EUGENIC EFFECTS

"However urgent the economic factors in the problem of the alien insane may be, far more serious possibilities lie in the effect of the mental defectives and the insane within our borders upon our future generations.

"Eugenics the practical application of facts learned in the study of heredity-is one of the most recent undertakings for race betterment, dating back little more than twelve years, while that branch of it relating to heredity in mental defects and diseases was taken up scarcely more than five years ago, research work therein being confined substantially to this country and Germany.

"From the results already obtained we can see how important to our descendants is a complete knowledge of the transmission of insanity and mental defect by heredity. For many years the popular mind has associated insanity with heredity. This belief has been confirmed by modern investigation so far, at least, as to assure us that heredity is by far the most important single factor in the causation of certain forms of mental diseases.

"To ancestors afflicted with feeble-mindedness, with dementia praecox and other mental disorders, numerous mentally defective or mentally diseased descendants have been traced in many of the families that have been investigated, while in a few of the cases examined, where one party to the marriage was normal (and presumably of pure normal ancestry) the other being insane, some normal children resulted.

"The result of investigations of heredity in mental diseases and defects down to the present time entirely justifies the statement that it is highly undesirable that the feeble-minded, epileptics and those with certain types of insanity should have children.

"It is patent, therefore, that both the insane, the mental defectives, and those particularly likely to become insane, who are so undesirable as parents of future generations of Americans, should be excluded, so far as possible, from entry into this State and country. If, however, they have been admitted and have not become citizens of this country, they should be returned to the homes from which they came.

ATTITUDE OF OTHER STATES

"At the suggestion of this Commission, the Governors of the States of New Hampshire, Connecticut, Massachusetts, New Jersey, Pennsylvania, Maryland, Rhode Island, Indiana, Illinois, West Virginia, South Carolina and Virginia have been making investigations on the same lines as those conducted in this State, and several of them have undertaken the collection of data on history cards of the form devised by this Commission. When all have been tabulated we will, for the first time, have data concerning citizenship and based upon statistics of a uniform character.

"It is interesting to know that one of the results of this study of their own problems has been the initiation in two states of an organized effort to deport those aliens in their hospitals for the insane who were clearly deportable.

"It would seem, however, that but few of the states fully realize the importance of deportation and the saving resulting therefrom, for the report of the Bureau of Deportation for 1913 states that, during the twelve months ending September 30, 1913, the total number of insane aliens deported from all ports in the United States upon Federal warrant as being insane from causes existing prior to landing numbered 641; that of those, 379, or 59.12 per cent, were deported from New York State through the certifications of that Bureau, leaving 262, or 41.88 per cent, as representing the efforts of all the remaining states.

"According to the figures of the census of 1910 New York State had 16.7 per cent of the insane in institutions in the United States, while in 1904, the last year of which figures are available, New York was caring for 25.2 per cent of the foreign-born insane. No similar percentages of the alien insane are obtainable.

"While the burden of the alien insane is heaviest in the State of New York other states already feel it to a greater or lesser degree and unless speedy action be taken to remedy the causes of present conditions they will be confronted with a situation similar to that existing in New York. As no single state, but the Federal government alone has power in the premises, to obtain the necessary relief, cooperation is much to be desired.

SUGGESTIONS RECEIVED

"Various methods have been suggested as a solution to this vexing problem, among them the following:

(a) That, as an aid to existing methods, there should be stationed at the ports of embarkation United States medical officers, who should take part in the examination of the intending immigrant.

(b) That there should be stationed upon each ship bearing immigrants to this country United States officials, either physicians or nurses, or both, who should observe the aliens from time to time and report to the immigration officials upon arrival those apparently suffering from psychoses or mental defects.

(c) That a larger number of medical officers should be detailed to Ellis Island and other large ports, and that these physicians should be men trained in the detection of mental diseases and defects.

(d) That there be provided large detention hospitals in which suspected cases could be isolated for a longer or shorter period until proper investigation could be made as to their mental condition.

(e) That the time during which deportation can be effected under Federal warrant be lengthened to five years, or longer.

