidity, and thus was decided his profession. It is true that hospitals in large cities or towns find the public libraries ready to supply them with books, and many of them avail themselves of such privileges. Nevertheless, the public libraries already have a wide field of readers, and new books are a long time in getting round the circle. The great thing in a psychiatric hospital is to have the thing you want just when you want it; if you have to rely on a public library, the need for a certain book is often past by the time the book is secured. Therefore each hospital should have its own library, however small, with at least a few new books added at as frequent intervals as possible, and someone, librarian, officer or patient,— the best available— to see that the books reach the patients and accomplish their purpose of recreation or education. The public library may be drawn on to supple- ment the one in the hospital, but the best results surely must be obtained from the books which are at hand when they are wanted. A good library is not so expensive after all. Each hundred dollars, judiciously expended, will yield approximately one hun- dred books. An annual appropriation of one hundred dollars is not a prohibitive sum, and as there are not, in these degener- ate days, one hundred novels worth reading produced in any one year, the departments of literature, travel, etc. may be in- creased materially by taking advantage of remainder sales, and a few visits to second-hand book shops for inexpensive but good editions. So each hundred dollars expended in books furnishes the means toward mental health for many successive years to hundreds of patients and employees. It is drawing interest all the time in recreation and education— in the world above the foundation line of creature comfort,— the world of intellectual and spiritual life in which we really live, and which keeps us happy. Digitized by the Internet Archive in 2017 with funding from University of Illinois Urbana-Champaign Alternates https://archive.org/details/valueoflibraryin00jone_0 «