Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
The first attempt ever made to provide special care for mental diseases
in the field was during the Russo-Japanese war. A hospital set aside
for this purpose by the Russian army at Harbin treated between fifteen
hundred and two thousand men in 1905 and 1906. It has, however, never
been claimed that all of the mental cases reached that place. Of 1,310
admissions the following conditions were represented[87]:—epileptic
psychoses, 22.5 per cent; alcoholic forms, 19.5 per cent; dementia
praecox, ten per cent; confused states, nine per cent; hysterical
psychoses, 7.7 per cent; general paresis, 5.6 per cent; toxic
conditions, 4.8 per cent; manic-depressive psychoses, four per cent;
degenerative types, 3.5 per cent; traumatic psychoses, 3.2 per cent;
and organic brain diseases, 2.9 per cent. It is interesting to note
that Steida, who analyzed the statistics of the Russo-Japanese war in
1906, reached the conclusion that a psychic trauma alone was not a
sufficient cause for the development of a neurosis. He attached an
equal importance to prolonged physical exertion, deprivation, loss of
sleep, hunger and thirst, etc. The most common disturbances following
battles were found to be hysterical excitements and confused states.
As soon as the examination of men for military service was undertaken
in this country in 1917 it became apparent that one of the most
frequent causes of rejection was either mental disease or deficiency.
The second report of the Provost Marshal General to the Secretary of
War in 1919[88] showed that of all rejections during the first year of
mobilization, twenty-two per cent were due to physical defects which
would interfere with duty (defects in bones, and joints, flat foot,
hernia, etc.), fifteen per cent were on account of imperfections of the
sense organs, thirteen per cent were for defects in the cardiovascular
system and about twelve per cent were due to nervous or mental
diseases. The inspection at camps following the physical examination
of the first million men mobilized resulted in a rejection of nine
per cent on account of nervous or mental diseases. Of all causes
for rejections from the army up to February 1, 1919, according to
Bailey,[89] mental and nervous diseases ranked fourth numerically. The
"neuropsychiatric" causes were:—psychoses, eleven per cent; neuroses,
fifteen per cent; epilepsy, nine per cent; organic nervous diseases or
injuries, eighteen per cent; mental defects, thirty-two per cent, and
constitutional psychopathic states, nine per cent; a total of 67,417
cases.
Public-domain text, read in full here on John Shaqi.
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