(f) That Decision No. 120' should be rescinded and the testimony of competent alienists as to mental condition be taken as sufficient authority for the issuance of Federal warrants of deportation, if other conditions admit.

(g) That the law, instead of providing that the authorities show that the causes of the alien's psychosis existed prior to his landing, should provide that the alien should show that the causes of his psychosis arose subsequent to his landing, thus putting the burden of proof upon the alien rather than upon the State.

(h) That the steamship companies which bring immigrants to this country be made responsible for the mental condition of the immigrants, as well as for the physical condition. In other words, the steamship companies shall make careful investigation into the family history and general surroundings of the proposed immigrants at their homes in order to determine that there is no hereditary taint.

RECOMMENDATIONS

I. FOR THE STATE OF NEW YORK

1. EXCLUSION OF INSANE AND MENTALLY DEFECTIVE IMMIGRANTS AT THE TIME OF THEIR ARRIVAL

"(a) The present law (chapter 27 of the Consolidated Laws, article II, section 19, as amended by chapter 121 of the Laws of 1912) provides that the Bureau of Deportation "shall maintain a careful inspection and observation of the methods and facilities for examining immigrants for mental disease and defect at the port of New York, and shall, from time to time, report to the commission upon the methods emplayed, and their efficiency***."

"This is probably as much as can be done by the State in regard to the examination of immigrants, for the only authority under which an insane alien can be debarred from entering this country. is the Federal law which can be enforced only by Federal officials.

"(b) The State, through its Executive or its Legislature, may urge upon Congress the necessity of providing sufficient appropriations for the efficient enforcement of the Immigration Act and of enacting needed amendments thereto.

2. DEPORTATION BY FEDERAL WARRANT OF INSANE ALIENS WHO BECOME PUBLIC CHARGES FROM PRIOR CAUSES OR ARE FOUND IN THE STATE IN VIOLATION OF THE IMMIGRATION Аст

"(a) The part of the State in effecting deportation of insane and mentally defective aliens consists in reporting such cases to the United States immigration authorities, furnishing information for the verification of their landing, and certifying to the conditions found and their origin from causes which existed prior to landing.

This work, so far as it relates to the insane, should be performed more efficiently each year by the Bureau of Deportation, with the cooperation of the State Hospital Commission and the superintendents of State hospitals, provided that adequate funds be furnished therefor.

The necessity of experienced alienists in the Bureau of Depor

tation is clearly apparent when it is recalled that in order to deport an insane alien under Federal warrant it must be proved, among other things, that the alien's insanity arose "from causes existing prior to landing" in this country. This fact, in most instances, can be established only by expert medical opinion.

"(b) Superintendents of State hospitals should make the most diligent efforts to determine, at the time of admission, the citizenship of every patient; should immediately notify the Bureau of Deportation not only of all admissions known to be aliens but of all not known to be citizens. For this purpose and to obtain the information essential for the verification of landing, a sufficient number of attendants able to speak foreign languages should be employed, and, in the case of languages less frequently spoken, the temporary services of interpreters should be enlisted. Unfortunately it appears that the number of attendants speaking foreign languages and of interpreters in the State hospitals is quite inadequate. Moreover, it has been shown that attendants speaking the language of the alien insane patient are of great assistance in the diagnosis of the patient's affliction and in the treatment thereof.

"(c) Physicians of the Bureau of Deportation should make frequent visits to all the State hospitals to aid in making the needed investigations of aliens and to see that no deportable aliens have been overlooked by the hospital authorities.

"(d) Everything possible should be done to insure the fullest cooperation between the Federal and State authorities in these deportations.

As deportation under Federal warrant is effected with but little expense to the State, every effort should be made to utilize the provisions of the Immigration Act to the fullest extent.

(3) REPATRIATION OF ALIENS WITH THEIR CONSENT AND RETURN OF NON-RESIDENTS AT EXPENSE OF STATE OR FRIENDS "(a) For the past three years the number of aliens repatriated and of nonresidents returned from this State has each exceeded the number of aliens deported therefrom by the Federal authorities.

As attendants are employed more frequently by the State than