A Preventive Community Psychiatry Project and its Relationship to Psychoanalytic principles

The Need for effective community mental health measures has come strongly to the attention of the psychiatric community during the past decade.^{1, 2} For many years we have cited a ten percent incidence of mental illness in the United States, but more recently the figure for such disorders is given as considerably higher.³ While ten percent of the population may have reached the attention of the psychiatrist and been diagnosed, another twenty to thirty percent of the population are said to have severe emotional disorders, but this group has never sought treatment. These figures are appalling, and any polemic about their accuracy is irrelevant. The fact that they exist at all has led to a growing awareness of the obligation of psychiatric personnel to attend to the pressing needs of the community. This awareness has resulted in many new programs, sponsored by both public and private agencies.^{4, 5}

In the public school system of this city there has been in existence for over five years a special program for children who cannot make progress in the regular classes.⁶ During my work as consultant to the staff of these special classes, I have had a chance to make some contact with numbers of young children who had developing, or already established, emotional disorders. As an armchair psychiatrist, I had known of these children for some time, and this firsthand contact strengthened my feeling that the combined efforts of psychiatric and para-psychiatric personnel would not be adequate to meet the future treatment needs of these youngsters. Therefore, I began to explore preventive possibilities in two of the elementary schools in a West Midtown neighborhood in Manhattan. This exploration, in the form of an experimental project and sponsored by Roosevelt Hospital, will be described in this paper. The description will outline the organization of the project, pertinent theoretical constructs, and a related training program.

Our goal in this study was to t