The Mental Hygiene Movement
- Author:
Helen Boyle, M.D.
Vice-Chairman, The National Council for Mental Hygiene i am deeply sensible of the honou when we Rowing me to address this meeting to- y> .^t, Welcome so heartily the presence of our J* ing and also so many friends and chance of * Present conditions, have had httle chance o corning together. Good social ^stment^ f the essence of mental hygiene, a d l we must meet. But we miss many gcOy riends who are away, practising I would not have you think that ^aV^eCause given the task of delivering this add ability. xt Ye. any special oratorical or persu:1S ? arian u is largely for a certain, shall I say, f tih est ? For I attended the birth of .all. three o ^ great voluntary Mental Health ass fV>x Guidance Council, the Centra -j for wr Mental Welfare and the National Cou ^ Rental Hygiene. We still have growing ‘Qrily We hope in the future to see the three satisfarton y J^ed in one body. It is of ^National Counc^ x Mental Hygiene, and of its history, that to speak.
It all began with a very sick younga ^rnerica, the late Mr. Clifford Bee?. ^h? fSon_ esult of his illness became the outstand g P He aiity in the work of mental hygiene in h ? ^ roke down mentally from the age o ^is Underwent indifferent treatment, surmoun difficulties with courage, and, with oatient, courage, used his experiences as ame y^is n? light matter in those days, to write a boo . book, A Mind that Found Itself, published in 1908, describes in detail his mental processes and recovery. He sent it to various distinguished people, among them the late Professor William James, who gave him heartening help. The book aroused intense interest in the subject of mental hygiene and the urgent need for its improvement. Among the things Clifford Beers said was this: ” Improvement can never be brought about without some central organization by means of which the best ideas in the world may be crystallized and passed along.” What he preached he practised.
He started the National Committee for Mental Hygiene, supported by many brilliant and thoughtful Americans, both lay and medical.
Just after the last war I went to America to see what was being done, and of all that I saw I thought this movement the most worthwhile activity in mental hygiene. On my return I approached various people, among them Sir Maurice Craig, a memorial to whom we hope to have soon. He had already heard of Mr. Beers’ work, and was himself a pioneer in the promotion of early treatment for mental disorders, urging the importance of physical rest and methods of treatment then new, but now generally recognized and used. Sir Maurice gave his far-seeing and powerful aid to starting the National Council for Mental Hygiene and later was the means of interesting the late Duke of Kent, who graciously became the Council’s President and gave it strong and ready support in every way possible, speaking warmly of its work on many fhe Pr^fdlrietSSTx*ven at a special meeting of the National Council for Mental Hygiene on.!^e<!icc?Q?i1 ?f ^’e v’s’( ?f estaent, H.R.H. The Duchess of Kent, at Manson House, Portland Place, W.l, on April 26th, 1944. occasions. May I be allowed to quote some of the things His Royal Highness said:?
At the Fourth European Reunion in 1936: These reunions, followed every five years by international congresses at which members of all mental hygiene councils can meet, are a very valuable means of helping to solve the mental health problems which confront the world.
Later in the same address he said:
There has never been a time in the history of the world when sane balanced minds are so needed, nor when mental hygiene propaganda is so greatly required. Surely those words are as true now as when they were spoken. At the Fifth Biennial Congress we heard these words: I want to stress straight away that the aim of this Council is not only to prevent mental illness but to improve the mental health of the community. With that strong and inspiring lead nothing less should content us: not only to aim at relief and cure, not only to prevent mental illness but to improve and raise the standard of mental health throughout the world, and it is possible, and probable, that the International Committee which Mr. Beers founded, and to which before this war 53 nations adhered, may well be his finest and most permanent work. At present the links are tenuous, but the work is going on and the Provisional National Council for Mental Health has arranged lectures on mental health subjects for members of other nations in this country who wish to know more of our methods.
Mental hygiene has made great advances in the last twenty years. The Mental Treatment Act is one of the most noteworthy, enabling any patients to be admitted voluntarily to a Mental Hospital if they feel they need treatment and rest. Previously they had to wait till they were so ill that they could be certified as insane. It was an absurd, a tragic position. I remember one case of a white-faced little mother who was refused admission and the treatment which she urgently needed, because?this was the reason given?” no one could say she was insane “.
