Aspects of mental health; Mental health and manpower

The poing program is produced by the University of Michigan broadcasting service under a grant he made from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters mental health and manpower ne. It's a program from the series human behavior social and medical research produced by the University of Michigan broadcasting service with special assistance from the Mental Health Research Institute of the University of Michigan. These programs have been developed from interviews with men and women who have the too often unglamorous job of basic research. Research in medicine the physical sciences the social sciences and the behavioral sciences. OK generally you will hear what may seem like strange or unfamiliar SOG these are the sounds of the participants office his laboratory or clinic where the interviews were first recorded. The people you will hear today are George W. Al B who is chairman of the Psychology Department at Western Reserve University and members of the staff of the Mental

Health Research Institute of the University of Michigan. They are Dr. James J Miller Dr. Anatol Rapaport Doctor Ralph Girard and Dr. Merrill flood and my name is Glenn Phillips. We begin by hearing an excerpt from a roundtable discussion with members of the University of Michigan Mental Health Research Institute. But asking questions about the needs of Mental Health Research Invariably the answer will be like the man who generally concur with his belief. That. They are. In the clinic. Researcher there is a much stronger group of researchers in the field of psychology than there is in psychiatry and almost none as yet either its social work or psychiatric nursing. I think psychology as a basic science obviously got going

much earlier than psychiatry or the other fields. And that this is one explanation. However there are encouraging signs in psychiatry. It would have been hard to find a dozen full time research psychiatrists in this country 10 years ago and now certainly there are well over a hundred perhaps up in the neighborhood of 200. This is largely due to vastly increase funds for psychiatric care surge from. The federal government and to a lesser extent from foundations and state governments. It's also due to the fact that there has been a change in the prestige of which accrues to research in the field of psychiatry which was for a play a clinical feel so that now it is quite respectable for a psychiatrist to devote his whole life to research. I tried I thought. Russian might have. Yes well I fully agree with this statement. Perhaps one would have to fragment the question a little bit which was in Clyde and Dr. Miller's

response into the service aspects in the research aspects. And there is a shortage of both. I suspect that the shortage relative to the need is even greater when it comes to straight research in this area than in the service aspects of it. And while it is true that psychiatrists and psychologists and some of these ancillary personnel are needed and are beginning to turn their attention to it especially in psychiatry where relatively little research was done it is also true that one needs great numbers of workers in other scientific disciplines in the laboratory sciences Merope chemistry neurophysiology or all pharmacology is becoming extremely important now and indeed in the whole area that one would call the behavioral sciences. This is really an aspect of behavioral science and it is rapidly gaining attention

rapidly gaining support and only slowly gaining qualified practitioners. Dr flood if I ask you as a professor of engineering How do you find your interest in behavioral sciences or me. Will help. Well the essential point that I would make is that the research that's relevant for one field is very often equally relevant for another field. Basic research in particular and fields of engineering which have produced. Computers and electronics produce also devices that are directly useful in medical problems including mental health. So that I guess my. Main feeling is that. Basic research in most any area. Here is very apt to be fundamentally important in other areas and this would be true of engineering research as well as computers and mathematical research. Certainly this points up to them. There are many disciplines now involved in

mental health research as Dr. Gerard was saying a few years ago we would have included only the clinical disciplines that I mentioned in my first comments. But now we have mathematicians like Dr. Rappaport physical scientists engineers and others who are concerned with the similarity between the function of computers and the function of the human brain as well as many other questions and include also social and biological scientists of a number of different fields. I think you said Dr. Miller that there was an upswing in manpower coming into mental health research. This does not mean however that you are satisfied with the number of people now in it. That's true. I think that it is almost always it's not always the history of scientific administration when there is a public need which results in funds being poured into an area that more people go into the area and attempt to solve the problems. And there is an increased probability

that the fundamental problems in that area will be solved. Now this is what's happened in the field of mental health. Some people have argued that there are not enough outstanding brains available our minds available to work in this area and that adding further funds would be an unnecessary luxury or a waste of public tax support. Actually I think a sober analysis of what's happened in the last decade would show that this is not so when Congress who reflected the attitudes of the people and insisted on the increasing of financing in these areas. In certain years perhaps a little more money in the order of two or three to five million dollars was appropriated to them which could be used but in the next year it was effectively used and there had been relatively little waste. Therefore public opinion has rather rapidly had the effect of bringing personnel into this field and I think

