Commonwealth of Virginia 
Trends in 
Hospitalization for Mental Disease 
and Mental Deficiency in 
Virginia 
Prepared for 
STATE HOSPITAL BOARD 
By 
POPULATION STUDY 
VIRGINIA STATE PLANNING BOARD 
RICHMOND, VIRGINIA 
1942 
POPULATION STUDY REPORT No. 1 Commonwealth of Virginia 
Trends in 
Hospitalization for Mental Disease and 
Mental Deficiency in Virginia 
Prepared for 
STATE HOSPITAL BOARD 
By 
POPULATION STUDY 
VIRGINIA STATE PLANNING BOARD 
RICHMOND. VIRGINIA 
1942 
POPULATION STUDY REPORT No. 1 Table of Contents 
Page 
Letters of Transmittal 7 
Introduction 9 
I Trends in Hospitalization of Mental Patients in Vir- 
ginia 9 
Figures 1-7 
II Analysis of Total First Admissions 17 
Figures 8-11 
Senile Psychosis 20 
Figures 12-13 
Cerebral Arteriosclerosis 20 
Figures 14-15 
Manic Depressive Psychosis 20 
Figures 16-17 
Dementia Praecox 24 
Figures 18-19 
“All Other” Types 24 
Figures 20-21 
Alcoholism 28 
Figures 22-24 
Epilepsy 28 
Figures 25-26 
Feeblemindedness 28 
Figures 27-28 
III Outlook for the Next Decade 32 
Figure 29 
IV Summary 37 
Appendix 39 
LIST OF FIGURES 
I Trends in Hospitalization of Mental Patients in Vir- 
ginia 
Figure 
1. Patient Population in Institutions for Mental Di- 
seases and Mental Defectives by Color, Virginia, 
July 1, 1913 to June 30, 1940 10 
3 LIST OF FIGURES—Continued 
Page 
2. Rate per 100,000 Population of Patients in Insti- 
tutions for Mental Diseases and Mental Defec- 
tives by Color, Virginia, July 1, 1913 to June 30, 
1940 10 
3. Rates per 100,000 Population of Patients in 
Mental Institutions for Selected States 1938, 
and Percent Urban Population, 1940 11 
4. Rates per 100,000 Population of First Admissions 
to Mental Institutions for Selected States 1938, 
and Percent Urban 1940 13 
5. First Admissions of Alcoholic Patients (without 
psychosis) to Mental Hospitals for Selected States 
1938, and Percent Urban 1940 14 
6. Movement of White Patient Population in State 
Institutions for Mental Diseases and Mental 
Defectives, Virginia, 1935-1941 16 
7. Movement of Colored Patient Population in 
State Institutions for Mental Diseases and Mental 
Defectives, Virginia, 1935-1941 16 
II Analysis of Total First Admissions 
8. White—First Admissions to State Institutions by 
Sex and Type of Disorder, Virginia, 1931, 1935- 
1940 18 
9. Colored—First Admissions to State Institutions 
by Sex and Type of Disorder, Virginia, 1931, 
1935-1940 18 
10. First Admissions of All Patients to State Mental 
Institutions by Age, Virginia, 1931, 1939, 1940. . 19 
11. Age Specific First Admission Rates of All Patients 
to State Mental Institutions, Virginia, 1931, 
1939, 1940 19 
Senile Psychosis 
12. First Admissions of Patients with Senile Psychosis 
to State Mental Institutions by Age, Virginia, 
1931, 1939, 1940 21 
13. Age Specific First Admission Rates of Patients 
with Senile Psychosis to State Mental Institu- 
tions, Virginia, 1931, 1939, 1940 21 LIST OF FIGURES—Continued 
Page 
Cerebral Arteriosclerosis 
14. First Admissions of Patients with Cerebral Ar- 
teriosclerosis to State Mental Institutions by Age, 
Virginia, 1931, 1939, 1940 22 
15. Age Specific First Admission Rates for Patients 
with Cerebral Arteriosclerosis to State Mental 
Institutions, Virginia, 1931, 1939, 1940 22 
Manic Depressive Psychosis 
16. First Admissions of Patients with Manic Depres- 
sive Psychosis to State Mental Institutions by 
Age, Virginia, 1931, 1939, 1940 23 
17. Age Specific First Admission Rates of Patients 
with Manic Depressive Psychosis to State Mental 
Institutions, Virginia, 1931, 1939, 1940 23 
Dementia Praecox 
18. First Admissions of Patients with Dementia 
Praecox to State Mental Institutions by Age, 
Virginia, 1931, 1939, 1940 25 
19. Age Specific First Admission Rates of Patients 
with Dementia Praecox to State Mental Institu- 
tions, Virginia, 1931, 1939, 1940 25 
“All Other” Types 
20. First Admissions of Patients of “All Other” Types 
to State Mental Institutions by Age, Virginia, 
1931, 1939, 1940 26 
21. Age Specific First Admission Rates of “All Other” 
Patients Including Alcoholics to State Mental 
Institutions, Virginia, 1931, 1939, 1940 26 
Alcoholism 
22. First Admissions of Alcoholic Patients to State 
Mental Institutions by Age, Virginia, 1940 27 
23. Age Specific First Admission Rates of Alcoholic 
Patients to State Mental Institutions, Virginia, 
1940 27 
24. First Admissions of Alcoholics to Four Mental 
Hospitals by Type, Virginia, 1931, 1935-1940. .. 29 LIST OF FIGURES—Continued 
Page 
Epilepsy 
25. First Admissions of Patients with Epilepsy to 
State Mental Institutions by Age, Virginia, 1931, 
1939, 1940 30 
26. Age Specific First Admission Rates of Patients 
with Epilepsy to State Mental Institutions, 
Virginia, 1931, 1939, 1940 30 
Feeblemindedness 
27. First Admissions of Patients with Mental De- 
ficiency to State Mental Institutions by Age, 
Virginia, 1931, 1939, 1940 31 
28. Age Specific First Admission Rates of Mental De- 
fectives to State Mental Institutions, Virginia, 
1931, 1939, 1940 31 
III The Outlook for the Next Decade 
29. Patient Population in Institutions for Mental 
Diseases and Mental Defectives, Virginia, 1914- 
1950. (1942-1950 Estimated) 36 
IV Summary 37 
Appendix Tables 41 COMMONWEALTH OF VIRGINIA 
VIRGINIA STATE PLANNING BOARD 
301 STATE FINANCE BUILDING 
RICHMOND 
February 19, 1942. 
Dr. H. C. Henry, 
Director of State Hospitals, 
309 North 12th Street, 
Richmond, Virginia. 
Dear Dr. Henry: 
Pursuant to your request that the Virginia State Planning Board, 
through the Population Study, inquire into the population factors 
related to the incidence of mental disease and mental deficiency in 
Virginia, and in furtherance of the Board’s collaborative study with 
you of factors affecting future building requirements of the State’s 
mental hospitals, we submit herewith a report by the Population Study 
of the Board entitled “Trends in Hospitalization for Mental Disease 
and Mental Deficiency in Virginia.” 
Respectfully, 
VIRGINIA STATE PLANNING BOARD 
HRP:B Hugh R. Pomeroy, Director. COMMONWEALTH OF VIRGINIA 
VIRGINIA STATE PLANNING BOARD 
301 STATE FINANCE BUILDING 
RICHMOND 
February 19, 1942. 
Mr. Hugh R. Pomeroy, Director, 
Virginia State Planning Board, 
301 State Finance Building, 
Richmond, Virginia. 
Dear Mr. Pomeroy; 
I have the honor to submit herewith a report of Trends in Hos- 
pitalization for Mental Disease and Mental Deficiency in Virginia. 
One of the important phases of the program of the Population 
Study concerns itself with the analysis of characteristics of the popula- 
tion. In our search for materials which would provide a basis for 
appraising the incidence of mental disease and mental deficiency, we 
found the State Hospital Board a most helpful source. As we discussed 
this phase of the Population Study with Dr. H. C. Henry, Director, 
and Mr. F. W. Gwaltney, Executive Secretary, of the Board, they 
expressed the hope that we would pursue an inquiry into population 
factors related to these conditions. 
The present report represents a preliminary excursion into the 
factors influencing the recent trends in mental disease and mental 
deficiency in Virginia. The methods of analysis are somewhat explora- 
tory and experimental. The results obtained from this method of 
inquiry hold considerable promise as a means of appraising the social 
and economic factors which influence mental disease and mental 
deficiency. 
Respectfully yours, 
Lorin A. Thompson, 
Director, Population Study 
LAT :B Trends in Hospitalization for Mental Disease and 
Mental Deficiency in Virginia 
INTRODUCTION 
This report brings together the available information regarding the 
patients in Virginia’s institutions for the mentally diseased and men- 
tally defective. Since the available data are fragmentary and incomplete 
in certain respects, it cannot be expected that a comprehensive report 
can be made at this time. However, there are certain trends regarding 
the care and hospitalization of mental patients in Virginia that may be 
useful in planning for the immediate future. The changing patient 
load and commitment rates for the last decade are examined in this 
report in some detail. Where the data will permit, an analysis has 
also been made of the following separate components of the population: 
white males, white females, Negro males, and Negro females. The 
incidence of mental disturbance by the age of first admissions is also 
shown for the last decade. 
This summary shows the extent to which the number of mentally 
disturbed committed to institutions in the State is increasing or decreas- 
ing. Further inquiry is directed toward the trends among different 
sectors of the population with respect to commitment of the several 
kinds of mental disturbance. This seems to hold some promise as a 
method of gauging what provision needs to be made for the institutional 
population in the immediate future. 
An analysis of institutional figures has limitations in that compar- 
able methods of reporting such statistics for the various State hospitals 
and colonies is only a recent development. For this reason it has been 
possible to analyze in detail only the recent figures. Mental patients 
have been separated into four categories: (1) mentally diseased, (2) 
mentally deficient, (3) epileptic, and (4) alcoholic. The treatment of 
alcoholics in Virginia differs widely from the practices of most other 
states. The categories are those now used in the statistical reporting 
adopted by the Division of Vital Statistics of the United States Bureau 
of the Census in cooperation with the American Psychiatric Association. 
