THE COMMONWEALTH OF MASSACHUSETTS
ANNUAL REPORT
of the l^o \ NORTHAMPTON STATE HOSPITAL (tM«^)
for the
Year ending June 30
1962
Department of Mental Health
•• • ••• /\J *6 ft* i. I* 1961 - 1962 A NORTHAMPTON STATE HOSPITAL
Post Office Address: Northampton, Massachusetts
BOARD OF TRUSTEES
Mrs. Victoria Kraushar, Northampton, Massachusetts, Chairman Henry 6. Clarke, M.D., Northampton, Massachusetts, Secretary Mr. Francis McKenna, Springfield, Massachusetts Mr. Barney Carlson, Northampton, Maasachusetts Mrs. Una P. Barsalou, Holyoka, Massachusetts Raymond R. Cross, Attorney, Northampton, Massachusetts Roger K. Slavson, Attorney, Northampton, Massachusetts
RESIDENT MEDICAL STAFF
Harry Goodman, M.D., Superintendent E. Philip Freedman, M.D., Assistant Superintendent Henry Benjamin, M.D., Director of Psychiatry •—•————»—— Director of Psychiatry .... .———. Director of Psychiatry, Springfield Mental Health Clinic Morris Kaplan, M.D., Director of Clinical Psychiatry (in lieu Chief Psychiatrist) Kendall A. Brail, M.D., Senior Psychiatrist (in lieu of Chief Psychiatrist) Shirley Gallup, M.D., Senior Psychiatrist (in lieu of Principal Physician) Willis H. Ploof, M.D., Senior Psychiatrist - Out-Patient Department Boris J. Sohn, M.D., Senior Psychiatrist Jaroslav Pavlivsky, Senior Psychiatrist Clemenclo Torres, M.D., Senior Psychiatrist John Mulligan, M.D., Senior Psychiatrist, Springfield Mental Health Clinic ...... —tnn.i«»»t Senior Physician ...... — „t Staff Psychlatriat -.—MMMtMMMWMM, Staff Psychiatrist »"««t«rt *••» •„ staff Psychiatrist ...... f Staff Psychiatrist Kai-Chia Ho, M.D., Staff Psychiatrist ...... —...... f staff Psychlatriat Heath D. Bourdon, M.D., Assistant Physician (in lieu of Staff Psychiatrist) ————--..-.....—t Assistant Physician
HEADS OF DEPARTMENTS
William J. Goggins, Jr., Steward Elisabeth G. Provost, Treasurer Florence L. Eaton, R.N., Director of Nurses Francis H. Carr, Chief Power Plant Engineer Raoul Menard, Maintenance Foreman George K. Haller, Head Farmer Frank C. Sullivan, Fharmacist Mary Lynch, Head Psychiatric Social Worker Eleanor M. Stack, Head Occupational Therapist Millicent Warnock, Dietitian Virginia A. Kielbowicz, Head Housekeeper 1961 - 1962
CONSULTANT STAFF
Thomas F. Corriden, M.D., Surgeon Joseph Hahn, M.D., Neuro-surgeon Edward J. Manwell, M.D., Surgeon David B. Junnison, M.D., Surgeon John J. Curran, M.D., Medicine Hugh Tatlock, M.D., Medicine James II. Averill, M.D., Medicine Edmund J. Zlelinskl, M.D., Cardiologist Alfred Hollander, M.D., Dermatologist Donald Freund, M.D., Gynecologist Russell F. Gervais, M.D., Oto-Laryngologist Donald Chrisman, M.D., Orthopedist George A. Snook, M.D., Orthopedist Dr. Thomas J. Crowe, Roentgenologist Dr. Myer Sharpe, Roentgenologist Alfred J. Kaiser, M.D., Anesthetist Ralph M. Tlmberlake, Jr., M.D., Anesthetist John E. Gilbert, M.D., Pathologist Sherwood Davidson, M.D., Psychotherapy Prank E. Dow, M.D., Ophthalmologist Charles A. Gleason, D.M.D., Dentist Peter Laban, D.M.D., Dentist
Movement of Population
Mala Female Total
1. Number on the books June 30, 1961 .... 974 1,491 2,465 On visit 76 206 382 On escape or A.W.A...... •••• 6 m 6 in family care • 9 9 In residence 892 1,276 2,168
2. Number of admissions during year 538 516 1,054 Number of discharges during year .... 485 482 967 Number of transfers to other hospitals 5 8 13 Number of deaths during year 73 78 151
3. Number on the books June 30, 1962 .... 949 1,439 2,388 / On visit 81 201 282 On absence 12 27 39
On escape or A.W.A. • •!>•••••••* 3 3 6 In family care .... * 6 6 In residence 853 1,202 2,055 1961 - 1962
To His Excellency, the Governor of the Commonwealth, and the Honorable Council:
The Board of Trustees of the Northampton State Hospital herewith submit the Superintendent's one hundred and fourth annual report for the year ending June 30, 1962.
