Dr. EBAUGH. I am, to the Surgeon General.

Mr. ADAMS. Yes, to the Surgeon General. Perhaps there is something you might have to say on that point.

Mr. BUSBEY. I raised the question because I am wondering in this -present emergency if your appeal should not be made to the Department of Defense rather than this subcommittee for the simple reason that I have known personally several well-qualified psychiatrists that have been wanting to make their services available to the Armed Forces and they report back to me there is just no provision for them to take them in because they have not that many positions open. Now, when Mr. Schlaifer says they need 1,500 and they tell me they have not positions to take in these qualified psychiatrists and commission them, I just wonder if something should not be done by your group to bring this to the attention of the National Defense Department rather than this subcommittee because in tremendous appropriation they are asking for and naturally will get from this Congress, a couple of million dollars for this program would be a drop in the bucket.

Mr. ADAMS. Yes; I think that is a very good point and we certainly will take it up with them. The thing is that the training of psychiatrists and researchers is not a thing that they are planning to do. This is the only place in the budget where psychiatrists can be trained and research done. So it should be both.

Mr. BUSBEY. I merely put it out as a suggestion. I think you are overlooking a very vital point in your program by not bringing to the attention of the Department of Defense the need of commissioning more psychiatrists.

Mr. ADAMS. I think it is a very valuable suggestion and we are going to follow it through.

Mr. McGRATH. I take it your point is that you are more interested in research in psychiatric treatment and from there on accomplish something that will seep down to defense agencies and to other civilian agencies.

Mr. SCHLAIFER. The point is that the Army have, if they have not drawn off the men you are speaking of now, they probably will be drawing them off shortly, if the psychiatrists have not been accepted yet. I am sure that as far as the 1,500 men, more or less, drawn off the civilian pool of psychiatrists that are available, and there are not very many available, then the whole civilian population, as well as the Armed Forces, will be left with no replacements for those men unless some such research and training program is continued as we are recommending, and within a very short space of time we will find a bigger gap in the field of psychiatry than there is today. It may be possible that the Armed Forces may, with their own reasons, for one reason or another, or may not be taking all the men they could or should who are available, but if they draw off in the same proportion as was done in World War II, we are going to find ourselves with a great big gap without any research being done or without additional training of new men.

Dr. EBAUGH. I will emphasize that later on in my statement.
Mr. BUSBEY. That is all, Mr. Chairman.

Mr. FOGARTY. I believe Mr. Bunker is next.

WITNESS

ARTHUR BUNKER, PRESIDENT OF THE CLIMAX MOLYBDENUM C

Mr. FOGARTY. Will you identify yourself for the record?

Mr. BUNKER. Mr. Chairman, I am Arthur Bunker. I am pres dent of the Climax Molybdenum Co., which is a fairly large minin company mostly making articles for defense.

I would like to say also to give you my background, and therefor my interest in this problem, that in World War II I was with th Government for 412 years in various positions and for a long tim as Chief of Staff, War Production Board, so that I am pretty we acquainted with defense problems and material problems that go t either mobilization or defense. At the present time I am a membe of the President's Materials Policy Commission, trying to dredg out those problems concerned with critical and strategic areas, i cluding, of course, manpower. Why am I here? Because for a nun ber of years I have been so interested in this mental-health proble that I have tried to put together and finally helped a good man others in merging all of the lay groups in the National Associatio of Mental Health. So that now we only have one national la organization concerned with the general educational and health pro lems in that area.

Mr. FOGARTY. When was that accomplished?

Mr. BUNKER. That was accomplished last September. It took great many years to do it and it represented three national organiza tions joining into one. You are going to hear later on the medica director of that organization.

Mr. FOGARTY. I think you will be more successful from now on.

Mr. BUNKER. We thought we could combine and have one agend instead of overlapping groups, we could accomplish a great deal mor You know, I am sure that all those private areas of endeavor are ex ceedingly difficult. I do not think I need to tell this group except terms of the most general reference any statistics. You are going hear a lot of them, but one must mention the dimensions of it.