I TRENDS IN HOSPITALIZATION OF MENTAL 
PATIENTS IN VIRGINIA 
A general picture of the institutional population of Virginia is 
shown in Figure 1 (see Appendix Table 1) which details the number of 
patients in institutions for mental diseases and mental defectives in 
Virginia from 1914 to 1940 separately by race. Figure 2 (Table 1) 
shows the relation between incidence of patients and the total popula- FIGURE I 
PATIENT POPULATION IN INSTITUTIONS FOR MENTAL DISEASES AND MENTAL 
DEFECTIVES BY COLOR, VIRGINIA, JULY 1,1913 TO JUNE 30, 1940. 
TOTAL 
WHITE 
COLORED 
RATE PER 100,000 POPULATION OF PATIENTS IN INSTITUTIONS FOR MENTAL DISEASES 
AND MENTAL DEFECTIVES, BY COLOR, VIRGINIA , JULY I , 1913 TO JUNE 30,1940. 
FIGURE 2 
COLORED 
TOTAL 
WHITE 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY FIGURE 3 
RATE PER 100,000 POPULATION OF PATIENTS IN MENTAL INSTITUTIONS 
FOR SELECTED STATES 1938, AND PERCENT URBAN POPULATION 1940. 
HUNDREDS OF PERSONS PER 100,000 POPULATION 
MENTAL DISEASES 
EPILEPTICS AND MENTAL DEFECTIVES 
PERCENT URBAN 1940 
PERCENT URBAN 
1 940 
PREPARED BY 
VIRGINIA STATE PLANNING BO ARO - POPULATION STUDY tion, or the rate per hundred thousand, separately by white and colored. 
In this comparison it is unfortunate that the statistics are such that 
it is not possible to compare the rates of mdntal disease, mental de- 
ficiency, and epilepsy separately. 
The rates per hundred thousand of population for the period 1930 
to 1940 have been recomputed and differ somewhat from those reported 
by the State Hospital Board in its 1939 report. These figures differ 
by reason of the fact that the interim population for the last decade 
has been more accurately estimated since the 1940 population figures 
for the State have become available. 
In Figures 1 and 2 there are several factors which stand out. Both 
the absolute and relative numbers of patients cared for by institutions 
for mental diseases and mental defectives have increased. The rate for 
the total population rose from 207 per hundred thousand in 1914 to 305 
in 1930 and to 407 in 1940. Among the whites the corresponding rates 
were 190, 271, and 347. For the colored population the corresponding 
rates were 242, 397, and 591. Thus, the rates of the colored population 
have increased considerably faster than those of the white population. 
On first thought the relatively rapid increase in the hospitalization of 
the patients in the institutions of the State would appear to reflect a 
tremendous increase in mental disease and mental deficiency. On the 
contrary, the increase probably reflects only an intelligent recognition 
of the problem in the Commonwealth and an effort to meet it. 
Figure 3 (see Table 2, Appendix) compares Virginia with the 
United States average, with a group of middle western states, and 
with a number of states in the South Atlantic area, with respect to the 
rate of patient population in institutions for the mentally diseased, 
mentally defective, and epileptic. The percent of urban population in 
1940 is also shown for each state, which permits a comparison of patient 
rates and extent of urbanization. These statistics appear to reflect 
the different administrative practices of the various states and can 
scarcely serve as reliable guides to the incidence of mental disease and 
mental deficiency. They indicate, however, that those states which 
have larger urban populations have proportionately larger patient 
rates. This phenomenon is probably due to the fact that the need 
for the care of mentally diseased and mentally deficient persons in- 
creases as the proportion of people living in a complex urban environment 
increases. 
Figure 4 (see Table 3, Appendix) compares the first admission 
rates to State institutions in Virginia with the United States, several 
middle western and the South Atlantic states with respect to mental 
disease, and epilepsy and mental deficiency. The first admission rate 
of the mentally diseased for Virginia is about the same as that for 
Illinois, and considerably higher than the rates for Ohio, Indiana, 
Michigan, and Wisconsin, as well as for other South Atlantic states, 
except Delaware and the District of Columbia. The rate for Virginia is 
higher than the average for the United States, but would not be so 
much larger if the proportion of non-psychotic alcoholics did not com- 
prise about one-fourth of the total number of first admissions. 
With respect to the epileptics and the mentally deficient, the 
rate is 9.0 per hundred thousand for Virginia as compared with 8.0 for FIGURE 4 
RATES PER 100,000 POPULATION OF FIRST ADMISSIONS TO MENTAL 
INSTITUTIONS FOR SELECTED STATES 1938, AND PERCENT URBAN 1940. 
HUNDREDS OF PERSONS PER 100,000 POPULATION 
Ill* 
INSTITUTIONS FOR 
MENTALLT DISEASED 
INSTITUTIONS FOR EPILEPTICS 
AND MENTAL DEFECTIVES 
PERCENT URBAN 1940 
PERCENT URBAN 
1940 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD-POPULATION STUDY FIGURE 5 
FIRST ADMISSIONS OF ALCOHOLIC PATIENTS (WITHOUT PSYCHOSlS)TO 
MENTAL HOSPITALS FOR SELECTED STATES 1938, AND PERCENT URBAN 1940. 
total 
male 
FEMALE 
PERCENT URBAN 1940 
PERCENT URBAN 
1940 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD-POPULATION STUDY the total United States. It may be observed that the rate for Virginia 
is lower than the rates for Ohio, Illinois, and Wisconsin, and slightly 
higher than those for Indiana and Michigan. It is higher than for any 
of the South Atlantic states except Delaware. There are few states in 
the country, however, which make adequate provision for the care of 
the feebleminded. 
Figure 5 (see Table 4, Appendix) compares the first admission 
rates of alcoholics without psychosis by sex for the same group of 
states. It will be noted that Virginia has a commitment rate for alco- 
holics without psychoses of 18.2 per hundred thousand. This is the 
highest such admission rate among all the states of the Union. In the 
group of states under consideration, the rate for North Carolina of 
9.8 per hundred thousand is the second highest. The figures as pre- 
sented, however, cannot be considered as representing true differences 
in the incidence of alcoholism, but rather reflect the administrative 
practices among the states with respect to the problem. These rates 
reflect the different legal definitions of inebriacy and the methods of 
dealing with “drunks.” Most states send “drunks” to jail, while in 
Virginia they are often committed to the State Hospitals. 
Figures 6 and 7 (see Table 5, Appendix) show the movement of the 
State’s population in State institutions for mentally diseased and 
mentally deficient from 1935 to 1940. These figures are taken from a 
summary of the reports issued by the State Hospital Board. The 
figures illustrate graphically the movement of patient population, by 
color, for all institutions during this period; the number of patients in 
hospitals at the beginning of the year, the number on parole or on 
escape, the number admitted during the year, and the number who died 
or were discharged. The total indicates the number of patients on the 
books. Adjacent to the top of this bar is another bar indicating the 
total number of admissions during the year, including first admissions 
and readmissions. Adjacent to the admissions bar is a third bar indi- 
cating the number of patients who died or were discharged during the 
year. The solid portion of the bar for each year indicates the total 
number of patients in the institutions. This number has been increasing 
steadily. There is also a considerable number of patients on parole or 
on escape. There has been little change in the number of admissions 
during the last five years, but the number of patients discharged has 
increased. This may possibly reflect a changing administrative policy 
on the part of the State Hospital Board. 
There are no striking differences between the behavior of the white 
and colored groups, other than the fact that the proportion of white 
patients on parole or on escape is much larger than the colored. The 
figures which include the number on parole and on escape were grouped 
together until 1939, for which year they are shown separately. Marked 
improvement in the number of escapes of white patients was shown 
in 1940 with less than half the number reported in 1939. This may be 
the result of either a change in administrative procedure or a change in 
the methods of reporting. MUM0ER OF PATIENTS IN HOSPITAL AT BEGINNING OF YEAR 
NUMBER OF PATIENTS ON PAROLE OR ESCAPE AT BEGINNING OF YEAR 
NUMBER OF PATIENTS ADMITTED DURING YEAR 
NUMBER OF PATIENTS DISCHARGED DURING YEAR 
NUMBER OF PATIENTS WHO DIED DURING YEAR 
* FIGURE 7 
MOVEMENT OF COLORED PATIENT POPULATION IN STATE INSTITUTIONS 
FOR MENTAL DISEASES AND MENTAL DEFECTIVES, VIRGINIA,1935-1941. 
LE6EN 0 
YEARS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY 
FIGURE 6 
MOVEMENT OF WHITE PATIENT POPULATION IN STATE INSTITUTIONS 
FOR MENTAL DISEASES AND MENTAL DEFECTIVES, VIRG1 NIA,1935-1941, 
THOUSANDS OF COLORED PATIENTS 
YEARS 
THOUSANDS OF WHITE PATIENTS II ANALYSIS OF ADMISSIONS 
In the preceding section attention was given to the total load 
carried by the State institutions for mental diseases and mental defec- 
tives. It is desirable, however, to study the composition of the patient 
population and the characteristics of the first admissions, so that a 
more satisfactory picture of future possibilities may be gained. The 
most promising method of analysis is to study the first admissions to 
the State mental institutions by type of disorder and by age. 
For the years 1931 and 1935 through 1940 it has been possi- 
ble to separate the first admissions to the six State mental institu- 
tions into four major types: the insane, alcoholics without psychosis, 
epileptics, and the feebleminded. The reports from 1932 to 1934 are 
incomplete in some respects, and consequently, they were omitted. Ad- 
ministrative practice in patient placement is to a large extent based on 
this classification. The insane, who constitute by far the largest group, 
including all admissions not otherwise classified, are treated at four 
mental hospitals: Eastern State, Western State, and Southwestern 
State for white patients; and Central State for colored patients. The 
largest proportion of the white alcoholics without psychosis are ad- 
mitted to Western State Hospital. Separate departments at the 
Lynchburg Colony are maintained for white feebleminded patients 
and for white epileptics. Colored feebleminded males are treated at 
the Petersburg Colony. In addition, a number of colored feebleminded 
persons including all the women, are placed in Central State Hospital. 
The colored epileptics are also treated at Central State. 
Figures 8 and 9 (see Table 6, Appendix) show first admissions for 
these four types of patients by color and by sex. The difference in 
incidence of the principal types of disorders as between males and 
females has not varied greatly from year to year. Among the insane 
there were more men than women in both the white and colored groups 
for the years compared. White males made up a large part of the group 
of alcoholics without psychosis. The sex differences were not so pro- 
nounced in the epileptic and feebleminded groups. There were slightly 
more admissions of epileptic men than of women. On the other hand, 
there were more first admissions of women than men among the white 
group of feebleminded in all but two years. Among the colored feeble- 
minded persons, there was little difference between the numbers of 
men and women admitted. 