Mr. W. Bradford West resigned from the Board in November 1961 and Mr. Raymond R. Cross was appointed to replace him. Mr. Roger K. Slawson replaced Mr. James Cahlllane, whose term expired in February 1962. We thank the retired members for their service to the hospital and thank the Governor and Honorable Council for their choice of replacements.
The Board, as in the past, holds monthly meetings at the hospital. The Board continues to be pleased at the progress in care and treatment of patients and are particularly pleased that more students of local colleges are showing marked Interest in the Northampton State Hospital and are hopeful that the public's attitude will continue to change for the better so far as State Hospitals are concerned. We realize that the process of acceptance by the community is slow but are thankful that a positive attitude is beginning to show itself.
The Board realizes the hospital's difficulty in administering to its patients with the extreme shortage of medical personnel and wishes to thank the remaining staff for their added efforts for a job well done.
Overcrowding is still a problem and the Board concurs with the Superintendent that the insistence on admission of alcoholics and Court cases adds to the burden of the hospital and staff, and diminishes the amount of attention that can be given to the other patients.
The Board would appreciate a concerted effort on the part of Alcohol Clinics and Courts to limit hospital admissions of alcoholics and personality disorders and have them examined or treated as out-patients elsewhere. The use of the hospital as a place of safe-keeping for alcoholics should be curtailed and the hospital should not be critlzed for refusing to accept the admission of such persons. 1961 - 1962
We are happy that funds have been allotted to study and plan for replacement of the Main group of buildings, which are inadequate and a fire hazard. We are hopeful that future Legislators will be as generous as the present State Government and allot money for construction when the plans are completed. The problem of caring for the aged still continues. More wards must be converted for the care of geriatric patients. The problem of ward feeding adds to the burden of the dietary department and the ward personnel. We are still hopeful that the plan to convert the Memorial Group into a geriatric unit with the construction of another building is not too far off.
The addition of more medical men to the staff seems to be an improbability. We understand that fewer foreign graduates are entering the country and that there is a definite shortage of graduates of American medical schools. Furthermore, there is a reluctance of physicians to enter State Hospital service because of the Ion; working hours, diminished fringe benefits, and not too attractive salary scale. We do not know what the answer to the problem is, but we do know the seriousness of the problem and appreciate the efforts of the hospital adminis tration to maintain an efficient hospital under an extreme handicap. We, therefore, concur with the Superintendent's plan to use ancillary medical personnel, psychological service, occupational therapy service, social service, nursing service, and students to aid in rehabilitation; all of course under the supervision of the medical personnel.
The Northampton Research Project has been helpful in stimulating the local colleges in supplying students as volunteers and case aid workers and also several of their teaching staff to help in the counselling of patients. They hope in the future to initiate a teaching program for staff and patients which may aid in recruitment of personnel and earlier rehabilitation of patients.
