THE NATION’S MENTAL HEALTH

[Music] the march of time [Music] today thousands of Young Americans are entering the Armed Forces but many others are being rejected easy to detect are the physical ills which disqualify a man much less obvious are are the sicknesses of the mind yet they are fully as Grave and as alarming rejected by the Armed Forces an emotionally unstable individual is turned back into society to become lost again one among the nearly 7 million Americans suffering from some form of emotional or mental ill health today mental illness is by way of becoming America's number one health problem for years what was called Insanity was regarding it as a problem for each state to solve as best it could in nearly all State Mental Hospitals little more than custodial care was provided few who were committed could hope to return to society many whose illnesses were comparatively mild at the start became increasingly worse until all hope of recovery vanished [Music] shocked by the appalling percentage of the emotionally unstable revealed by the World War II draft figures Congress in 1946 passed the national mental health act which recognized for the first time that mental illness was a national problem witness to the government's intention to act as a huge modern building going up at Bethesda Maryland to house among other groups the National Institute of Mental Health created by the national mental health act keenly aware of the tremendous problems ahead is Dr Robert H Felix director of the vast new project a primary objective of the national metal health program is to increase our fund of scientific knowledge about mental health and about mental illness meanwhile we should make full use of existing knowledge we're not doing this why because there are not enough Community Mental Health Services because there is not enough public understanding of the importance of mental health and because there are all too few skilled mental health workers largest US training center for mental health workers is Topeka Kansas where three separate hospitals cooperate in an intensive program located at Topeka is the famed manager Clinic its teaching staff makes possible a three-year training course for about 100 doctors who use the facilities of the cooperating hospitals Dr William C manninger General Secretary of the manninger foundation was chief of neuros Psychiatry for the US Army during World War II his brother Dr Carl a manninger is a trustee of the foundation and is director of education training is available not only for doctors but also for other psychiatric Personnel to Topeka has also come the Veterans Administration which cooperates in the effort to build up adequate Personnel winter hospital with 1400 beds is one of its largest training [Music] hospitals psychiatric nurses and psychiatric AIDS spend more time with patients than any other members of the hospital staff their role is Major and their professions grow in stature year by year the AIDS who in the past mainly acted as guards today take a helpful part in the therapy which is designed to bring Disturbed patients back to [Music] reality to be eligible for training as a psychiatrist the doctor must be a graduate of an approved Medical school and must have completed one year of General internship in an approved hospital when the young doctor enters psychiatric training he finds he must learn new procedures terms and treatment methods one thing is most familiar and he is reminded of its importance regularly and that is the physical examination in today's belief that almost every illness is a combination of physical and emotional factors the psychiatrist must be able to diagnose and prescribe treatment in the light of both working closely with the psychiatrist is the clinical psychologist who contributes special skills and knowledge to the diagnosis and treatment of mental and emotional disorders while the psychiatrist seldom gives these tests which determine a patient's mental capacity and provide understanding of his mental problems he must have a working knowledge of them and their evaluation [Music] the psychiatrist must also learn the vital importance of taking the patient history in a way which will establish confidence and encourage the patient to recall seemingly unimportant details with complete Freedom uh I'm going to ask you some very specific questions Mr Jones because we won't have you here for very long if you have no objection you just answer them and if have some objections then say so and we won't go on with those questions now I'd like very much to know about your babyhood were you told that you ever had any difficulty with feeding or anything of that sort no not that I remember um you started school at about what age about 5 years old I believe sir uhhuh and uh where did you start in school in kindergarten yes sir how did you get along about fine as well as I remember mhm did you have any particular teachers that you liked anything of the sort I liked all my teachers except one I remember what was the trouble with this one I don't know she just scared me most of the time holler at me and I'd run outside and vomit I see as his training progresses the young psychiatrist learns the various techniques which will be at his disposal and how to use them among these are such physical methods as electric shock electric shock is used most frequently to leave depression another form of physical treatment is the administration of insulin patients so sick they cannot even talk are frequently able to cooperate with the doctor after insulin injections properly used such treatment has helped extreme cases of anxiety in certain chronic illnesses brain surgery may be indicated a chemical such as sodium amatol is often administered by the psychiatrist in order to enable a patient to overcome an emotional [Music] block it must be just enough to put the patient into a state between sleep and waking so that he may be able to express his feelings more freely many persons think that Psychiatry consists of only one thing psychoanalysis actually psychoanalysis is a prolonged and very specialized form of treatment it properly can be given only by a doctor qualified as a psychiatrist and fully trained in the exact specialty of psychoanalysis treatment may go on for years Cornerstone of psychotherapy is the relationship between the doctor and patient most often established in the interview face to face in such interviews the doctor leads the patient to gain better insight into his own behavior well uh I got nervous and irritable I got so I couldn't get along with people I I couldn't hold down a job I uh I had to be doing something all the time but yet I couldn't hold down a job um I I got to keep doing something I smoking cigarettes or uh uh or doing something with my my hands all the time like your cigarette lighter now yes I I need something done I need some help I effective in helping patients release emotional tension is drama therapy in this group treatment the psychiatrist sets up a situation