From Mental Hygiene to Post wwii psychiatry and Community Psychiatry



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From Mental Hygiene to Post WWII Psychiatry and Community Psychiatry








Boston Psychopathic Hospital Myrtelle Canavan, E.E. Southard



Mental Hygiene

  • Prevention of mental illness through public health education: lectures, pamphlets, courses.

  • Focus on emotional adjustment: helping people to change bad habits, adjust to challenges of life.

  • Concerned with child delinquency, alcoholism, immoral behavior, immigrant mental health and syphilis.

  • Operated in new locales: child-guidance clinics, juvenile courts, school counseling centers.

  • Assisted by emergence of new professional role of the psychiatric social worker.

  • Team approach to treatment: psychiatrist, psychologist and social worker.

  • Focus on maintaining mental health.





















“Thousands spend their days—often for weeks at a stretch—locked in devices euphemistically called 'restraints’: thick leather handcuffs, great canvas camisoles, 'muffs,’ 'mitts,’ wristlets, locks and straps and restraining sheets. Hundreds are confined in 'lodges’—bare, bedless rooms reeking with filth and feces—by day lit only through half-inch holes in steel-plated windows, by night merely black tombs in which the cries of the insane echo unheard from the peeling plaster of the walls.” Maisel, Life 1946

  • “Thousands spend their days—often for weeks at a stretch—locked in devices euphemistically called 'restraints’: thick leather handcuffs, great canvas camisoles, 'muffs,’ 'mitts,’ wristlets, locks and straps and restraining sheets. Hundreds are confined in 'lodges’—bare, bedless rooms reeking with filth and feces—by day lit only through half-inch holes in steel-plated windows, by night merely black tombs in which the cries of the insane echo unheard from the peeling plaster of the walls.” Maisel, Life 1946



Albert Deutsch (historian of medicine, social reformer)





Shame of States























Group for the Advancement of Psychiatry (GAP)

  • Formed in 1946

  • 150 psychiatrists

  • William Menninger, Chairman

  • Advocated for psychiatrists to have more time for treatment in mental hospitals

  • Social workers conduct more treatments

  • Mental hospitals to be located in cities, with closer connections to medical schools, and training possibilities



Menninger Clinic, 1925 Topeka Kansas











Mental Health Legislation-1

  • 1946 –National Mental Health Act, which called for the establishment of a National Institute of Mental Health.

  • 1949 –NIMH was formally established; it was one of the first four NIH institutes. Robert Felix was first director.

  • 1955 – The Mental Health Study Act called for "an objective, thorough, nationwide analysis and reevaluation of the human and economic problems of mental health." The resulting Joint Commission on Mental Illness and Health was formed.



Mental Health Legislation-2

  • 1961Action for Mental Health, a 10-volume series, assessed mental health conditions and resources throughout the United States

  • 1963 – President Kennedy submitted a special message to Congress –Congress quickly passed the Mental Retardation Facilities and Community Mental Health Centers Construction Act beginning a new era in Federal support for mental health services. NIMH assumed responsibility for monitoring the Nation's community mental health centers (CMHC).



Community Mental Health Centers

  • Improve national health

  • Provide emergency services, evaluation, consultation, education of community

  • Broad spectrum of services: partial hospitalization, outpatient and inpatient

  • Focus on prevention; situated in communities










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