there are many students at the graduate level and medical school and so on who will have been influenced by this increasing interest in this area and will undoubtedly in shitty years spend their life careers in this field. That was an excerpt from a roundtable discussion with members of the Mental Health Research Institute of the University of Michigan. The men we have heard were Dr. James J Miller Dr. Ralph Girard and Dr. Merrill flood and Dr. Anatol Rapaport one man who has done much work on the manpower shortages appearing in mental health is Dr. George Albi of Western Reserve University. Before hearing Dr. Al B's comments me I read from portions of his book entitled mental health manpower needs. He says increasingly there are signs that our society is ready to face the fact that a serious manpower crises exist in a large number of specialized field.

Everything is becoming so easy for us for so long that until recently we have failed to notice that our system of education upon which rests most of the achievement of our high standard of living has been steadily changing its functions in the direction that leads away from its original task of training the minds of our young in knowledge and its application and in techniques for the discovery of further knowledge which our society has grown so used to such a great variety of goods and services to such a high level of technical productivity and to the expectation of ready satisfaction of many of our health and welfare needs that we have taken all of these blessings for granted. The time has now come for us to discover that such achievements do not occur by themselves but are largely based on the effectively trained intelligence of our nation's brain power. The field of mental health faces a real manpower crisis. This

seems paradoxical in view of the fact that our nation has many more trained mental health personnel per capita than any other nation in the world. Professional mental health services are available in some form to most of our citizen shortages in many areas of living are largely a matter of aspiration to a hungry man. There is only one shortie to the society living on the verge of starvation. Mental health personnel are a luxury far down its list of priorities. But in the industrial societies that have developed in Europe and the new world in the last century services of many kinds have become important daily needs in a country with serious and widespread disease whether it be malaria tuberculosis or typhoid fever very few voices are raised to demand that more psychiatrists be trained. But as one by one the plagues of mankind have been controlled in the West the plague of mental disorder has been increasingly exposed to public view. Mental

Disorder is not an important cause of death. No one dies of schizophrenia schizo phrenic die of pneumonia or of tuberculosis or of malnutrition or of some other cause. Well mental disorder is not an important cause of death. It is in our society. The most important source of human incapacity and of manpower lost to the nation. Manpower in the mental health professions is insufficient to meet our society's current needs and demand. The prospect for the future. Well we shall see as we go along. It is for more shortages however and that was from Dr. Al beach book. Mental health manpower training. We asked Dr. Albi if he would describe something of his current research in this field for the past three years I've been working on the problem of manpower primarily manpower availability in the various mental health professions. But this concern is also a result of Incidentally in my examining manpower

trends throughout higher education because you can't study manpower in one field without looking at manpower resources and shortages in other fields since they're interdependent. I've just finished a book which was published summer 959. Called mental health manpower trends. That represents a summary of the manpower resources and needs in shortages throughout the whole field of. Mental health and higher education. That's represented volume three of a series of reports by the Joint Commission on Mental Illness and health. A national commission established by Congress. And. Concerned with a study of this whole problem. I also asked Doctor L.B. if he would describe for us what is really meant by a profession. He said neighbor him Flexner in 1910. After completing a study of the nation's medical schools. Wrote a report.

For Carnegie. That is still a classic. Answer to this question Flexner pointed out. That. A profession. Must. Be identified primarily as a group of people with a theory with an intellectual structure about a certain area or aspect. Of nature. This means that. Any group that aspires to be a profession. Organizes itself and moves into higher educational institutions that is nearly every profession or every aspiring profession. It was into a university and. Has a controlled curriculum. A series of courses or experiences which present the intellectual content of the theory with which the profession is concerned. Whatever profession you take as an example you find historically that they often started.

Through an apprenticeship system and then gradually moved into higher educational institution. This means that you control not only the theoretical content presented to the neophyte but the profession develops a sort of subculture. With a value system. With a code of ethics with a special language and with skills and techniques based on the theory or based on the knowledge that are not available to the general public. So that these are the various criteria I think for recognizing a profession. A group that simply emphasizes let's say a motor skill can't ever qualify as a profession there must be some kind of theoretical or intellectual. Content. From which new techniques are discovered. And with which the group can identify.

