Notes and Comment

AFTER-CARE OF THE INSANE.-The State Charities Aid Association of New York has recently taken up work for the aftercare of the insane discharged recovered from State Hospitals, co-operating with the State Commission in Lunacy and the managers and superintendents of state hospitals. The need for some system of providing temporary assistance and friendly aid and counsel for persons who have suffered from mental disorders and have recovered has long been recognized and in many Europeans countries has for many years constituted an important branch of social or charitable work. In this country the subject has been discussed at many medical and charitable conferences but until now without any practical results. At the annual meeting of the American Medico-Psychological Association in 1893, Dr. P. M. Wise read a paper in which he urged the need of aid for recovered patients in the first weeks after their discharge from hospitals. In 1894 the subject was presented before the American Neurological Association by Dr. Henry R. Stedman and a committee consisting of Dr. Stedman, Dr. Charles L. Dana, and Dr. F. X. Dercum was appointed to investigate and report to the association upon some feasible plan for the aid and supervision of needy patients discharged recovered or improved, from institutions for the insane. In 1897 the report of this committee was submitted, strongly favoring the establishment of after-care work in this country, and presenting a large number of letters from medical superintendents of state hospitals and prominent alienists and neurologists in many parts of this country, the great majority of them favoring the initiation of a movement of this sort. Dr. Richard Dewey urged it in papers presented at the National Conferences of Charities and Correction in 1904 and 1905.

At the November and January conferences of the State Commission in Lunacy with the managers and superintendents of

State hospitals, the State Charities Aid Association was asked to organize and put into practical operation a system of aftercare for the insane in the State of New York. Pursuant to this the Association's Committee on the Insane appointed a sub-committee on After-Care of the Insane, and this sub-committee is organizing After-Care Committees for the different state hospitals. Those for Manhattan, Willard and Hudson River are already appointed and in active operation. The sub-committee employs an agent who assists these hospital committees in visiting in their homes patients discharged recovered from state hospitals and assists them to secure employment or in other ways in which assistance or counsel may seem to be required. The work is of too recent establishment to show as yet very important results, but it seems likely to prove of considerable value in the prophylaxis of mental disorders.

At the annual meeting of the American Medico-Psychological Association at Boston the subject of After-Care was discussed by representatives of various states and the following resolution was unanimously adopted:

WHEREAS, the State Charities Aid Association of New York has recently established a Committee on the After-Care of the Insane, to work in co-operation with the State Hospitals for the Insane in that State, and to provide temporary assistance, employment and friendly aid and counsel for needy persons discharged from such hospitals as recovered, and

WHEREAS, In the opinion of the American Medico-Psychological Association, it is very desirable that there should be carried on in connection with all hospitals for the insane such a system of after-care, therefore,

Resolved, That the American Medico-Psychological Association expresses its gratification at the inauguration of this movement in the State of New York, and its earnest hope that similar work may be undertaken for hospitals for the insane generally.

THE ANNUAL MEETING.-If the prosaic individual, careful of speech and determined to be accurate at all hazards, should search the pages of this JOURNAL for appreciations of the annual meeting of our Association, he would probably find ample warrant for his suspicion that the latest gathering of the brethren has invariably been the most successful. The recorder may not always have reflected the average judgment as passed orally by those who are fond of making comparisons, and it may have