A community’s use of a mental hygiene clinic: A statistical study of one hundred and fifty-five cases referred to the Long Beach Mental Hygiene Clinic

71 Pages·03.029 MB·English

by  Laidlaw, Dorothy

A COMMUNITY'1 S USE OP A .MENTAL HYGIENE CLINIC:
A STATISTICAL STUDY OP ONE HUNDRED AND FIFTY-FIVE CASES
REFERRED TO THE LONG.BEACH MENTAL HYGIENE CLINIC
t
A Thesis
Presented to
the Faculty of the Graduate School of Social Work
The University of Southern California
In Partial Fulfillment
of the Requirements for the Degree
Master of Social Work
by
Dorothy Laidlaw
June 195^
UMI Number: EP66394
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This thesis, written under the direction of the
candidate's Faculty Committee and approved
by all its members, has been presented to and
accepted by the Faculty of the Graduate School
of Social Work in partial fulfilment of the re­
quirements for the degree of
MASTER OF SOCIAL WORK
vl..
Dean
Ctv&n ‘cfs. i
Date.- ____-j.
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Thesis of Dorothy Laid law
Faculty Committee
Chairman
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TABLE OP CONTENTS
Page
LIST OF TABLES iii :
I
ILLUSTRATION iv !
Chapter
I. INTRODUCTION 1
Background
Purpose of the Study
Setting
Organization and Method
, II. THE CHILDREN REFERRED 14
Age and Sex of Children Referred
Race and Religion of Children Referred
Parental Constellation
Ordinal Position
Occupation of Father
Income of Parents
Level of Socio-Economic Need
Previous Familiarity with the Clinic
Acceptance or Non-acceptance of
First Interview
Chronieity of the Problem
Parent’s Recognition of Inter-
Personal Factors
Continuation into Second Interview
Presenting Problem Seen by
Referral Source
Presenting Problem Seen by the Parent
III. SUMMARY AND CONCLUSIONS 46
i
BIBLIOGRAPHY 59
APPENDICES
I. THE COMMUNITY OF LONG BEACH 6i
II. FEE SCHEDULE ............. 64
ii
LIST OP TABLES
Table Page
1. Age and Sex of Children Referred.......... . . . l6
2. Religions of Children Referred............. 19
3. Parental Constellation . . . . . . . . . . . . . 21
J4.. Ordinal Position with Two Children
in the Home ................................ 22
5. Ordinal Position with more than Two
Children in the Home • • • • • • • • . . • • • • 23
6. Occupation of Father...............................25
7* Income of Parents .................... 27
8. Level of Socio-Economic Heed................... 28
9* Acceptance or Non-acceptance of
First Interview....................... JJL
10* Chronieity of the Problem ............... 33
11. Parent1s Recognition of
Inter-Personal Factors........ . . ..............35
12. Continuation into Second Interview . . . . . . . 37
13* Presenting Problem Seen by
Referral S o u r c e ............................. . 39
1I4.. Presenting Problem Seen by P a r e n t ................I4.3
iii
ILLUSTRATION
Figure
1. Yearly Increase In Childrens Cases
since January 1, 19^5 ...........
iv
CHAPTER I
INTRODUCTION
Background
**Why do I have to go to a Mental Hygiene Clinic?
Am I crazy?1* So says Johnny, aged eight, an eager,
handsome hoy who cannot resist setting fires.
I ftBut, darling, ** says his distraught mother, wthe
I school says we must go.1*
I
.. .
! f*I canft go to that place,1* cries ten-year-old
Gloria. 9I can’t walk]"
wBut the Doctor thinks maybe it will help you.**
And so they come to the Mental Hygiene Clinic,
'these sick children - the fire-setters, those who lie, who
j steal, who cannot walk, who vomit when it is time to go to
school. In the early days they were called ^delinquentw
or ^pre-delinquentn children, and stern measures were used
to try to change this behavior that was a threat to
'society. But society learned, angrily at first, then with
bewilderment, that stern measures did not cure.
I Thus out of bitter experience developed the
i
| recognition of the need for psychiatric programs for
2
delinquent children, primarily led hy Dr. William Healy in
his study of the children brought before the Juvenile Court
j
in Chicago. Concurrently with this development was the