Accepting the fact that manpower is being wasted. I wondered why it would be through in adequate testing perhaps or a motivation of the individual doctor L.B. addressed himself to that question. Most of our sciences and professions recruit. From the pool. Of college graduates. And as. Most sciences and professions whether it's in behavioral science or other fields attract able students from the pool of college graduates for either graduate or professional training. In the recent past a number of studies have indicated that we're wasting tremendous amounts of intellectually competent young people. Who don't actually enter this pool. Just as one example. If we take the top 20 percent of young people in terms of intellectual ability. Only a third of this group actually graduates from college. This means that. Throughout our

nation two thirds of the brightest fifth of our young people don't enter the pool and which are from which they could be recruited into science into education into the professions into all of these areas with which you're concerned. I wondered if the techniques of some of these methods to which Dr. Al be referred were improved. If this might improve the manpower utilization he said according to the U.S. Department of Labor there is a direct linear relationship. Between the amount of training required. For. An occupation. And the shortage in the perspective shortage. That is the kinds of activities that require the most training. Are the ones in which the greatest shortages are developing. And projecting. Into the future of the Department of Labor estimates that the only group where there will be an oversupply in the next 10 or

15 years is the unskilled working group. That. Because of the increasing. Technical nature of our culture. And of our civilization the demands for highly trained and highly educated manpower continue to increase even more rapidly than the population. I asked Doctor L.B. if he had suggestions on how to improve the techniques to which we have just referred in the preceding question and answer. It's hard to make simple suggestions because part of our problem is the sort of pervasive. Attitude of the culture. That. For a long time has under emphasized education we've been able to solve our production problems we can produce far more than we can consume. And so increasingly there has been an emphasis on. Salesmanship. Distribution encouraging people to consume a vast amount of material that comes from industry and from our farms. This is

meant that. The traditional role of education to provide. People who could improve production. Has actually become increasingly less necessary. So this I think is one of the reasons for the pervasive lack of interest or lack of emphasis in education. There are so many jobs that don't require specific skills. But simply require social polish and. Skill in human relations. Rather than specific techniques. Now we find ourselves in a situation where those aspects of society that really. Are represented by social problems such things as mental illness poverty housing areas where. Private enterprise doesn't have any normal or integral

stake. Are there areas in which the greatest shortages are developing. Fields such as for example social work. I have tremendous need for trained people but no one has a particular economic stake in training these individuals. There are no simple solutions it seems to me to the problem of. Shortages of highly trained people because it's sort of a pervasive lack of interest in the educational process. That. Has. Grown up almost as a result of social forces that are very general and very diffuse. My final question to Dr. Albi was would early deficiencies in childhood training play an important part in the eventual selection of a profession or a position by an individual which might account for the present shortage of manpower in highly skilled or professional areas.

He commented thusly. Butler certainly are serious deficiencies in our educational system and as we've been increasingly told. By social critics in the last few years. The steps leading to. A choice of vocation or occupation are complicated but nearly all studies indicate that young people decide to go into a particular field as a result of the satisfying experience of being exposed to a new area by a gifted teacher. And one of the problems here is that. The quality of our educational system from elementary through secondary schools and in the colleges has declined. If I may add and might just give you a couple rough approximations of this problem. Three years ago the fund for the Advancement of education. Indicated that if we were simply to maintain. The ratio of teachers to pupils

in our elementary and secondary schools it is only to maintain the inadequate ratios that exist at present. We would have to attract half of all the college graduates into teaching and as have all the college graduates in the country into teaching each year for 10 successive years. Now it's no secret that we're not attracting anywhere near this number. We're probably not attracting even half this number. The inescapable conclusion is that either the. Number of pupils per teacher is going to increase even beyond its present unfortunate number. Or else we're going to have to employ underprepared or poorly prepared teachers to fill the positions in our schools and we see this happening almost universally now this. It implies. That the quality. Of Education and the abilities of the

