The Health bulletin [serial] - University of North Carolina at Chapel Hill

prevalent
;
Ajril 1927 The Health Bulletin 13
value of health, in these words : "First,
because health largely determines the
factors of interest and endurance
second, interest and endurance largely
determines efhciency ; third, efficiency
during youth in studies and games, and
in maturity in the more serious tasks
of life largely determine happiness
fourth, happiness largely determines
disposition and attitude." This very
significant description of health is
particularly appropriate to our subject
today. I am glad to quote further from
the Health Education Report of the
Joint Committee on Health Problems in
Education of the National Educational
Association and the American Medical
Association. The quotation I gave you
from Dr. Rankin was taken from that
same report ; and he was one of the
valued advisory committee of twentyseven
technical experts that helped,
through generous contribution, to prepare
that report. I quote again : "The
ideal of health is not mere freedom
from obvious deformities and pathological
symptoms ; it is a realization of
the highest physical, mental, and
spiritual possibilities of the individual
being."
The task of the social worker is not
exclusively with social disorder, for the
failure of mental adjustment is rarely
the only problem in cases of mental
disease. Dr. Margaret Wooster Curti
said in the Scientific Montlily some
months ago that "Lombroso's theory of
a criminal class distinguished by definite
physical stigmata is no longer held
by scientists. It has supplanted by an
equally simple and not dissimilar theory
that a large percentage of deficiency
is due to inborn mental weakness,
measurable by psychological tests. The
social workers are sincere, the judges
fairminded, the average educated person
intelligent : but all are misinformed.
Psychologists have been overhasty and
prone to apply prematurely the findings
of a .science yet in its infancy. However,
we have scientific proof that the earlier
and still . estimates were
greatly exaggerated and there are clear
indications that the whole percentage
of feeblemindedness in the criminal
group may be only slightly greater,
possibly no greater, than in the population
as a whole." Dr. Burt says
that mental defect cannot be regarded
as the primary cause either of delinquency
or crime ; "That its effect is
negative rather than positive and that
the deficiency itself merely removes
some of the usual checks which, based
on prudence and rational insight, keep
a more normal mind from giving way
to antisocial promptings." In addition
to the mental test, he applies also a
technic by which he gets the child's
own story and the results of the child's
introspections.
Stealing may be caused by a variety
of original desires. Next to theft,
truancy is the commonest of offenses.
The herd instinct comes in for its share
in juvenile crime, particularly in boys.
Much juvenile misconduct appears as
a forcible mode of self-expression,
cruelty often being directly due to the
self-assertive instinct. The psychiatrists
tell us that in many of these cases of
youthful over-assertiveness the individuals
are using the protective and
defense mechanisms often to justify
themselves or to try to justify themselves
to their fellows, as a mask for
a fundamental and disturbing sense of
inferiority. In well over one-third of
the cases but in rather less than onehalf
Burt finds some deep constitutional
failing to be the primary cause or
source of misconduct ; nevertheless, in
the total group he finds the part played
by heredity a less important cause. The
three most imix)rtant causes were found
to be defective discipline, specific instincts,
and general emotional instability.
Next come mental dullness, not
enough to be called defect, and the
next the family life and friendships
formed outside the home.
Juvenile defendants possessing both
physical and mental complaints are of
course often referred to the mental
clinics. Although it is often necessary
for the psychiatric social worker to
handle the case as a worker, she must
have the cooperation of the hospital
social service worker. The person responsible
for the treatment of delinquents
should never be content to
deal with such a case except with full
knowledge of the facts relating to the
physical, mental, and environmental
status of the case.