In studying the ages of first admissions to mental institutions a 
somewhat more detailed classification of types of disorder has been 
made. This is done in order to show the striking age differences for the 
various diseases. The figures which follow show the age distributions 
of all first admissions to all mental institutions, and the age distribu- 
tions for a number of separate disease classifications for the years 
1931, 1939, and 1940. 
Figures 10 and 11 (see Table 7, Appendix) show the ages of first 
admissions to State mental institutions of all types for the years 1931, 
1939 and 1940. Figure 10 shows the number of first admissions by 
age groups. Figure 11 shows the corresponding age specific admission 
rates by five-year age groups. It will be noted in Figure 10 that the FIGURE 8 
WHITE-FIRST ADMISSIONS TO STATE 
INSTITUTIONS BY SEX AND TYPE OF 
DISORDER,VIRGINIA,1931, 1935 - '40 
LEGEND 
WALE ALCOHOLICS 
FEMALE ALCOHOLICS 
MALE INSANE 
FEMALE INSANE 
MALE EPILEPTIC 
FEMALE EPILEPTIC 
male feeble-minded 
female feeble-minded 
NUMBER OF PATIENTS {IN HUNDREDS) 
FIGURE 9 
COLORED-FIRST ADMISSIONS TO STATE 
INSTITUTIONS BY SEX AND TYPE OF 
DISORDER ,V IRG IN I A, 1931, 1935- '40 
YEARS 
YEARS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY FIGURE 10 
FIRST ADMISSIONS OF ALL PATIENTS TO STATE MENTAL 
INSTITUTIONS BY AGE , VIRGIN1A , 1931 , 1939,1940. 
NUMBER OF PATIENTS 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
FIGURE II 
AGE SPECIFIC FIRST ADMISSION RATES OF ALL PATIENTS TO 
STATE MENTAL INSTITUTIONS, VI RGINI A , 1931, 1939, 1940. 
1931 
1939 
1940 
RATE PER 100, 000 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY number of first admissions under 55 years of age was larger in 1939 and 
in 1940 than it was in 1931. In 1931 the number of commitments of 
those over 60 was less than in either 1939 or 1940. The component 
parts of this picture will be clearer as each of the major classifications is 
considered separately. 
The following classifications of mental disease are shown each on a 
separate figure: senile psychosis; cerebral arteriosclerosis; manic- 
depressive psychosis; dementia praecox (schizophrenia); all other types, 
including alcoholics without psychosis. The feebleminded and epi- 
leptics are also shown separately. The first figure in each pair shows the 
number of first admissions in each classification by age groups, and the 
second figure in each pair shows the corresponding age specific admission 
rates. In all the figures five-year age classes have been used where 
possible. When the age data available for inclusion were given in ten- 
year age classes, the five-year age class has been estimated by dividing 
the ten-year age class into equal groups. It would be possible to refine 
further the age data given in ten-year classes by distributing the cases 
into five-year classes in proportion to their number in their respective 
color and sex groups of the total population. In view of the small 
numbers involved this procedure did not seem advisable. 
Senile Psychoses 
Figure 12 (Table 8, Appendix) of this series shows the number of 
first admission patients with senile psychoses for three selected years. 
Figure 13 shows the age specific first admission rates of this group. 
There has been no appreciable change either in the number of patients 
committed or the age specific rate. The figures indicate, however, 
that fewer patients under age 60 were committed in 1939 and 1940 
than in 1931. This probably reflects the influence of other social 
programs designed to give assistance to the aged. 
Cerebral Arteriosclerosis 
Figure 14 (Table 9, Appendix) shows the same information for the 
patients with cerebral arteriosclerosis. The number of patients with 
this malady who were committed to institutions increased sharply in 
1939 and 1940 as compared to 1931. With the population of the State 
becoming older, a larger number of people will be susceptible to cerebral 
arteriosclerosis, since this is a disease typical of old age. In all proba- 
bility the number of patients in this category will increase considerably 
in the years to come. Figure 15 shows the age specific admission rates 
for the disease. There has also been a sharp rise in the admissions of 
patients per hundred thousand for each age group over 55, between 
1931 and 1940. This increase may be due to better methods of diagnosis, 
as well as to greater awareness of the problem. It is of further im- 
portance to note that few patients under 50 years of age are committed 
to institutions with arteriosclerosis. 
Manic-Depressive Psychoses 
Figures 16 and 17 (Table 10, Appendix) show that there has been a 
tendency for both the numbers and rates per hundred thousand to FIGURE 12 
FIRST ADMISSIONS OF PATIENTS WITH SENILE PSYCHOSIS TO 
STATE MENTAL INSTITUTIONS BY AGE,VIRGINIA,1931,1939, 194 0. 
NUMBER OF PATIENTS 
J 93 1 
1939 
1940 
AGES OF FIRST ADMISSIONS 
FIGURE 13 
AGE SPECIFIC FIRST ADMISSION RATES OF PATIENTS WITH SENILE 
PSYCHOSIS TO STATE MENTAL INSTITUTIONS, VI R G I N IA , 1931,1939,1940. 
1931 
1939 
1940 
RATE PER 100,000 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY FIGURE 14 
FIRST ADMISSIONS OF PATIENTS WITH CEREBRAL ARTERIOSCLEROSIS 
TO STATE MENTAL INSTITUTIONS BY AGE, VIRGINIA, 1931,1939, 1940. 
NUMBER OF PATIENTS 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
FIGURE 15 
AGE SPECIFIC FIRST ADMISSION RATES FOR PATIENTS WITH CEREBRAL 
ARTERIOSCLEROSIS TO STATE MENTAL INSTITUTIONS,VIRGINIA, 1931,1939 , 1940. 
RATE PER 100, 000 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY FIGURE 16 
FIRST ADMISSIONS OF PATIENTS WITH MANIC DEPRESSIVE PSYCHOSIS 
TO STATE MENTAL INSTITUTIONS BY AGE , VI RGIN IA, 1931, 1939,1 940. 
1931 
1939 
1940 
NUMBER OF PATIENTS 
AGES OF FIRST ADMISSIONS 
FIGURE 17 
AGE SPECIFIC FIRST ADMISSION RATES OF PATIENTS WITH MANIC DEPRESSIVE 
PSYCHOSIS TO STATE MENTAL INSTITUTIONS, VIRGINIA, 1931, 1939,1940 
RATE PER 100,000 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD-POPULATION STUDY 
23 decrease in the manic-depressive group. For example, in 1931, there 
were 429 patients admitted to State mental institutions who were 
diagnosed as manic-depressives. In 1939, there were 418, and in 1940 
only 287. The age specific rates for this group have also shown a cor- 
responding drop. For example, the age specific rate for those aged 
45 to 49 was 32.6 in 1931, 29.3 in 1939, and 15.0 in 1940. There are 
corresponding decreases in other age groups for the same years. This 
drop is inconsistent with the trends in the number of manic-depressive 
patients reported for most other states as well as for the total United 
States. Such patients, however, are often diagnosed as schizophrenics 
(dementia praecox). 
Dementia Praecox 
The number of dementia praecox patients has decreased slightly 
between 1931 and 1940. The changes are illustrated in Figures 18 and 
19 (Table 11, Appendix). While the decline in the number of patients 
is small, the decline in the admission rate is somewhat larger. 
The number of patients hospitalized with dementia praecox and 
manic-depressive psychosis in Virginia has shown a tendency to de- 
crease, whereas most other states, as well as the United States total, 
show an increase in the number of such patients during the same 
period. The counter movement of this part of the patient population 
in Virginia can hardly be explained on the supposition that the people 
in Virginia are less susceptible to dementia praecox or manic-depressive 
psychosis. In some instances psychiatrists will differ in their diagnoses 
to the extent that some patients will be classified by one psychiatrist 
as manic-depressive and by another as dementia praecox. When the 
totals for the two diseases are combined, however, the Virginia trend 
does not become any more clear. It is undoubtedly due, therefore, 
to factors beyond the scope of the present report. In considering the 
possible future trends for hospitalization of mental patients it is quite 
likely that the number of manic-depressive and dementia praecox 
patients will increase. 
“All Other Types” 
The last group of first admissions to be considered for the years 
1931, 1939, and 1940 is designated as “All Others” and includes alco- 
holics. Figures 20 and 21 (Table 12, Appendix) show the absolute 
numbers as well as the age specific rates per hundred thousand. This 
group of patients has increased strikingly in the ten-year period. A 
substantial proportion of the “All Other” group, however, includes 
alcoholics without psychosis (Table 13, Appendix). If this group is 
separated from the remainder of the “All Other” group, there is no 
substantial increase in the total number of first admissions. In the 
“All Other” group in 1940, 462 out of 1,096, or 42 per cent, were classi- 
fied as alcoholics without psychosis, a rate of 17.3 per hundred thousand 
total population. FIGURE 18 
FIRST ADMISSIONS OF PATIENTS WITH DEMENTIA PRAECOX TO STATE 
MENTAL INSTITUTIONS BY AGE, VIRGINIA, 1931,1939,1940. 
NUMBER OF PATIENTS 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
FIGURE 19 
AGE SPECIFIC FIRST ADMISSION RATES OF PATIENTS WITH DEMENTIA 
PRAECOX TO STATE MENTAL INSTITUTIONS,VIRGINIA, 1931, 1939, 1940. 
RATE PER 100,000 
• 1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD — POPULATION STUDY , FIGURE 20 
FIRST ADMISSIONS OF PATIENTS OF "ALL OTHER" TYPES TO 
STATE MENTAL INSTITUTIONS BY AGE .VIRGIN! A , 1931,1939,1940. 
1931 
1939 
1940 INCLUDING 
ALCOHOLICS 
NUMBER OF PATI ENTS 
1940 WITHOUT 
ALCOHOLICS 
FIGURE 21 
AGE SPECIFIC FIRST ADMISSION RATES OF "ALL OTHER" PATIENTS INCLUDING 
ALCOHOLICS TO STATE MENTAL INSTITUTIONS, VI RGINIA , 1931,1939,1940. 
AGES OF FIRST ADMISSIONS 
RATE PER 100.000 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY FIGURE 22 
FIRST ADMISSIONS OF ALCOHOLIC PATIENTS TO STATE 
MENTAL INSTITUTIONS BY AGE,VIRGINIA, 1940. 
