Psychiatrist, Calm Thyself

The one place in the U.S. where a bagful of tranquilizing drugs was most urgently needed last week was the National Institute of Mental Health at Bethesda, Md.--and more for the staff than for the 45 patients.

Immediate cause of the ruckus was a strident protest by a staff psychiatrist, Dr. Jordan Scher, against the institute's decision to drop (as of July 1) his project for a forceful, unorthodox treatment of schizophrenic patients. He is getting results, claims Psychiatrist Scher, by being stern with schizophrenics, making them work, and forcing them into social situations (usually with the aid of relatives). It was too soon to judge whether Scher's method had any value (similar techniques have previously been tried and found wanting). In any case, he violated all the rules of the psychiatric club by taking his protest outside the institute's massive brick walls (by way of the patients' families) to Congressmen and to Secretary Marion Folsom of Health, Education and Welfare.

Three Years Late. Whatever the merits of the current dispute, the trouble is far more deepseated. The institute, set up at a cost of $40 million under the U.S. Public Health Service in 1953, supposedly to conduct farsighted research in mental health and mental illness, was slow to get rolling. Or, as its own staffers might say, its behavior down the years had been schizoid at best, and often catatonic.

One difficulty is financial. Institute Director Robert H. Felix gets only $16,500 a year; his clinical director, Dr. Robert A. Cohen, gets $19,000. (Top scientists may get more than their boss.) Either could make two or three times as much in private practice. In junior posts the disproportion is just as great, and there has been a heavy turnover of staff members. Result: no integrated program, no continuity in most research projects.

Probably NIMH's biggest boner was in trying to ignore the tranquilizing drugs. Its top brass are accused of being too Freudian ("Analytically oriented," as they put it) and scarcely interested in anything so humdrum as drugs for the mind. Instead of setting up rigidly controlled studies to evaluate the drugs, they appointed committees that belittled them. Last year Congress rammed $2,000,000 down NIMH's throat and ordered it to get going on a comprehensive tranquilizer evaluation. The work is hopefully scheduled to begin in July--only three years late.

Stiff Questions. One diagnosis of NIMH's current troubles is that Clinical Director Cohen is highly permissive for a father-figure and tries to give subordinates a free hand in working with patients. But even this permissiveness ran out when Psychiatrist Scher made ambitious demands for guarantees of space, facilities and money to continue his experiment in treating schizophrenics "tough." Cohen ordered the six patients in Scher's special project transferred to a state hospital, provoking angry protest from their families. Last week a congressional subcommittee" on appropriations handed Director Felix a set of stiff questions on the conduct of the institute.

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