Preventing Mental Illness in the United States during the Twentieth Century

by Matthew Smith

Jan 1, 2017
My primary objective in coming to the Rockefeller Archive Center (RAC) was to investigate the history of preventive psychiatry in the United States during the twentieth century, the subject of my Arts and Humanities Research Council (AHRC - UK)-funded early career fellowship on the history of social psychiatry. Although we may characterize psychiatry during the twentieth century as being dominated first by psychoanalysis and then later by psychopharmacology, preventive approaches which examined the socioeconomic, environmental, and interpersonal determinants of mental health were also important, though they are less understood. Among these initiatives were the mental hygiene, child guidance, social psychiatry, community mental health, and radical psychiatry movements, all of which sought not only to identify the causes of mental illness, but also to take steps to alleviate them. Moreover, such preventive approaches were attractive to American politicians, not least President Kennedy, who pledged in 1963 "to seek out the causes of mental illness and mental retardation and eradicate them. Here, more than any other area, 'an ounce of prevention is worth more than a pound of cure.'" Such sentiments, however, were not to last. By the end of the twentieth century, and despite escalating rates of mental illness, preventive psychiatry was largely a spent force.
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