>> WELCOME.
I'M JEFF RES INITIATION CK
SENIOR HISTORIAN HERE FOR AND
THANK YOU FOR -- JOINING US.
WE HAVE HISTORY FOR BIOMEDICINE,
SOCIAL SCIEN SCIENCES AND HUMAN.
WE SUPPORT THE COMMITMENT OF THE
NLM FOR THE DIVERSITY OF DLEKSES
WHICH HAVE A RANGE OF DIJ CAL
FORMAT AND RANGE OVER THE WORLD.
WE HAVE VOICES OF PEOPLE OF
COLOR, WOMEN AND INDIVIDUALS OF
A VARIETY OF BACKGROUNDS WHO
VALUE THESE COLLECTIONS AND USE
THEM AT THE ADVANCE THEIR
RESEARCH, TEACHING AND LEARNING.
WELCOME EVERYONE.
FOR THOSE OF YOU WHO WISH TO
SHARE THEIR QUESTIONS WITH
SPEAKER, USE THE LIVE FEEDBACK
BUTTON ON THE VideoCast.
TODAY I HAVE THE GREAT PLEASURE
AND PRIVILEGE TO INTRODUCE
NAMHEE LEE WHO IS WITH EWHA
UNIVERSITIES IN SOUTH KOREA AND
TEACHES HISTORY THEORY TO
GRADUATE STUDENTS.
HE WAS A POSTDOCTORAL FELLOW AND
TEACHES IN SOUTH KOREA.
SHE COMPLETED HER PhD. IN
HISTORY AT SYRACUSE EEFORT WITH
THE DIRS TAITION ENTITLED SPOCK
PARADOX,IVENESS AND CONTROL AND
NEW ADVICE FOR PARENTING IN
DEMOCRACY.
DR. LEE IS AUTHOR OF ANY TIME
RUSS SCHORLY AVRILS TWO IN
JOURNAL OF MELON TALL HEALTH
INCLUDING THE DREAM OF THE NEW
DESCRIBE TRI WILLIAM C.
MANAGENNER AND PSYCHE ANALYSIS.
SHE'S PUBLISHED IN THE KOREAN
JOURNAL IN HISTORY AND WESTERN
REVIEW.
SHE SHARES ASPECTS OF RESEARCH
IN MENTAL WE WELL-BEING IN WESTN
AMERICA FOCUSING ON ROBERT H.
FELIX.
IF IN HER RESEARCH SHE IS HE
BEEN DRAWING ON THE NLM'S
COLLECTION OF DR. FELIX'S
PAPERS.
DR. LEE, THANK YOU SO MUCH FOR
JOINING US FROM SOUTH KOREA.
>> THANK YOU, JEFF.
THANK YOU FOR LETTING ME HAVE
THIS OPPORTUNITY TO PRESENT MY
CITY.
IT'S THE PRIVILEGE AND HONOR FOR
ME TO DO SO.
I WOULD LIKE TO AND BEGIN --
THERE WE GO.
I WOULD LIKE TO BEGIN BY
REFLECTING ON THE REMARK WHICH
[INDISCERNIBLE] WROAPT IN THE
AMERICAN JOURNAL OF PSYCHIATRIC
RI IN JULY 1961.
IN HIS INTRODUCTION, ROBERT
FELIX, THE NLM PRESIDENT FROM
1960 TO 1961 HE WAS DESCRIBE DR.
FELIX AS SUMP.
AS WE SURVEY THIS WONDERFULLY
PRODUCTIVE CAREER IN WHICH A
DEDICATE MAN CARRIED
BENEVOLENCE, WE CAN I SAY TO HIM
AND OF HIM.
THIS REMARK ALLOWS US TO ASSUME
THAT THE PATH DR. FELIX WENT
THROUGH MIGHT BE DIFFERENT THAN
OTHER PSYCHIATRISTS SINCE
PROMINENT FIGURES IN PSYCHIATRY
AND THE DISCIPLINE BEGAN TO
ACQUIRE FAME AT THE TIME.
DURING -- TODAY I WOULD LIKE TO
DRAW ATTENTION TO DR. FELIX'S
EFFORT IN ESTABLISHING THE POST
WAR DIRECTION IN PUBLIC MENTAL
HEALTH.
BEFORE MOVING ON TO HOW DR.
FELIX CONTRIBUTED TO THE
NATIONAL HEALTH SECTOR, I WANT
TO INTRODUCE OVERALL INFORMATION
ABOUT DR. FELIX WHO HAD A LONG
CAREER IN THE PUBLIC SERVICE,
PHS, ALL THEAUX THERE IS NO
PUBLISHED NOTTOGRAPH OR
PUBLISHING ON DR. FELIX, HE'S
PROMINENT IN THE MENTAL HEALTH
RELATED TOPICS AFTER WORLD WAR R
II, IT FELIX APPEARS WITHOUT
FAIL IN DEALING WITH NATIONAL
MENTAL HEALTH FUNDING FROM
RESEARCH INSTITUTES AND
DRUG-RELATED EMENTS.
LMENTS.
DR. FELIX WAS EYE PSYCHIATRIST,
MEDICAL DR DOCTOR AND
ADMINISTRATOR.
WIDELY KNOWN AS THE FIRST
DIRECTOR OF THE NATIONAL
INSTITUTE OF MENTAL HEALTH, FRM
12959 TO 1964.
HE WAS THE PRESIDENT OF THE
AMERICAN SCR PSYCHIATRIC ASSOCIN
FROM 1960 TO 1961 AND ONE OF THE
KEY PLAYERS TO DEVELOP A OVERALL
PICTURE OF MENTAL HEALTH POLICY
WHO MADE A MENTAL HEALTH ACT IN
1946 POSSIBLE.
BORN IN 1904, DOWNS KANSAS TO
[INDISCERNIBLE], HE FER SUED A
CAREER IN PEN TALL HEALTH RATHER
THAN PSYCHIATRY.
AFTER GRADUATING
FROM -- HE WORKED AS A RESIDENT
AT COLORADO PSYCHOPATHIC
HOSPITAL.
HE BEGAN HIS CAREER IN 1933 AND
MAINTAINED VARIOUS POSITIONS AT
THE PHS DURING THE SECOND WORLD
WAR.
AS ON OFFICER OF THE PHS FROM
1936, HE WAS ASSIGNED TO THE
FEDERAL NARCOTIC TREATMENT
CENTER IN LEXINGTON, KENTUCKY.
AFTER SERVING FOR THREE YEARS AT
THE PHS CENTER IN SPRINGFIELD
MISSOURI UNDER THE DEPARTMENT OF
JUSTICE.
HE RECEIVED HIS MASTERS DEGREE
FROM JOHNS HOPKINS UNIVERSITY
SCHOOL OF PUBLIC HEALTH IN 1942
AND WAS DEPLOYED TO THE COAST
GUARD ACADEMY AS A PSYCHIATRIST
AND SENIOR MEDICAL OFFICER.
HE RETURNED TO THE PHS IN 1944
AND WORKED AS AN ASSISTANT CHIEF
IN THE BUREAU OF MEDICAL
SERVICE.
IN THE SAME YEAR, DR. FELIX
BECAME THE CHIEF OF THE MENTAL
HYGIENE DIVISION.
HIS CAREER DEVELOPMENT ALLOWED
HIM TO BE THE MOST EXPERIENCED
OFFICER WHO UNDERSTOOD PUBLIC
MENTAL HEALTH POLICY DURING THE
TIME.
AROUND 1940s, MOST PSYCHIATRIC
SPECIALISTS HAD EXPERIENCED --
HAD EXPERIENCE WITH STATE
HOSPITALS OR RUNNING PRIVATE
CLINICS.
IN CONTRAST, FELIX, BECAUSE OF
HIS CAREER AND EXPERIENCES AT A
COUPLE OF AGENCIES UNDER THE PHS
WAS ONE OF THOSE WHO KNEW BETTER
THAN ANYONE WHAT WAS NEEDED TO
IMPROVE THE MENTAL HEALTH CARE
SYSTEM WHICH WOULD DETERMINE THE
GREAT FRAMEWORK FOR POLICY
DIRECTION AFTER WORLD WA WORLD .
ALSO THE FACT THAT HE WAS OUT OF
THE POST WAR DEBATE ON PSYCHE O
ANALYTIC APPROACH PLAYED A ROLE
IN HIS UNRIVALED POSITION.