NUMBER OF PATIENTS 
AGES OF FIRST ADMISSIONS 
FIGURE 23 
AGE SPECIFIC FIRST ADMISSION RATES OF ALCOHOLIC PATIENTS 
TO STATE MENTAL INSTITUTIONS, VIRGINIA , 1940. 
RATE PER 100,000 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY 
AGES OF FIRST ADMISSIONS Alcoholism 
Figures 22 and 23 (Table 13, Appendix) show the age specific first 
admission rates of alcoholics without psychosis for 1940, which is the 
first year for which age data are available. The commitment rates 
for this group are highest between the ages 25 and 60. During this 
thirty-five-year span, the largest number of admissions and the highest 
age specific rates are for those from 30 to 40 years of age. Furthermore, 
the diagnosis of alcoholism without psychosis applies chiefly to white 
males. Figure 24 (Table 14, Appendix) shows the first admissions to 
mental institutions who are classified as alcoholics. This group is 
further subdivided into alcoholics with and without psychosis. The total 
number of alcoholics in 1931 was 235. By 1935, it was 567. In 1936 
it reached 660, dropped to 539 in 1938, went up to 584 in 1939—and 
dropped back to 522 in 1940. The number of first admissions with 
alcoholism approximates closely the total number of alcoholic patients 
in mental hospitals, since the average time spent in hospitals by these 
patients is fairly short. 
Epilepsy 
The next group to be considered is that of the epileptics. The total 
number of admissions of patients with epilepsy was 120 in 1931, 96 in 
1939, and 103 in 1940. Figure 25 (Table 15, Appendix) shows the 
number of first admissions by age groups. Figure 26 gives the corre- 
sponding age specific rates, but it should be pointed out that the numbers 
on which these rates are based are too small to be reliable. They do 
suggest, however, that epilepsy is a disease which usually appears 
before age 40. The number under 15 increased from 19 in 1931 to 38 
in 1940. However, the number of admissions under 15 in 1939 was 
only 10, so that it is entirely possible that this change in number may 
represent only a time lag in commitment. 
Feeblemindedness 
The final group of patients in mental institutions to be considered 
is comprised of those with mental deficiency, or feeblemindedness. 
Figure 27 (Table 16, Appendix) showing the number of first admissions 
by age groups indicates that such commitments have been increasing. 
In 1931 there were 261 first admissions, in 1939 there were 360, and in 
1940 there were 498. Figure 28 showing the age specific commitment 
rates indicates no important changes in age composition, but again 
the rates are based on small numbers. Their chief value lies in the 
fact that they indicate the ages at which the largest numbers of patients 
are committed. It should be noted that the present rates of admissions 
of feebleminded in Virginia are still far below the commitment rates 
of other states which have large urban populations, even though such 
commitments have increased considerably in Virginia during the last 
ten years. This group will become more of a social problem as the 
proportion of population living in urban areas increases, due primarily 
to the fact that mentally deficient persons cannot easily adjust them- 
selves to complex environments. There is a further problem. In the FIGURE 24 
FIRST ADMISSIONS OF ALCOHOLICS TO FOUR MENTAL HOSPITALS 
BY TYPE, VIRGINIA, 1931, 1935-1940. 
alcoholics without psychosis 
ALCOHOLICS WITH PSYCHOSIS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD-POPULATION STUDY FIGURE 25 
FIRST ADMISSIONS OF PATIENTS WITH EPILEPSY TO STATE 
MENTAL INSTITUTIONS BY A GE , VI RGIN IA , 1931, 1939,1940. 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
FIGURE 26 
AGE SPECIFIC FIRST ADMISSION RATES OF PATIENTS WITH EPILEPSY 
TO STATE MENTAL INSTITUTIONS, VIRGINIA , 1931 , 1939 , 1940. 
AGES OF FIRST ADMISSIONS 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY FIRST ADMISSIONS OF PATIENTS WITH MENTAL DEFICIENCY -TO 
STATE MENTAL INSTITUTIONS BY AGE,VIRGINIA, 1931, 1939, 1940. 
FIGURE 27 
1931 
1939 
1940 
AGES OF FIRST ADMISSIONS 
FIGURE 28 
AGE SPECIFIC FIRST ADMISSION RATES OF MENTAL DEFECTIVES 
TO STATE MENTAL I NST1TUTI ONS, VI RGI N 1 A , I 931 , 1939, 1940. 
1931 
1939 
1940 
i 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD - POPULATION STUDY 
AGES OF FIRST ADMISSIONS long view, if the feebleminded are permitted to marry and have children 
freely, the total burden which the State must bear at a future time is 
increased. It would seem the part of wisdom, therefore, to think in 
terms of a much larger number of patients with mental deficiency than 
has been considered heretofore. In a report made in 1937 by the late 
Major Charles J. Calrow, then Director of the Virginia State Planning 
Board, on the potential needs of the Negro feebleminded, the conclusion 
was reached that the probable capacity required to take care of only 
the Negro portion of the feebleminded population was about 1,800. 
This report was based on an analysis of World War I draft data and 
the experiences of other states which have devoted more time and 
resources thus far than has Virginia in improving the methods for the 
care and diagnosis of mentally deficient persons. There are scarcely 
sufficient data in the figures here presented, however, to determine 
the probable size of the patient load of mental defectives. 
The reports of the State Hospital Board and other agencies deal 
largely with administrative problems. The purpose in this report 
has been primarily to observe the trends which influence the size and 
composition of the population to be treated or cared for in mental 
institutions. 
The size and composition of Virginia’s patient population for the 
next decade will be influenced by the increasing urban population, 
changes in administrative practice as regards the care and treatment 
of the different forms of mental disturbance, the facilities available, 
and the extent to which Virginians in the armed forces return home 
from the war with shattered nerves and mental breakdowns. The 
trend in admission rates to mental institutions shows the types of 
mental disturbance which may be expected to increase, those which 
may remain relatively unchanged, and those which may possibly 
decrease, under the less rigorous conditions of peace. Plans for the 
further development of mental institutions should anticipate, so far as 
possible, the expansion needed for the treatment and care of the cas- 
ualties of war. There is little doubt that mental institutions will need 
to prepare themselves for this contingency, and the principal question 
becomes that of how large the increased load will be. 
Present indications are that cerebral arteriosclerosis and senile 
dementia will increase during the next decade. This increase will be 
due primarily to the aging of the State’s population and the fact that 
these are diseases of old age. The incidence of manic-depressive 
psychosis and of dementia praecox (schizophrenia) has decreased in the 
years compared. Since the trends in Virginia in this respect are at 
variance with the national trend, a change in commitment or diag- 
nostic procedures might result in a marked increase in the number and 
the commitment rate of patients so classified during the next decade. 
There is no basis for assuming that all the patients suffering from these 
diseases are in the State hospitals. 
In Table 17 (Appendix) the urban and rural components of the 
population are shown from 1920 to 1950. The rural population is 
Ill THE OUTLOOK FOR THE NEXT DECADE further subdivided into farm and non-farm. Two estimates of the 
population are given for 1950, each on a separate set of assumptions, 
a high estimate of 3,193,057 and a low estimate of 2,972,420. The 
assumptions are stated in later paragraphs. The estimates were com- 
puted by a simple extension of straight line trends of the urban and 
rural components of the population. This procedure seems satisfactory 
at present since the conditions influencing population change in Virginia 
are too unsettled at present to warrant the use of more elaborate 
methods. 
As yet is it impossible to determine with any confidence what the 
future urban-rural distribution of population in the State will be. 
Necessarily some assumptions regarding this factor were made as a 
basis for the 1950 estimates. With the prospect of a long war, the 
ultimate effects on the State’s population of Virginia’s war industries 
and the extensive inward migration of workers can only be a matter 
of speculation. The estimates have been made, therefore, on the 
basis of expected changes in the composition of the population as 
regards urban, rural farm, and rural non-farm residence status. These 
three classifications seem appropriate for the following reasons: 
1. The war activities are centered largely in a few areas, mostly 
urban, but some rural. While some of these areas in the 1940 
Census did not have population densities sufficient to qualify 
them as urban places under the rules of the Census, they are 
likely to be so classified in 1950 if present trends continue. 
This will tend to augment considerably the urban proportion 
of the State’s total population, so far as census figures are 
concerned. 
2. There is some evidence to indicate that many farm workers, 
rural residents, and part-time farmers have left agriculture to 
work in war establishments. This will no doubt accelerate 
the rate of decline of the farm population in the State. 
3. The rural non-farm population of the State, that is, the group 
living in small towns and villages, has been growing steadily. 
There is no evidence at the present time that this trend will 
change. If anything, an acceleration in the rate of growth 
in the rural non-farm population is to be expected. 
The following assumptions regarding the urban, rural farm, and 
rural non-farm population are made as a basis for the 1950 estimates. 
Estimate Number 1—Total Population of Virginia In 1950, 3,193,057. 
1. A decrease in the rural farm population of 10.5 percent is 
assumed between 1940 and 1950; the same relative decline as 
between 1920 and 1930. During the twenties there was con- 
siderable opportunity for workers in rural areas to find em- 
ployment in northern industrial cities, where wages and cash 
incomes were considerably greater than on Virginia farms. A 
similar situation prevails today. The longer the war lasts the more serious will be the disruption of the urban-rural popula- 
tion pattern. During the thirties there was a small absolute 
increase in the rural farm population of Virginia, although the 
net result of population shifts shows that many people moved 
from the rural areas to urban centers. The extent of this farm 
to city migration, however, was much less during the thirties 
than the twenties. It is probable that the various public 
assistance programs of the past decade have served to reduce 
somewhat this away-from-the-farm movement. At the be- 
ginning of the forties, however, the trek from farm to city has 
been accelerating at an ever increasing pace in response to the 
urgent demand for workers in war industries. The effects are 
already reflected by the shortage of farm labor in rural Virginia, 
and the housing shortages in defense areas. 
2. A gain of 19.5 per cent in rural non-farm population between 
1940 and 1950 is assumed. This is the same relative increase 
as occurred between 1920 and 1930. Each of the past two 
decades has witnessed a substantial growth in the village and 
non-farm population in Virginia. A similar trend is evidenced 
all over the country. There seems to be little prospect of 
change in this trend for a decade or so, 
3. A fifty per cent increase in the urban population is assumed. 
The basis for this assumption rests on the rapid growth now 
occurring in the Hampton Roads area, the Arlington-Alexan- 
dria-Fairfax area, and other defense areas in the State. With 
the progress of the war, more areas are likely to expand far 
beyond any pre-war expectations. There have already been 
substantial migrations of workers and their families into Vir- 
ginia since 1940. After the war the migrants then living in 
the defense areas who have come from other states, as well as 
from other parts of Virginia, will have sacrificed their residence 
status in the places from which they came. Consequently, 
they will expect jobs, unemployment compensation, relief and 
public assistance in the areas where they have been working. 
