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To the Editor:
The recent article on “Community and Preventive Psychiatry” (Vol. 30, No. 1) seems to be a step in the direction of broadening the scope of the Journal. Up to this point we have been preoccupied primarily with the therapeutic aspect of psychoanalysis.
The educational programs which are being developed to enlighten parents, teachers, counselors, ministers, etc., are quite helpful, but, let's face it, they are inadequate. We should think more realistically and boldly. It seems to me that knowledge of etiology and mechanisms of mental illness does not help people in raising healthier children. If intellectual awareness were sufficient, parents in the psychological professions should have the healthiest children. This does not seem to be the case.
Moreover, treatment of neuroses, not to mention the psychoses, has, thus far, proved to be very frustrating. We can, in spite of our most refined and sophisticated techniques, treat very few people at one time, and at the expense of a great deal of time and money. Even if the community mental health programs prove to be successful, realistically only a fraction of people in need will be reached and the treatment will be little more than superficial.
Mental illness is so widespread that it should be regarded as a true epidemic. The carriers are the adults and the environments that adults have created. The victims are the children. Unless we develop a method to prevent such an epidemic, our professional efforts will never be adequate to the task.
Physical medicine has been very successful in routing several epidemic diseases by removing the carrier of the disease from the environment. I believe that the only way to remove emotional disorders is to adopt a modified medical model of epidemic prevention. We may have to remove the potential victim from the contaminated environment.