KNOWN AS THE FIRST PRESIDENT OF
THE NATIONAL INSTITUTE OF MENTAL
HEALTH AND A CENTRAL FIGURE IN
PASSING THE NATIONAL MENTAL
HEALTH ACT OF 1946, FELIX IS NOT
A WIDELY KNOWN FIGURE COMPARED
TO THE FAME OF HIS TIME.
DESPITE PLAYING AN IMPORTANT
ROLE IN DETERMINING AMERICAN
MENTAL HEALTH POLICY IN THE MID
20TH CENTURY, INFORMATION ABOUT
HIM IS IT LIMIT COMPARED TO
OTHER MEDICAL PROFESSIONALS WHO
WORKED AROUND THE SAME TIME.
FORTUNATELY I WAS ABLE TO HAVE
AN OPPORTUNITY TO RESEARCH THE
ROBERT H. FELIX PAPERS AT THE
NATIONAL LIBRARY OF MEDICINE IN
SUMMER 2022.
THIS TALK IS PART OF THE THE
STUDY BASED ON THE FIELD WORK
FOR THE FELIX PAPERS.
HE'S KNOWN TO SOME EXTENT
SERVING AS AN OPPORTUNITY FOR
THE DEVELOPMENT.
OF BOTH AMERICAN
DESCRSCRIKS AND MENTAL HEALTH.
IT WILL WOULD BE GOOD TO TRACE
HIS ACCOMPLISHMENTS AND
CONTRIBUTIONS AND ALSO THE
UNDERSTANDING OF THE DIRECTION
AND GOAL OF THE FEDERAL MENTAL
HEALTH POLICY WOULD ILLUMINATE
THE ORIGIN AND COMPLICATE THE
REALITY OF POST WAR NATIONAL
MENTAL HEALTH POLICY.
SO, WHEN WE DEAL WITH CHANGE OR
DEVELOPMENT, OFTENTIMES
OVERCOMING VARIOUS CIRCUMSTANCES
OF THE PAST AND IMPROVING IN A
BETTER WAY IS THE IDEA OF
DESCRIPTION.
THE PERIOD I COVERED HERE WAS
RECOGNIZED AS MODERN DEVELOPMENT
OF PSYCHIATRY OR A PERIOD OF
CHANGE.
WORLD WAR II GAVE UNPRECEDENTED
EXPERIENCE BECAUSE OF THE NUMBER
OF PATIENT SOLDIER WHOSE
SUFFERED FROM NEW NEWERO PSYCHIC
SYSTEMS -- NURO PSYCHIATRIC
SYSTEMS.
THEY REALIZED THE STATEMENT OF
THE HOSPITAL SYSTEM WHICH HAD
BEEN MAINTAINED UNTIL 40.
HOWEVER, THESE DRAMATIC ELEMENTS
HAVE THE EFFECT OF MAKING THE
PREVIOUS WEAK AND EXPISSING EXIG
PRACTICES LOOK LIKE FAIL LTD
ATTEMPTS.
I WANT TO TALK ABOUT EARLY
MENTAL HEALTHCARE IN THE EARLY
20TH CENTURY FIRST.
AS PREVIOUSLY KNOWN, THE REALITY
OF PSYCHIATRIC INSTITUTIONS AT
THE BEGINNING OF THE 20TH
CENTURY DID NOT SEEM IDEAL.
IN PARTICULAR, MENTAL HEALTH
SITUATION JUST BEFORE WORLD WAR
II SEEMED TO BE WORSE THAN THAT
OF OTHER MEDICAL DEPARTMENTS AT
THAT ADVOCATED SCIENTIFIC
MEDICINE.
AUTOMATIC THOUGH WORLD WAR II
AND SCWEPT CHANGES SEEMED TO
HAVE A SIGNIFICANT IMPACT ON
PSYCHIATRY'S TRANSFORMATION INTO
A DISCIPLINE THAT PLAYS A MAJOR
ROLE UNTIL POLICY, THE WAR WAS
THE MAIN CULPRIT AT THAT MADE
THE SITUATION OF WAR-TIME MENTAL
HEALTH MUCH WORSE.
UNDER THE WARTIME SYSTEM,
PSYCHIATRISTS WHO WERE NOT
PLENTY HIM TO GO TO THE
BATTLEFIELD.
THIS WAS NOT LIMITED TO DOCTORS.
WILL ALL NURSES AND OTHER STAFF
WHO WERE DIRECTLY OR INDIRECTLY
ENGAGED IN THE STATE MENTAL
HOSPITAL SYSTEM HAD TO MOVE TO
WORK FOR THE COUNTRY IN A
CRITICAL NATIONAL CRISIS.
AS A RESULT, THE NUMBER OF
DOCTORS AND MEDICAL WORKERS TO
PATIENTS DECREASED EVEN MORE.
IT WAS RELATIVELY TO MAINTAIN
THE STATUS QUO IN MENTAL HEALTH
BECAUSE FUNDS WERE INVESTED IN
CONDUCTING WAR IN ALL
DIRECTIONS.
HOWEVER, THE POOR MENTAL HEALTH
SITUATION HAD ALREADY DWUN IN
THE EARLY 20TH -- BEGUN IN THE
EARLY 20TH CENTURY.
THE TURNOVER RATE OF PATIENTED L
ADMITTED TO MENTAL HEALTH
HOSPITALS DROPPED.
THERE WAS THE THOUGHT PSYCHOSIS
WAS INKEURL DISEASE.
PATIENTS WERE DISCHARGED.
THE STICKS WERE NOT AN INDICATOR
OF THE EFFECTIVENESS OF THE
PRE20TH CENTURY HOSPITAL SYSTEM.
PATIENTS SUFFERING FROM CHRONIC
DISEASE WHO WERE NOT ABLE TO BE
TREATED WERE SENT TO OTHER
INSTITUTIONS.
SINCE THE 1890s
HOSPITALIZATION STEADILY
INCREAINCREASED AND LONG TIME
HOSPITALIZATIONS WERE MORE THAN
FIVE YEARS AND ACCOUNTED FOR
MORE THAN 50%.
THIS CHANGE WAS ACCOMPANIED BY
MEASURES TAKEN BY STATE POLICY.
THE CLEAR LINE OF THE COMMUNITY
RESPONSIBLE FOR CHRONIC PATIENTS
AND THE GOVERNMENT IN CHARGE OF
TREATING ACUTE PATIENTS AND
STATE INSTITUTIONS HAVE BEEN
BLUSHED SINCE THE END OF THE 19
H 19TH CENTURY.
TREATMENT APPEARED TO BE
EFFECTIVE IN MENTAL ILLNESS BUT
FACILITIES UNDER LOCAL COMMUNITY
APPEAR TO BE INEFFICIENT AND
POOR INSTITUTIONS FILLED WITH
COUNTRY ILL PATIENTS.
STATE OFFICIALS, THEREFORE,
DETERMINED THAT STATE-AFFILIATED
HOSPITALS ADMIT PEOPLE WHO COULD
BE CLASSIFIED AS MENTALLY ILL.
THE THING IS THAT THE CHRONIC
CONDITION OF THE PATIENTS WAS
NOT THE RESULT OF THEIR
CONFINEMENT 23 IN COMMUNITY
INSTITUTIONS.
MOST OF THEM COULD RECEIVE --
COULD NOT RECEIVE FAMILY HELP IN
THE FIRST PLACE.
EXPWH LOCAL GOVERNMENTS DID NOT
MISS A GOLDEN OPPORTUNITY FOR
BUDGET.
THEY IDENTIFIED VAIR JUST MENTAL
DEFECTS AND DEGRADATION CAUSED
BY SENILITY.
BY 19150, 40% WERE OVER THE AGE
EVER 60.
STATE MENTAL HOSPITALS WHICH
HAVE MAINLY DEALT WITH
SHORT-TERM AND EXTREME SYSTEMS
BECAME INSTITUTIONS RESPONSIBLE
FOR CHRONIC PATIENTS WITH
PHYSICAL ILLNESS ESPECIALLY
OLDER PATIENTS SINCE THE 1920s
AND THESE INSTITUTIONS OFTEN HAD
TO TAKE CARE OF THEM UNTIL
DEATH.
EFFECTIVE TREATMENT AND SUCKFUL
OVERCOMING GRADUALLY DISAPPEARED
AND THE STATE HOSPITALS SIMPLY
BECAME PLACES WHERE THE PATIENTS
STAY UNTIL THEY DIE.
23RD PATIE -- 23 FOR PATIENTS WH
PHYSICAL ILLNESS OR AGING, THE
PSYCHIATRIST WOULD RELIEVE OR
STABILIZE THE SYSTEMS.