Another great advance is the provision of OutPatient Clinics, which are becoming more and more numerous, enabling patients troubled with any form of nervous difficulty to get advice and treatment easily, and usually at the same hospital which they are accustomed to attend for physical illness. Unfortunately, beds for such cases are still woefully lacking. They are needed for patients for whom treatment inside a Mental Hospital is not suitable, and for children who need treatment away from home. Here is such a case, the case of a little girl who refused to speak at all outside her home. At school not one word would she utter.
It was plain that she adjusted all right to her hofl^’ It was the outside world that was the difficulty’ So she was taken into hospital. There it ^ discovered that she had been badly cuffed on u? head at school by the teacher for talking when, 1 fact, it was not she, but the girl next to her who h<* talked. The injustice rankled in her soul, and & did not speak again except in the security of hofli * In the end she became again a normal child in honj and school, but it took months to warm her lip . heart before she could trust the world and not fea those in authority.
Great advances have also been made not only lIj the opportunities for treatment, but in the treatmefl itself, by the use of electricity, by the new use o drugs, and by ” rehabilitation “, but perhaps tfl greatest advance of all has been in the change.0, public opinion on the whole subject, a change whip this Council has helped by its propaganda, 11 lectures, the work of its committees and the evident which in different ways it is continually putting before the public.
There is still much to be done. One of oll.j biggest problems is juvenile crime, and the Counci is very much interested, from the mental ^eale aspect, in the Criminal Justice Bill. It has for nmoment been put on one side, but we all hope tha this will not be for long.
That, very briefly, is how the Council began 11 work and what has been done since then, history, however interesting, is of little worth unles it leads to wider understanding of the present, an to the development of fruitful ideas for the futu^ I should like to make one or two suggestions for t*1 future, and in doing so, let me say that I am n? speaking for the Council but for myself alone. There is still a fertile field for energy, a vaS_ country where, indeed, there is no room for coin placency. As the men and women of this W?r’ develop, ever adding to their powers and, let it ” said also, to the difficulties they have to surmouf1 physically, mentally and spiritually, so will t*1 knowledge of the body, mind and spirit of man hav to grow also. Pathologists tell us that there af millions of resting, or undeveloped, cells in the braj of whose uses we know nothing. Are they nierev to replace others in case of need, or, more splend1 idea, are they the seeds of fresh capacities and po^r9 which remain to be explored, understood and used ? Certain it is that there seem to be powers possess^ by certain races which are absent in others. Son1^ Eastern people have powers of concentration, an can attain a curious degree of suspended animati0”’ which are strange to us. Across India, and acros Africa, so those best acquainted with the country? tell us, news is transmitted with a rapidity inexpl1 able to us, for it is done without wires, accumulator’ batteries, or any of the means that we understan ? Indeed, have not the powers of the spirit bee7 demonstrated over and over during this war ? There is a land of hope and glory ahead of u > Who can say that we may not master the problenj matter, as we know it, and be free from our bodi ^ explore the universe ? Probably ^ on^ shall fly to the moon, which I am . , j yov twenty-eight flying days away. Wi wiU say. Maybe; and yet, maybe n small sjze I wonder if anyone here has notice ordinar> of a goose’s head. (I am referring v,eads ma> goose, not to the human variety whos ^ has i he large.) And yet what a brain ? . ^ When a hen that has hatched ou^os i jn his a coop on the lawn, a gander, who know hfe seen a gosling, being an only <? . with a at once that they are his chddren, ^ ^ does Queer mother he has never met them and not trust. He will mount guard ove so one gander I knew would hardly fee ^an concerned was he to take care of his larM rtant II be that the actual brain-matter is advantage than we sometimes think ? To ge t we of all human possibilities we must loo t^e care do not stultify our powers by ne?lect^gd body, of. the three parts of which we ar= made, boj, mmd and spirit, and to use all three recovery, to protect, and to develop. ^ more This unity of man has never bef _ Qf the clearly recognized than it is now, ncern, the first importance in what is our^ch continually Prevention of mental instability. body, ^e the inter-relation of the three par ? cessively, if acting irregularly, insufficiently jn(jeed may perturb the activities of the min<d, d by seem to affect the spirit. A mmd PP t Qn the flings of inferiority or by loss m ^ Gf appetite body, driving it to sleeplessness, mind may a”d other disorders, and anxiety o . ? seen a affect the activities of the glands. teen days Patient develop a large th^??ijf^hen th anxiety of anxiety, to disappear as quickly wnen Was removed. , . t_ u0th mind Of the power of the spirit to domi lately and body I would say that m0^ ^e0LP what Mr. ^en proof of it, and I would qu recently Winston Churchill said of it when he spoK ?f the ” miracle of the British Empire . What is this miracle, for endsofthe which calls men from the utterm reach a earth, some riding twenty day . t0 be recruiting station, some armies?a ? they sent 14,000 miles across the seas bet reach the battlefield ? . which makes What is this force, this mira*cle, . as any Governments, as proud and sovere g that have ever existed, immediate all their affairs and set themselve Old Land to beat the common ioe . f and You must look deep into the heart of m ^ then you will not find the answ it js that look with the eye of the spirit. dominated you learn that human beings are n they by material things, but by ideas for wh.clftw are willing to give their lives or th To enhance this knowledge of the spii’it, to^ an(j facts showing this inter-relation of b y, anything sPirit is worthy of research, is indeed w ; we can pay in energy, industry, work and treasure. i There must be more research. The work of Child 1 Guidance?work of great delicacy and precision, and perhaps needing certain qualities of personality?is i contributing greatly to our understanding of mental r instability and to the preventing of it. Observations ‘ and records of early difficulties have already thrown ! a blaze of light on certain basic troubles, and i perhaps will enable us not only to cure cases of ; instability, but to succeed in that greater task of which the Duke of Kent spoke when he said that our aim was ” to improve the mental health of the community “.
