and the
Psychiatry
Community?II
An Experiment in Mental Health Education
By Senior
Psychiatry
CYRIL GREENLAND
Worker,
Social
Psychiatric
Crichton
Royal, Dumfries
and the Social Services
In October
1951,
we were
again approached by
the
University
Glasgow Extra-mural Education Committee to organise another course of Mental Health lectures. Although it was felt that this would not be very successful, we were persuaded to organise one on a less ambitious scale with a syllabus designed to meet the needs of a small body of advanced students. As in the previous Course the writer acted as organiser and group leader and in this capacity attended all of the sessions.
of
The lectures,
given weekly,
were
as
follows:
An Outline of the "Psychiatry and the Social Services. Course and its Aim". By Dr. W. McAdam, M.B., M.R.C.P.I., D.P.M. (Consultant Psychiatrist, Crichton Royal). "Psychiatry and Social Medicine". M.B., Ch.B., B.A.O., D.P.M.
By Dr. W. T. McClatchey, (Senior Registrar, Crichton
Royal). "Measuring Individual Differences". By Joseph Kelly, M.A., Hons. E. Ed. B. (Clinical Psychologist, Crichton Royal). "Measuring Group Differences".
'Social Techniques
As above.
Psychiatry".
in
A Discussion of various
Therapy". By Cyril Greenland Psychiatric Social Worker, Crichton Royal). "Psychiatry and Mental Deficiency". (Introduction). forms
of
Social
(Senior By
Dr.
Subnormality".
By
Dr.
Intellectual Subnormality".
By
Mr.
W. McAdam.
"The Psychology W. T. "The
Intellectual
of
McClatchey.
Psychology of
Joseph Kelly. "The Training As above.
Intellectually Subnormal Individual".
of the
"Community Care".
By
"The Child Deprived
Mr.
Cyril
Greenland.
Normal Home Life".
(Introduc By Dr. Philip Pinkerton, M.B., Ch.B., D.P.M. tion). Child in Charge, Dept. of Psychiatry, Crichton {Physician Royal). "Personality Studies of Children in Institutions". By Mr. Joseph Kelly. "Psychiatric Aspects of Institutionalisation". By Dr. W. T. McClatchey. 14
of
a
'The Problem Family". "Geriatrics".
(Introduction).
By
"Mental Illness in Old Age".
"Psychological Changes "Social Problems
of
in
the
Cyril Greenland.
Mr.
By
Dr. W. McAdam.
By
Dr. W. T.
Old Age".
Aged".
By
By Mr.
McClatchey.
Mr.
Joseph Kelly.
Cyril
Greenland.
The series concluded with a report back by the students and with all the lecturers taking part.
general discussion
Most of the sixteen students who enrolled had previously attended Mental Health Lectures. Among them were two teachers, one assistant Children's Officer, a District Nurse and four mental nurses.
From 7.30-8.30 p.m.
period after tea-break until and free discussion.
the formal lecture 9.30 p.m.
was
was
occupied
given with
and the
questions
This series of lectures was not so successful as the first. Being the small attendances our initial enthusiasm soon waned. The small group of regular attenders were quickly able to predict the pattern of each others contribution to discussion and so were easily bored. Group hostility resulting from this expressed itself in thinly veiled criticism of the lecturers. Although great care had been taken to avoid this, students complained of being overwhelmed by the mass of information thrust upon them. Lecturers too were frustrated and complained about the lack of discussion. These tensions if not absent were at least not obvious in the first, series of lectures.
disappointed by
from the difficulty of finding a suitable technique for with a small number of students with different interests and different levels of emotional and intellectual development, the problem of intensity of the Course requires careful consideration. From our experience it soon became clear that five lectures on a smgle topic was beyond the interest and comprehension of the
Apart
dealing
group. These problems were fully discussed by the group whose Unanimous opinion was that their real interest was in actual cases father than theories. As one member put it, "I am more interested knowing what actually happened to people rather than what could happen". This popular interest in case material presents both a lead and a challenge to the prospective mental health educator. 15
It is probable that in any community there is only a limited number of people sufficiently interested in mental health problems to attend a regular series of lectures. Among these, about half would be teachers, nurses and social workers of one kind or another, attending for "professional reasons". A large proportion of the remaining half would attend for personal reasons, many because they have unresolved problems. A few would have already attended psychiatric out-patient clinics, or child guidance clinics. Others would be on the verge of doing so. It is possible that for them attendance at mental health lectures represents engaging in non-specific and undirected therapy, a type of self-prescribed supportive treatment. This may explain why some of our students having attended mental health lectures for the past four years will when given the opportunity continue to attend. In view of this, should plans for future lectures include non-specific therapy as one of its aims? If so, how far should this aim be disguised? In their
chapter on "Health Education of the Public", The Committee on Mental Health implicitly accept therapy as necessary part of mental hygiene education.
Expert a
"It appears now to be agreed by specialists in this field that health education in general is most effective with individuals and with small groups, and when the educator not only has an intimate knowledge of the community in which he is working, but is known and
warmly respected by
it.
