Mental Hygiene and Socio-environmental Factors

The subject of this paper is one that has comeincreasingly and compellingly to the attention of psychiatristsand other students of human behavior in recent years. The im-pact of the social environment on the life history, and the relevance of the life history to mental illness, are no longer in serious question as clinical and research findings. But, even though we have come a considerable distance in our systematic understanding of the symptomology and psy-chodynamics of mental disorders, such understanding does not extend to any extent the role played by socio-environmental factors. The growing recognition of the seriousness of this gap for the etiology and treatment of mental disorders serves also to point to its seriousness for case-finding and prevention, equally important segments of a national mental hygiene program. Thus it seems well to attempt to define the dimensions of the problem, survey its present research status and outline some important areas of needed research for the future. In so doing, we shall also be defining the role of social science in the mental hygiene movement, a matter too long postponed for the benefit of each. By mental hygiene we shall mean the knowledge and skills requisite to reduce mental disorders and maintain mental health. These will be specified in more detail shortly when we place the problem in its full epi-demiological context. However, at this point it should be made clear that mental hygiene must be concerned with more than the psychoses and with more than hospitalized mental illness. In fact, its great problems are the ambulatory ill and the pre-ambulatory ill (those whose proba-bility of breakdown is high). The appropriations for state aid under th