Emphasis should be laid on the relation of directed activity to mental adjustment and social rehabilitation. There are three groups to be dealt with: (a) Patients likely to remain permanently in hospital, (b) recoverable hospital cases, (c) pre-hospital work at clinics. The candidate for training should not be too young and should be selected by a committee. Personality and character are of the highest importance, and the work demands consecration and genuine human love. The training is both theoretical and technical. The student is taught a little of general hospital administration, hospital etiquette, and the relation of her work to the organisation as a whole. She starts with the lower grades, and is taught something of the interdependence of the mental and physical, of the nature of habit reactions and methods of overcoming bad and forming good habits, including the habit of attention. Habit training is especially important in the reception service and with the unemployed deteriorating class. The deteriorated patients of many years' standing are the most difficult of all, but the writer looks forward to a lightening of this burden in the future when improved methods of prophylaxis and treatment have been used from the beginning. However, these patients are entitled to a chance, and even now results are encouraging. The next grade is the kindergarten. Here the student learns methods of re-education along lines of sensory stimulation and training: colour, music, simple exercises, games and story-telling are employed along with occupations. In the grades above this patients are given manual occupations chosen to meet individual needs. They are of increasing complexity, increasing interest, and require increasing concentration. Still higher is the occupation centre or “curative workshop,” where really beautiful work is sometimes done. Patients may be sent here for special observation, or before parole, or before passing to the “pre-industrial” or vocational training departments. The student should here make a general survey of the patient from the point of view of his personal needs, interests, inhibitions, emotions and relation to environment and the construction of a balanced programme of work, rest and play.

For thirty years—first at State Hospitals for the Insane, and later as Medical Director of Phipps Psychiatric Clinic—Dr. Meyer has assisted at the progress of occupational treatment for mental illness. He has seen it develop from a purely industrial type of employment with mainly utilitarian aims to the educational methods of occupation and recreation under the direction of specially trained organisers, in establishing which Mrs. Meyer was one of the pioneers.