It is expected that 1 individual out of every 18 in the country wi at some time be in a mental institution. In other words, one out every five families will have a member in an institution. It seems me that on the civilian level now, the incidence of this great cripplin problem, greater than all the other diseases and issues we have, on th military front I am sure you all know that in World War II that 3 percent of all the rejections in induction centers were mental healt many times more than any other single cause. Fifty-two percent of a of the medically discharged people were for mental health. In th veterans hospitals today, some 55 percent of all the patients, again, a mental patients. So that whether in civilian life or military life, any other life, where there is a great strain, you have enormo incidence of destruction.

Now I do not think that the question that perplexes us is the bigge problem connected with manpower in an age, after all, in which w need all of the arms and legs and effort and sinews of strength wheth it is in the factories or the Armed Forces or any other place; as i dustrialists, certainly manpower is one of the greatest problems. I d not think it is difficult to say that the health of the Nation in any su

form as this is a defense problem. I think it is inseparably a part of defense. The problem that concerns, it seems to me, industry today more than any other single problem, extraordinarily perplexed by that problem is how you are going to get manpower to operate these facilities, to superimpose upon a high standard of living a standard of munitions and all of the equipment we need for the present emergency. It is a very difficult problem from an all-out war for many years, but one of the principal things I might point out is that last time we moved into war from an area of great unemployment. Today we move in from an area of full employment. We have not got any more arms and legs and people. We have to take the people that we have got and put more strain on them and use them to a greater degree and put them under greater strain if we are going to accomplish these things and work longer hours. There is not any other way that I can see that you can possibly speed up the industrial process.

Now, with my own institution as an example, which is certainly only one of thousands and I am sure is typical, whether you have absenteeism or alcoholism or accident-proneness or all the other things which either gives you the labor turnover or reduces your output by enormous percentages, I think that we all know that and I think the big problem is why has not more been done about it? And I think the answer to that question is that, generally speaking, as a group, as a Nation, we have not been convinced that there is something that can be really, in fact, be done about it because over the years it has been somewhat obscure. It has not been like simply saying we can take an X-ray picture and after all here is a man with cancer which we can find out or a lump in his chest or foot or what-not and we can diagnose this or this picture shows that he has TB and a certain specific thing is indicated. Fifty years ago, little or nothing was known; 25 years ago or 30 years ago, fortunately, man began to recognize symptoms of basic origins, how these things came about and recognized the origin of some of these basic causes; he recognized how to deal with them so that when he dealt with it he could operate on the areas of prevention, cure, rehabilitation.

Frankly, as a fairly hard-headed businessman, I would not have tauched this thing unless I thought that those things can be done, that this whole major problem could be dealt with on prevention and cure and rehabilitation. Otherwise, in my opinion, it would be pure wasted effort.

I think you have a field here of scientific development in which the development itself has so much further outstripped action than in any other area that there is no comparison. I mean I think in the field of heart, cancer, TB, you have keep very good pace with the scientific development; but I think in mental-ill-health areas in this whole question of what you do with the mentally and emotionally disturbed person that we have really just suffered from and for reasons I understand that in fact it is a neglected area and it is extraordinarily neglected. In fact, we do not pay very much attention to it but we let people in very great measure live out their lives in a mental hospital and high percentages we now know can be restored to activity and use. There is an enormous loss there. They can be kept from all of the troubles that they head into. I believe that those people who spend their lives studying these things say we have 8,000,000 of these people

in the country-and 8,000,000 is a staggering number. Now, I think the whole question comes down to saying, not whether it is $10,000,000 or $23,000,000 because if one really believes in this problem, those are very tiny sums of money, $71,000,000 subdivided into any portion that you wish, I think if one is convinced that you can do things, and it is a long-term game, you have to spend your money today and get your geometric return or rewards tomorrow. By tomorrow I mean 1 year, 2 years, 5 years. But if you do not lay the ground work, you do not have the weapons of defense.

Now, after all, what can private funds do? Very little in this area. We have a little institution. It was my ambition that maybe we can see ourselves spending $10 million a year on an educational basis. That $10 million is just peanuts. This is something for the Federal Government, something for the State level if it is to be coped with properly. It is far too big and we have not got trained psychiatrists, probably to the extent of 20 percent, that we need, and as far as trained, skilled attendants, I think we need 15 times as many as we have got just now for the civilian problem. If you want to superimpose on that the strains of the fear of the war or war itself, or an increase in emergency, obviously those are the particular conditions which shock people into greater distress and you are going to need more. So that your present unattended problem is that you need about 400 percent of what you have got at the top level. And with trained psychiatrists, you need about 20,000 against 5,000. You are just about on as long-time a job as making the atomic bomb, if you wish.

