Abstract
The tradition of committing the mentally ill in America is only one century-and-a-half old: it is then relatively recent and easy to change.
The psychiatric profession, however, was born during that ‘custodial’ period, and has been accustomed to isolation from society and the other medical groups.
The Second World War put a term to that isolation; not being familiar with social participation, the psychiatrist is a little reluctant to take over this new role.
A better control of psychotic symptoms, through pharmacology now makes possible the release of many mental patients without, however, making predictable within the near future the closing of mental hospitals. The tolerance of families and communities to the presence of the mentally ill is not unlimited, and suggestion is made of a large investigation to make a precise evaluation of the saturation point of varied groups, in order to prevent panic reactions and a deterioration of social attitudes towards the mentally ill.
The gradual increase of people wanting to undergo psychiatric treatment forces the psychiatrist to learn the techniques of team work in order to treat patients with benign symptoms indirectly.
More and more the psychiatrist will be asked to co-operate in community leadership and in social reforms. He should be cautious in this field on account of the present ambiguity concerning the specific influence of this or that social factor on the rate of mental illness. He should also avoid the disgraceful impression given to the public by radically opposite scientific statements, as heard in criminal cases. It is then preferable in the present conditions that the psychiatrist involves himself in social action as a citizen rather than as a psychiatrist.
Up to now, and up to a certain point, psychiatry has succeeded in integrating biology and psychology. The ‘third revolution’ presents the challenge of integrating a third level, the socio-anthropological one, in the decades to come.