Our Volunteer program has been expanding and we wish to thank all volunteers for their efforts. We also wish to thank the Northampton State Hospital Auxilliary for their help in purchasing articles for the patients to add to their comfort.
The Board wishes to thank the Superintendent and all employees of the Northampton State Hospital for their untiring efforts and a job well done under difficult circumstances. -. 5.
•• 1961 - 1962
The Honorable John A. Volpe has shown extreme interest in the Mental Health problem and we wish to thank him for his efforts on our behalf.
We wish to express our appreciation to Dr. Harry C. Solomon, Commissioner of Mental Health and his Staff, to the Legislature and to other Departments of the State for their interest and cooperation.
Respectfully submitted
- _M.D. jcretary -\ Board of Trustees 6. 1961 - 1962 Superintendent's Report To the Trustees o£ the Northampton State Hospital: The one hundred and fourth annual report of the Northampton State Hospital for the fiscal year July 1, 1961 to June 30, 1962 is hereby submitted in accordance with the provisions of the Department of Mental Health of Massachusetts. Our purpose continues unchanged, - we are responsible for the care, treatment, rehabilitation and custody of mentally ill persons, alcoholics and personality disorders. We must maintain the primary objective of returning patients to the community in a better state of mental health. We are also attempting to retrain and re-educate patients for job placement in the community, and trying to return aged patients to rest homes. In order to do an adequate job, we need more personnel for job training and rehabilita tion, we also need more personnel for community placements and more nursing personnel to care for our patients. This hospital has fewer personnel; physicians, social workers, graduate nurses, and occupational therapists per 100 annual admissions then any other State hospital, and is in next to last place in the number of attendant personnel. This is even true when our quota of positions is filled. Throughout the year we have been working under a considerable handicap; our Medical Staff has been cut in half due to the inability to replace foreign medical graduates; some left because of failure to pass the Educational Council for Foreign Medical Graduates examination, others because their five year limit on licensure had expired and also because the Board of Registration in Medicine failed to license some foreign medical graduates by endorsement or were too severe in their requirements for licensure. These latter doctors were accepted for licensure in Connecticut and subsequently left our service. We have been unable to replace the doctors who have left because the jobs offered are not too attractive, the hours are long, the responsibilities are great, the work is difficult, the salary is still lower than other States, living conditions and fringe benefits do not meet the standard of other medical facilities or other States, and it is too difficult to ge.t a Massachusetts license. We cannot even get doctors to visit on a consultant basis to help our depleted Staff because the Veterans Administration Hospital in Northampton pays a much higher fee. We, however, have managed to keep our discharge rate above our 1961 - 1962 admission rate because of the dedication of the few remaining doctors and the endeavors of other than medical personnel, i.e..• t nursing service, occupational therapy service, social service and college students. Although the pay scale for doctors has been increased, It is still inadequate and does not compare favorably with other States. The lower grade for doctors should be eliminated and all doctors start in Job Group 25. Salaries of other professional help must be increased; social workers, occupational therapy workers, and psychologists all demand a higher pay scale. In addition, we require positions of rehabilitation director, personnel director, director of psychological research, medical records librarian in order to function properly and meet our primary goal. Our patients are ell first class citizens and deserve the best care and treatment the Commonwealth can offer. Our readmission rate Is increasing which indicates a need for more after-care clinic facilities in the community. This is indeed a problem for, not only must the jobs of social worker, psychologist, mental health coordinator, as well as psychiatrist, be made available for these clinics, but we must be able to find such persons to accept these positions. A greater recruitment effort must be made by the Commonwealth; positions must be made satisfactory not only from a salary basis, but educational opportuni ties must be offered. Our staffing must be brought up to a higher level. IN ORDER TO GIVE OUR PATIENTS THE NECESSARY SIMPLE COMFORTS, HASTEN THEIR RECOVERY AND PROTECT THEM FROM CERTAIN HAZARDS, WE HAVE MANY NEEDS. THESE NEEDS HAVE NOT CHANGED AND BECOME MORE URGENT FROM YEAR TO YEAR. Our main group of buildings are obsolete. They should be replaced, - many are over one hundred years old. They are inadequate, unsanitary, poorly ventilated, and with an antiquat ed heating system. They are combustible and offer poor protection to our patients from the hazards of fire. A new fire alarm system has been installed but the buildings will burn just as quickly, alarm system or no alarm system. They are over one hundred years old with wooden interiors and tinder dry, particularly five buildings housing over 600 patients. The present plans for replacement of the old Main Group must be pursued until completion of new fire-proof buildings. This must be done before a holocaust occurs. 