These conditions will tend to deter outward migration from 
.the defense areas at the conclusion of the war. Increases 
are also in prospect for other urban centers of the State, 
but not of the spectacular proportions already in evidence in 
the Hampton Roads and Washington areas. 
Estimate Number 2—Total Population of Virginia, 1950, 2,972,420. 
This low estimate of 2,972,420 assumes the following changes in 
Virginia’s population between 1940 and 1950: 
1. 3.6 per cent gain in the rural farm population. 
2. 9.0 per cent increase of the rural non-farm population. 
3. 20.0 per cent increase in urban population. 
The foregoing percentages of increase are the same as those which 
obtained from 1930 to 1940 for the same categories. Estimates of Patient Population, 1950 
Figure 29 (Table 18, Appendix) gives four estimates of the 1950 
patient population, each on a different set of assumptions. The first 
two of the following estimates are based upon the expected changes 
in total number and distribution of population by community classes, 
leaving out of account: (a) influence of changing age composition, 
(b) possible changes in administrative practice, and (c) possible effects 
of war experiences on personal characteristics. The second two estimates 
are based on a simple extrapolation of the trend of hospital population, 
1914-1940, relative to the trend of total population. 
Estimate 1 of the patient population (13,436) uses the high total 
population estimate of 3,193,057 for the State as its base. It assumes 
that the present rates of commitment for the urban and rural com- 
ponents of the population will not change. 
Estimate 2 makes the same assumption as to rates of commitment 
as Estimate 1, but uses the low total population estimate of 2,972,420 
as its base. It places the patient population in 1950 at 12,240. 
Estimate 3 places the patient population at 15,087. It uses the 
high total population estimate of 3,193,057 as a base, and assumes a 
gradually increasing commitment rate for the total population, which 
is a projection of past trends. No separate projections of the urban 
and rural components of the population were made in this estimate. 
Estimate 4 makes the same assumption as to rates of commitment 
as Estimate 3, but uses the low total population estimate of 2,972,420 
as a base. It places the patient population in 1950 at 14,045. 
These four estimates of the size of the patient population which 
may be expected by 1950 serve to emphasize the roles which population 
distribution, size and characteristics play. Past trends show clearly 
that more patients come from the urban areas than from the rural 
portions of the State. With the trend toward urbanization in Virginia, 
even prior to the war, there was no evidence to indicate that the fifty- 
year trend would change its direction. As the result of the war it seems 
likely that a much larger increase in the State’s total institutional 
population will occur between 1940 and 1950 than could reasonably 
have been expected on the basis of conditions existing prior to 1940. 
In considering the prospects for the future, the desirability of 
treating the problems of mental disease, mental deficiency and epilepsy 
separately is essential. The provisions for diagnosis and commitment 
differ, as do the types of facilities needed in the treatment of these 
different types of mental disturbance. Separate estimates of the 
prospective patient populations need to be made for each type of 
disease. When the figures are grouped many essential characteristics 
of the patient population are obscured. 
No allowances have been made in these estimates for the possible 
effects of changes in administrative practice, advancement in the 
treatment of certain diseases or other technological developments. It 
is difficult to appraise the potential effects of such changes on the 
hospitalization and treatment of the mentally deficient and mentally FIGURE 29 
PATIENT POPULATION IN INSTITUTIONS FOR MENTAL DISEASES AND 
MENTAL DEFECTIVES .VIRGINIA, 1914-1950 (1942-1950 ESTIMATED.) 
PREPARED BY 
VIRGINIA STATE PLANNING BOARD — POPULATION STUDY diseased during the next ten years. During the past ten years startling 
discoveries were made with respect to the treatment of dementia 
praecox. Up to the present, however, the application of these treat- 
ments has not materially decreased the number of schizophrenics in 
State hospitals. Moreoever, there has not been a sufficient period of 
time since the discoveries were made to ascertain the extent to which 
the treatments may result in permanent cure. Some patients apparently 
have been cured, others return after a period of apparent cure with a 
second breakdown. The general assumption here is that while there 
have been tremendous advances, these advances will not drastically 
influence the size of the patient load during the next decade. The 
prospect of continuation of the current increase in the State population 
and increasing urbanization would indicate an increased patient load. 
The changes in composition of the total load are outlined in the sum- 
mary. 
It is likely that during the next decade the total number of patients 
to be hospitalized in Virginia will increase. The size of the increase 
will depend upon the amount and character of population growth, 
changes in administrative practice regarding the care and treatment 
of the mental patients, the effects of the war on the civilian population, 
and the extent to which those who return from combat will be broken 
in mind and body. The prospective changes in the various components 
of the patient population to be cared for in the State’s mental institu- 
tions, without regard to the possible effects of the war, are as follows: 
1. An appreciable increase may be expected in the number of 
patients with senile dementia and arteriosclerosis. This will 
be the result of the fact that each year sees a somewhat larger 
proportion of the State’s total population come into the age 
range where these diseases strike. The patient load in the 
hospitals may be eased somewhat by the fact that some of the 
senile patients can be adequately cared for on the outside. 
This is far more difficult, however, with arteriosclerotic 
patients. 
2. If the past trends prevail, little or no increase is to be expected 
in the number of patients with manic-depressive psychosis 
and dementia praecox. As pointed out, however, the patient 
trend in Virginia in this respect runs counter to the trend in 
the rest of the nation. An increase among this group of 
patients is a distinct possibility. 
3. The prospect of an increase in the “All Other” group of patients 
is slight, particularly if the non-psychotic alcoholic patients 
are excluded from consideration. 
4. The practice in Virginia of including alcoholic patients with- 
out psychosis as a part of the total patient population materially 
raises the patient rate. Alcoholics are a special problem and 
SUMMARY should be separately reported, especially when the rates of 
mental diseases in Virginia are compared with those of other 
states. 
5. The prospects of an immediate increase in either the number or 
incidence of epilepsy appear remote. 
6. A marked increase in the number of mental defectives is in 
prospect. During the past decade a sharp rise in the number 
of such patients has occurred. At present more than 500 
such patients are on the waiting list for admission to State 
institutions. Facilities for their care are not available. The 
increasing urbanization of the State will also bring this problem 
into greater prominence. APPENDIX 
The figures in the tables are based on the Annual Reports of the 
State Hospital Board unless otherwise noted. Data for 1940 were 
obtained from the State Hospital Board in advance of publication. Appendix Tables 
Table Page 
1 Number of Patients in Institutions for Mental Diseases 
and Mental Defectives in Virginia, and Ratio of Patients 
to Total Population, July 1, 1914, to June 30, 1940 43 
2 Proportion of Urban Population 1930 and 1940; Rates of 
Patients in Mental Institutions Per 100,000 Population for 
Selected States 44 
3 Rates of First Admissions to Mental Institutions Per 
100,000 Population for Selected States, 1938 45 
4 First Admissions of Alcoholic Patients (without psychosis) 
to Mental Hospitals and Corresponding Rates Per 100,000 
Population by Sex for Selected States, 1938 46 
5 Movement of Patient Population in State Institutions for 
Mental Diseases and Mental Defectives by Color, Virginia, 
1935 to 1940 47 
6 First Admissions to State Mental Institutions by Type of 
Disorder by Color and Sex for Selected Years 50 
7 Total First Admissions to State Mental Institutions by Age, 
and Corresponding Age Specific Admission Rates, 1931, 
1939, 1940 52 
8 First Admissions of Patients with Senile Psychoses to State 
Mental Institutions by Age; Corresponding Age Specific 
Admission Rates, 1931, 1939, 1940 53 
9 First Admissions of Patients with Cerebral Arteriosclerosis 
to State Mental Institutions by Age; Corresponding Age 
Specific Admission Rates, 1931, 1939, 1940 54 
10 First Admissions of Patients with Manic-Depressive 
Psychoses to State Mental Institutions by Age; Corre- 
sponding Age Specific Admission Rates, 1931, 1939, 1940. . 55 
11 First Admissions of Patients with Dementia Praecox to 
State Mental Institutions by Age; Corresponding Age 
Specific Admission Rates, 1931, 1939, 1940 56 
12 First Admissions of Patients of “All Other” Classes (in- 
cluding alcoholics) to State Mental Institutions by Age; 
Corresponding Age Specific Admission Rates, 1931, 1939, 
1940 57 APPENDIX TABLES—Continued 
Table Page 
13 First Admissions of Patients With Alcoholism (without 
psychosis) to State Mental Institutions by Age; Corre- 
sponding Age Specific Admission Rates, 1931, 1939, 1940. . 58 
14 First Admissions of Alcoholics to Four Mental Hospitals 
by Color, Sex, and Type, Virginia, for Selected Years. ... 59 
15 First Admissions of Patients with Epilepsy to State Mental 
Institutions by Age; Corresponding Age Specific Admission 
Rates, 1931, 1939, 1940 60 
16 First Admissions of Patients with Mental Deficiency to 
State Mental Institutions by Age; Corresponding Age 
Specific Admission Rates, 1931, 1939, 1940 61 
17 Estimates of Future Population of Virginia 62 
18 Estimates of Patients in Institutions for Mental Diseases 
and Mental Defectives in Virginia, 1950 63 
42 TABLE 1 
Number of Patients in Institutions for Mental Diseases and Mental Defectives 
in Virginia and Ratio of Patients to Total Population 
July 1, 1914, to June 30, 1940 
Total 
White 
Colored 
In 
Hospital 
Rate 
Per 
100,000 
Population 
In 
Hospital 
Rate 
Per 
100,000 
Population 
In 
Hospital 
Rate 
Per 
100,000 
Population 
1914 
4,488 
206.9 
2,842 
190.2 
1,646 
241.9 
1915 
4,787 
218.6 
3,034 
200.6 
1,753 
256.9 
1916 
5,032 
226.6 
3,249 
211.6 
1,783 
259.1 
1917 
5,000 
222.7 
3,195 
204.9 
1,805 
262.4 
1918 
4,997 
220.0 
3,187 
201.3 
1,810 
262.9 
1919 
5,025 
218.8 
3,212 
200.0 
1,813 
262.6 
1920 
5;098 
220.8 
3',327 
205.6 
1,771 
256.6 
1921 
5,265 
226.4 
3,456 
210.7 
1,809 
263.9 
1922 
5,625 
240.7 
3,717 
224.5 
1,908 
279.9 
1923 
5,844 
248,9 
3,834 
229.5 
2,010 
296.4 
1924 (9 mos.)... 
