Total Push

Like many another copybook maxim, the old saw about an idle mind being the devil's workshop has validity in psychiatry as well as in everyday life. A little over a year ago, Psychiatrist Louis F. Verdel, manager of the Veterans Administration Hospital at Northport, N.Y., began an experiment that leaned heavily on the maxim. Dr. Verdel decided to keep a test group of mental patients so busy that they would have no time to mope, brood or withdraw from reality.

Psychiatrist Verdel does not like the term "hopeless." But all 106 men in his pilot group, he said last week, had failed to respond to other methods of treatment. They had been at the hospital for varying periods up to five years;* 95% had schizophrenia, one of the most difficult mental diseases to treat.

Dr. Verdel and Staff Psychiatrist William L. Harris worked out a full timetable of intensive treatment that left no time for the patients to retreat into their own sick fancies. The system worked. Out of the 106 patients, 16 were able to go home, and two of the 16 had full-time jobs; 4 more were about ready for trial leaves; 45 others were "good prospects" for release.

The men's busy day was divided into periods timed to the minute. Doctors, nurses, attendants, psychiatric workers, clinical psychologists, and experts in various kinds of therapy went to work on a five-day, 75-hour week. The men were up at 6 a.m. and in bed by 9 p.m. On Saturdays they cleaned up the ward ("ward hygiene"); some went to sports events (to keep in touch with what well people were doing). Sundays they got ready for visitors.

The system looks so promising that the hospital is now giving the special treatment to 200 patients, and other VA hospitals have adopted the treatment. One of the wrinkles added by the Bedford (Mass.) Hospital: a three-paneled mirror. It helps patients who slump along with bent head and shoulders to straighten up, look the world in the face.

The busy timetable system is known officially at Northport as the "Reintegrative Research Program." Dr. Verdel's shorter, better name for it is the "total push."

* Of 53,033 neuropsychiatric patients in VA hospital's last May, 57% had been there over three years.

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