Guide for the Family
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Reviews
slcTn”neSi?’ u ^ Edith M. x i-j” wim me collaboration of Samuel W. Hamilton, Th Commonwealth Fund, N.Y. 1942. $1-00.
tion”ls smaU book, suitably adapted to English condi- hei ‘ and perhaps also to English temperament, should coum0 enlighten and reassure many people in this ^ent 1 W^? ” ^ave ^een initiated into the service of patients by experiencePaul Winterton’s
Mending Minds seems to offer the nearest English parallel, but is written for a wider public and does not attempt in the same way to get beneath the skin of the anxious and bewildered relative,or to address him so intimately and directly.
Written primarily for the family of those mentally disordered persons who have to be admitted for a shorter or longer period to a mental hospital, the present
work takes up its theme at the point where ” mental illness strikes ” and tries to show what part the relative can play before, during and after hospitalization. English readers will be astonished to find how admis- sion procedure varies from state to state, ranging from the absence of all judicial intervention at one end of the scale to trial by jury as the unavoidable gateway to a mental hospital at the other. Remote as these things seem from present conditions in this country, the author’s general attitude is not irrelevant to the English situation. She makes it clear that the individual patient’s welfare is best served by a realistic acceptance of the existing legal procedure, combined with an expectation that those persons who are responsible for carrying out the law are on the whole humane and will co-operate with the relative in tempering the procedure to the patient to the limits of legality. Energy, which might have been dissipated in fruitless indignation or in futile attempts to circumvent the law may then be applied to the wider cause of reform, so that the angry relative becomes a valuable apostle of mental hygiene.
Acceptance of the authority and faith in the skill and integrity of the doctor at every stage of mental illness is urged throughout the book. This undoubtedly needs to be stressed, but the English reader may wonder whether it is not reiterated rather too often. The author’s justification must be sought’ in the preface, where she describes the Americans as ” a nation of self diagnosers and self dosers ” who ” do not sufficiently respect our doctors
The author is not herself engaged in the service which she describes, but has come to know something of the mental hospital from the inside, has consulted many people engaged in this work in various professional capacities and has had the collaboration throughout of Dr Samuel W. Hamilton, Mental Hospital Adviser, U.S. Public Health Service, who has supplied the “Foreword”. “Probably”, he writes, “the way she says things is easier to understand than the way doctors would say them,” and one might add that only a psychiatrist of rare imagination and sensibility could discard the protection of custom and of scientific interest and face with the relative what the catastrophe of mental illness means when it enters one’s own home. The lay author deserves both praise and gratitude for what her book achieves in this difficult imaginative task. Its appeal is rightly to the reason ; because it is so it cannot take the place of?though it can most usefully supplement?the personal support which must be given to the relative by psychiatrist, psychiatric social worker and others of the hospital personnel. The general line taken is that of orthodox mental hygiene. ” Once you have accepted the essentially simple fact that you are dealing with someone who is sick, you will be no more or less unhappy than you would be if your home were disrupted by tuberculosis or appendicitis or pneumonia.” No doubt it is useful to stress this, as a counterweight to the shame, secretiveness, bewilder- ment and moral judgment which still attend a case of mental illness. Nevertheless, one may be heretical enough to question whether, in the realm of feeling and experience, mental illness does of its very nature give rise to distresses, alienations and questionings of a peculiar quality and depth. N.G. s
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