Seven years ago Dr. Clouston read a paper to this Association “On the Question of Getting, Training, and Retaining the Services of Good Asylum Attendants.” Such a paper could scarcely fail to attract considerable notice and elicit a very hearty discussion, for the subject is one of far-reaching importance to us as asylum physicians, and of very great moment in the interest of the insane. To get the best raw material possible, and to manufacture out of it the best asylum attendant possible, were two great aims suggested by Dr. Clouston, and the subsequent discussion of his paper showed that the Association was fully alive to these, and the serious obstacles which lay in the way of their accomplishment. If the aims here indicated should be more fully realised in the future than in the past, we will probably find that the third desideratum, viz., the keeping of our attendants for a reasonable length of time, will be realised in like proportion as the others. We all willingly admit that the first serious difficulty is how and where to get them. What will attract the best raw material into the asylum market ? or, putting the question in a negative way, what is it that does not attract the best raw material into asylums? These questions will admit of a variety of answers, many having their root in the idea of non-respectability. Undoubtedly the status of an attendant is at present an inferior one in the industrial scale. Some common popular notions are that the rougher and stronger the material the better is the attendant; that it is not a trade for men, and is suited only for the coarser types of women; that it leads to nothing reliable or desirable as a permanent occupation; and that as a life-work it is not sufficiently respectable to satisfy an average ambition. These and other considerations materially affect the supply of good attendants. Seeing, therefore, that in attendants themselves we find the best advertisement, and through them may command the highest success, it is worth considering, whether or not it is possible for us to advertise asylums, in such a way as to attract to them the better raw material which we crave so much after, and which we need so much. If the public mind must be educated to better purpose we must go upon a new tack. We shall require to bring more elevating influences to bear upon our attendants. In raising their social and industrial status we shall raise them in the estimation of the public and themselves, and may reasonably expect a more marketable article by-and-bye. It is surely fair, in the interest of all concerned, that attendants should receive from us the best possible training of which they are capable. There is reason enough for it in this, that as medical helps they will then develope more fully, and their work will become a life-work worthy of the name.
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