COST OF CARE WAS THE MAIN TASK.
THIS CHANGE WAS NOT JUST A
PROBLEM FOR STATE MENTAL HEALTH
HOSPITALS.
THE EXPERIENCE WAS A FACTOR IN
MAINTAINING MEDICAL DISCIPLINE.
BUT PRESCRIBING LONG TERM
PATIENTS DRUGS AND MONITORING
HAD THOUGH CHOICE BUT TO
NEGATIVELY EFFECT PSYCHIATRY AS
MEDICAL DISCIPLINE ITSELF.
IN ADDITION TO THE POOR WORKING
CONDITIONS, THE INABILITY TO
FEEL REWARDED AS A PROFESSION
MAKES PSYCHIATRY EVEN MORE
UNATTRACTIVE AND THE CLINICAL
EXPERIENCE THAT IS MOST
ESSENTIAL FOR THE DEVELOPMENT
MEDICINE WAS LIMITED TO EAJ
GROUPS AND SPECIFIC DISEASES.
THE TREATED PATIENTS WITH NEW
SYSTEM, WAS RI RISKY BUT STATE
MENTAL HEALTH HOSPITALS WERE NO
LONGER ABLE TO PLAY THIS WILL
ROLE.
HOWEVER, IT IS INTERESTING TO
NOTE THAT MENTAL HOSPITALS
CONDITIONS WERE RELATIVELY
BETTER THAN OTHER STATE
DISMERINSTITUTIONS WERE BETTER.
HOSPITALIZATION TREATMENT WAS
BETTER THAN COMMUNITY AND
INDIVIDUAL MANY TREATMENT.
THE NUMB NUMBER OF ELDERLY PATS
COULD NOT BE CARED FOR AT HOME
INCREASED IN THE AFTERMATH OF
THE COUNTRY CRISIS.
MAINTAINING THE STATUS QUO ALONE
MIGHT HAVE SEEN LIKE A BETTER
CONDITION AT THE TIME BUT THAT
DOES NOT SOLVE THE MENTAL
HOSPITAL ITSELF WHICH HAD BEEN
REVEALED SINCE THE 1920S.
TIME PASSED WITHOUT CHANGING THE
REALITY OF INCREASING PATIENT
NUMBERS REDUCED FINANCES AND
AGING FACILITIES.
COMPARED TO THE 1930s, THE
1940s, THE EXISTING PROBLEMS
BECAME MORE EVIDENT.
THE INCREASING NUMBER OF
PATIENTS WITH CHRONIC DISEASES
MEANT AN INCREASE IN THE DENSITY
OF THE RECEIVING POPULATION.
THE 1930s, EVEN INSTITUTIONS
THAT RECEIVED STABLE FINANCIAL
SUPPLY AND DEMAND WOULD HAVE
BEEN ABLE TO MAINTAIN THE STATUS
QUO.
SO IT WAS DIFFICULT TO EXPECT TO
IMPROVE THE ENVIRONMENT OF
PATIENTS.
THE BIGGEST PROBLEM WAS THAT THE
NUMBER EVER MEDICAL
PROFESSIONALS WAS DECREASING
NATIONWIDE DUE TO WORLD WAR II.
THE NUMBER OF PATIENTS PER
CAPITA INCREASED, MUCH COURSE OT
MADE FOR PRESSURE ON
IN-PATIENTS.
THE CARE INCREASED AS THE NUMBER
OF EMPLOYEES DECREASED.
FINANCIAL DIFFICULTIES MADE IT
IMPOSSIBLE TO BUILD NEW
FACILITIES TO ACCOMMODATE A
GROWING NUMB NUMBER OF PATIENT.
WORLD WAR II HAD A NEGATIVE
EFFECT ON THE EXISTING STATE
MENTAL HEALTH HOSPITAL SYSTEM.
IT IS WELL-KNOWN THAT WORLD WAR
II WAS A SYMBOLIC TURNING POINT,
AS I MENTIONED BEFORE, FOR THE
DEVELOPMENT OF PSYCHIATRY IN THE
UNITED STATES.
THE IMAGE OF THE DISEASE
PREVIOUSLY DEALT WITH BY
PSYCHIATRY WAS TREATED FROM
MODERN SCIENCE WHICH ADVOCATED A
SCIENTIFIC APPROACH UNTIL THE
MOMENT THE UNITED STATES DECIDED
TO PARTICIPATE IN THE WAR DUE TO
THE ATTACK ON PEARL HARBOR,
PSYCHIATRY WAS STILL POOR IN
DEALING WITH MENTAL ILLNESS AND
MENTAL STATE.
SINCE THE END OF THE 1-9DTH
CENTURY, MANY THEORIES HAVE
EMERGED DUE TO PSYCHE ANALYSIS
BUT WERE REJECTED BY THE
AMERICAN PSYCHIATRIC COMMUNITY
BECAUSE THOSE THEORIES HAD A
EUROPEAN TRADITION OR SEEMED
UNSCIENTIFIC FOR THEM.
FROM THE MID TO LATE 19TH
CENTURY, STATE MENTAL HOSPITALS
WERE BY NO MEANS AN
UNDER-DEVELOP ACCOMMODATION
FACILITY.
50% OF PATIENTS WITH ACUTE
MENTAL ILLNESS IN THE 19th
CENTURYIVE WERE HOSPITALLED FOR
LESS THAN A YEAR.
UNTIL 1808 THE NUMBER OF
PATIENTS WITH CHRONIC DISEASES
REMAINED AT 5 TO 10%.
THIS DETERMINED THE CAPACITY OF
MENTAL HOSPITALS.
IT CAN BE SAID THAT PSYCHIATRIC
DEPARTMENTS CENTERED ON
PSYCHIATRIC HOSPITALS BEFORE THE
20TH SE CENTURY EXPERIENCED
RELATIVE SUCCESS BEFORE THE 20TH
CENTURY.
THE CARE IN THE EXISTING
ENVIRONMENT WAS RECOGNIZED AS
THE BEST TREATMENT FOR ACUTE
DISEASES.
HOWEVER, THIS BLEEFL LED TO THE
ENVIRONMENTAL DEGRADATION OF
STATE MENTAL HEALTH HOSPITALS
FROM THE LATE 19TH CENTURY TO
THE EARLY TO MID 20TH CENTURY.
THIS DETERIORATION LOAD TO
EFFORTS TO IMPROVE THE
ENVIRONMENT IN MEN HALL HEALTH
HOSPITALS.
THE BEGINNING OF THE ME MENTAL
HEALTH MOVEMENT WAS THE
PUBLICATION OF THE BIOGRAPHY IN
1908 WHICH WAS A FAMOUS ONE.
THE ESTABLISHMENT FOR THE
COMMITTEE FOR MENTAL HYGIENE IN
1909, THE SCOPE OF THE MENTAL
HEALTH MOVEMENT GRADUALLY
EX-PNDED TO AREAS IT THAT WERE
THOUGHT TO BE RELATED TO MENTAL
HEALTH AT THE TIME.
AS THE IMPORTANCE OF THE
ENVIRONMENT, INCLUDING THE
RELATIONSHIP WITH CAREGIVERS
EXPERIENCING THE PROCESS OF
GROWTH WAS HIGHLIGHTED IN THE
HUMAN MIND.
IT WAS THOUGHT THAT THE
ENVIRONMENT SHOULD BE IMPROVED
TO PREVENT THE DETERIORATION OF
MENTAL ILLNESS IN EVENTS.
THEREFORE, TRILLION IN LECTURE
DISABILITY SINLS SINCE THE 192N
POOR ENVIRONMENT IN THE STATE
HOSPITALS WAS MADE.
THIS WAS E EMPHASIZED IN A
QUARANTINE OF IMMIGRANTS AND
FOREIGNERS.
SCHOOL AGE OF SCHOOL CHILDREN
EXPANDED TO AREAS EVER MENTAL
PROBLEMS SUCH AS JEUF NIEF NILE
DLIRCHG T DELINQUENCY AND OTHER
PROBLEMS.
IT WAS RELATED TO DRUG
ADDICTION.
THE ENACTSMENT OF THE HARRISON
NARCOTIC ACT OF 1914 MADE IT
POSSIBLE TO PUNISH DOCTORS WHO
HAD THE AUTHORITY TO PRESCRIBE
DRUGS.
