Few problems that the public health nurse must meet in her routine work present so many difficulties or are of such far-reaching importance as those of mental hygiene. Whether the home nursing visit be in the interest of bedside care, communicable disease control, maternal or child hygiene, or any of the many other groupings into which such visits may be classified, one factor is common to all, namely, the mental attitude of the person with whom the nurse is dealing. The effectiveness of the visit depends not alone on the nurse’s professional skill and knowledge but equally on her ability...

The field of community nursing is undergoing a gradual but tremendous transformation. In the early days of the public health movement emphasis was placed necessarily on the curbing of epidemics, the improvement of physical health, and the provision of care for the chronic invalid. The advances made in bacteriology and the discovery of specifics in prevention and treatment have controlled many scourges. Improved sanitation, more careful supervision of milk and food supplies, and better understanding of the dietary needs of all ages have removed many of the conditions that formerly constituted the major problems of health workers.

Prevention has always...

At a recent meeting called to consider the formation of a new committee for mental hygiene, eighteen individuals representing different branches of community service were invited to express their ideas as to what the goal of such a program should be. Psychiatrists, psychologists, teachers, social workers, probation officers, parents, ministers, public health nurses, physicians, and pediatricians were all there to express their opinions. It was apparent early in the meeting that although each person had different ideas, all their plans had merit as part of a campaign directed toward better mental health in the community.

To each one the problems...

Before one can understand and deal with children presenting behavior problems it is essential to have a sound knowledge of the normal developmental process—a base line of standards with which deviations can be compared. Normality is not a constant, static condition but the accepted standard in a particular situation. What is considered normal is influenced by many factors—socioeconomic, racial, and cultural patterns, intellectual endowment, and geographical environment. Behavior that is normal in one setting may be abnormal in another.

Throughout the entire field of mental hygiene this variability must be kept constantly in mind. When we talk of...

On the day he enters school the child begins his gradual emancipation from the home. Until now he has lived in a highly protective environment, where he is a person of great importance. At school, for the first time, he is exposed to new ideas, new personalities, and especially the new experience of being merely one of a group. Our educational system assumes that all children when they reach the age of six are equally ready to take this initial step toward independence. From then on they are expected to progress up through the grades at a set pace determined...

No case in the whole realm of medical work is more tragic than that of the child who through no fault of his own is stricken with a physical handicap. Even the most experienced nurse or physician feels a rush of natural sympathy when a bright, eager, active boy is suddenly crippled by poliomyelitis or a little girl is afflicted with deafness or some other permanent defect. For this reason it is often difficult to use one’s best judgment in treating the child. In hospitals, of course, the emphasis is placed on his physical needs, even though the emergency measures...

It is a popularly accepted belief that the problems of adolescence are sudden outcroppings of the biological changes that are occurring within the body. There are, however, other equally important causal factors in adolescent conflicts. As the child attains maturity he enters a new world in which more is expected of him and from which he demands more. The biochemical transition taking place within him and the natural alteration of his psychological outlook make it necessary for him to make many new adjustments. If he has been taught independence throughout childhood by wise parents he can take this transition in...

Marriage is the keystone of social organization. Without the institution of marriage a social order as large and complicated as civilization entails would descend into chaos. Ever since prehistoric times monogamy has been an almost universal custom, a custom necessary for tribe survival. In the early days of the revolution, Soviet Russia attempted to dissolve the institutions of marriage and family life in order to set up a system of completely communal living, but the habits and customs of innumerable generations could not be abolished by any governmental decree. The attempt was a failure because the new philosophy could not...

The life of the chronic invalid often becomes a burden to himself and those about him. The daily routine grows monotonous and dreary, and without diversion every day is like the day before. Those who are in charge of nursing him soon fall into a routine that involves the least possible effort. Even if the invalid is not confined to bed but is confined within the house, the opportunities of community life are still beyond his reach.

Today there are many ways in which the lives of these chronic invalids can be made interesting, but people often lack the imagination...

Many psychiatric syndromes can be explained only on a theoretical basis. A few, such as general paresis and the toxic confusional states, demonstrate definite organic change but most of them have obscure, if any, organic bases. The psychoneuroses belong to this majority. Recent studies of the influence of hormones, the endocrines, and metabolic changes on people’s psychic moods indicate that there may be certain physiological correlates to neurosis, but whether these bodily changes are the cause or the result of emotional tension remains to be established. The two opposing schools of thought—the psychoanalytic school and the more conservative neurological...

In recent years there has been a tremendous change in the attitude of society toward mental disease. People have begun to realize that the mentally ill do not differ greatly from the rest of us. The attitude toward state mental hospitals is also undergoing modification. Recent studies of the admission and length of stay of patients in mental hospitals reveal that patients are now being admitted at a much earlier stage of illness than formerly and that the length of stay is shorter and the recovery rate higher. Modern methods indicate that the earlier treatment begins, the better is the...

Although the care of the feebleminded was one of the earliest projects of the mental hygiene program the results have been disappointing. Facilities are at hand for the recognition and diagnosis of subnormal intelligence, special classes have been established to provide for the educational needs of the subnormal child, and the state has erected special institutions for their care. All these efforts are great advances in themselves, but there is a lack of continuity among them that destroys much of the value of the work that is done.

Control of the feebleminded is an orphan child in the organization of...

In order to promote mental hygiene within the community the nurse herself must be emotionally and socially well adjusted. So far, few nursing schools have attempted to capitalize on the individual potentialities of their student nurses or to develop in them well-integrated personalities. Consequently many schools produce graduates of a high standard of technical proficiency in whom most warmth of personality has been suppressed during the professional education. Underneath the starched exterior there is a human being but as long as the nurse is in uniform this side of her personality is often hard to find.

This fault lies with...