teachers. Will have a negative influence on the attracting of students into whatever area. Another example. Last year according to the National Education Association report. We train more physical education teachers for high schools than the combined total in mathematics physics chemistry biology and foreign languages. The words are more physical teachers trained in the combined total in all of these other areas. That's almost. The only gist of the conclusion that. These subjects will be taught. And as. Sciences mathematics languages will be taught by people that are not qualified by training to teach them. Let's then sort of represents a vicious circle because if you have poorly prepared and disinterested and incompetent teachers in these areas you won't attract young people to these areas with the result that your shortages grow increasingly

large with each succeeding generation. Look at the colleges and universities for a moment. Again according to. Forward estimates we will need some 10 to 15 thousand new college professors each year over the next 15 years or training roughly eight or nine thousand Ph.D.s a year of this group at least half already have academic jobs so this means that. Roughly 4000 are available for college teaching. But of this group a very significant number are attracted away from teaching by better pay and better opportunities in history so that we're left with two or three thousand people to fill ten or fifteen thousand jobs. The inevitable consequence is that new faculty members employed and again there are documented studies of this are less well prepared than the people already teaching. Men and women will be hired to fill these

jobs but their preparation will be less adequate than has been the case in the past. So once again if you accept my argument that the way to attract young people into fields is by providing them with good models this. Vehicle isn't going to function isn't going to run. Properly. There are techniques of identifying. Talent. Intelligence being the most obvious example. And it's possible to identify very early in life the intellectually able student. It's possible also to identify talents skills interests aptitudes art techniques here are sufficiently refined so that it's possible to discover young people with interests and talents and aptitudes and intellectual ability. That would be sufficient for them to succeed in a particular field or a particular area. However the

availability of the guidance counselor's necessary for example in the schools to. Identify these talents and to direct young people into the areas for which they are best qualified is extremely short. It is the supply of the guidance counselor's is extremely short. The Office of Education and the federal government is aware of this and there are programs. Always under financed and always in sufficient numbers to train more guidance counselors. If you are fortunate suburban schools in. Well to do communities have an adequate complement of guidance people but for the country as a whole for your inner city schools for your small home schools in their towns and villages. No such guidance is available. I'm not talking here about adjustment. I'm not talking about the emphasis that has been criticized so frequently recently that the schools

should replace the parents and should replace the religious organizations in helping students to adjust. I'm talking about identifying and encouraging and guiding young people into those areas for which they are best qualified to conclude this program I should like to read once again from Dr L. B's book this time from the chapter entitled implications for the future. He said one of man's unique capacities is his ability to anticipate and to plan his future. The ability to use trends in the present or to predict and control reality in the future is a major source of security to a human being. Unfortunately we do not always use this ability too often. Securing the future for one group means mortgaging the future of another or worse still it means sacrifices for groups which do not enjoy sacrifice. Looking ahead we can be sure that our nation will be faced with serious problems in the field of

mental illness and mental health for a long time to come. We can also foresee a continuation of the shortages of professional manpower already outlined. Our mental hospitals will continue to be overcrowded and our mental patients will receive little treatment. Much is made of the fact that in the last year more patients have been discharged from mental hospitals than were admitted. The reality is less optimistic. But new trend realising drugs have enabled us to discharge has improved sizeable numbers of patients who would not otherwise have left our institution. But the rapid growth of our population and the increasing numbers of older people in the age groups where mental illness is most common. Promise to keep our institutions filled and overcrowded from whatever viewpoint we look at humanitarian economic or scientific. Mental Disorder is our nation's most serious health problem. Everyone concerned agrees that our professional personnel prospects are grim and promised

to get worse. That excerpt was from Dr. George Alba his book entitled mental health manpower trends. We wish to take this opportunity to thank Dr. George L.B. of Western Reserve University also Dr. James Miller Dr. Merrill flood and Dr. Ralph Girard and Dr. Anatol Rapaport who are members of the Mental Health Research Institute of the University of Michigan and professors at various departments of the university. This is Ben the final program aspects of mental health from the series on human behavior social and medical research. We extend our special thanks to the Mental Health Research Institute for their assistance and Jamir for the series is Neal McLean and this is Glenn Phillips speaking asking that you join us for other programs from the series dealing with medical research behavioral science research and the challenge of aging. Thank you for being with us at this time.

This program has been produced by the University of Michigan broadcasting service under a grant in aid from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters. This is the NEA E.B. Radio Network.