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New York: John Wiley and Sons, 1968, 250 pages, $7.95.
AS ITS SUBTITLE indicates, A Decade Later reassesses the discoveries reported in 1958 by Hollingshead and Redlich in Social Class and Mental Illness. Few in community psychiatry are completely unfamiliar with the earlier volume, a pioneer documentation of how extensively psychiatric care is influenced by the patient's socioeconomic status. Its urgent message fortunately suited the times and became integral to the rationale for public mental health reform.
Hollingshead, from his sociological orientation, and Redlich, as a psychoanalyst, were quite explicit in assessing treatment problems of the poor as involving more than simply their inability to pay for it, and also as more than class prejudice of bourgeois professionals. Difficulties were pointed out in prevailing psychotherapeutic methods, including psychoanalysis, which are better suited to middle- and upper-class life styles. That is, social strata were recognized as separate subcultures and cultural circumstances were seen as necessary considerations in the development of psychotherapeutic strategies.
A year after the Hollingshead-Redlich book, two of their junior colleagues in the "New Haven Project" published Family and Class Dynamics in Mental Illness, which further specified class differeneces affecting treatment outcomes. One of its authors, Bertram Roberts, was a psychitrist whose untimely death prevented further contributions. The other, a sociologist named Jerome Myers, is senior author of the third New Haven report, which is reviewed here. His co-author, Lee Bean, and their collaborator, Max Pepper, also are sociologists.