Conversely,
education undertaken
by
persons who are unknown or unacceptable to the community may not only be ineffective but may even be dangerous in that resistance may be engendered which may defeat the educational process.
These principles are presumably true in mental hygiene education of the public as they are in other public educational activities.
"Education, in short, has its best individuals and groups are stimulated to studying and solving their own problems. likely to change their behaviour when they the
change.
chance of success if an active part in
take
People have
are
much more
part in planning If this is so, the best mental hygiene education will a
result from the practice of mental hygiene principles, by publichealth workers in their day-to-day work. The successful solution of individual problems will be the most potent educational force. Small group discussions of persons facing the same type of problem, conducted by a health worker experienced in handling group
study, planning,
educational technique
Our 16
experience
as
and
action, any".
are
probably
would lend strong support
as
to
effective
an
this view.
Summary Two separate experiments in mental health education are Both were organised by the Crichton Royal in described. conjunction with the Glasgow University Extra-mural Education Committee.
1951, under the general title of and the Community" twenty lectures were given to "Psychiatry the public by various speakers, most of them experts in their subject. At each session the lecture was followed by controlled group discussion. All meetings were well attended, particularly so when films were shown and when publicity was adequate. Although no other tangible results could be demonstrated the organisers were gratified by the high level of student participation. From October 1950 to March
to March 1952, at the request of the Extra-mural Education Committee, we agreed to organise a further series of lectures under the general title of "Psychiatry and the Social Services". The aim this time was to provide a programme of mental hygiene lectures suitable for a small group of advanced students. An attempt was made to focus attention on local problems. Five lectures were devoted to each of the four main topics. Again, the first half of the session was taken up by the formal lecture which was followed, this time, by free discussion.
From October 1951
Glasgow University
Although this experiment was in many ways less satisfactory than the first, the problems raised by prolonged and intimate contact with the smaller group are infinitely more interesting to the organiser of mental health education.
Acknowledgment My
thanks
Superintendent,
this work would
are
due, first
Crichton
Dr. P. K. McCowan, Physician Without his interest and support,
to
Royal.
not have
been
possible.
acknowledge my indebtedness to all those who so took part, often at the cost of much personal inconvenience. In particular, thanks are due to the group leaders, the lecturers, officials elected by the students and Mr. de Bear Nicol, Extra-mural Organiser in Dumfries, for their loyal co-operation. I also
willingly
Finally,
I record my
gratitude
to Dr. W.
Mayer-Gross,
Director
Research, Crichton Royal, for his advice and friendly encouragement at all stages, especially for his helpful criticism of of Clinical
this paper.
17
Psychiatry
Community?II
An Experiment in Mental Health Education
By Senior
Psychiatry
CYRIL GREENLAND
Worker,
Social
Psychiatric
Crichton
Royal, Dumfries
and the Social Services
In October
1951,
we were
again approached by
the
University
Glasgow Extra-mural Education Committee to organise another course of Mental Health lectures. Although it was felt that this would not be very successful, we were persuaded to organise one on a less ambitious scale with a syllabus designed to meet the needs of a small body of advanced students. As in the previous Course the writer acted as organiser and group leader and in this capacity attended all of the sessions.
of
The lectures,
given weekly,
were
as
follows:
An Outline of the "Psychiatry and the Social Services. Course and its Aim". By Dr. W. McAdam, M.B., M.R.C.P.I., D.P.M. (Consultant Psychiatrist, Crichton Royal). "Psychiatry and Social Medicine". M.B., Ch.B., B.A.O., D.P.M.
By Dr. W. T. McClatchey, (Senior Registrar, Crichton
Royal). "Measuring Individual Differences". By Joseph Kelly, M.A., Hons. E. Ed. B. (Clinical Psychologist, Crichton Royal). "Measuring Group Differences".
'Social Techniques
As above.
Psychiatry".
in
A Discussion of various
Therapy". By Cyril Greenland Psychiatric Social Worker, Crichton Royal). "Psychiatry and Mental Deficiency". (Introduction). forms
of
Social
(Senior By
Dr.
Subnormality".
By
Dr.
Intellectual Subnormality".
By
Mr.
W. McAdam.
"The Psychology W. T. "The
Intellectual
of
McClatchey.
Psychology of
Joseph Kelly. "The Training As above.
Intellectually Subnormal Individual".
of the
"Community Care".
By
"The Child Deprived
Mr.
Cyril
Greenland.
Normal Home Life".
(Introduc By Dr. Philip Pinkerton, M.B., Ch.B., D.P.M. tion). Child in Charge, Dept. of Psychiatry, Crichton {Physician Royal). "Personality Studies of Children in Institutions". By Mr. Joseph Kelly. "Psychiatric Aspects of Institutionalisation". By Dr. W. T. McClatchey. 14
of
a
'The Problem Family". "Geriatrics".
(Introduction).
By
"Mental Illness in Old Age".
"Psychological Changes "Social Problems
of
in
the
Cyril Greenland.
Mr.
By
Dr. W. McAdam.
By
Dr. W. T.
Old Age".
Aged".
By
By Mr.
McClatchey.
Mr.