1961 - 1962 The Memorial Group requires the addition of another building with feeding areas so that patients need not travel to another level, then this group of buildings may be converted into a geriatric unit to care for about 700 aged patients* The Memorial Cafeteria should be renovated if this group is to be used as a geriatrics' center. The cafeteria could be converted into a food distribution center for this group and also into a recreation area for the old people who are ambulatory. The problem of caring for the aged becomes greater each year, more aged are admitted and our own hospital population is aging and requires special facilities. Our aged population is becoming a greater problem and this population will increase with the coming years. Provisions must be made to care for them for, every few months it is necessary to shift our wards so that we can feed these people on the wards because of their inability to walk to the cafeteria. More adequate facilities and more nursing personnel are needed for their care. A new Administration Building is needed, - this too is over one hundred years old, is functionless, does not have adequate office space. Our pharmacy located here is inadequate and falls far short of the requirements of the Board of Pharmacy. This building also has inadequate quarters for doctors; with poor toilet facilities, leaking roofs and is a fire hazard. Our Staff could function more efficiently in an adequate Administration Building. We still need an adequate Assembly Hall and Chapel. Present one is housed In a one hundred year old building, is combustible and a fire hazard. An Occupational Therapy Building with recreational facilities and industrial space Is needed. Shops are now scattered throughout the basements and are poorly located, poorly equipped and are a definite fire hazard. We also do not have adequate gymnasium facilities. We converted an old kitchen into a gymnasium but it is very unsatisfactory. Bachelor quarters and apartments for doctors are a necessity. We do not have anything attractive to offer doctors; compared to our competing hospitals, we give them nothing. Besides, if the old Administration Building is replaced, present living quarters will be eliminated. 1961 - 1962 Other structures needed are: A new garage. Present garage Is a fire hazard and in no condition to renovate. Maintenance Storage Building to store building supplies; basements and old barn now used, which adds to fire hazard. Greenhouses should be replaced. Present ones are old and falling apart to a degree that they cannot be adequately repaired without greater expense than to construct new ones. We still require the replacement of many old and uncomfortable beds, also replacement of home manufactured mattresses with new comfortable commercial mattresses. We have gotten rid of some of the old beds, replacing about 750 of them, but we do have a population of nearly 2,100. More adequate bathing facilities are needed; showers, tubs and toilet facilities are inadequate. Many of the wards have been painted but the process must be continuous. Interior painting of attendants and nursing quarters must be done. The longer this is not done the more dilapidated the buildings become. Clinical Services As in the past years, our therapy program continues, the tranquilieing and mood elevating drugs are used; some electro- shock therapy is done on very depressed patients in whom we cannot wait for the lag period of the mood elevators; only three or four patients per treatment day receive electro-shock treatment. Group psychotherapy is carried out on an active basis; however, with the loss of almost fifty percent of our medical staff, these groups have been cut in half. The group* are conducted mostly by non-medical personnel, psychologists and social workers. Psychodrama groups are still being held weekly. With the lack of medical personnel we are also relying on volunteer workers in such programs as remotivatlon and case aid. We plan to use more of our auxiliary personnel to stimulate our patients to activity and in therapeutic programs. This is not out of choice but of necessity. After-care is still a problem, we do not have personnel to conduct out-patient clinics in distant towns, to see patients after release. As a result relapses are frequent and our readmisslon rate increases. Our own small remaining staff held over two hundred patient interviews a month with released patients and relatives. There are hundreds of other patients who do not report because of the distance of this hospital from their homes. With adequate after-care clinics we feel that the admission rate would be much lower. 