HOWEVER, DRUG ADDICTION WAS NOT
THE ONLY AREA WHERE THIS WAS
CURED, ALTHOUGH IT WAS NOT EASY
TO UNDERSTAND THE DIRECTION OF
THE MENTAL HYGIENE MOVEMENT AT
THE TIME AND THE ADDICTION OR
DISPENT AT THE TIME.
DPLENSED AT THE. DEPEN DANCE.
THIS WAS A PROBLEM TO BE SOLVED
NOT JUST BY CRIMINALIZATION.
THERE WAS CREATED THE DIVISION
OF MENTAL HYGIENE AND EXPANDED
THE ROLE OF FEDERAL GOVERNMENT,
THE DIVISION OF CANDIDATES LED
TO RESEARCH ON NATURE AND
TREATMENT METHODS OF DRUG
ADDICTION AND REHABILITATION OF
ADDICTS SPREAD INFORMATION ABOUT
TREATMENT AND RESEARCH.
WORK WITH THE STATE AND
COMMUNITY IN MAINTAINING
FACILITY FOR THE TREATMENT AND
CARE OF ADDICTS AND PREPARED
MEDICAL AND PSYCHIATRIC
TREATMENTS IN FEDERAL PRISONS.
IT ALSO PLAYED A ROLE IN
INVESTIGATING THE PROCESS OF
SPREAD OF NEUROSIS AND PSYCHOSIS
AS WELL AS THE METHODS FOR
PREVENTION AND TREATMENT.
IN 1938, BARNES COLE WHO WAS
KNOWN AS THE AUTHORITY ON DRUG
RESEARCH AND TREATMENT WAS THE
HEAD OF THE DIVISION OF MENTAL
HYGIENE CAME TO THE POOR AND
SERVED AS THE LEADER AND THEN
HAD A SUCCESSOR IN 1944.
HOWEVER, FROM 1939 WHEN THE
DEVASTATION OF THE WAR HIT
EUROPE, THE UNITED STATES HAD TO
CONSIDER PARTICIPATING IN THE
WAR.
IN LINE WITH THE ROOSEVELT
GOVERNMENT, THE FUTURE WAR WAS
TO SAY GOOD-BYE TO NON-SCIENCE
WHICH WAS UNPREDICATED IN THE
PREVIOUS WAR.
THE ESTABLISHMENT OF THE OFFICE
OF SCIENTIFIC RESEARCH AND
DEVELOPMENT, OSRD, IN 1941 WAS
LIKE SIGNALING THAT THE
SITUATION DURING AND AFTER WORLD
WAR II WOULD BE COMPLETELY
DIFFERENT FROM BEFORE.
AS I MENTIONED PREVIOUSLY,
FELIX'S HISTORY ALLOWS TO US
PRESUME WHY HE WAS THE FIRST
DIRECTOR OF THE NATIO NATIONAL
INSTITUTE OF MENTAL HEALTH WHICH
WOULD HAVE POLICY AFTER WORLD
WAR II.
MANY PEOPLE IN THE POST CAR
PSYCHIATRY THOUGHT THAT THE
DISCIPLINE SHOULD PLAY AN STNDED
ROLE DIFFERENT FROM BEFORE.
BUT THERE WAS DIVISION ON THE
APPROACH AND METHODOLOGY
STARTING FROM WORLD WA WORLD WA,
VOICES CALLING FOR EXPANDING THE
ROLE OF PSYCHIATRY WERE --
CENTERED ON THE AMERICAN
PSYCHIATRIC ASSOCIATION.
THIS DEBATE REPRESENTED A
DISAGREEMENT BETWEEN THOSE WHO
WERE TRAINED IN THE STATE
PSYCHIATRIC HOSPITAL SYSTEM
BEFORE THE 1940s AND THOSE WHO
WERE NEWLY DEPLOYED DURING WORLD
WAR II.
HOWEVER, BECAUSE THE NUMBER OF
DOCTORS WHO WORKED BEFORE WORLD
WAR II WAS ALMOST THE SAME AS
THE DOCTORS WHO WERE PUT INTO
THE WAR FRONT.
THE DIRECTION OF DEVELOPMENT IN
PSYCHIATRY AND MENTAL HEALTH
DEPEND MORE ON NEWLY -- DEPENDED
MORE ON NEWLY-TRAINED DOCTORS.
THEY ACTIVELY TRIED TO USE
PSYCHO DYNAMIC THEORY TO EXTEND
THEIR POWER.
AND STAFF WHO WERE FAMILIAR WITH
THE HOSPITAL SYSTEM WERE AGAINST
THIS TREND.
HOWEVER, BY NUMBERS, ABOUT HALF
OF THE ASSOCIATION'S APA MEMBERS
SEEMED TO HAVE AGREED TO EXTEND
THE PSYCHIATRIC DIEMENT AND
EXPAND THEIR INFLUENCE AND A
WATER EVER THE MEMBERS FIRMLY
EXPRESSED ANTIPATHY TO THIS.
THE MANAGER WHO ROSE TO THE
HIGHEST RANK WHO FOUGHT DURING
WORLD WAR II LED THIS CHANGE.
HE WAS THE MAIN SUPPORTER OF
PSYCHO DYNAMIC THEORY AND WANTED
TO MAKE THE MOST OF IT TO EXTEND
THE AUTHORITY OF BRANCH OF
PSYCHIATRY TRI BY ACHIEVING THIS
TOGETHER.
FELIX WAS DISTANT FROM THE
ASSOCIATION'S DEBATE.
WHEN THE APA BEGAN DEBATING WHAT
ROLE THEY SHOULD PLAY AFTER THE
WAR, FELIX HAD ALREADY PLANNED
UNDER THE LEADERSHIP FL LAWRENCE
COLE, HIS MACHINER TO, A
BLUEPRINT OF REGIMENTAL HEALTH.
HE WAS PREPARING FOR A
LEGISLATIVE PROCESS FOR THE
NATIONAL ACT AT THE FEDERAL
LEVEL WHICH FAILED ONCE BEFORE.
THE DIVISION OF MENTAL HYGIENE,
WHICH WAS CREATED IN 1930 UNDER
THE INFLUENCE OF THE MENTAL HIGH
JOAN MOVEMENT IN THE EARLY 19 PT
CENTURY WAS UNPRECEDENTED IN
SCALE AT THE TIME BUT IT WAS
PRIMARILY RESPONSIBLE FOR DRUG
ADDICTION.
THOARP FOCUSED ON -- THEY WERE
FOCUSINGED ON THAT.
HOWEVER IN 18936 THE NATIONAL
SURVEY COMMITTEE WAS LAUNCH
ALONG WITH THE APA AND OTHER
MAJOR MEDICAL ASSOCIATIONS.
THIS WAS BECAUSE THEY WERE AWARE
OF THE POOR ENVIRONMENT OF
MENTAL HOSPITALS AT THE TIME AND
THERE WAS SOME CENSUS THAT THERE
SHOULD BE FEDERAL ACTION TO
IMPROVE THE SITUATION.
II'M ALSO NOW STUDYING HIS PAPES
AS WELL, COLE.
IT WAS THOUGHT THAT THE
INSTITUTIONS FOR BASIC RESEARCH
SUCH AS NATIONAL CANCER
INSTITUTE IN 1937 WERE NECESSARY
TO IMPROVE MACHINE TALL HEALTH.
COLE PLANNED TO CONDUCT MORE
RESEARCH AND ESTABLISH AN
INSTITUTE TO FUND STRATEGIC
AREAS BUT IT WAS NOT REALIZED
DUE TO THE OUTBREAK OF WORLD WAR
II.
FELIX'S ROLE IN ENACTING MENTAL
HEALTH LAWS SHORTLY AFTER THE
WAR CAN BE UNDERSTOOD AS AN
EXTENSION OF THE PUBLIC HEALTH
DEPARTMENT'S CONSISTENT EFFORTS.
IN 1943 STUDY, INTEGRATED
MEDICINE COLLEGE PROGRAM AT THE
U.S. COAST GUARD ACADEMY WHERE
HE WAS SERVING, FOUR AUTHORS
INCLUDING FELIX MEASURED WHETHER
SUCCESS OR FAILURE IN PERFORMING
THEIR DUTIES AS AN OFFICER WAS
PREDICTABLE DURING A VARIETY OF
METHODS INCLUDING IN-DEPTH
TESTS.
PERSONAL DATA SURVEYS AND GROUP
PSYCHOLOGY TASKS.
IT WAS CONCLUDED THAT THIS
COMPLEX TESTING METHOD ALLOWED
THE POTENTIAL FOR SURVIVOR AND A
DAP NATION GROUPS.