Joseph Kelly.
Cyril
Greenland.
The series concluded with a report back by the students and with all the lecturers taking part.
general discussion
Most of the sixteen students who enrolled had previously attended Mental Health Lectures. Among them were two teachers, one assistant Children's Officer, a District Nurse and four mental nurses.
From 7.30-8.30 p.m.
period after tea-break until and free discussion.
the formal lecture 9.30 p.m.
was
was
occupied
given with
and the
questions
This series of lectures was not so successful as the first. Being the small attendances our initial enthusiasm soon waned. The small group of regular attenders were quickly able to predict the pattern of each others contribution to discussion and so were easily bored. Group hostility resulting from this expressed itself in thinly veiled criticism of the lecturers. Although great care had been taken to avoid this, students complained of being overwhelmed by the mass of information thrust upon them. Lecturers too were frustrated and complained about the lack of discussion. These tensions if not absent were at least not obvious in the first, series of lectures.
disappointed by
from the difficulty of finding a suitable technique for with a small number of students with different interests and different levels of emotional and intellectual development, the problem of intensity of the Course requires careful consideration. From our experience it soon became clear that five lectures on a smgle topic was beyond the interest and comprehension of the
Apart
dealing
group. These problems were fully discussed by the group whose Unanimous opinion was that their real interest was in actual cases father than theories. As one member put it, "I am more interested knowing what actually happened to people rather than what could happen". This popular interest in case material presents both a lead and a challenge to the prospective mental health educator. 15
It is probable that in any community there is only a limited number of people sufficiently interested in mental health problems to attend a regular series of lectures. Among these, about half would be teachers, nurses and social workers of one kind or another, attending for "professional reasons". A large proportion of the remaining half would attend for personal reasons, many because they have unresolved problems. A few would have already attended psychiatric out-patient clinics, or child guidance clinics. Others would be on the verge of doing so. It is possible that for them attendance at mental health lectures represents engaging in non-specific and undirected therapy, a type of self-prescribed supportive treatment. This may explain why some of our students having attended mental health lectures for the past four years will when given the opportunity continue to attend. In view of this, should plans for future lectures include non-specific therapy as one of its aims? If so, how far should this aim be disguised? In their
chapter on "Health Education of the Public", The Committee on Mental Health implicitly accept therapy as necessary part of mental hygiene education.
Expert a
"It appears now to be agreed by specialists in this field that health education in general is most effective with individuals and with small groups, and when the educator not only has an intimate knowledge of the community in which he is working, but is known and
warmly respected by
it.
Conversely,
education undertaken
by
persons who are unknown or unacceptable to the community may not only be ineffective but may even be dangerous in that resistance may be engendered which may defeat the educational process.
These principles are presumably true in mental hygiene education of the public as they are in other public educational activities.
"Education, in short, has its best individuals and groups are stimulated to studying and solving their own problems. likely to change their behaviour when they the
change.
chance of success if an active part in
take
People have
are
much more
part in planning If this is so, the best mental hygiene education will a
result from the practice of mental hygiene principles, by publichealth workers in their day-to-day work. The successful solution of individual problems will be the most potent educational force. Small group discussions of persons facing the same type of problem, conducted by a health worker experienced in handling group
study, planning,
educational technique
Our 16
experience
as
and
action, any".
are
probably
would lend strong support
as
to
effective
an
this view.
Summary Two separate experiments in mental health education are Both were organised by the Crichton Royal in described. conjunction with the Glasgow University Extra-mural Education Committee.
1951, under the general title of and the Community" twenty lectures were given to "Psychiatry the public by various speakers, most of them experts in their subject. At each session the lecture was followed by controlled group discussion. All meetings were well attended, particularly so when films were shown and when publicity was adequate. Although no other tangible results could be demonstrated the organisers were gratified by the high level of student participation. From October 1950 to March
to March 1952, at the request of the Extra-mural Education Committee, we agreed to organise a further series of lectures under the general title of "Psychiatry and the Social Services". The aim this time was to provide a programme of mental hygiene lectures suitable for a small group of advanced students. An attempt was made to focus attention on local problems. Five lectures were devoted to each of the four main topics. Again, the first half of the session was taken up by the formal lecture which was followed, this time, by free discussion.
From October 1951
Glasgow University
Although this experiment was in many ways less satisfactory than the first, the problems raised by prolonged and intimate contact with the smaller group are infinitely more interesting to the organiser of mental health education.
Acknowledgment My
thanks
Superintendent,
this work would
are
due, first
Crichton
Dr. P. K. McCowan, Physician Without his interest and support,
to
Royal.
not have
been
possible.
acknowledge my indebtedness to all those who so took part, often at the cost of much personal inconvenience. In particular, thanks are due to the group leaders, the lecturers, officials elected by the students and Mr. de Bear Nicol, Extra-mural Organiser in Dumfries, for their loyal co-operation. I also
willingly
Finally,
I record my
gratitude
to Dr. W.
Mayer-Gross,
Director
Research, Crichton Royal, for his advice and friendly encouragement at all stages, especially for his helpful criticism of of Clinical
this paper.
17
