
TI HE BASIC CONCEPTS of mental health and social welfare cannot be clearly separated one from the other. Bradley Buell in "Community Planning for Human Services" (1) groups mental health clinics with his group of welfare services. The World Health Organization definition of health as "not merely the absence of disease, but physical, mental, and social well-being," on the other hand, includes social welfare in health. The conclusion indicated is that psychiatrists must collaborate with social planners and social workers and vice versa. Each field has experience that demands the others for the formulation of satisfactory theory to explain what is happening and to plan for what should happen. Psychiatric theory since Freud has set forth clearly that both mental health and mental illness depend, among other things, on what the relationships are between family members. It has been equally clear to the social scientist that the social health of the family depends upon the mental health of its members. Gruenberg's chapter, "Socially Shared Psychopathology," in "Explorations in Social Psychiatry" (2) makes this apparent. There is ample evidence that, whatever the succession of events leading to the condition, social and health problems are associated more than mere chance could account for. Buell found this in his study populations and Svihus (3) has just shown that the same thing happens in naval recruits. Although social factors were not directly studied in the chronic disease survey in Baltimore, Downes found that all sorts of diseases tended to "nest" together; psychoneurosis had more than chance expectancy in families where there was also cardiac, arthritic, or diabetic disease (4). We badly need a theoretical structure for the facts, but in the cases the facts speak loudly of the association between social welfare and psychiatry, between social welfare planning and psychiatric planning. From a therapeutic viewpoint, no modern psychiatrist imagines that psychiatric illness is cured by absolutely individual treatment. Social psychiatry is popular at the moment, and we hear a great deal about treating all family members and of the need to establish healthy environments. "A sound mind in a sound body" is no longer an adequate aim. Social psychiatry is more than a fad, and the aim must now be "a sound mind in a sound body, a sound family and a sound community" if it is adequately to express present health notions. When these notions escape the ivory tower and get into the melee of living, they cause no end of administrative trouble. One gets to longing for the simplicity of Popeye's old "I am what I am." Instead, he finds himself a member of a crowd of helping professions not simply a "doctor" or a "social worker." The physician who confines himself to the hospital or to the operating room is recognized as an inadequate physician, however valuable he may be as an operating room technician. The social worker who confines herself to food and cloth-ing needs is inadequate as a social worker. The physician must sharpen his sensitivities to include what the social worker faces; the social worker must be cognizant of the medical and psychiatric condition of her relief client. While we may ponder the meaning of "social, physical, Dr. Lemkau is professor of public health administration at the Johns Hopkins University School of Hygiene and Public Health. The paper is based on an address at the National Conference on Social Work, Atlantic City, N.J., June 8, 1960.
Mental Health, Humans, Social Planning
Mental Health, Humans, Social Planning
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