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172
SECTION VI
MENTAL HEALTH SERVICES
Introduction
If it were necessary, the aims of the mental health services
could perhaps be epitomised as 'the helping of each individual with
a mental disability, in a confident and suitable manner, to make as
good an adjustment to life as his own particular potentialities and
circumstances will allow'.
Undoubtedly the degree to which these aims are achieved
depends upon the accuracy of the assessment or measurement of
'potentiality' and 'circumstances' and herein lies one of the more
important difficulties. Circumstances, in this context, is a broad term
to be construed as society in general, the control of which is impossible
even if it were desirable and it is only the immediate environment
which can be subject to a modicum of amelioration.
To say that there is a 'genetic' or a 'social environment' connection
with mental illness is to state the obvious but, at the present
time, it is unlikely, if not impossible, for a definition of mental health
to be given which would be universally acceptable. Nevertheless, in a
negative way, it can be said that mental health is absence of disease
and also that it is possible to assess mental ill-health in terms of
behaviour and the social problems it engenders.
In the preventive field, there is very little epidemiological data
available and, indeed, our scanty knowledge of mental health is
mainly empirical. Naturally, therefore, our services are concerned
with care and after-care of persons suffering from various mental
disorders and that this is rehabilitation rather than prevention.
So far, there is little indication that the incidence of serious
mental illness is reduced by preventive measures. It is true that
circumstantial evidence points to the fact that hormonal changes in
adolescence, pregnancy and in old age may predispose an individual
to emotional instability but there is a desperate need for a reliable
method of measuring mental health in order that real progress
towards prevention can become a practicable proposition.
To date, attention has been mainly confined to the measurement
of 'performance' which is the psychologist's general approach. It is
more probable, however, that prevention, if at all feasible, will be
better served and many of the anomalies of human behaviour
explained by the modern studies now taking place in neuro-physiology.
It has been suggested that mental illness is a combination of
three disorders, namely, inadequate personality, unresolved depression
and unrelieved anxiety. With the use of modern drugs, the
latter two disabilities can be controlled but inadequate personality,