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Unfortunately for medical purposes, value judgements are made
upon definitions which then begin to mean different things to
different people and religious, political and social influences are
to be observed in the use of such terms as "optimal development".
Under the broad heading of mental illness, changing patterns
of disorders, both mental and emotional brought about by
modern conditions, introduce forms not usually associated with
mental disability such as alcoholism, prostitution, crime and
drug addiction, etc., which demand from local health authorities
more varied and extensive support services. This immediately
confronts us with a further dilemma—does mental health care
begin preventively with the basic health services or is its introduction
to be made only when deviation from the "norm" is
established by consensus?
What is inescapable is that a nation's future is bound up with
its past and the link—its children—is its most precious resource
and it is in our understanding of them that success lies. Their
health and development are of paramount importance and society
must spare no effort to achieve these ends.
Children are individuals with varying constitutions and there
is no ideal or normal child behaviour pattern but, nothwithstanding,
there is a constant search for the average "norm" which
tends to be a damaging influence in diagnosis. Mental illness in
children presents in many ways such as fear, rebellion, deliberate
isolation from and lack of stable relations with others, learning
difficulties, inability to give or receive affection, sleeping and
eating problems, incontinence or constipation at an age when
these problems should have been mastered, tantrums and/or
crying episodes, etc. Patently, in itself, no single symptom is
abnormal and, clearly, the duration and severity of symptoms
must be thoroughly assessed before a diagnosis of mental illness
is made.
Research has shown how reactive the young are to environmental
stimulation and, without doubt, a home in which a child
can receive tender loving care is a sine qua non for all children
and adolescents. In the modern society this is becoming progressively
more elusive but, for the preventive services, this offers
a fertile field for innovation. Chemotherapists are being constantly
urged to explore techniques to improve care and treatment
for the autistic and schizophrenic child and the biochemists and
endocrinologists are similarly being pressurised to explain
behavioural problems and to suggest remedies. Recent studies at
Aberdeen University show that significant reductions in epilepsy
in children could be achieved by eliminating many of the adverse
perinatal conditions closely associated with perinatal mortality.