The plan was carried out with most successful results. At the end of six months he was released from the parole of Danvers State Hospital and returned to his home to report once a month to the mental clinic at the dispensary.
The social work in this case was not confined entirely to arrangements for the boy, but extended to the preparation of the family for his return, which involved moving to a less congested neighborhood in a Jewish section of a Boston suburb. It was also necessary to arrange for his attendance in an open air class, win his teacher's interest and co-operation, and educate the father to a realization of the need of discipline, the value of regular hours for eating and sleeping, the desirability that the boy should sleep alone, and the danger of exciting recreations.
R. has now been at his own home for twelve months. A recent entry on the medical record states: "Patient in excellent physical and mental condition."
The third class includes patients who have been discharged from insane hospitals as cured, or as so much improved that they should be able to maintain themselves and take part in family life again.
This work of after-care is extremely important. Many cases of mental disease can be safely discharged from an insane hospital if there is assurance that they will be properly followed up in their homes. Such supervision requires the joint efforts of the physician and the social worker.
Miss C., for instance, a woman of thirty-three years, was sent to the clinic for after-care, by arrangement with the superintendent of the insane hospital to which she had twice been sent for maniac-depressive insanity. Her mother had also been a patient for years in the same hospital. During the first weeks of her treatment at the clinic, she was still nervous, complained of gnawing sensations in the back of her head, and dreaded to ride in the street cars. When sitting, she constantly pulled and twitched different parts of her clothing, beat upon the floor with one foot, and kept one hand on her head, using the other one alone. She lived with a married sister who was in comfortable circumstances, and worked for her brother in an unprofitable little plumber's shop, which he apparently kept mainly to afford employment for Miss C. and a younger brother.