April 5, 1954
Dear Congressman Fogarty,
In your letter of March 25, 1954, you asked for some comments on an editorial 
entitled, "Mental Health Crisis: There Is A Way Out".
There is growing interest in providing 1) better treatment services in mental 
hospitals, 2) services that will reduce the number of admissions to mental 
hospitals, and 3) aftercare services to minimize hospital readmissions. The 
editorial recognizes that there is a need for appropriate physical facilities, for 
improved treatment services that will shorten the length of hospital stay, and for 
clinic services. This editorial points out that some people have become too 
preoccupied with providing additional buildings and not enough interested in 
improving the treatment services in the hospitals and in the communities. 
Additional physical facilities are not, as the editorial points out, "the only 
answer". However, it may be that there is a real need for additional physical 
facilities and also a real need for improved staff and treatment in the hospitals 
and improved clinic facilities in the communities.
One might get the impression that the number of admissions to mental hospitals 
would be reduced considerably by having community psychiatric clinics. The 
majority of patients treated in community clinics have mental disorders of a 
different type and usually less incapacitating than those that require hospital 
treatment. There are some patients who would have to be admitted to a hospital if 
clinic services were not available in the community. One study indicated that 5 
percent of the patients treated in a community clinic would have required 
hospitalization if clinic treatment had not been available. It was estimated that 
the savings that resulted from not having to hospitalize these patients were 
almost enough to pay the entire cost of the clinic.
I thought you might be interested in having a copy of "A Ten Point Program of the 
National Governors' Conference on Mental Health"; a copy of this is attached.
I hope that these comments will be of some use to you. Please call upon me for any 
additional help that you desire.
Sincerely yours,
Leonard (handwritten)
Surgeon General