h the hospitals render
than to supplement the work of the physicians by that of well educated
and highly trained executive assistants who would themselves find an
extremely interesting and productive field for their efforts.

A period has now been reached in this field of work when what amounts to
a movement not inferior in significance and importance to that of a
hundred years ago, seems to be in active operation. The character and
scope of this movement and the lines of its progress have, to some
extent, been indicated in the illuminating formulations which have been
presented here to-day. The medical study and treatment of the mind is no
longer so exclusively confined within the walls of institutions nor to
the type or degree of disorder which necessitates compulsory seclusion.
Psychiatry is extending out from the institutions into the communities
by means of out-patient clinics and social workers, through newly
created organized agencies, through informed individuals, physicians,
nurses, and lay workers, and through the general spread of psychiatric
knowledge. This process is being expedited by the efforts of organized
bodies such as the National and State Committees and Societies for
Mental Hygiene, and the public is rapidly learning what can properly be
expected of institutions, officials, physicians, nurses, and other
responsible individuals in whom special knowledge and ability are
supposed to be found. As in the prevention of tuberculosis, so, in the
prevention of mental disorders, the informed public is likely to start a
campaign which the medical profession may have to make haste to follow
in order to maintain its needed leadership. Although much is yet
required to improve the facilities necessary in carrying on the present
work, it seems to us that at such a time a further extension of the
activities of an institution such as Bloomingdale Hospital may be
necessary to enable it to fulfil its possibilities for greater
usefulness. To extend the work our experience indicates that a
department in the city at the General Hospital would be of great
advantage. During the past few years the oversight of discharged
patients has grown to such an extent that it seems as though some
organized method of carrying it on may soon become necessary. This and
out-patient work generally could be best attended to in a city
department. Much emergency work and preliminary observation and the
treatment of certain types of cases now