5,918 
250.9 
3,875 
229.9 
2,043 
303.2 
1925 
6,059 
255.7 
3,916 
230.4 
2,143 
319.9 
1926 
6,287 
264.9 
4,005 
233.6 
2,282 
342.6 
1927 
6,607 
276.2 
4,276 
247.2 
2,331 
352.1 
1928 
6,924 
288.2 
4,451 
255.2 
2,473 
375.7 
1929 
7,025 
291.6 
4,571 
259.8 
2,454 
375.0 
1930 
7,389 
305.1 
4,802 
271.2 
2,587 
397.1 
1931 
7,685 
314.1 
5,030 
280.5 
2,655 
406.8 
1932 
8,054 
325.9 
5,237 
288.3 
2,817 
430.8 
1933 
8,256 
330.8 
5,377 
292.2 
2,879 
439.4 
1934 
8,640 
342.7 
5,609 
300.9 
3,031 
461.7 
1935 
8,983 
352.7 
5,812 
307.8 
3,171 
482.1 
1936 
9,449 
367.3 
6,063 
317.0 
3,386 
513.8 
1937 
9,816 
377.8 
6,263 
323.3 
3,553 
538.2 
1938 
10,162 
387.2 
6,627 
337.7 
3,535 
534,4 
1939 
10,525 
397.0 
6,832 
343.7 
3,693 
557.2 
1940 
10,912 
407.5 
6,988 
347.0 
3,924 
590.9 
Source—Annual Report of the State Hospital Board, 1939, p 
Data for 1940—State Hospital Board. 
. 60, TABLE 2 
Proportion of Urban Population 1930 and 1940; Rates of Patients in Mental 
Institutions Per 100,000 Population for Selected States 
Population Per Cent 
Urban 
Rate Per 100,000 
Population 
STATE 
1930 
1940 
Mentally 
Diseased* 
1938 
Epileptic 
and 
Mental 
Defectives! 
1938 
United States 
56.2 
56.5 
289.3 
75.2 
Virginia 
32.4 
35.3 
319.3 
44.2 
Ohio 
67.8 
66.8 
270.9 
108.0 
Indiana 
55.5 
55.1 
229.4 
98.7 
Illinois 
73.9 
73.6 
359.2 
87.8 
Michigan 
68.2 
65.7 
295.9 
124.0 
Wisconsin 
52.9 
53.5 
70.1 
79.8 
Delaware 
51.7 
52.3 
428.0 
159.8 
Maryland 
59.8 
59.3 
362.7 
64.8 
District of Columbia 
100.0 
100.0 
886.1 
88.2 
West Virginia 
28.4 
28.1 
205.2 
4.3 
North Carolina 
25.5 
27.3 
184.2 
19.8 
South Carolina 
21.3 
24.5 
215.7 
37.6 
Georgia 
30.8 
34.4 
233.5 
10.8 
Florida 
51.7 
55.1 
252.3 
30.0 
* Patients in Mental Institutions 193 S, U. 
the Census, Table 12, p. 23. 
fSame, Table 73, p. 115. 
S. Department of Commerce, Bureau of 
44 TABLE 3 
Rates of First Admissions to Mental Institutions Per 100,000 Population 
for Selected States, 1938 
STATE 
Institutions for the 
Mentally Diseased* 
Institutions for the 
Epileptic and 
Mentally Defectivef 
United States 
61.4 
8.0 
Virginia 
92.5 
9.0 
Ohio 
49.1 
10.2 
Indiana 
43.6 
8.1 
Illinois 
91.3 
13.2 
Michigan 
56.4 
8.8 
Wisconsin 
45.5 
10.1 
Delaware 
94.3 
25.7 
Maryland 
61.5 
6.1 
District of Columbia 
125.0 
6.1 
West Virginia 
58.1 
0.3 
North Carolina 
53.9 
1.4 
South Carolina 
68.7 
' 2.7 
Georgia 
31.9 
0.8 
Florida 
39.2 
5.6 
*Patients in Mental Institutions 1938, U. S. Department of Commerce, Bureau of 
Census, Table 13, p. 24. 
fSame. Table 74, p. 117. First Admissions of Alcoholic Patients (Without Psychosis) to Mental 
Hospitals and Corresponding Rates Per 100,000 by Sex for 
Selected States, 1938* 
TABLE 4 
STATE 
Number 
Rate Per 100,000 
Total 
Male 
Female 
Total 
Male 
Female 
4,230 
488 
3,708 
443 
522 
3.2 
5.6 
.8 
45 
18.2 
32.8 
3.4 
48 
44 
4 
.7 
1.3 
.1 
7 
7 
.2 
.4 
524 
470 
54 
6.6 
11.8 
1.4 
57 
48 
9 
1.1 
1.8 
.4 
155 
147 
8 
4.9 
9.2 
.5 
Delaware 
2 
1 
1 
.8 
.7 
.8 
40 
35 
5 
2.2 
3.8 
.6 
97 
87 
10 
5.1 
9.0 
1.1 
351 
332 
19 
9.8 
18.6 
1.1 
90 
88 
2 
4.7 
9.4 
.2 
18 
16 
2 
.6 
1.0 
.1 
6 
6 
.3 
.6 
*Patients in Mental Institutions 1938, U. S. 
Census, Table 15, p. 30. 
Department of Commerce, Bureau of TABLE 5 
Movement of Patient Population in State Institutions for Mental 
Diseases and Mental Defectives by Color, Virginia, 1935 to 1940 
1935 
1936 
Total 
White 
Colored 
Total 
White 
Colored 
Number on books at the begin- 
ning of year . 
In hospitals 
On parole \ 
On escape / 
Admitted During Year: 
First admissions \ 
Re-admissions / 
Total admitted 
11,794 
8,497 
3,297 
12,965 
9,543 
3,422 
8,640 
3,154 
5,609 
2,888 
3,031 
266 
9,033 
3,932 
5,862 
3,681 
3,171 
251 
3,002 
2,315 
/ 620 
\ 67 
3,041 
87 
2,318 
723 
87 
3,002 
1 
2,315 
1 
687 
3,128 
2 
2,318 
2 
810 
Grand total admitted. 
Total under treat- 
ment 
Discharged 
Died 
Total discharged and 
died 
3,003 
2,316 
687 
3,130 
2,320 
810 
14,797 
10,813 
3,984 
16,095 
11,863 
4,232 
1,136 
693 
838 
429 
298 
264 
1,601 
745 
1,353 
471 
248 
274 
1,829 
3 
1,267 
3 
562 
2,346 
7 
1,824 
7 
522 
Grand total dis- 
charged 
Total at end of year 
In hospitals 
On parole \ 
On escape / 
1,832 
1,270 
562 
2,353 
1,831 
522 
12,965 
9,543 
3,422 
13,742 
10,032 
3,710 
9,033 
3,932 
5,862 
3,681 
3,171 
251 
9,449 
4,293 
6,063 
3,969 
3,386 
324 TABLE 5—Continued 
1937 
1938 
Total* 
White* 
Colored 
Total 
White 
Colored 
Number on books at the begin- 
ning of year 
In hospitals 
On parole \ 
On escape / 
Admitted During Year: 
First admissions \ 
Re-admissions / 
Total admitted 
Transferred 
13,809 
10,099 
3,710 
14,420 
10,457 
3,963 
9,449 
4,360 
6,063 
4,036 
3,386 
324 
9,894 
4,526 
6,341 
4,116 
3,553 
410 
3,314 
2,405 
/ 832 
\ 77 
2,705 
423 
1,957 
316 
748 
107 
3,314 
3 
2,045 
3 
909 
3,128 
6 
2,273 
6 
855 
Grand total admitted. 
Total under treat- 
ment 
Discharged 
Died 
Total discharged and 
died 
Transferred 
3,317 
2,408 
909 
3,134 
2,279 
855 
17,126 
12,507 
4,619 
17,554 
12,736 
4,818 
1,783 
852 
1,473 
506 
310 
346 
1,605 
930 
1,199 
517 
406 
413 
2,635 
3 
1,979 
3 
656 
2,535 
5 
1,716 
5 
819 
Grand total dis- 
charged 
Total at end of year 
In hospitals 
On parole 1 
On escape / 
2,638 
1,982 
656 
2,540 
1,721 
819 
14,488 
10,525 
3,963 
15,014 
11,015 
3,999 
9,886 
4,602 
6,333 
4,192 
3,553 
410 
10,162 
4,852 
6,627 
4,388 
3,535 
464 
*The 1937 Report of the Southwestern State Hospital gives the number on the 
books at the beginning of the year as 1,850, a difference of 67 from the number 1,783 
given in the 1936 report as the number on the books at the end of 1936. Similarly the 
number on the books at the end of the year is given as 1,968, a difference of 68 from the 
number 1,900 given in the 1938 report. In making the charts the 1936 and 1938 totals 
were used, giving a discrepancy of 1 in the figures for white and total races. TABLE 5—Continued 
1939 
1940 
Total 
White 
Colored 
Total 
White 
Colored 
Number on books at the begin- 
15,014 
11,015 
3,999 
14,830 
10,643 
4,187 
10,162 
4,107 
745 
6,627 
3,686 
702 
3,535 
421 
43 
10,525 
3,675 
630 
6,832 
3,218 
593 
3,693 
457 
37 
On parole 
Admitted During Year; 
2,725 
497 
1,941 
353 
784 
144 
2,622 
614 
1,787 
462 
835 
152 
3,222 
192 
2,294 
42 
928 
150 
3,236 
69 
2,249 
67 
987 
2 
Transferred 
Grand total admitted. 
