Mental hygiene, the public-health perspective within psychiatry, was influential from 1910 until about 1960. Since World War II, mental hygiene ideas became increasingly incorporated into mainstream psychiatry, in particular through the community health movement of the 1960s. The mental hygiene, or mental health, movement thereafter ceased to exist as a separate movement.
Instead of focusing on the treatment of MENTAL ILLNESS, mental hygienists emphasized early intervention, prevention, and the promotion of mental health. Mental hygienists were interested in children because they were convinced that mental illness and mental disorder were to an important extent related to early childhood experiences. Their interest in prevention made them focus their public-health education activities on reaching parents to inform them about the latest scientific insights in child development and child rearing. Mental hygienists also viewed the educational system as a suitable location for preventive activity and became involved in programs for teacher education and educational reform.
The National Committee for Mental Hygiene was founded in New York in 1909 by a number of leading psychiatrists and Clifford W. Beers (1876–1943), who had been institutionalized in several mental hospitals after a nervous breakdown. He described his experiences and the deplorable conditions in mental hospitals in his autobiography A Mind That Found Itself (1913). The National Committee aimed to improve conditions in mental hospitals, stimulate research in psychiatry, improve the quality of psychiatric education, develop measures preventing mental illness, and popularize psychiatric and psychological perspectives. Although mental hygiene originated within psychiatry, mental hygiene ideas also inspired social workers, teachers, psychologists, sociologists, and members of other professions. Consequently the mental hygiene movement became interdisciplinary in nature.
The basic ideas of mental hygiene were derived from the dynamic psychiatry of Adolf Meyer (1866–1950). According to Meyer, mental illness and mental disorder were the out-come of the dynamic interaction of individuals with their environments. Inspired by evolutionary theory and the philosophy of pragmatism, Meyer interpreted these conditions as inadequate responses to the challenges of everyday life or as forms of maladjustment. Investigating an individual's life history enabled psychiatrists to trace the origins of maladjustment and to intervene therapeutically. In Meyer's views, the treatment of early forms of maladjustment could prevent more serious problems later on. His ideas also contained suggestions for preventive measures.
During the 1920s, SIGMUND FREUD's psychoanalytic ideas became increasingly influential in the United States. Psychoanalysis emphasized the importance of early childhood experiences and their impact on mental health later in life. Mental hygienists became convinced that preventive intervention was best directed at growing children and those individuals who had the most extensive contact with them: parents and teachers. Initially mental hygienists emphasized the importance of therapeutic intervention in the emotional problems of young children. They later also emphasized the importance of fostering mental health in all growing children.
Starting in the 1920s, mental hygienists promoted a therapeutic perspective toward the everyday problems of children. The National Committee was instrumental in the establishment of CHILD GUIDANCE clinics. Initially these clinicswere associated with JUVENILE COURTS. They were modeledupon the clinic of WILLIAM HEALY (1869–1963), who had been the first director of the Juvenile Psychopathic Institute in Chicago, which was associated with the juvenile court there. In 1917 he became the director of the Judge Baker Foundation in Boston. According to Healy, juvenile delinquents needed to be investigated individually by a team consisting of a psychologist, a psychiatrist, and a social worker in order to ascertain the child's abilities, home background, emotional life, motivations, and intelligence. On this basis an individualized treatment plan could be developed and implemented. During the 1930s child guidance clinics came to focus less on diagnosing and treating juvenile delinquents and more on the therapeutic treatment of the emotional problems of children from middle-class families. Child guidance clinics increasingly treated parents and children who came for help on their own initiative.
During the 1920s academic research on children became increasingly respectable and well organized as a consequence of the funding provided by the LAURA SPELMAN ROCKEFELLER MEMORIAL, a large philanthropic organization that supported research in child development at several academic institutions. The aim was to investigate the development of normal children and to popularize the findings of this research. Inspired by this research, a number of leading mental hygienists argued that preventive activity should no longer be focused on detecting early signs of maladjustment but instead on tracing aberrations in normal child development. Consequently preventive activity was potentially directed at all children instead of only those children who were troublesome to parents and teachers. During the 1930s a few leading mental hygienists developed educational programs aimed at fostering mental health in schoolchildren.
Mental hygienists viewed the educational system as a promising venue for preventive activities because it could potentially reach all children. During the 1930s they successfully influenced teacher education programs to include developmental psychology. Initially they wanted to raise awareness among teachers about the ramifications of educational practices–particularly methods of maintaining control and punishment for transgressions–for mental health. A number of educational reformers became interested in mental hygiene to provide a rationale for educational reform by claiming that the curriculum needed to be organized in conformity with insights in child development. In addition, many Progressive educators viewed the school as the place where children were trained for adjustment; they viewed the school as the preparation for life. The life adjustment movement in education claimed that the school should train the whole child and not just his or her intellect. Educational reformers criticized the traditional academic curriculum for its emphasis on mental discipline and rote learning, which they saw as irrelevant for most children. They advocated instead a variety of educational initiatives such as vocational training and project learning. The influence of these ideas on education was profound: the development of the personality became one of the central goals of education.
The influence of mental hygiene ideas after World War II was illustrated by the pervasive interest of parents, especially mothers, in child-rearing literature. Critics have argued that this literature made mothers unnecessarily worried about the well-being of their children, and the influence of mental hygiene ideas on education was countered at times by an emphasis on the teaching of basic academic skills. In the 1990s the influence of psychiatric and psychological ideas on educational practice has been criticized as one of the causes of educational decline in North America.
Beers, Clifford W. 1913. A Mind That Found Itself: An Autobiography, 3rd ed. New York: Longmans, Green.
Cohen, Sol. 1983. "The Mental Hygiene Movement, the Development of Personality and the School: The Medicalization of American Education." History of Education Quarterly 23:123–148.
Dain, Norman. 1980. Clifford W. Beers: Advocate for the Insane. Pittsburgh: University of Pittsburgh Press.
Jones, Kathleen. 1999. Taming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority. Cambridge, MA: Harvard University Press.
Meyer, Adolf. 1948. The Commonsense Psychiatry of Adolf Meyer: Fifty-Two Selected Papers Edited, with Biographical Narrative, by Alfred Lief. New York: McGraw-Hill.
Pols, Hans. 2002. "Between the Laboratory and Life: Child Development Research in Toronto, 1919–1956." History of Psychology 5, no. 2: 135–162.
Richardson, Theresa. 1989. The Century of the Child: The Mental Hygiene Movement and Social Policy in the United States and Canada. Albany: State University of New York Press.