and assigns the patients to act it out each patient is asked to react without thinking too carefully about what he ought to say the patient named as principal actor pretends he is a young man whose father has complained about his keeping late hours as he warms to the make believe role the patient looses a torrent of words in which the doctor May find Clues to the underlying causes of his illness then the group reviews the situation but Joe your father was only trying to help you Joe don't want to be helped remember when I tried to teach you to shoot poo you know Joe sometime a fell can't make it all on his own sometimes needs a little help on the scene here it was your father maybe a friend in the hospital maybe your doctor the psychiatrist must learn which of the various occupational therapies to prescribe for a patient during the course of his treatment in addition to occupying his time the patient also may be learning a new vocation in the hospital's own radio station an activity helpful for certain patients provides entertainment for many my heart goodbye when the echo of your footsteps die that record we just brought you was a a favorite of Eddie Arnolds uh it was a request from Joe Balmer and uh Bob burns down on A5 when a patient paints pictures or models in clay the psychiatrist learns to appraise this work carefully and thereby gains insight into the nature of the illness this patient worked in clay he was too compliant anybody could push him around what he thought of himself is shown by this first self-portrait childlike and undeveloped it took him 6 months to admit his illness by calling this inner Strife he frankly admitted that he need help it was a long while later that he developed a large aggressive piece when his training is complete one of the most important roles a psychiatrist may assume is director of a Community Mental Health Clinic of which there are about 500 in the US today working at the community level the clinic deals with mental health problems which although at the outset May develop into major disorders at such clinics the psychiatrist is customarily assisted by a clinical psychologist and a social worker to them come cases like that of Martha Warren 15 years old Mrs Mars what do you have on the Warren girl her father Thomas Warren came to us two weeks ago and told us about their difficulties I've been having some trouble with my daughter Martha a while back she was babysitting at her neighbors and stole some money Mr Warren told how he'd paid back the money the neighbor suggested that Martha see a doctor but that very night the girl ran away from home finally Martha came back but again she stole some money this time from her mother remembering what the neighbor had said Mr Warren was now appealing to The Guidance Center for help when the social worker called on Martha's mother she heard a story of hard times it was capped by a fire 2 years before when the Warren lost nearly everything Mrs waren had had to take a job and she considered it only natural that Martha should do most of the housework when Martha came to the guidance center she appeared indifferent and sometimes resentful the clinical psychologist through a series of tests sought better understanding of her problem a clue to why she was stealing money when she came to talk to the psychiatrist Martha was almost Sullen by her tur answer she made it plain she didn't want to be cooperative using patience and tact the psychiatrist slowly succeeded in breaking her shell of indifference but your mother does have to work doesn't she I guess so but why do I have to do all the Dirty Work keeping house I hate it and I hate my mother for making me do it your mother is tired when she comes home I suppose so why doesn't she make my brother do some of it well they're too good for that she's always on their side how do you mean Martha well after the fire we got the insurance money we all needed new clothes my brothers just got about everything they wanted when I'd asked for anything mother do say oh you can make your old ones do do you recall any particular time when your mother played favorites once she promised to get me a new sweater my other one was old and I didn't like it when Martha's younger brother raced home to announce he'd have to have new track shoes if he was to win Saturday's race Mrs Warren hesitated only a moment before deciding that Martha could wait for her new sweater but you [Music] promised from such incidents uncovered during several interviews the psychiatrist pieced together the pattern of Martha's growing resentment a resentment that had found Outlet in her anti social behavior the team agreed that Martha's stealing stemmed from this resentment resentment at being unloved by her mother and at being imposed upon by her family with this knowledge the social worker was able to convince the father and mother that Martha needed more affection from them and needed to feel that she too was part of the family soon it was no longer Martha's nightly chore to do the supper dishes all alone understanding had brought Harmony to the Warren household and The Guidance Clinic could take credit for forestalling a possible case of delinquency promoting the cause of prevention and treatment of mental illness at the community level the National Association for mental health has been formed as a coordinating agency utilizing many means of communication from specially prepared comic books to stage plays the association seeks to get across to the general public the central truths about mental and emotional problems at the same time it is welding state and local mental health societies into a nationwide Network heading the association is aurin root New York lawyer medical director is psychiatrist dror George S Stevenson a leader in the mental health field and in concluding this report Mr Rude I'd like to mention that the people of Fitchburg Massachusetts have just organized their own mental health Society but we have to have is 5,000 societies of this kind hundreds of thousands of people all over the country working at this job we can help them get organized but in the last analysis it's they the people in the communities who have to do the job throughout America in every city and town the family doctor has the best opportunity for detecting and preventing mental illness the spiritual leaders of the community have always been conscious of their role in maintaining among their parishioners not only moral equilibrium but also peace of mind the schools of the nation more and more are recognizing that they are dealing not only with the mind but with the emotional development of Youth but in the last analysis a healthy mental state is fostered by the understanding and Cooper ation of the parents of the nation for in bringing into America's homes the simple concepts of shared affection shared activity and mutual respect for the individual whether parent or child lies the best hope for an ever increasing betterment of the nation's mental health Time Marches On I