10. 1961 - 1962 AlcoholicsAnonymous holds its group therapy session at the hospital regularly at weekly intervals and it is attended by patients addicted to alcohol and persons from the community. We have an active vocational rehabilitation screen ing group, which is attempting, with the help of Massachusetts Vocational Rehabilitation Commission, to place long term patients in suitable job situations In the community. This group, a doctor, social service workers, occupational therapy workers and a nurse have other hospital duties to perform and their efforts toward this end is limited. We need a full time vocational rehabilitation team to carry out this program satisfactorily. We owe thanks to our few remaining dedicated doctors who are working harder than one should expect in order to give as near adequate care as possible to our patients. The situation is serious and some services will have to be curtailed if we lose more medical personnel. Medical and Surgical Service We continue to use the local general hospital for the care of our surgical and seriously 111 medical cases. The Weetfield State Sanatorium sees many of our patients at their surgical out-patient clinic and also does elective surgery. During the past year they treated 260 of our patients and performed 60 major and minor operations on our patients. Thirty-one patients received emergency surgical treatment, including fractures, at the Cooley Dickinson Hospital. This procedure is much less costly and more satisfactory than constructing a surgical unit and performing the operations here. Even If we did have a surgical unit we would not have the nursing personnel to staff it. We still employ consultants in all specialties who we call for service when needed, but with the ever decreasing medical staff we are going to be obliged to use consultants at a greater rate, providing we can obtain such service. We have one dentist to care for 2,100 patients. Most of his work is examinations and extractions. Very little tooth reconstruction is done. We need another dentist and a dental hygienist, if available. 11. 1961 - 1962 Nursing Service The shortage of registered nurses still continues and attempts to recruit registered nurses have been made without appreciable gain. There are 44 graduate nurse vacancies; these have been filled with Licensed Practical Nurses or Attendants in lieu of. We are beginning to be able to recruit licensed practical nurses from the Springfield Vocational School and Pittsfield Vocational School as a result of having cooperated with both schools in training programs for their students. It has also become difficult to hire male attendants who can devote their full engeries to this particular job. A large percentage of men hired in attendant nurse categories must of necessity, for their own financial needs, carry a second job. The nursing service at this hospital attempts to provide safe nursing care to all patients. They are doing a remarkable job considering the minimum coverage of the wards because of the low quota of ward personnel allowed in our budget. The program of teaching public health nurses in Western Massachusetts has been active. These nurses become acquainted with the facilities of the Northampton State Hospital, they are given a general introduction to patient care and psychiatric nursing, and given assistance in handling discharged patients in the community. A full program is also carried on with the affiliating licensed practical nurses as well as assisting with the University of Massachusetts field students. The University supplies the instructors and the nurses work with male and female patients in the Admission Building. The nursing service has established a total push program with such activities as calisthenics, personal hygiene, and group discussions on a ward level. These patients have been selected from regressed wards. Volunteer students have been given instruction in Remotivatlon and are working on the wards under the supervision of the nursing service, these groups are recruited from Smith College, Mount Holyoke College, University of Massachusetts, and Springfield College. One hundred and twenty students gave us approximately 2,100 hours of service on the wards. 