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People working in mental hospitals are showing increasing interest in the social environment of their patients. This interest is reflected both in attempts to analyse the mental hospital as a social system, and in concern for the external world of the patient. Two main approaches have been taken to the latter: the first, taken by the epidemiologist, relates the incidence and prevalence figures for mental illness to broad dimensions of society, e.g. social class, area of residence; and the second looks intensively at the family group of the patient.
It is the study of the family group with which Handel's book is concerned. His approach to the family, which forms the basis for the selection of papers, is'… dynamic in that it seeks to encompass the interplay—both supportive and conflictual—between fantasy and overt action, between person and person, between family member and family group, and between family group and the extrafamilial world' (p. ).
By including some papers which attempt to conceptualize the interplay between family group and the extrafamilial world, Handel is to some extent bridging the gap between the epidemiological studies and the family studies. This conceptual gap is one which is rarely bridged, but without this bridge it is both difficult to interpret the results of epidemiological studies and to see the family in the context of its broader social network. As I believe that this attempt is the most relevant section of Handel's book, I propose to consider it first. Handel's thesis is that we look at the ways in which the family utilize its broader social culture rather than the way in which society imposes a structure on the family. The most effective illustration comes in an extract from Elizabeth Bott's book Family and social network. Although by considering the ways in which the family utilize aspects of the broader social culture it is possible to account for differences in families within a particular section of society, I believe that society