Leon Reporter, Leon, Iowa
Thursday, December 27, l900

'Regulations Adopted by the State Board of Control'

Hereafter Decatur County Hospital for the insane and all other similar institutions in the State will be operated under new rules and regulations just adopted by the State Board of Control. They are intended to work important reforms in the care of the insane by the counties and by private institutions. At the same time the Board members say they have sought as far as possible not to make their regulations unnecessarily radical. The Board has not gone at things by any means blindly. Every county and private institution in the State has been given a personal inspection by one or more of the members of the Board of Control. This work has consumed much time and energy, about six months having been devoted to it, in connection with other duties of the Board. The rules are designed to correct such evils as were discovered through this inspection, or more exactly, to correct the worst of the evils.

Members of the Board say there are not to exceed ten county institutions in Iowa, where the insane are given such care as should be given. There are l,200 patients in the county institutions and several hundred more in the private institutions. Hence, the rules will affect a large number of the insane. They will go into effect today, but managing officers of institutions are given until January l, in which to make changes required. Boards of Supervisors are also given until February to provide for changes. The Board has the power to remove the insane from the institutions where they are not properly cared for. Ample time will be given for the rules to be put into effect. Then another inspection will be made, and the insane will be transferred from asylums that are not living up to the rules. There can be no considerable number of transfers to State institutions, as these are overcrowded. But transfers will be made, if necessary to well regulated county institutions.

In many institutions the Board found some paupers and insane patients mingling together and being given the same care. This is a practice the Board will not permit under any circumstance. The reprehensible system of allowing male and female patients to intermingle, a practice followed at many places, will be checked. Moreover, great strictness is to be observed in compelling male patients to be attended only by males, and female patients only by females. It is said there is a shocking need for reform along these lines in some institutions.

One provision of the new rule is that beds and clothing must be kept free from vermin. This might not seem important, but members of the Board tell of thrilling experiences along this line in certain institutions, where great armies of bedbugs and kindred creatures fled in terror when the beds were inspected. The new rules provide for provision for fire escapes, the number of attendants at county institutions, that records shall be kept of all insane inmates and that there shall be female attendants for female inmates. The new rules among other things say:

l. All insane persons are to be treated as diseased and mentally irresponsible for their acts, and are not to be punished as persons of sound mind may be for violations of rules and offenses against others. But it must be the constant aim of all persons to induce them to acquire regular, cleanly and orderly habits with respect to caring for themselves, eating, exercising, working and sleeping. Insane persons must be clothed as nearly as is practicable like sane persons and be encouraged to act and control themselves in like manner at the table and elsewhere.

2. Punishments are not to be inflicted on insane persons, but the freedom and privileges of those who will not obey proper rules and orders, or are dangerous to their associates, or whose habits are destructive, disorderly or filthy, may be restricted so far as is necessary to prevent injury to persons or property, to preserve good order and cleanliness, and to avoid giving offense to others. Corporal punishment shall not be inflicted in any case, and only so much force shall be used as is necessary to prevent violence, to preserve persons and property from injury, and to keep insane persons in proper condition. Physical restraint must not be resorted to in any case unless absolutely necessary, and then it should be as mild and of as brief duration as will permit the accomplishing of the desired and necessary object of the restraint. Seclusion by confinement in rooms during the daytime should be resorted to only in extreme and exceptional cases and should not be continued longer than is absolutely necessary.

3. All insane persons whose condition permits shall be required to take regular daily exercise in the open air when the weather is suitable, and be furnished with amusements and employments suited to their mental and physical capacity and condition. The amusements may consist of games, musical, literary and theatrical performances, and any other harmless diversions. Suitable newspapers, magazines and books shall be regularly supplied to all insane persons who are able to read and understand them, and opportunities for attending religious services shall be given as often as shall be practicable, to each insane person who is capable of being interested in and who may be benefited by such services, and who desires to attend them.

Moderate labor is beneficial to insane persons capable of performing it and all such persons should be encouraged and if possible with reasonable and humane effects induced to perform such labor where practicable.

4. All insane persons must be kept neat and clean and supplied with clothing ample in quantity and suitable for the season in which it is worn. Each insane person, unless otherwise ordered by the physician, shall be thoroughly bathed at least once each week and as much oftener as shall be required to keep him or her clean, in clean water which shall not have been used previously, and which shall be of the temperature most suitable for the person bathed. No insane person shall be permitted to remain in a filthy condition, but must receive prompt attention and be thoroughly cleansed, whether in the day or night time, as soon as the filthy condition of such person is ascertained and care must be taken constantly to know of such condition as soon as it exists.

Each insane person shall also be furnished a clean suit of underclothing each week and as much oftener as a due regard for cleanliness shall require. The bed of each insane person shall be comfortable and kept in all respects neat and clean. Clean sheets and pillow cases shall be furnished for it each week, blankets and other bed coverings shall be washed frequently and kept clean and in good condition. All clothing, beds, bedding and furniture used by insane persons shall be kept free from all kinds of vermin.

5. All rooms occupied by insane persons shall be dry and well lighted by means of one or more outside windows and shall be kept at a proper temperature and well ventilated, and be made as pleasant and attractive as is practicable. No insane person shall be permitted to live or sleep habitually in any room the floor of which is more than two and one-half feet lower than the surface of the earth outside of and next to the building. Basement rooms and rooms having brick or cement floors are, as a rule, undesirable for living or sleeping purposes, and such use of them is not recommended. All buildings and parts of buildings and water closets and appurtanences occupied or used by insane persons shall be kept in good order, clean and free from disagreeable odors and from all kinds of vermin.

PROVISIONS FOR FIRE ESCAPE:

6. Suitable means for escaping from buildings in case of fire shall be provided for all insane persons who occupy rooms in a building above its first story. Access to two or more interior stairways suitably located may be sufficient, but there must be at least two separate means of escape so located and constructed that both will not be apt to be obstructed by a fire until all persons shall have a reasonable time in which to escape.

7. No insane person or persons shall be confined or kept in any building not also occupied by sane adult persons, nor in any part of a building not near to a part occupied by such adult person, unless provided with one or more attendants who shall always be on duty in such building or part of building and be at all times within hearing of the insane person or persons.

8. Every insane person shall be furnished three times each day with a supply of food suited to his or her condition. The meals so furnished shall be abundant in quantity of good variety and quality and be well prepared.

9. Insane persons must, so far as is practicable, be kept separate and apart from paupers, and shall not be dependent upon paupers for care or assistance. Where the two classes of persons are kept in the same institution, they shall be kept in different buildings, or, if that be not practicable, in different parts of the same building, and shall occupy separate dining rooms, or, if that be not practicable, then separate tables in the same dining room.

l0. No insane person shall be permitted to operate any furnace, boiler, or machinery except while under the immediate personal supervision of a competent person of sound mind, nor shall any insane person be entrusted with the control or supervision of other insane persons.

Copied by Nancee(McMurtrey)Seifert
"With permission from the Leon Journal Reporter"
December 6, 2002