Much of this research is for the future, but what immediate improvements can we consider ? Do we wish to see perpetuated the mental hospitals with vast buildings and patients whose numbers reach thousands ? The one I was Medical Officer in, not far from here, had 2,500. patients. What should the immediate future do in planning and building its mental hospitals ? Before the Town and Country Planning is completed it is important that the needs of mental health should be considered and that its hospitals should not be thrust out into the wilderness, very truly the wilderness. Many are now placed in the depths of the country, miles from the town they serve. One I know is five stations away, with a walk at the end. I would submit that we should aim at small hospitals near, or in, the area from which they receive patients. The Board of Control have suggested that a thousand patients should be the maximum. I venture to suggest 500. There is hope, and intention, that the psychiatric teaching units, proposed for the teaching hospitals, shall be small, and what a splendid thing it will be to have all medical students trained in them ! But we must think, too, of the desirability of having all mental hospitals smaller, so that those erected by the Local Authorities shall never again house thousands a long way from their own homes, and that the term ” put away ” shall never again be used of mental patients.
A new problem of importance will be the mental hygiene of the people demobilized after the war. Never before has a war so entered the homes of the people, either directly by bombs or by evacuation, or indirectly by calls to the Forces and other war work. One great difficulty may be the large number of girls and women who, having become accustomed to a social life never before experienced, and also to the handling of their own money, may find a small house very dull, even with babies, when their men are away all day, or the harder cases of the girls whose husbands will never come home and who, leaving their war work, will have to try to settle to a new and lonely life.
After a League of Nations meeting some years ago, at which I had said that social opportunities were needed, a reporter came up to me and contrasted that cold meeting with one which he had attended the night before, where a number of old soldiers had met, had had coffee and buns, had sung the old songs that they all knew and had almost had to be driven out of the hall in which they had met.
He asked: How can we perpetuate the camaraderie of war in peacetime ? We must answer that question, too. Would it be possible to have something in the nature of clubs with accommodation for whole families, where the tired man could have a drink and a smoke, and the tired wife, too, where the children could be cared for and where, if not tired, the parents could dance, play games, read or chat, and possibly have general talks on the subjects they voted to discuss. The present opportunities for such meeting and recreation provided by Women’s Institutes and the Mothers’ Union, by the Boy Scouts and the Girl Guides, by the Y.W.C.A. and the Y.M.C.A., plus pubs, invaluable as they all are, tend to split the family, and the wife cannot go out with her husband, whom she may not have seen all day. The Peckham Pioneer Health Centre I believe already supply much of all this, but I would prefer not to start W having other things in these clubs. They should solely for recreation. They should be simple, an they should be run by the people themselves. . Others may have better suggestions to make, an I hope that all will give thought to it, for it is ofl of the many things to which we must give though and on which we must act, if we are to have a nation with a sound mind. .
In this brief talk I have only been able to toucn the fringe of this mighty subject, and I would say again that in all we think and plan and do, we mus remember the inter-relation of body, mind an(i spirit, and their relation to God. That is ? stupendous importance, and the possibilities of p. work of mental hygiene, carried on in that belieI> are illimitable.
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