ADAPTATION IN GROUPS.
IIT SHOWS THAT FELIX WAS SOMEWHT
DIFFERENT FROM CONVENTIONAL
PSYCHIATRISTS.
MANY PSYCHIATRISTS WHO SERVED AS
MEDICAL OFFICERS DURING WORLD
WAR II OFTEN DIRECTLY OBSERVED
AND DEL DEALT WITH THE SYSTEMS F
WAR LOSSES WHILE FELIX WAS
CUTTING RESEARCH TO ESTABLISH
NATIONAL MENTAL HEALTH POLL
SIGNIFICANCE.
FELIX WAS STRUGGLING WITH
FEDERAL MENTAL HEALTH POLICIES
WHEREAS OTHER MENTAL HEALTH
PROFESSIONALS HAD MADE EFFORTS
TO IMPROVE THE STATUS OF
PSYCHIATRY AS A MORE ACCEPTABLE
DISCIPLINE TO MAINSTREAM
MEDICINE.
AFTER WORLD WAR II, MENTAL
HEALTH TOOK ON A COMPLEECTLY
DIFFERENT APPEARANCE AND
DIRECTION.
AS HISTORIAN GERALD ROBB NOTED,
THE LONG LASTING PAIR TIME THAT
WHOEVER HAD A MENTAL ILLNESS
SHOULD GO TO A MENTAL HOSPITAL
HAS CHANGED.
ALTHOUGH THE ENVIRONMENT UNTIL
MENTAL HOSPITALS IN THE 19TH
CENTURY IS STILL CONSIDERED
POOR.
THEY WERE INSTITUTIONS THAT TOOK
CARE OF PATIENTS WITH
UNCONTROLLABLE SYSTEMS ON BEHALF
OF THEIR FAMILIES OR
COMMUNITIES.
BASED ON THE HOSPITAL'S RECORDS,
MOST OF THE PATIENTS WERE SENT
BACK TO THEIR FAMILIES AFTER
SPENDING SOME TIME IN THE
HOSPITALS.
THERE WAS NO REASON NOT TO SEND
PATIENTS WITH MENTAL ILLNESS TO
THESE INSTITUTIONS.
EVEN THOUGH SOME INSTITUTIONS
SUFFERED FROM FINANCIAL
PROBLEMS, THEY SHOWED A SHORTAGE
OF MEDICAL PERSONNEL AND
DETERIORATION OF THE
ENVIRONMENT.
THE SUPERINTENDENTS AND STAFF OF
THE INSTITUTIONS THOUGHT THAT
THOSE PROBLEMS WERE NOT
UNSOLVABLE.
THEY ORPHAN THOUGHT THAT
FINANCIAL AND MANPOWER SHORTAGES
COULD BE TEMPORARY SO THAT THE
IMPROVEMENT OF THE ENVIRONMENT
WAS POSSIBLE ACCORDINGLY.
HOWEVER, AS WE'VE SEEN
DETERIORATING IN THE PSYCHIATRIC
HOSPITALS IN THE EARLY 20TH
CENTURY AND NEUROSIS FURTHER
MADE THE SYSTEM INOPERABLE.
PATIENTS SUFFERING FROM NEWERO
PSYCHIATRIC STIM TOMORROWS
INCLUDING WAR NEUROSIS WOULD NOT
BE ACCOMMODATED IN AN
ENVIRONMENT WAR TREATMENT
EFFORTS WERE MAINLY FOCUSED ON
PSYCHOSIS.
FURTHER MORE, THERE WAS NO WAY
TO EXPLAIN NEWERO PATHIC SYSTEMS
CAUSED BY EXTREME - SITUATIONS.
THOUGH NEEDED TO BE TREATMENTED
IN PERSON TO CERTAIN WHICH WAS
CLAIMED.
THE NEW MENTAL HEALTH HAD TO GO
IN A COMPLETELY DIFFERENT
DIRECTION FROM THE SYSTEM.
HOWEVER, IT WAS NOT ENOUGH TO
DETERMINE THE NATIONAL MENTAL
HEALTH POLICY SIMPLY BY GOING
DIFFERENTLY FROM THE EXISTING
SYSTEM.
SINCE THE MID 20TH CENTURY,
MENTAL HEALTH POLICYS HAD AIMED
TO CREATE AND IN-DEPTH
UNDERSTANDING OF THE DISEASE.
, THE NECESSITY FOR THE MEDICAL
PERSONNEL AND THE CREATION OF AN
ENVIRONMENT COMPLETE BY
DIFFERENT FROM THE EXISTING
SYSTEM.
THEREFORE, THE NATIONAL MENTAL
HEALTH ACT IN 1946 PRO
INDIVIDUALED RESEARCH SUPPORT --
PROVIDED RESEARCH FOR THE CAUSE,
DIAGNOSIS AND TREATMENT OF
PSYCHIATRIC BASED ON ESTABLISH
THE OF RESEARCH INSTITUTE WITH
HOSPITALS AND LABORATORIES
CAPABLE OF CLINICAL TESTING,
FOSTERING PROFESSIONALS CAPABLE
FL SIMULTANEOUS RESEARCHING AND
NURTURING PRS PEBLGHTIVE --
PROSPECTIVE STUDENTS FUNDED BY
STATE GOVERNMENT TO EXPAND THE
NATIONAL HEALTH FOUNDATION OF
THE COMMUNITY.
IF MENTAL HEALTH PATTERNS
DEVELOPED AROUND THE OPERATION
AND MAINTD OF STATE HOSPITALS BY
1940, IT BECAME CLEAR THAT THE
DIRECTION OF POST WAR MENTAL
HEALTH POLICIES WAS
SIGNIFICANTLY DIFFERENT.
FELIX'S TESTIMONY AT THE
THREE-DAY HEARINGS HELD IN
SEPTEMBER 1945 AND 1946
REPRESENTS THE VIEWS OF THE PHS,
A HOUSE HEARING HELD IMMEDIATELY
AFTER THE END OF THE WAR
EMPHASIZED THAT THE HEALTH
SYSTEM DURING THE WAR WAS
TEMPORARY.
HE EMPHASIZED A NEED TO REAND
REEXAMINE THE MENTAL HEALTH
SYSTEM NOTING THAT THE
TRANSITION FROM WAR-TIME TO
PEACE-TIME WAS NOT LIMITED TO
VETERANS.
IT WAS AN URGENT TASK TO
DETERMINE WHETHER STATE OR
COMMUNITY FACILITIES AND
PROFESSIONAL TRAINING
INSTITUTIONS WERE PREPARED TO
ACCEPT NEW CHANGES.
AFTER THESE PREPARATIONS WERE
COMPLETED, IT WAS PLANNED TO
ALLOW MEDICAL STUDENTS TO
RECEIVE BASIC PSYCHIATRIC
TRAINING.
THIS WAS THE FIRST LINE EVER --E
OF DEFENSE WHICH MEANT GIVING
GENERAL PRACTITIONERS
INFORMATION OR TRAINING TO
DETECT VARIOUS SYMPTOMS.
SO IT WAS MENTIONED THAT
HOSPITALS WERE EMPTY SEATS
ACCOUNTED FOR TWO-THIRDS.
IT WAS ARGUED THAT OTHER
INSTITUTIONS THAT CAN BE TRAINED
SHOULD BE INCREASED.
AND MENTAL HEALTH MEDICAL
PERSONNEL SHOULD BE EXPANDED AS
SOON AS POSSIBLE.
THROUGH SHORT TERM TRAINING OR
LOW INTENSITY TRAINING UNDER THE
SUPERVISION OF PROFESSIONAL
MANPOWER.
AFELIX PREPARED A DOCUMENT TO
WATCH THE SITUATION ALREADY.
VOICES OF GREAT OPPOSITION TO
THE URGENCY WERE NOT GAINING
STRENGTH, BUT FELIX REMAINED
CAUTIOUS UNTIL THE END.
THE BLUEPRINTS WERE
WELL-CONTAINED AND EMPHASIZED
THE NEED FOR MORE MANPOWER.
SINCE TRAIN WAS NOT POSSIBLE IN
A SHORT SOMETIME, IT HAD TO
PROCEED QUICKLY.
EXPANDING MANPOWER WAS AN WE
VEREQUISITE.