12 1961 - 1962 Nursing Service has assisted in many of the recreational activities, in occupational activities, assisting in picnics, bus rides, trips to fairs, entertainment, ball game8, concerts, etc. There must of necessity be cooperation between all services or disciplines, in order to carry on active programs in stimulation or remotivatlon and rehabilitation. No hospital services has the required number of personnel, so duties must over-lap and full cooperation is a necessity in order to carry on a beneficial program of patient care and treatment. X-ray and Laboratory Services Our X-ray Department consists of an X-ray Technician and two consultant radiologists who read the plates. This depart ment took and read over 2,000 X-rays during the year. In addition they took 228 electrocardiographs and 143 electroencephalographs. The Laboratory completed about 5,500 tests including hematology, bacteriology, chemistry and functional tests. Psychology Service The Psychology Department consists of three positions, one Principal Psychologist, one Psychologist and one Assistant Psychologist. Emphasis continues on testing and evaluation, but as in the past, the members of the Department spent a considerable amount of time on other activities such as individual and group psychotherapy, teaching, training, consulting with other Staff members, and supervising case aid programs. During the year the Department again served as a pxacticum facility for the doctoral candidates of the University of Massachusetts and for graduate students in the Master's program in Clinical Psychology at Spring field College. The Department participated in staff and adminis trative meetings and attended consultant lectures. Individual members of the Department also attended certain functions outside the hospital of a professional, as well as an educational nature. Three psychologists are not enough for participation in so many activities. Services must be curtailed in one activity in order to participate in another. More man power is needed to (1). increase individual and group psychotherapy; (2). increase the scope of the training program; (3). for greater participation in rehabilitation of chronic patients; (4). initiation of research programs; (5). vocational testing and counseling and (6). greater participation in out-patient activities. 13, 1961 - 1962 Social Service Miss Mary Lynch joined our staff as Head Psychiatric Social Worker. Miss Lynch is well qualified to handle this department and will endeavor to develop a more functional Social Service organization within the hospital. ghs hospital has a total of eight social work positions, there has been a re-assignment of duties so that more coverage can be given to more units within the hospital and it Is hoped by this method to reach more patients who could move to chronic care facilities in the community, to vocational facilities with/the community and to their own homes. Last year there was some conspicuous success when two workers were concerned only with community placement, some sixty chronic patients were placed out side the hospital. Unfortunately these two workers left for other employment and their project could not be carried on. With the new shifting of social service personnel, it is hoped that not only can the hospital be covered for admission information, histories, contact with other agencies, etc., but the successful return of the patient to the community be further accomplished. The Social Service Department will continue to work with other disciplines within the hospital as shown in the development of a Rehabilitation Committee through the efforts of Social Service, they will continue training of Social Service staff and develop community relationships which will contribute to the effort to return the patient to the community. To do this successfully will require more trained Social Workers. Occupational and Recreational Service There have been no changes in occupational therapy personnel during the year. We are continuing to carry on programs with chronic regressed patients as well as with the acute treatment cases. Music therapy has proved successful so far as patient participation and patient enjoyment was concerned; rhythm bands, community sings and minstrel shows were some activities of this department. During the past year more volunteer participation occurred than ever before. Large groups of college students worked with the music therapist. Volunteers assisted in ceramic classes, cooking classes, and dance therapy. Recreational therapy has been expanding, more patients have been participating in outdoor activities under the supervision of the Occupational Therapy Department and the Recreation al Therapist. Outdoor picnics during the warm weather, baseball 14. 1961 - 1962 games and bowling, are enjoyed by many. Patients were taken to a few of the County fairs and to big league baseball games in Boston. All in all the activity has stepped up, but there are still several wards that the Occupational Therapy and Recreational Therapy is at a minimum. More Occupational Therapists and Recreational Therapists ere needed to step up activity in the chronic continued treatment wards. What we offer is not enough. We have initiated a program of correspondence courses with the cooperation of the Massachusetts Department of Education, Division of University Extension. At present only thirteen patients are participating but we hope to expand the program depending upon the availability of volunteer teachers. Chaplain Service The Chaplain Service has been active at this hospital. Protestant, Catholic, Greek Orthodox and Jewish Services are held. The Protestant Chaplain has been exceedingly active, not only conducting religious services but conducting Bible classes, making pastoral visits on the wards, counselling patients and relatives, officiating