Psychiatric Clinics for Children: with special reference to State programmes
- Author:
Helen
Witmer. Commonwealth Fund. $2.50.
Despite the experience of humanity since time began of the importance of ” mind ” in relation- ship to ” body public imagination has not yet been stirred to any great extent, at least in this country, by the greatest of modern adven- tures in the field of human welfare, that of psychiatry. This is perhaps scarcely surprising in that medicine has tended to deal with the physical state of the patient, to the detriment of the mental. But there is a growing tendency to recognize the unity of the mind-body relationship and it is to be hoped that the care of the sick will develop along these lines after the war.
Those to whom the subject and its practical application make an appeal will find in Dr Witmer’s book an interesting survey of the developments in America in the field of psychiatry which led to the establishment of child guidance clinics.
The first type of mental disorder in children to receive attention was mental defect and neurological disorders and since these cannot be cured, the essential object is care and protection which has to be undertaken either in institutions or, in some cases, in their own homes. Secondly an attempt was made to deal with difficult children, especially juvenile delinquents, in the hope of preventing such children from becoming either insane or criminal. Finally Adolf Meyer showed the necessity for treatment of the child needing psychiatric help for his own sake, not merely for the benefit of the race or protection of society.
Dr Witmer then goes on to examine various types of clinics in the United States and methods of administration. Many problems appear to have been unsolved, problems of staff, finance, variations in clinic objectives, mental hygiene education?so necessary if local support is to be forthcoming. Arising out of this survey, sugges- tions are made for the organization of clinics on the basis of function and it is this section that will appeal to those interested particularly in the future of mental health in this country after the war. It is considered that to establish clinics for the treatment of children who may possibly develop mental disorders, even were evidence available that such children can be picked out from their fellows, would tend to foster attitudes of fear and suspicion: that to organize clinics specifically for the prevention of delinquency might cause children to be labelled as potential criminals. The conclusion is drawn that the psychiatric programme can profitably aim only at the treatment of an existing unhappiness rather than at the prevention of some impending disease or misconduct, although such desirable results may not be impossible as an incidents1 consequence. A clinic offering a service of th’s kind has to consider whether it can open its doors to the feebleminded?whether the parents and patient can utilize the clinic’s help. From the review of the evidence it would appear that many defective children could be helped to adjust to life outside an institution.
An excellent exposition follows of modern child guidance and a short section is included on the training of staff. The final chapter is devoted to a discussion of the problem of a psychiatry service for small communities and it emphasized that the possibilities of psychiatric work will be greatly enhanced when the psychiatric point of view has permeated the various agencies in the community.
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