ASYLUM TO COMMUNITY

(Published by F. W. Cheshire Ltd., Melbourne, Australia. 30s.) A book by Dr. Cunningham Dax is of great interest to both lay and professional workers in the psychiatric field in this country. This particular book, however, occupies an outstanding position in the history of the development of psychiatry. Dr. Dax left this country having taken the work of Netherne on to an outstanding level, and was able, together with the team of co-workers with whom he was working, to effect in a period of five years a virtual revolution in the practice of psychiatry in the state of Victoria, Australia. He did, in fact, achieve in this short period of time, a change as revolutionary as those that had taken some thirty or forty years' continuous and sustained work in this country. The mental institutions were changed from being medieval in their grimness into modern psychiatric hospitals and clinics. The book is clear, well illustrated and easy to read. It is a revelation as to the enthusiasm that can arise in a team when encouraged by the results that arise out of a transformation of practice. The custodial attitudes which were the practice in the mental hospitals of Victoria, the patients living most drab lives, and undoubtedly developing in the light of this the patterns of the illness that can only arise in the institutionalised person, gave place to the contemporary practices, with the full ancillary services including properly organised out-patient clinics, clubs and occupational therapy. This work was made possible by a campaign in the community as to the meaning of mental illness and the change that was required in the patterns of treatment in this. All sections of the community contributed including the Press and the Government. Teaching was offered to the existing Staff of the mental hospitals and they were granted the facilities through which, with the help of their patients, they were able to transform the hospitals. Dr. Dax very clearly recognised the impact upon the patients of activities of this type, and he gives a clear picture as to the extent to which non-verbal communication between the staff and the patients effects the prognosis in even serious mental illness. This work principally conducted in the Hospitals does not extend itself as yet adequately to the impact that must be made by this pattern of communication, not only between the staff and the patient, but also between the patient and his close relatives. Nevertheless, the direction of its development is indubitably correct. A revolution in the practice of psychiatry achieved within a period of five years can leave no doubt whatsoever as to the value of the change in the social situation as a therapeutic weapon in the practice of psychiatry. The book must have a wide