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social and moral changes in the community. Our not insignificant
successes in recent times in eliminating threats to life from a
number of infectious and deficiency diseases were founded upon
the identification of causal organisms or deficient substances and
introducing effective preventive measures. Some authoritative circles
postulate that the same approach to mental illness would
bring a similar success story but, as usual, there are complications.
It is certain that since recorded history the human species has
had to wrestle with the problem of mental illness. Indeed, until
comparatively modern times, it was the recognised responsibility
of religious and spiritual healers to treat such disability and, in
cases of failure, to attribute same to the patient's blameworthy
existence. However, we must not dismiss their efforts too lightly
for a great deal is owed to these traditional healers who were
often thoroughly familiar with herbs (and therefore drugs) and
many manipulative procedures with which modern treatment
and care for the mentally sick has much in common.
Medically speaking, we have moved on from those days but our
preventive actions are somewhat impaired by the use of an inexact
terminology, the significance of which ought to be identical to all
engaged in the mental health field. What, for instance, do we
mean by "mental health"? Is it just freedom from mental illness
or is something more implied? One fact stands clear—all societies
are aware of members who are "different", who are mentally
disordered and who are unable to play their part in the community.
It is at this point that our difficulties begin. How do
we successfully "prevent", "treat" or "cure" a disability where
the aetiology is so indeterminate and the medical phraseology
insufficiently circumscribed? Even the numbers involved are no
more than an estimate which varies from one to two per cent
of the population, a figure which could easily be doubled if
account is to be had of similar illnesses of a milder form.
Whilst genes determine and limit an individual's potential, it
is the interaction of this "genotype" with the environment that
settles which of the genetically possible features will become fully
developed and which, relatively speaking, will be neglected. In
the adult, the sum total of such reciprocity produces the "phenotype",
a fact which in 1947 prompted a W.H.O. Commission to
frame a definition of mental health, viz. "Mental health is a
condition which permits the optimal development, physical, intellectual
and emotional, of the individual, so far as this is compatible
with that of other individuals" and qualified this with a
further definition, namely, "A good society is one that allows this
development to its members while at the same time ensuring its
own development and being tolerant towards other societies".