Total under treat- 
3,414 
2,336 
1,078 
3,305 
2,316 
989 
18,428 
13,351 
5,077 
18,135 
12,959 
5,176 
Discharged 
2,632 
790 
2,203 
479 
429 
311 
2,280 
804 
1,809 
487 
471 
317 
Died 
Total discharged and 
3,422 
176 
2,682 
26 
740 
ISO 
3,084 
68 
2,296 
66 
788 
2 
Grand total dis- 
3,598 
2,708 
890 
3,152 
2,362 
790 
14,830 
10,643 
4,187 
14,983 
10,597 
4,386 
10,525 
3,675 
630 
6,832 
3,218 
593 
3,693 
457 
37 
10,912 
3,766 
305 
6,988 
3,342 
267 
3,924 
424 
38 TABLE 6 
First Admissions to State Mental Institutions by Type of Disorder, by 
Color and by Sex for Selected Years 
1931 
1935 
1936 
1937 
1938 
1939 
1940 
Total All Races 
2,085 
2,663 
2,740 
2,887 
2,722 
2,725 
2,622 
Male 
1,218 
1,699 
1,705 
1,798 
1,676 
1,716 
1,606 
Female 
867 
964 
1,035 
1,089 
1,046 
1,009 
1,016 
Insane 
1,483 
1,532 
1,594 
1,824 
1,688 
1,679 
1,519 
Male 
822 
887 
883 
1,030 
957 
948 
889 
Female 
661 
645 
711 
794 
731 
731 
630 
Alcoholic (without psychosis). . 
219 
531 
595 
527 
492 
522 
462 
Male 
209 
502 
556 
483 
446 
474 
425 
Female 
10 
29 
39 
44 
46 
48 
37 
Epileptic 
120 
151 
106 
150 
129 
110 
143 
Male 
71 
85 
58 
95 
81 
74 
77 
Female 
49 
66 
48 
55 
48 
36 
66 
Feebleminded 
263 
449 
445 
386 
413 
414 
498 
Male 
116 
225 
208 
190 
192 
220 
215 
Female 
147 
224 
237 
196 
221 
194 
283 
Total White 
1,516 
2,043 
2,017 
2,055 
1,974 
1,941 
1,787 
Male 
897 
1,340 
1,294 
1,311 
1,264 
1,270 
1,103 
Female 
619 
703 
723 
744 
710 
671 
'684 
Insane 
991 
1,041 
1,021 
1,152 
1,121 
1,097 
948 
Male 
545 
593 
548 
633 
639 
612 
546 
Female 
446 
448 
473 
519 
482 
485 
402 
Alcoholic (without psychosis) . . 
219 
529 
585 
521 
476 
511 
446 
Male 
209 
500 
547 
478 
432 
466 
411 
Female 
10 
29 
38 
43 
44 
45 
35 
Epileptic 
87 
111 
70 
111 
102 
94 
117 
Male 
50 
60 
37 
68 
66 
64 
61 
Female 
37 
51 
33 
43 
36 
30 
56 
Feebleminded 
219 
362 
341 
271 
275 
239 
276 
Male 
93 
187 
162 
132 
127 
128 
85 
Female 
126 
175 
179 
139 
148 
111 
191 
Total Colored 
569 
620 
723 
832 
748 
784 
835 
Male 
321 
359 
411 
487 
412 
446 
503 
Female 
248 
261 
312 
345 
336 
338 
332 
Insane 
492 
491 
573 
672 
567 
582 
571 
Male 
277 
294 
335 
397 
318 
336 
343 
Female 
215 
197 
238 
275 
249 
246 
228 
Alcoholic (without psychosis). . 
2 
10 
6 
16 
11 
16 
Male 
2 
9 
s 
14 
8 
14 
Female 
1 
1 
2 
3 
2  
1931 
1935 
1936 
1937 
1938 
1939 
1940 
Epileptic 
33 
40 
36 
39 
27 
16 
26 
Male 
21 
25 
21 
27 
IS 
10 
16 
Female 
12 
15 
15 
12 
12 
6 
10 
Feebleminded 
44 
87 
104 
115 
138 
175 
222 
Male 
23 
38 
46 
58 
65 
92 
130 
Female 
21 
49 
58 
57 
73 
83 
92 
TABLE 6—Continued Total First Admissions to State Mental Institutions by Age and Corresponding Age Specific Admission Rates*, 1931, 1939, 1940 
AGE GROUP 
Population 
1930 
First 
Admissions 
1931 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under IS 
818,639 
86 
10.5 
766,832 
131 
17.1 
214 
27.9 
15-19 
255,757 
183 
71.6 
282,053 
244 
86.5 
248 
87.9 
20-24 
217,603 
205 
94.2 
253,320 
246 
97.1 
234 
92.4 
25-29 
176,938 
214 
120.9 
228,915 
285 
124.5 
263 
114.9 
30-34 
156,596 
226 
144.3 
200,633 
295 
147.0 
268 
133.6 
35-39 
158,211 
201 
127.0 
181,267 
292 
161.1 
275 
151.7 
40-44 
136,024\ 
337 
128.8 
/ 159,458 
214 
134.2 
205 
128.6 
45-49 
125,667/ 
\ 143,185 
201 
140.4 
155 
108.3 
50-54 
110,4231 
269 
139.1 
/ 124,019 
174 
140.3 
153 
123.4 
55-59 
82,933/ 
\ 99,638 
164 
164.6 
173 
173.6 
60-over 
181,876 
359 
197.4 
238,453 
479 
200.9 
434 
182.0 
Unknown 
1,184 
5 
Total—All ages. . . . 
2,421,851 
2,085 
86.1 
2,677,773 
2,725 
101.8 
2,622 
97.9 
*Age Specific Admission Rates are computed by dividing the number of commitments in an age group by the total population of the cor- 
responding age group and expressing the rate per 100,000. 
TABLE 7 AGE GROUP 
Population 
1930 
First 
Admissions 
1931 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under 40 
1,783,744 
136,024 
125,667 
110,423 
82,933 
65,198 
116,678 
1,184 
1,913,020 
159,458 
143,185 
124,019 
99,638 
83,509 
154,944 
4044 
1 
.6 
45-49 
50-54 
8 
14 
40 
143 
7.2 
16.9 
61.4 
122.6 
i 
9 
15 
186 
.8 
9.0 
18.0 
120.0 
3 
9 
19 
145 
2.4 
9.0 
22.8 
93.6 
55-59 
60-64 
65-over 
Unknown 
Total—All ages.... 
2,421,851 
205 
8.5 
2,677,773 
212 
7.9 
176 
6.6 
First Admissions of Patients With Senile Psychoses to State Mental Institutions by Age; Corresponding 
Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 8 AGE GROUP 
Population 
1930 
First 
Admissions 
1931 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under 30 
1,468,937 
1,531,120 
30-34 
156;596 
200,633 
i 
5 
35-39 
158;211 
3 
1.9 
181;267 
40-44 
136,024 
5 
3.7 
159;458 
i 
.6 
2 
1.3 
45-49 
125,667 
7 
5.6 
143,185 
4 
2.8 
2 
1.4 
50-54 
110,423 
16 
14.5 
124,019 
22 
17.7 
18 
14.5 
55-59 
82,933 
13 
15.7 
99,638 
27 
27.1 
28 
28.1 
60-64 
65,198 
17 
26 1 
83 509 
39 
46 7 
37 
44 3 
65-over 
116;678 
18 
15.4 
154 944 
100 
64.5 
94 
60.7 
Unknown 
1,184 
1 
Total—All ages. . . . 
2,421,851 
80 
3.3 
2,677,773 
194 
7.2 
181 
6.8 
First Admissions of Patients With Cerebral Arteriosclerosis to State Mental Institutions by Age; 
Corresponding Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 9 AGE GROUP 
Population 
1930 
First 
Admissions 
1931 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
818,639 
255,757 
217,603 
176,938 
156,596 
158,211 
136,024 
125,667 
110,423 
82,933 
181,876 
1,184 
2 
.2 
766,832 
282,053 
253,320 
228,915 
200,633 
181,267 
3 
.4 
1 
.1 
15-19 
IS 
5.9 
24 
8.5 
15 
5.3 
20-24 
31 
14.2 
38 
15.0 
42 
16.6 
25-29 
47 
26.6 
48 
21.0 
43 
18.8 
30-34 
65 
41.5 
60 
29.9 
32 
15.9 
35-39 
48 
30.3 
59 
32.5 
40 
22.1 
40-44 
46 
33.8 
159^458 
143,185 
124,019 
99,638 
238,453 
38 
23.8 
34 
21.3 
45-49 
41 
32.6 
43 
30.0 
22 
15.4 
50-54 
42 
38.0 
37 
29.8 
23 
18.5 
55-59 
38 
45.8 
30 
30,1 
23 
23.1 
53 
29.1 
38 
15.9 
12 
5.0 
1 
Total—All ages.... 
2,421,851 
429 
17.7 
2,677,773 
418 
15.6 
287 
10.7 
First Admissions of Patients With Manic Depressive Psychoses to State Mental Institutions by Age; 
Corresponding Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 10 AGE GROUP 
Population 
1930 
First 
Admissions 
1931 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under 15 
818,369 
255,757 
217,603 
176,938 
3 
.4 
766,832 
282,053 
253,320 
228,915 
200,633 
181,267 
2 
.3 
3 
4 
15-19 
29 
11.3 
34 
12.1 
25 
8 9 
20-24 
33 
15.2 
49 
19.3 
53 
20 9 
25-29 
55 
31.1 
42 
18.3 
46 
20.1 
30-34 
\S6,S96 
158,211 
136,024 
125,667 
110,423 
82,933 
181,876 
1,184 
35 
22.4 
28 
14.0 
47 
23 4 
35-39 
26 
16.4 
26 
14.3 
24 
13.2 
40-44 
22 
16.2 
159*458 
143,185 
124,019 
99,638 
238,453 
15 
9.4 
14 
8.8 
45-49 
20 
15.9 
14 
9.8 
17 
11.9 
50-54 
13 
11.8 
11 
8.9 
4 
3.2 
55-59 
7 
8.4 
5 
5.0 
4 
4.0 
10 
5.5 
3 
1,3 
4 
1.7 
2 
Total—All ages. . . . 