at funerals, speaking to the public and attending Chaplains' conferences. He also conducted a school of Pastoral Care at this hospital for six weeks. Five clergy students attended. We are grateful to the Institute of Pastoral Care , the national body which endorses and accredits the supervisors who are authorized to conduct these schools of Pastoral Care* Library Service The last fiscal year has been another year of increased popularity and activity in the three patients' Libraries. We are ever reminded of the real pleasure that reading gives to our patients. It is not only enjoyment but another source for remotivating the patient. We have been fortunate again this year to have been the recipient of many books and numerous magazines fro* interested friends of the hospital. The Librarian this year edited a weekly news bulletin, "News and Views", which is a valuable source of information to patienta and the community. On June 30, 1962 there were 7,697 volumes in combined libraries, 281 volumes had been added and 166 had been discarded. A total of 2,600 volumes, plus innumerable magazines and paper bound books were circulated on the wards and about 17,000 visits were made by patients to our libraries. 15. 1961 - 1962 Volunteer Services Sixteen different organizations continue to give service to this hospital, by working on the wards in reraotivae- ion therapy, holding dances, bingo parties and theatrical events. Some sponsor teas, and patients are taken to volunteers' homes. Others donate their time to occupational therapy, recreational therapy, and take part in cooking classes, ceramic classes, and helping in various activities with geriatric patients. The average for the year was 260 volunteers per month donating 1,185 hours of service per month. The Northampton State Hospital Auxiliary has grown, they held many activities and the donations were contribut ed to the hospital. They supply cigarettes and candy to patients; have purchased outdoor furniture for the courtyards; many lawn chairs, and a record player, and will continue to donate funds for patients* activities. We are thankful to the Volunteer and Auxiliary Groups for their service and generosity. Non Medical Services The Steward's office is the control center of all non professional activities. Business activities, maintenance, housekeeping, kitchen, dinlngroom, farm and grounds, come within the province of that office. Maintenance is still a problem, most repairs are done on an emergency basis. Painting, plumbing repairs, and carpentry, is a constant process and it would be less costly to replace old equipment and buildings. A new fire alarm detection system has been installed on all wards and buildings but it has not yet been activated. This system does not directly tie in with the City fire alarm system and for this reason is considered by us to be unsatisfactory. Laundry: Our dry cleaning plant was activated and we can offer a much needed service to our patients as well as Belchertown State School and Monson State Hospital. Farm Service: During the past year we had a change of Head Farmers, Mr. George Haller came to us from the Gardner State Hospital to replace Mr. Frederick Higgins, who retired. Tons of hay and silage were harvested and fed to the farm r* is. 1961 - 1962 animals. We board 80 heifers for the Belchertown State School. We reduced our pig herd, over 200 pigs were slaughtered and 31 tons of fresh pork delivered to our storehouse. The farm crop was good, fresh vegetables were fed to the patients and surplus sold to other institutions. The University of Massachusetts gave us 25 tons of chickens and 4% tons of turkey during the year. Considerable praise goes to our groundskeeper and his men for the beauty and neatness of the grounds. Acknowledgements We have been crying these needs for many years and are hopeful that in the near future the entire Main Group of buildings will be replaced by modern structures and Northampton will have a State Hospital second to none. We are thankful to our friends who are working in behalf of the mentally ill and who will make this possible. We are now active in a teaching program and steadily gaining the interest of students to work in the field of Mental Health. Students from local colleges are cooperative by working as volunteers and case workers. One college is using the hospital for academic purposes in interim courses in psychology and we are hopeful of being able to attract students as Fellows in Medical Sociology. Such a program will prove that State Hospitals need not be outmoded but still recognized as the cornerstone of American Psychiatry on which to expand education, as well as actively treat patients. The students, faculty and volunteers are too many to thank individually, therefora, we take this opportunity to thank them all for their time, generosity, and interest in the patients. Needless to say we are grateful to the Department of Mental Health for its support and understanding of our needs. Respectfully submitted Mgm^ Vro-o-cl)Vwcoux M.D. Superintendent Northampton State Hospital Northampton, Massachusetts