HE MENTIONED THAT THE NUMBER OF
FACULTY MEMBERS SHOULD BE
INCREASED IN MEDICAL SCHOOLS AND
ADDITIONAL TRAINING CENTERS
INCLUDING HOSPITALS AND MEDICAL
SCHOOLS AND OTHER EDUCATIONAL
SCHOOLS SHOULD BE INCREASED.
HE EMPHASIZED THAT THE STANDARDS
FOR ESTABLISHING ELD KEATION AND
INSTITUTIONS HAD ALREADY BEEN
ESTABLISHED.
SO IT CAN BE IMPLEMENTED
IMMEDIATELY, HE THOUGHT IT WAS
USELESS TO SET UP CLINICS AND
INCREASE MENTAL HOSPITALS
WITHOUT ADEQUATE MANPOWER FOR
EXTENSION.
IT WAS A STEP-BY-STEP PROCESS
FOR HIM.
IT WOULD HAVE BEEN HOSPITAL TO
EXTEND THE FIELD EVER RESEARCH
IF MORE PSYCHIATRIST'S COULD BE
TRAIN.
FELIX POINTED OUT THAT THE
IDENTIFICATION OF CAUSES OF
MENTAL ILLNESS UP TO THAT POINT
WAS POOR.
HE THOUGHT THAT RESEARCH TO
EXAMINE THE INNATE KRIK TRIS
PARTICULARS OF MEN TAM ILLNESS
SHOULD BE CONDUCTED FIRST.
THE STUDY WAS CONDUCTED TO
EXPLORE THE FUNCTIONAL TYPES
SUCH AS DIET AND NUTRITION.
MECHANISMS OF THE AUTONOMY
NERVOUS SYSTEM AND CONDITION
REFLECTION, FUNCTIONS OF VARIOUS
BRAIN REGIONS AND ELECTRIC
MOVEMENT IN THE BRAIN.
IN ADDITION, THAT WAS THOUGHT
THAT THE EFFECTS OF VARIOUS
CAUSES MUST BE STOOD FROM THE
PERSPECTIVE OF THE DYNAMICS OF
MENTAL ILLNESS.
THROUGH THIS, HE ARGUED THAT
CASE DISCOVERY TECHNIQUES THAT
CAN BE APPLIED TO MANY PEOPLE
SHOULD BE DEVELOPED.
THE DIRECTION OF THIS STUDY WAS
ULTIMATELY ONE OF THE BASIC
TASKS FOR COMMUNITY HEALTH.
IN PARTICULAR, IDENTIFYING HOW
THE DISEASE ITS SELF DEVELOPS
AND RATHER THAN DEVELOPS IN AN
INDIVIDUAL SPECIFIC SITUATION
WAS ESSENTIAL TO THE HEALTH
PROMOTION PLAN FOR THE GROUP.
IN ADDITION, FINDING OUT THE
MECHANISM OF THE DISEASE WAS
ONLY POSSIBLE WHEN IT WAS
POSSIBLE TO SPECIFY THE INITIAL
STAGE AND DETERMINE WHAT
MEASURES WERE POSSIBLE.
THE PLAN TO INTERFERE WITH THE
PROGRESSION OF THE DISEASE AS
MUCH AS POSSIBLE THROUGH
PREVENTION AND INITIAL
INTERVENTION WAS AN URGENT
REQUISITE FOR THE TRANSITION
TOMORROW COMMUNITY HEALTHCARE.
IT CAN BE DIFFICULT TO ESTIMATE
THAT CLINICS OR HOSPITALS
ESTABLISHED IN THE COMMUNITY
WILL BE ABLE TO FUNCTION
PROPERLY ONLY AFTER THESE
THINGS, IT PRESENTED A BLUEPRINT
FOR EXPANDING OUTPATIENT CLINICS
IIN THE HOSPITALS TO TO --
COMMUNITY CLINICS MUST BE EASILY
ACCESSIBLE TO ANYONE AND
IN-PATIENTS WERE CONSIDERED TO
MANAGE THEM AFTER EARLY
DISCHARGE IF FOLLOW-UP TREATMENT
SERVICES THROUGH THE CLINIC WERE
POSSIBLE.
THIS WAS A WAY TO IMPROVE THE
EFFICIENCY OF MENTAL HEALTH
HOSPITALS THAT HAD CONSIDERABLE
FINANCES AT THE TIME.
TO CONCLUDE, DR. FELIX'S EFFORT
ON NATIONAL MENTAL HEALTH
REPRESENTS AN ASPECT OF MOTOR
CONTROL IN MOST WAR AMERICA TO
ME.
LOOKING AT THE ESTABLISHMENT IN
OPERATION OF NLM FROM 1949, WE
CAN SEE THAT THE GOAL OF THE
FEDERAL POLICY WAS TO PENETRATE
EVERY DAY LIFE IN ALL
DIRECTIONS.
THIS IF YOU DIRECTION OF MENTAL
HEALTH POLICY AFTER WORLD WAR II
SIFTED THE CENTRAL POINT OF
CONTROL THAT WAS UBIQUITOUS BY
CHOOSING TO INFILTRATE
COMMUNITIES.
IN OTHER WORDS, UNLIKE THE
EXISTING CONTROL METHOD.
IT WAS A WAY TO PREVENT THE
MENTAL HEALTH OF THE COUNTRY TO
DEVELOPING DISEASE AND DEFEND
AGAINST MINOR PROBLEMS.
MY POINT OF VIEW IS MORE
ACCUSTOMED TO THE AUTHORITARIAN
SYSTEMS OF THE STATE.
I DON'T KNOW.
THIS ALL THE FILTRATION INTO THE
COMMUNITY MEANT DECENTRALIZE.
CONTROL WITH CENTRALIZE FEDERAL
FUNDING.
THANK YOU VERY MUCH.
THIS IS IT.
>> DR. LEE, THANK YOU VERY MUCH
FOR YOUR TALK.
FASCINATING.
SEVERAL QUESTIONS WE'VE RECEIVED
AND I'D LIKE TO BEGIN WITH A
VERY BROAD ONE.
MANY HAVE WRITTEN IN THIS THANK
YOU FOR YOUR TALK, OF COURSE.
THE BROADER QUESTION IS TO WHAT
EXTENT IF AT ALL AND THE
ASSESSMENT OF ENVIRONMENTAL
FACTORS AS YOU DESCRIBE REFLECT
THE BEGINNINGS OF WHAT WE CALL
TODAY THE "SOCIAL DETERMINANTS
OF HEALTH."
ANY THOUGHTS ON THAT?
>> ENVIRONMENT, I GUESS I'M
STRUGGLING WITH THE CONCEPT OF
THIS ONE NOW.
I THINK I MIGHT JUST GENERATE MY
MEMORY.
ENVIRONMENTAL.
II THINK IT'S EARLY 20TH CENTURY
OR A FREUD FREUDIAN ERA.
1920s IN THE U.S.
ENVIRONMENT MEANT THAT SOME SORT
OF -- LIKE THE CHARACTER -- EGO
DEVELOPMENT OR CHARACTER
DEVELOPMENT OR DEALING WITH SOME
SORT OF SELF-DEVELOPMENT.
IT WAS MORE LIKE A FIRST
CAREGIVER AND ME.
THEY'RE GOING TO -- INTERACTING
WITH EACH OTHER THROUGH THAT
PROCESS SOMEONE ACTUALLY WAS
SHAPED.
OR SOMEONE'S CHARACTER WAS
SHAPED THROUGH THAT PROCESS.
SO I GUESS IN THE INITIAL STAGE
OF THE PSYCHE ANALYTIC THOUGHT,
THE ENVIRONMENT WAS MORE LIKE AN
ABJECT RELATION THEORY WAS SOME
PART OF THE FORMATION OF THE
CHARACTER THAT WAS THE
ENVIRONMENT.
LIKE YOU ARE FAMILY AND SOME
SORT OF -- THE BOOK THAT YOU
READ OR SOMETHING LIKE THAT.
BUT THEN, I THINK AFTER WORLD
WAR II, THE ENVIRONMENTAL FACTOR
WAS MORE LIKE EXPANDED TO AN
EXTERNAL STRESS OR EXTREME
ANXIETIES.
AT THE TIME THEY FELT SOME SORT
OF VERY DIFFERENT EXPERIENCE.
THEY FELT AND THEY EXPERIENCED
THERE SOME SORT OF VERY EXTREME
FEELINGS OF SOMETHING.
