Mental Health and Community Welfare
Boehm, Werner W.
Mental Health and Community Welfare ACTION FOR MENTAL HEALTH. Basic Books. 338 pp. $6.75. Reviewed by Werner W. Boehm THIS VOLUME, the final report of the Joint Commission on Mental Illness...
...Ultimately, of course, a breakthrough in knowledge and manpower can come about only through increased expenditures for mental health...
...The report frankly acknowledges the paucity of tested knowledge about diagnosis and treatment of mental conditions...
...The report makes ingenious suggestions about more effective and efficient use of highly trained professional personnel that is available and makes a strong case for enlisting volunteers in the treatment process...
...But knowledge will lie fallow unless there is the personnel to produce and to use it...
...The report recommends increased emphasis on research where clinicians as well as scientists, including those in the social and behavioral sciences, make common cause...
...Since mental illness is viewed as being much more than a medical condition, but rather the outcome of an unfortunate combination of physiological, psychological, social, cultural, and economic factors, measures for treatment and alleviation need to involve all forces and segments of the community...
...Occasionally the recommendations seem to be too exclusively pointed to the medical profession as the pivotal group in the treatment of mental illness...
...Reviewed by Werner W. Boehm THIS VOLUME, the final report of the Joint Commission on Mental Illness and Health, is the end result of the most comprehensive survey of mental illness ever conducted in the United States...
...Clearly the manpower shortage in the mental health professions (psychiatry, psychology, social work, and nursing) and in such allied fields as the ministry and education, is but a function of the total shortage of professional manpower in the United States, a shortage which reflects our tremendously wasteful loss of talent between high school and college...
...For it is one of the findings of this report that mental illness, far from being the exclusive responsibility of the medical and allied professions, is the business of the whole community as long as attitudes of social ostracism and rejection of the mentally ill are rampant...
...Nor will every reader draw the same conclusions from the data assembled or arrive at the same priorities, but the facts are here and thus the responsibility for implementation is clearly placed: it rests with the experts in the mental health professions and, beyond them, with the citizens at large...
...Our disregard of the mind "that is lost" is just as costly, socially and individually, as our disregard of the productive mind, both being facets of our indifference to matters human in a primarily objectoriented society...
...Despite our present limits in manpower and knowledge, much more can be done than is being done now...
...Nevertheless, the recommendations for more effective recruitment, training, and deployment of personnel in the mental health professions, and for elimination of the barriers between these professions, are worthy of serious consideration...
...The report pulls no punches and in its criticism of existing conditions spares no vested interest...
...The report recommends doubling of public expenditures for mental patient care in five years and tripling them in ten years and suggests a matching formula calling for the participation of local, state, and Federal governments...
...While recognizing that a variety of therapeutic approaches seem to "work," it also reveals the relative absence of well developed and generally accepted principles of diagnosis and treatment...
...Again, the report hits home by showing that the limited volunteer contributions for mental health (as compared with cancer, polio, and heart) and the grudging appropriations by public bodies for the care of the mentally ill reflect the cpmmunity's pattern of rejection...
...The report makes intriguing recommendations about the involvement of the total community in the care of the mentally ill, the increased and more effective use of out-patient facilities, such as halfway houses, foster home care, and the humane and effective utilization of the hospital itself...
...The Commission responded by producing ten monographs, six of which are published and four more in process, each dealing with a major aspect of mental health...
...They are lack of knowledge, lack of manpower, and lack of funds...
...The report, while recognizing the great importance of enhancing mental health in America, forthrightly places the major emphasis on the reduction and alleviation of major mental illness...
...Perhaps the most important lesson this report teaches the sophisticated reader is that mental health and community welfare are inextricably bound up with each other...
...What are the obstacles that stand in the way...
...A good many of the most searching and probably the most controversial recommendations deal with the manpower problem...
...It presents a cohesive, closely-reasoned set of recommendations supported by facts and designed to serve as a basis for programs aimed at the reduction of mental illness...
...The Joint Commission was established in 1955 by Congress, given an appropriation of $1,250,000 and a mandate to make "an objective, thorough, and nation-wide analysis and re-evaluation of the human and economic problems of mental illness...
...Not everybody will be in agreement with the recommendations and some of them undoubtedly will be fiercely debated...
...This concluding, highly readable report is precisely what the title promises: a call for action...
...This flaw is remedied by the report's strong presentation that mental illness requires much more than the traditional medical approach and that treatment is much more than a purely medical problem, a point which will spark some sharp debates...
Vol. 25 • November 1961 • No. 11
