Personal Problems Associated with Mental Health and Mental Illness

The trend toward the management of an increas ing number of psychiatric patients in the community has led to concern over the evaluation of this policy, particularly with regard to the adjustment of such patients within the community. In the case of patients admitted to a mental hospital, successful treatment must be measured not only by their early discharge from hospital but also by their subsequent social adjustment. Several studies have shown that a successful out come for psychiatric patients in the community has depended on such factors as having a job (Stringham, 1952; Cohen, 1955-56; Brown, Carstairs, and Top ping, 1958; Simmons, Davis, and Spencer, 1956), and further research will undoubtedly identify other factors with which it is associated; but whatever facet of functioning is investigated, the problem remains of defining a satisfactory level of attainment. The most realistic standards for purposes of com parison would seem to be those achieved by mentally healthy individuals living in the community. Unfortunately, this random selection of a control group does not necessarily ensure that its members are in fact mentally healthy. It was shown by Pollin and Perlin (1958) that, in a group of 29 volunteer research subjects, significant psychopathology was demonstrated in fifteen cases, in eleven of which psychiatric diagnoses were made. In a comparison between control, neurotic, and psychotic groups by Winokur, Guze, and Pfeiffer (1959), the controls were selected from medical and surgical clinics. However, it has been shown by Culpan, Davies, and Oppenheim (1960) that the incidence of emotional disturbance among patients attending medical and surgical clinics can be considerable. If the compari son is to be a valid one, it is important that the control group should not contain the experimental factors present in the other groups. Purpose and Method of Study