ADVANTAGES OF COLONY CARE OF MENTAL DEFECTIVES* BY CHARLES BERNSTEIN, M. D., SUPERINTENDENT OF ROME STATE SCHOOL There are several outstanding advantages of colony care for mental defectives, namely: 1. Availability of houses in towns for females and farm houses for males and these pieces of property under rental, may be taken on short notice and made available within a few weeks, thus quickly meeting the need for increased numbers without overcrowding institutions. 2. Humanitarian consideration of the individual patient. It is our experience that inmates are always glad to live at colony homes where they are cared for in small numbers and thus, individual attention may be given the patient and his individual likings in food, lodging, associations, etc., may be more carefully considered. 3. A large variety of environmental conditions may be created in these small groups fitting the individual to the environment which seems to suit him best. 4. Much larger opportunity may be given the individual to contribute toward his own care and support, such as, assisting with general house work, preparing food, doing the laundry work, working on the land and producing food supplies, etc. 5. Possibility of giving all inmates home life, surroundings and conditions more nearly like those of their natural home life previous to institutional care even to the extent of having the colony located in a community where he may have contact with individual friends or relatives and thus, if desirable, to have an opportunity to carry on work with those with whom the individual previously associated. 6. The establishment of a simple protected environment in which the individual can live without great stress or extreme effort to meet social and economic demands. 7. Economic or cost values. A fair basis for rental values is 10 per cent of the tax value of the property which will about equal a rental basis as follows: Twenty-five dollars per bed capacity per year for the use of the * Address at Quarterly Conference at Rome State School, September 20, 1927. house and if there are reasonable out-buildings and barns on the place $2 to $3 per acre for the land for a 100-acre farm. This will make a rental value of $500 for the house which will accommodate 20 inmates and from $200 to $300 for the land or a total of $700 to $800 per year rental for such a farm. Under these conditions the owner will pay taxes and insurance and will usually allow the institution about $200 per year of rental money for repairs to property. If this $200 is used to buy material, and labor done by institution inmates and skilled help such property may be greatly improved in the course of two or three years. Where such improvement takes place, of course, the State, town and county derive benefit through increased taxation based on increased valuation. Under these conditions of rental a 200-acre farm would have rental value of $500 to $600 for the house as usually the larger farm will have the larger house and room may be found for 24 inmates and about $400 to $500 for the land, making rental from $1,000 to $1,100 per year for a 200-acre farm. Usually the larger farms will have better buildings thereon, especially better out-buildings for cattle, storage of crops, etc. Under these conditions the costs of maintenance per year are from two-thirds to three-quarters of what it actually costs to maintain a like number of inmates at the institution, this because at the colony the inmates do much of their own washing, do their own cooking, chamber work, house work, etc., which reduces considerably payroll costs per capita. Also the overhead costs per capita under rental is less than the investment charge for buildings, were they built for a like number of patients at present prices. The two main considerations would be that of immediate availability of more bed space at an economical cost and the humanitarian treatment of the individual from the standpoint of his associations, daily life, etc., and the relieving of the individual of the necessity of becoming institutionalized through a long-term residence in a large congregate institution where later the habits of life thus formed tend to render the individual ever thereafter lonesome and discontented when removed from such institutional environment. In planning for the care and training of the higher grade feeble |