Cook County and the mentally handicapped : a study of the provisions for dealing with mental problems in Cook County, Illinois : report of survey 1916-1917

Contents

Page

Introduction v

Preface ix

Introduction

The more progressive American cities no longer attempt to deal with their great problems of dependency and delinquency by measures applicable only to groups of persons. It has come to be generally understood that those persons who for one reason or another become a charge upon the community must be dealt with as individuals and, as individuals, either helped to self-support and right living or segregated from the community in institutions where they may receive appropriate care and education, and live out their lives under supervision. We recognize now that the success of efforts for the economic or social reconstruction of an individual depends chiefly upon that individual's personal resources, and that among these resources none compares in its importance with his mentality. With a normal mind, severe physical and economic handicaps may be overcome ; with a mind that is defective from birth or that has been damaged by disease, the best-planned efforts at reconstruction are doomed to failure. Already there is abundant evidence that feeblemindedness, mental disease, and other maladjustments underlie an enormous proportion of the cases of dependency, criminality, and inebriety that heavily tax a community's resources.

Although the controlling importance of mental factors in such problems has come to be widely recognized, the method by which a community can best deal with these factors is the subject of difference of opinion. Experiments are frequently tried in one place which have failed in other places and which it is to be expected will fail wherever tried, because they are not based upon scientific conceptions of the nature of mental disease or mental defect. As there is no mechanism

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in city governments fitted to deal with all phases of these problems, there exists great uncertainty as to what should be done.

Fortunately, these are not wholly matters for experiment. Modern studies in psychiatry have provided us with extremely useful means of diagnosis and classification, and enough work has already been done in different parts of the country to show which methods are advantageous and economical and which are disadvantageous and wasteful. Perhaps nowhere in the United States has a more successful attempt been made to bring the resources of the study of the mind to bear upon the solution of social problems than in Boston. Here, the Psychopathic Hospital stands ready to serve the community in whatever way it can. The parent with a deficient child, the magistrate with a problem in delinquency, the teacher with an unusual pupil, all can bring their troubles to the Psychopathic Hospital and secure the best advice that men trained in this work are able to give.

Until taking up the Cook County Survey, Dr. Adler had been chief of staff of the Boston Psychopathic Hospital since it opened its doors and had seen it gradually widen its usefulness to the city. This experience, his training, and. his broad outlook upon mental problems (especially the practical questions of dealing with delinquency, crime, and dependency) particularly fitted Dr. Adler for the study in Cook County.

The Mental Hygiene Survey of Cook County (Chicago) Illinois was one of a series of surveys made by The National Committee for Mental Hygiene at the request of governors, state boards of control, state boards of charity and social or civic organizations. Surveys have been made or are being made in Nassau County, New York, New York City, Tennessee, Wisconsin, South Carolina, Louisiana, California, Connecticut, Georgia, Texas, Maine, Kentucky, Mississippi, and Indiana. The expense of these surveys is met by a

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special appropriation to The National Committee for Mental Hygiene by the Rockefeller Foundation.

With the exception of the Nassau County, New York, Survey, the Cook County Survey, made at the request of the Committee on Local and State Charities of the Chicago City Club and the Illinois Society for Mental Hygiene, represents a much more intensive study than any of the state surveys. Every phase of the county's activities which had to do with the management of mental disorders has been carefully examined. The specific subjects studied include the work of the psychiatric clinics attached to two of the courts, the work of the Cook County Psychopathic Hospital, the work of all the institutions, clinics or laboratories in the county, both public and private, having to do with problems of delinquency, mental disorder or mental defect, the actual administration of the commitment laws and the facilities for social service for mental cases. Especial attention has been devoted to methods of dealing with mental problems in children. The period of the survey was from September, 1916, to July, 1917.

Many of the recommendations made by Dr. Adler in his preliminary report have already been adopted through conference with public officials or officers of private agencies. It is hoped that in this published report the citizens of Cook County will find material and suggestions that will help in the further endeavor of the community to provide adequate assistance for those who have failed in adjustment to community life because of mental or nervous disease or defect.

The National Committee for Mental Hygiene.