Even, however, if the doctor were allowed to help such a person in the asylum, this would be far from an ideal solution of the difficulty. Entry into such an institution, even if voluntary, would entail the serious social stigma which has been so often mentioned. Furthermore, the asylum, with its associations and implications, particularly the assumption of the irresponsibility of the patients interned in it, would destroy one of the chief therapeutic agents in the treatment of such cases. We mean the conviction of the patient that he is still responsible for his actions, and that he is still able, under direction, to cure himself.
The place to which such a patient should be able to go is obviously one which is exempt from any stigma; one in which of his own free will he may stay for a time under care, or if this be unnecessary, as is very frequently the case, which he may visit at frequent intervals for advice and treatment. It should be staffed by skilled specialists who are familiar with the diagnosis and treatment of early and incipient mental disorder, not only with that of advanced insanity. For years such institutions have existed in other countries and form an important part of their contribution towards the alleviation of human suffering.
The chief functions of such a psychiatric clinic would be:—
(1) Attendance on the mentally sick.
(2) The provision of opportunities for personal intercourse between patients and the psychiatrists in training.
(3) The theoretical and practical instruction of students.
(4) Advising general practitioners and others who are faced with difficult problems arising in their daily work.
(5) To serve as a connecting link between investigation in the large asylums and that in the anatomical, pathological, bacteriological, bio-chemical, psychological and other laboratories of the universities.
(6) The scientific investigation of the mental and bodily factors concerned in mental disease.
(7) The furtherance of international exchange of scientific knowledge concerning mental disorder, by the welcome accorded to visitors from other countries.