jgrowth of the mental hygiene movement, and it was
inevitable the two should converge. In 1921 the National
Committee for Mental Hygiene and the Commonwealth Fund
started a clinical program to demonstrate the value of
psychiatry in prevention of delinquency.
Psychiatric treatment for children soon spread
Into areas other than that of delinquency, and now mental
jhygiene clinics offering help to both adults and children
i are an accepted part of our society. The emphasis in the
mental hygiene movement is on prevention of mental Illness,
because it is recognized that many difficulties in adult
life are the result of unresolved childhood conflicts. As
Thomas Rennie states:
i Common sense dictates attention to the prevention
; of these disorders and the formulation and promulga­
tion of principles that can be applied or adapted by
those who wish to prevent mental illness. This focus
has led . . . to the establishment of extensive
mental hygiene clinics and to the giving of special
attention to the maladjustments of children through
; the medium of child guidance clinics.
!
Nevertheless, a vicious cycle exists. To prevent
I the adult breakdown, the child and adolescent should
| be treated. But to treat the child, the parent must
j also be treated. Obviously the problem must be
attacked wherever it is found, at any age from
3
infancy to senescense .-*•
Public concern over mental illness has been given '
iI
vast impetus through government sponsorship. But what of
the many voluntary mental hygiene and child guidance
clinics? Their existence is dependent upon the communi­
ties in which they operate. The need is seen for such ]
service, the agency is established, and then, in spite of
i
the community^ growing demand for this service, the
community itself is unwilling to provide increased
! financial support. Can it be that the community believes,
I once the pioneering job is done, the government should
^ assume the financial responsibility? However, what the \
future may bring to the voluntary clinics no one can say. '
It is a fact the mental health of our society concerns us
’ all, and the steady expansion of psychiatric services |
j
! proves it.
j Though psychiatric treatment for children has
t
' become a large part of this expanding program, it is not
completely justifiable to put it on the basis of prevention
i
■ of some future breakdown. Children must live with them-
i
i
! selves, with their parents, with society today, and
whatever help they can get In a present adjustment is as
i - - - - - - -..- — - — - --- - -- - - - --
— -----I
i 1
1 xThomas A. C, Rennie, ^Mental Hygiene, ** Social
Work Yearbook, 19^-7* Edited by Russell H. Kurtz (New
| York: Russell Sage Foundation, 1914-7) > P* 3^-5* j
important as worrying about what will happen to them in the
, future•
Little Johnny who likes to set fires is a disturbed
child, and he needs help now, Gloria who cannot walk may
develop a severe anxiety neurosis, but how does she feel
about herself today? Children have a right to a secure
world. When their world is shaken they, as individuals,
need help to straighten it out.
Sandor Larand says of this point:
j The stress should not be so much on the possible
I outcome in adult neurosis, but cure of the present
1 childhood problem. The former attitude brings a
i tendency to dismiss the child1s present predicament
1 without sufficient consideration of it.2
Children are a potent force in formulating a
stable, secure, and healthy society. What parents can
, give their best to each other and to their family if they
1 are beset by the frustrations of an aggressive, hostile
j child? What school teacher can direct her clearest
i
thinking toward a pupil who has severe hysterical attacks
in the class room? What child can reach out eagerly for
knowledge if he is caught in a desperate pattern of
/
i
1 stealing?
j It is up to society to reach out a helping hand so
I p
,
^Sandor Larand, trThe Psychoanalytic Contribution
! to the Treatment of Behavior Problems in Children,11 The |
| American Journal of Psychiatry. CV (November, 19^8), 357* |