That is my story, gentlemen. If one is convinced that this country could really take over this problem and do something about it, I don't think there is any question but whether the problem is there and needs attention or whether the problem is neglected. I think there has been doubt in some areas as to whether it can be dealt with and can be benefited-then I think these are small sums of money. That is all I have to say.

Mr. FOGARTY. Thank you, Mr. Bunker.

I do not know whether you know it or not-I think perhaps you do, that this committee has always felt that the need is apparent and that we should do something about this particular situation and as a result, in 1946 or 1947, the National Mental Health Institute was authorized by an act of Congress and we began appropriating funds for the carrying out of that program back in 1948, and that was the first time that the Federal Government had contributed in this all-out effort but we have always felt that there is a responsibility on the part of the Federal Government to do something for these people, but at the same time. we always expected that the public and the local communities and States would do their share at the same time. We have been increas ing these appropriations since 1948 and in a gradual scale, we have also been increasing other appropriations especially to research on heart and cancer and now arthritis, rheumatism, and all these other chronic diseases where sometimes offshoot from that helps something in mental health as you well know.

On top of that, we started a program 3 years ago, the National Institutes of Health where we were building what is known as the outstanding clinical laboratory in the world costing a sum of about $70

million. So you can see that we have not been standing still. We have been going along with this program and we recognize that there is a need for research and trained personnel in this field. I honestly think myself that a better job of education throughout the country could be done and I think that is a responsibility of your public organization. I know it is being done in the field of heart and cancer and other problems, arthritis, and that is being accomplished. As a consequence, we are making gains at a local level on this over-all problem.

Mr. BUNKER. I think it is true. There is one thing that concerns me about some forms of education and that is that I think we differ a great deal from cancer and heart because the ground work is not laid. If you educate people in fact on too grand a scale that there is something that can be done about it and there are in fact practically no facilities to do anything about it, then that is even worse in my opinion in some aspects than at present because you can tell a man in State after State after State that if you can get the psychiatric aid you can help yourself, you can prevent yourself from falling over the cliff; you can bring yourself back from the abyss if you have fallen there, but we have not got facilities; but in cancer, heart, circulatory diseases, and others, you can get attention and you cannot here.

Mr. FOGARTY. Eight or ten years ago, we did not have facilities available for heart and cancer, either. It has been in that time that they have made great strides in building research laboratories and making available clinical facilities and new methods of diagnosis and care and technique. It has been a gradual development all along the line. It is not something that the ground work was not laid for cancer and heart 25 years ago, 30 years ago, that there was no blueprint. So it is not one of those problems that you can overcome overnight. It is a long-range program.

Mr. BUNKER. It is a long-range program and your award will be geometric; that is why I would like to see seasonable funds spent. I am very sympathetic to the tremendous forward steps your committee has taken, but I sat down here in the last war, Mr. Fogarty, and spent billions. We would let $2 billions for contracts in 2 months for measurable things. It made a great impression that one does not forget, and then another $2 billion and another $2 billion.

Mr. FOGARTY. That is probably going to happen again.

Mr. BUNKER. Exactly. I am up to my neck in it right now. Mr. FOGARTY. We appreciate the problem, Mr. Bunker. We want to do our part about it. We are going to do our part.

Mr. BUSBEY. Mr. Bunker, do you think the fear of being bombed by atomic bombs that we hear about all the time might have some effect on the mentality of a lot of people and increase the rates of patients in the hospitals?

Mr. BUNKER. I can guess freely as a layman. I guess definitely that it will. I am not a doctor; but I see signs of it all around.

Mr. BUSBEY. What would your thought be in regard to the scare headlines we read all the time in the papers that keep agitating this thing instead of approaching it from a conservative standpoint? Do you think the people as a whole would be better off if it was not overemphasized so much?

Mr. BUNKER. Just giving you my personal opinion, I think the press is shocking and I think that all we have is scare headlines. I