SO I THOUGHT IT WAS IDEAL TO --
I NEED TO HAVE MORE CLEAR
CLASSIFICATION OR DEFINITION OF
THE ENVIRONMENT, BUT I NOW JUST
BRIEFLY, I COULD DRAW THE LINE
BETWEEN THOSE ENVIRONMENTAL OR
ENVIRONMENT, THE CONCEPT OF THE
ENVIRONMENT.
>> SURE.
AND YOU'VE DN AN EXCELLENT JOB
IN THAT REGARD.
THE TRAJECTORY FROM THE INTERNAL
TO THE EXTERNAL.
THANK YOU, THAT'S VERY GOOD.
APPRECIATE THE QUESTION.
SOMEONE ELSE WRITES IN, THANK
YOU FOR YOUR RESEARCH INTO DR.
FELIX AND THE AMERICAN MENTAL
HEALTH POLICIES.
THE QUO IS WAS THERE ANY FORMAL
EVALUATION OFFER THE
EFFECTIVENESS OF PSYCHIATRIC
TRAINING INTO MEDICAL SCHOOL.
WHEN DOCTORS THAT WENT INTO
PRACTICE INTO MEDICINE, DID IF
IMPROVE THEIR ABILITY TO REFER
PATIENTS TO MENTAL HEALTH
SPECIAL CYSTS?
>> IT'S A DIFFICULT QUESTION FOR
ME.
AS A HISTORIAN, NOT A DOCTOR.
SO I'M NOT REALLY SURE ABOUT
THAT.
REFERRING TO WORLD WAR II AS I
KNKNOW, THERE ARE A BUNCH OF
PHYSICIANS THAT TRAIN RESIDENTS
OR SPECIAL EDUCATION FOR MAYBE
TWO TO THREE WEEKS OR A MONTH,
THEN THEY JUST GOT INTO THE WAR
FRONT OR SOME SORT OF ARMIES AND
THINGS LIKE THAT.
THEY PROBABLY COULD RECOGNIZE
THE SYMPTOMS OR EXTERNAL -- I
DON'T KNOW HOW DO YOU SAY,
SYMPTOMS AND SIGNALS.
THAT'S WHAT THEY DID ACTUALLY
DURING THE WORLD WORLD WAR II.
DR. FELIX INCLUDING OTHER
SCRITSES, PSYCHIATRISTS, THEY FY
WERE NOT PREPARED FOR THAT SORT
OF SITUATION.
LIKE SO MANY PEOPLE SUFFERED
FROM LIKE NEUROTIC SYMPTOMS.
AT THE TIME NEUROTIC SYMPTOMS
WERE VISIBLE.
SOME I THOUGHT IT WAS -- THEY
WERE PROBABLY COME GUESS AND
ALSO WITH THEIR TRAINING, THEY
COULD TELL SOMETHING.
BUT I DON'T THINK IT'S PROPER
TRAINING TO BE REAL
PSYCHIATRISTS.
I THINK DURING THE TIME, BUT I
DON'T KNOW BEING A REAL
SPECIALIST OR MEDICAL
PROFESSION, OR JUST -- IT WAS MY
GUESS.
>> SURE.
>> TO UNDERSTAND.
>> THANK YOU.
HOW DID YOU BECOME -- I'M SORRY.
>> THAT'S FINE.
>> HOW DID YOU BECOME INTERESTED
IN FELIX AND THE BROADER SUBJECT
OF MENTAL HEALTH IN AMERICA?
>> Dr. Lee: ALL RIGHT.
AS YOU KNOW, MY DOCTORATE
DISSERTATION WAS ABOUT
PEDIATRICIANS.
THE MOST FAMOUS DR. SPOCK,
RIGHTS?
-- RIGHT?
SO I NATURALLY GOT INTO A
DISCIPLINE OF MEDICINE AND I WAS
MORE INTERESTED IN THE CONCEPT
OF SOMETHING.
I WAS PLEASED TO HAVE THAT FIRST
QUESTION, THE CONCEPT OF
ENVIRONMENT AND THEN THE
DEFINITION THAT I AM ALWAYS INTO
THAT KIND OF CONCEPT.
AND I GOT INTO THE CONCEPT OF
ADDICTION FIRST.
AND AS I MENTIONED, LAWRENCE
COLE, HE WAS A SPECIALIST FOR
ADDICTION.
AND I WAS ON WONDERING WHY DR.
FELIX WAS -- LAWRENCE COLE WALS
AWE PREDECESSOR -- LAWRENCE COLE
WAS A PREDECESSOR OF DR. FELIX.
LAWRENCE COLE WAS A PSYCHIATRIST
AS WELL, BUT THEN HE WAS A
SPECIALIST ON ADDICTION.
AND THEN I WAS JUST PUZZLING AT
WHAT IS KIND OF THE CONNECTION
BETWEEN THE ADDICTION SPECIALIST
AND THE PSYCHIATRIST.
PSYCHIATRISTS AT THE STATE
HOSPITAL, THEY GOT WITH THE
DRUGS.
PROBABLY THERE WERE SOME SORT OF
CONNECTIONS BETWEEN THEIR
PROFESSION OR EVEN THEIR
RELATION.
BUT THEN I AM DIGGING IN WITH
THE CONCEPT EVER A DEKS AND
HOW -- CONCEPT OF ADDICTION AND
HOW HE PUT ADDICTION IN THE
ELEMENT OF PSYCHIATRY AS WELL.
HOW I GOT INTO DR. FELIX WAS AT
THAT POINT.
ACTUALLY THERE WAS A CONNECTION
BETWEEN LAWRENCE COLE WAS THE
FIRST.
AND THEN I FOUND FLEKS' PAPER,
OF COURSE COLE'S PAPER IS
ACTUALLY ON LINE.
I THOUGHT IT WAS INTERESTING TO
SEE ACTUALLY BOTH OF THEM.
>> RIGHT.
>> Dr. Lee: FROM PHS AND I
WANTED TO FIGURE OUT HOW THE
CONCEPT OF ADDICTION ACTUALLY
DEVELOPED INTO THIS PSYCHIATRIST
TERMS AND IT WAS UNTIL PART OF
THE PSYCHOPATHIC DISORDERS,
ACTUALLY, IN THE FIRST EDITION
OF THE DSM.
I GOT INTO ALL THOSE INTERESTING
THINGS.
>> VERY GOOD.
VERY GOOD.
GLAD THE LIBRARY COULD BE A
RESOURCE FOR YOU.
>> A LOT OF THINGS TO DO FOR ME.
>> SO, A COUPLE MORE QUESTIONS.
THANK YOU, AGAIN FOR THIS
EXCELLENT AND INFORMATIVE TALK.
COULD YOU SAY MORE ABOUT THE
BUDGET ASPECTS OF MENTAL HEALTH
INSTITUTIONS IN THE EARLY 20TH
CENTURY.
WAS STATE AND FEDERAL FUNDING
AVAILABLE FOR INSTITUTIONS AT
THE COMMUNITY LEVEL?
AND WERE THERE FOR-PROFIT
INSTITUTIONS THAT TOOK MONEY
FROM FAMILIES TO PAY FOR
INSTITUTIONS.
HOW DID THE FOR-PROFIT
INSTITUTIONS COMPARE WITH THE
STATE FUNDED FACILITIES?
>> Dr. Lee: I ASSUME THERE
SHOULD BE SOME INSTITUTIONS WITH
THE -- JUST A PROFIT FROM THE
PATIENT'S FAMILY.
BUT I HAVEN'T LOOKED AT DEEPLY
OR THORL AT THAT.
DEEPLY -- OR THORLLY AT THAT.
IN THE 1920s, THEY BUILT SOME
SORT OF INSTITUTIONS OR ASYLUMS
OR -- NOT ASYLUMS BUT A
SEGREGATED COLONIES OR FARMS
BECAUSE THEY WANTED TO DIVIDE
SOME PATIENTS INTO DIFFERENT
PARTS OF INSTITUTIONS BECAUSE AS
I MENTIONED, UP UNTIL 19 40S,
THEY FELT -- 1940s, THEY FELT
A HELPLESSNESS, FOR PATIENTS,
THEY WERE NOT REALLY CURED.
IT WAS MORE LIKE A HELPLESS
FEELING IT MAKE A CLASS AT
THISCATION OF THEM.
AND 1920s AS YOU MIGHT KNOW,
IT'S THE ERA OF SC SOME SORT OF-
I WOULD SAY THE SEGREGATION OF
THE -- HOW DO YOU SAY THAT -- I
JUST -- I SLIPPED THAT WORD.
INTELLECTUAL FITS, I GUESS I
WOULD SAY.
