ERADICATING FOCI OF MENTAL DEFECT 273 



public or private. Improved state roads have opened up hitherto un- 

 known and neglected territory, and families of the type just described 

 have come to our attention in increasing numbers. We expect them to 

 conform to our standards — an impossible task — and then they fall into the 

 hands of the school attendance officer, a social agency, or the Court. 



In June, 1922, the Bureau of Mental Health of the Pennsylvania Depart- 

 ment of Welfare began a system of state-wide clinics, having as one objective 

 of the clinics that gradually all defectives in a community would be identi- 

 fied through them, and registered at the central office. The face sheet of 

 our clinic history blanks provides space for the names of three generations, a 

 statement as to the school achievement of various members of the family 

 gives us some idea of the mental level and type of the family with which 

 we are dealing, and furthermore the referring agency is asked especially 

 for any history of mental deficiency in the family. Our field workers who 

 have been with the Bureau as long as clinics have been organized in their 

 territory— ten, nine, and eight years — are by this time well acquainted 

 with many of the defective groups residing in these sections. 



We search out all known relatives, examine them when possible, and 

 chart the families to give us some idea of the seriousness of the problem 

 they present; we follow up the children of defective adults, who are often 

 illegitimate, and if they are defective they are kept under supervision until 

 institutional care is available for them. In the course of our examinations 

 of the inmates of various types of institutions, we are constantly on the 

 lookout for other defective members of these families, and when possible 

 these are kept in the institution until other suitable institutional care can 

 be arranged for them. In so far as our limited institution accommodations 

 permit, we arrange for the commitment of all members of such families who 

 come to our attention. 



Much of the success in clearing up such foci depends on the cooperation 

 of public officials and Courts, their comprehension of the fact that the 

 initial cost for care, while heavy, is less than the ultimate cost of neglect, 

 and their willingness to do something about it. Our first clinic was estab- 

 lished in a county which is a home of a well-known tribe thoroughly investi- 

 gated by a member of this Congress. We have had a clinic there for ten 

 years. During that period any number of the tribe have been referred for 

 examination and found to be defective; we have found defective relatives 

 in all types of institutions; a large percentage of the dependent children 

 coming under the care of the Children's Aid Society are members, and 

 therefore "unplaceable"; they make up a large group of the families living 

 on public relief; and the list of names of persons on trial at practically every 



