On the question of servants in psychiatric hospitals

The question of caring for the mentally ill in the sense of this word, in the sense of leaving the lower and middle staff, always presented to me as being of paramount importance, stopped my attention almost from the very beginning of my psychiatric work as a provincial resident in one of the largest departments. Hospital efficiency strengthened me even more in the importance of good care, showing together how poorly it is in most cases in Russia and how little has been done so far for more or less satisfactory dissolution of it. Leaving the question of the average staff until another time, I find it possible to say without exaggeration that the lowest nursing staff in our Russian psychiatric institutions is the most sick place. And between the two, I would be mistaken and would meet a principled objection from someone if I said that whatever improved methods of care and treatment of mentally ill were introduced into psychiatric hospitals, no matter how well these last days were arranged, at the end of all this will still be the care staff. All our improvements run the risk of being unsuccessful, inapplicable to the task, far not as useful as one might expect, if there is not a person who is sufficiently prepared, reasonably, fit for his difficult assignment, with sufficient moral and mental qualifications of caring for which servant personnel, through get a practical application of all kinds of patient care.