AND I GUESS THAT WAS KIND EVER
FEEBLE-MINDED PEOPLE.
DURING THAT TIME THEY CALL THAT.
THEY WERE SEGREGATED AS WELL AND
STATE POLIC POLICIES WITH MORE E
THEY BUILT SOME SORT OF
INSTITUTIONS OR MORE LIKE A
WORKING FARM IN ORDERE IN ORDERM
TO WORK.
THEY WERE NOT REALLY
HANDICAPPED.
THEY WERE NOT REALLY WITH
DISABILITIES.
THEY THOUGHT THEY WERE MORE LIKN
CALLED FEEBLE-MINDED, THEY WERE
MORE LIKE LOW INTELLIGENCE OR
SOMETHING LIKE THAT.
AND A LOT OF PEOPLE, I GUESS,
MAYBE ELITE GROUPS IN THES
THOUGHT IT WAS USELESS TO HAVE
THEM IN THE HOSPITAL.
THEY WANTED TO MAKE THEM WORK SO
THEY COULD SEND THEM TO ANOTHER
INSTITUTION.
SO PROBABLY THE STATE FUNDED A
LOT OF MONEY TO BUILD THOSE
FACILITIESES FOR.
AND THEN THEY WANTED TO DIVIDE
IT OR EVEN FOR STATE MENTAL
HOSPITAL, THEY WANTED TO HOUSE
OR THEY WANTED TO HAVE THOSE
LIKE LONG-TERM PATIENTS.
BUT THEN IT GOES UP TO -- I MEAN
THE BUDGET, THEY'RE MORE LIKE
RUNS OUT OF THE BUDGET TO HAVE
ALL OF THEM UNTIL THEY TIE.
I GUESS IT'S THE REASON WHY THEY
WANTED TO DIVIDE A LEVEL OF
PATIENTS AND SEND THEM TO
UTILIZE THEM AS WORKERS OR
LABORERS IN THAT INSTITUTION.
I THOUGHT IT WAS -- I DON'T
KNOW.
ACADEMICALLY INTERESTING TOO TO
SEE THAT AS WELL.
IT'S ANOTHER ONE THAT I'M
DIGGING INTO NOW.
>> THANK YOU.
SO WE HAVE TIME FOR ONE MORE
QUESTION.
YOU NOTED THAT OLDER PEOPLE WITH
COMMON AGE-RELATED MENTAL
DECLINE WERE OFTEN
INSTITUTIONALIZED BY THEIR
FAMILIES.
DID THE MANAGERS AND LEADERS OF
THE INSTITUTIONS TRY IT
DISCOURAGE THIS BY REJECTING
THOSE PATIENTS OR EXPLAINING TO
THE FAMILIES THAT THEIR
RELATIVES WERE NOT MENTALLY ILL,
JUST EXPERIENCING NORMAL
AGE-RELATED DECLINE?
>> I THINK I JUST MISS THE
QUESTION.
>> SO -- MISSED THE QUESTION.
>> I THINK WHAT IN QUESTION
GETTING AT, IS DID THE LEADERS
AND MANAGERS OF THE STATE
INSTITUTIONS, DID THEY TRY TO
DISCOURAGE THE --
>> Dr. Lee: YOU MEAN DECLINE
THEM TO BE INSTITUTIONALIZED?
>> CORRECT.
>> Dr. Lee: WELL, I GUESS MAYBE
UNTIL 1940s, THEY COULDN'T
REJECT THEM.
BECAUSE, I MEAN, WHEN THEY GOT
THEIR PATIENTS PROBABLY JUST
THEY HOUSED UNTIL THEY DIE.
THAT'S KIND OF THE PATTERN
BECAUSE OF THAT.
COST OF CARE WHICH MEANS --
CUSTODY OF CARE WHICH MEANS THEY
DIDN'T HAVE ANYWHERE TO GO.
I GUESS THEY PROBABLY -- IN THE
BEGINNING OF THEIR
INSTITUTIONALIZATION, I GUESS,
THERE IS NO PLACE TO GO FOR
THEM.
SO INEVITABLY, THEY WERE MORE
LIKE PERMANENT PATIENTS.
SO THAT'S WHY I MENTIONED THE
SUPERINTENDENT SERVED THE
INSTITUTION, THEY ESTABLISHED
ANOTHER ONE TO LIKE
INSTITUTIONALIZE SOME SORT OF
HYBRID OR IN-PATIENTS WITH SOME
SORT OF ABLE-BODIED.
I GUESS THAT'S PART OF THE
SITUATION THAT THEY KIND OF TRY
TO MAKE THE SITUATION BETTER
WINDCHILL THAT DENYING PEOPLE OR
OLDER PEOPLE WITH ANY
POSSIBILITY TO RECOVER.
I GUESS THAT'S THE WAY -- THEY
DIDN'T REALLY REJECT, BUT THEY
DID SOMETHING TO SOLVE THE
PROBLEM WITH THE OLDER PEOPLE
LIKE JUST -- I MEAN LIKE USING
SEDATIVES TO BE CALM.
AND I GUESS THAT'S KIND OF THE
SITUATION DURING THE 1940s.
BUT UNFORTUNATELY AFTER 1940s,
THEY MOVED TO THE DREKS DIRECTIN
THE 1940s AND 1950s, THIS
WERE MOVING TOWARD SOME SORT OF
COMMUNITY-BASED
NON-INSTITUTIONALIZED
PSYCHIATRY.
I THOUGHT IT WAS KIND OF THE END
OF -- UP UNTIL THEIR LIFE, THEY
DIDN'T GET ANOTHER PATIENTS
MORE.
BUT I GUESS -- UP UNTIL 1940s
THEY HADN'T REJECTED -- THEY
DIDN'T.
BUT THEN, I WOULD SAY THEY USED
DIFFERENT WAYS OF CLASSIFYING
THOSE PATIENTS.
I WOULD SAY THAT.
>> OKAY.
THANK YOU.
>> WE'VE REACHED THE END MUCH
OUR TIME TOGETHER.
ON BEHALF OF THE NATIONAL
LIBRARY OF MEDICINE AND MY
COLLEAGUES, I WOULD LIKE TO
THANK YOU VERY MUCH, DR. LEE,
FOR PREPARING THIS CAU TALK AND
COMING TO OUR CENTER FOR
RESEARCH.
WE'RE HAPPY TO SEE YOU VIRTUALLY
AND IN-PERSON AND WE WISH YOU
SUCCESS IN YOUR SEARCH AND
PUBLISHING YOUR WORK SO WE CAN
LEARN MORE ABOUT YOUR WORK ON
DR. FELIX AND RELATED SUBJECTS.
I WISH YOU WELL YOU AND YOUR
FAMILY IN SOUTH KOREA.
I KNOW IT'S THE MIDDLE OF THE
NIGHT FOR YOU SO WE'RE
ESPECIALLY GRATEFUL FOR YOU TO
BE WITH US.
WE LOOK FORWARD TO KEEPING IN
TOUCH WITH YOU.
THANK YOU.
>> Dr. Lee: THANK YOU.
>> BEFORE OUR VIEWERS LEAVE US
TODAY, I WOULD LIKE TO RENIEND
EVERYBODY THAT WE HAVE -- REMIND
EVERYBODY THAT WE HAVE OUR LAST
NLM HISTORY TALK COMING UP
THURSDAY NOVEMBER 21ST.
WE'LL WELCOME DR. WILLIAMS FROM
THE UNIVERSITY OF BUFFALO WHO IS
AN ASSOCIATE PROFESSOR THE
HISTORY THERE.
SHE'S A 2022 NLM FELLOW.
THE TEATAL OF HER TALK IS
"ASSAILED AT HOME THE PUSH FOR
MATERNAL CARE ADVANCEMENTS IN
NIGERIA."
PLEASE JOIN US NOVEMBER 21ST,
2:00 EASTERN TIME.
THIS WILL BE VideoCast.
IN THAT REGARD, I WOULD LIKE TO
THANK OUR COLLEAGUES BEHIND THE
SCENES THAT MAKE THE
VideoCast AND YouTube
STREAMS POSSIBLE AND WE THANK
YOU DR. NAMHEE LEE FOR HER
RESEARCH TODAY.
WINDOW THANK YOU HER AND ALL OF
YOU FOR TUNING IN TODAY.
WINDOW LOOK FORWARD TO SEEING
YOU ON NOVEMBER 21ST FOR DR.
WILLIAMS' TALK.
THANK YOU, HAVE A GOOD DAY.
GOOD-BYE.