2,421,851 
255 
10.5 
2,677,773 
229 
8.6 
241 
9.0 
First Admissions of Patients With Dementia Praecox to State Mental Institutions by Age; 
Corresponding Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 11 AGE GROUP 
Population 
1930 
First 
Admissions 
1931 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under IS 
818,639 
255,757 
217,603 
176,938 
156,596 
158,211 
136,024 
125,667 
110,423 
82,933 
181,876 
15 
1 8 
766,832 
282,053 
253,320 
228,915 
200,633 
181,267 
159,458 
143,185 
124,019 
99,638 
238,453 
12 
1.6 
7 
.9 
1S-19 
45 
17.6 
45 
16.0 
32 
11.3 
20-24 
74 
34 0 
100 
39.5 
70 
27.6 
25-29 
71 
40 1 
152 
118 
51.5 
30-34 
90 
57.5 
180 
89.7 
164 
81.7 
35-39 
102 
64 5 
182 
100 4 
176 
97.1 
40-44 
89 
65 4 
141 
88 4 
125 
78.4 
45-49 
77 
61 3 
129 
90 1 
101 
70.5 
50-54 
59 
53 4 
97 
78.2 
93 
75.0 
55-59 
45 
54 3 
89 
89.3 
96 
96.3 
60-over 
68 
37.4 
89 
37.3 
114 
47.8 
Unknown 
1,184 
Total—All ages.... 
2,421,851 
735 
30.3 
2,677,773 
1,216 
45.4 
*1,096 
40.9 
*This total includes 39 cases for whom diagnosis was deferred. 
First Admissions of Patients of “All Other” Classes (Including Alcoholics) to State Mental Institutions by Age; 
Corresponding Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 12 TABLE 13 
First Admissions of Patients With Alcoholism (Without Psychosis) to State 
Mental Institutions by Age; Corresponding Age Specific 
Admission Rates, 1940 
AGE GROUPS 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under 15 
766,832 
15-19 
282;053 
1 
.4 
20-24 
253,320 
25 
9.9 
25-29 
228,915 
51 
22.3 
30-34 
200,633 
96 
47.8 
35-39 
181,267 
96 
53.0 
40-44 
159,458 
55 
34.5 
45-49 
143,185 
44 
30.7 
50-54 
124,019 
39 
31.4 
55-59 
99,638 
26 
26.1 
60-over 
238,453 
29 
12.2 
Unknown 
Total—All ages 
2,677,773 
462 
17.3 TABLE 14 
First Admissions of Alcoholics to Four Mental Hospitals by Color, Sex and 
Type for Selected Years—Virginia 
1931 
1935 
1936 
1937 
1938 
1939 
1940 
Alcoholics With Psychoses: 
Total—All races 
16 
36 
65 
69 
47 
62 
60 
Male 
14 
31 
60 
55 
42 
59 
S3 
Female 
2 
5 
5 
14 
5 
3 
7 
White 
10 
12 
27 
17 
22 
32 
30 
Male 
10 
12 
24 
13 
19 
32 
28 
Female 
3 
4 
3 
2 
Colored 
6 
24 
38 
52 
25 
30 
30 
Male 
4 
19 
36 
42 
23 
27 
25 
Female 
2 
5 
2 
10 
2 
3 
5 
Alcoholics Without Psychoses: 
Total—All races 
219 
531 
595 
527 
492 
522 
462 
Male 
209 
502 
556 
483 
446 
474 
425 
Female 
10 
29 
39 
44 
46 
48 
37 
White 
219 
529 
585 
521 
476 
511 
446 
Male 
209 
500 
547 
478 
432 
466 
411 
Female 
10 
29 
38 
43 
44 
45 
35 
2 
10 
6 
16 
11 
16 
Male 
2 
9 
5 
14 
8 
14 
Female 
1 
1 
2 
3 
2 
Total Alcoholics: 
Total—All races 
235 
567 
660 
596 
539 
584 
522 
Male 
223 
533 
616 
538 
488 
533 
478 
Female 
12 
34 
44 
58 
51 
51 
44 
White 
229 
541 
612 
538 
498 
543 
476 
Male 
219 
512 
571 
491 
451 
498 
439 
Female 
10 
29 
41 
47 
47 
45 
37 
Colored 
6 
26 
48 
58 
41 
41 
46 
Male 
4 
21 
45 
47 
37 
35 
39 
Female 
2 
5 
3 
11 
4 
6 
7 AGE GROUP 
Population 
1930 
First 
Admissions 
1931* 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
818,639 
255,757 
217,603 
176,938 
156,596 
158,211 
136,024 
125,667 
110,4231 
82,933/ 
181,876 
1,184 
19 
2.3 
766,832 
282,053 
253,320 
228,915 
200,633 
181,267 
159,458 
143,185 
/ 124,019 
\ 99,638 
10 
1.3 
38 
5 0 
15-19 
18 
7.0 
17 
6.0 
24 
8 5 
20-24 
23 
10.6 
16 
6.3 
15 
5 9 
25-29 
14 
7.9 
14 
6.1 
20 
8 7 
30-34 
14 
8.9 
12 
6.0 
13 
6.5 
35-39 
15 
9.5 
6 
3.3 
14 
7 7 
40-44 
8 
5.9 
4 
2.5 
5 
3 1 
45-19 
4 
3.2 
6 
4.2 
4 
2 8 
50-54 
4 
2.1 
3 
2.4 
4 
3 2 
55-59 
2 
2.0 
1 
1.0 
60-over 
1 
.5 
238*453 
6 
2.5 
5 
2.1 
Total 
2,421,851 
120 
5.0 
2,677,773 
96 
3.6 
143 
5.3 
*Figures do not include epileptics without psychoses in four hospitals; do include this group in Lynchburg Colony. 
First Admissions of Patients With Epilepsy to State Mental Institutions by Age; Corresponding 
Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 15 AGE GROUP 
Population 
1930 
First 
Admissions 
1931* 
Rate Per 
100,000 
Population 
1930 
Population 
1940 
First 
Admissions 
1939 
Rate Per 
100,000 
Population 
1940 
First 
Admissions 
1940 
Rate Per 
100,000 
Population 
1940 
Under IS 
818,639 
255,757 
217,603 
176,938 
156,596 
158,211 
136,0241 
125,667/ 
47 
5.7 
766,832 
282,053 
253,320 
228,915 
200,633 
181,267 
/ 159,458 
1 143,185 
/ 124,019 
\ 99,638 
238,453 
104 
13.6 
165 
21 5 
15-19 
76 
29.7 
124 
44 0 
152 
53 9 
20-24 
44 
20 2 
43 
17.0 
54 
21 3 
25-29 
27 
IS 3 
29 
12 7 
36 
15 7 
30-34 
22 
14 0 
14 
7.0 
12 
6 0 
35-39 
7 
4 4 
19 
10 5 
21 
11 6 
40-44 
18 
6.9 
14 
8.8 
25 
15 7 
45—49 
5 
3 5 
9 
6 3 
50-54 
110,4231 
82,933/ 
181,876 
1,184 
10 
5.2 
3 
2 4 
8 
6 5 
55-59 
2 
2 0 
12 
12 0 
60-over 
9 
4.9 
3 
1.3 
4 
1.7 
Unknown 
1 
Total 
2,421,851 
f261 
10.8 
2,677,773 
360 
13.0 
498 
18.6 
*Figures do not include mental defectives without psychoses in four hospitals; do include this group in Lynchburg Colony. 
"(Total does not agree with total of 263 given in Table 6. 
First Admissions of Patients With Mental Deficiency to State Mental Institutions by Age; Corresponding 
Age Specific Admission Rates, 1931, 1939, 1940 
TABLE 16 
61 COMMUNITY 
CLASS 
Population 
Percentage Distribution 
1920 
1930 
1940 
19501 
19502 
1920 
1930 
1940 
19S01 
19502 
Total—All classes 
2,309,187 
2,421,851 
2,677,773 
3,193,057 
2,972,420 
100.0 
100.0 
100.0 
100.0 
100,0 
Urban 
673,984 
785,537 
944,675 
1,417,013 
1,136,444 
29.1 
32.4 
35.3 
44.4 
38.2 
Rural—Non-farm. 
575;290 
687,568 
749,739 
895,938 
817,216 
25.0 
28.4 
28.0 
28.0 
27.5 
Rural—Farm 
1,059,913 
948,746 
983,359 
880,106 
1,018,760 
45.9 
39.2 
36.7 
27.6 
34.3 
COMMUNITY 
CLASS 
Population Change 
Percentage Change 
1920-1930 
1930-1940 
1940-19501 
1940-19S02 
1920-1930 
1930-1940 
1940-19501 
1940-19502 
Total—All Classes 
Urban 
Rural—Non-farm 
Rural—Farm 
112,664 
255,922 
515,284 
294,647 
4.9 
10.6 
19.2 
11.0 
111,553 
112,278 
—111,167 
159,138 
62,171 
34,613 
472,338 
146,199 
—103,253 
191,769 
67,477 
35,401 
16.6 
19.5 
—10.5 
20.3 
9.0 
3.6 
50.0 
19.5 
—10.5 
20.3 
9.0 
3.6 
Estimate 1. See page 33. 
2Estimate 2. See page 34. 
a. Population and Percentage Distribution by Community Class 
h. Population Change by Community Class by Decades 
Estimates of Future Population 
TABLE 17 Estimates of Patients in Institutions for Mental Diseases and 
Mental Defectives in Virginia—1950 
TABLE 18 
Estimated 
Population 
1950 
Estimated 
Rate Per 
100,000 
Population 
1950 
Number of 
Patients in 
Hospitals 
1940 
Estimated 
Number of 
Patients in 
Hospitals 
1950 
1. Total 
3,193,057 
420.8 
10,912 
13,436 
Urban 
1,417,013 
501.9 
*4,741 
7,112 
Rural 
1,776,044 
356.1 
*6,171 
6,324 
2. Total 
2,972,420 
411.8 
10,912 
12,240 
Urban 
1,136,444 
501.9 
*4,741 
5,703 
Rural 
1,835,976 
356.1 
*6,171 
6,537 
3. Total 
3,193,057 
472.5 
10,912 
15,087 
4. Total 
2,972,420 
472.5 
10,912 
14,045 
*Estimated figures based on distribution between urban and rural residents reported 
by first admissions in 1939. 
1939 patient population with urban residence 
1. Estimate of patient population based on 
1940 urban population -f- 100,000 
1939 patient population with rural residence 
and —— , assuming 1950 population to be 
1940 rural population -f- 100,000 
3,193,057. This estimate assumes a rapid growth in the Hampton Roads and Arling- 
ton, Alexandria, and Fairfax 
areas and a drop in rural population to the 1930 level. 
2. Estimate of patient population based on urban-rural rates as in (1), assuming 1950 
population to be 2,972,420. 
3. Estimate of patient population assuming a continuation of present trend in total 
commitment rate and a population base of 3,193,057. 
4. Same as (3) with a population base of 2,972,420. 
63