Thirty-seventh annual report for the year 1944 / [Cardiff City Mental Hospital].
- Cardiff City Mental Hospital
- Date:
- [1945?]
Licence: In copyright
Credit: Thirty-seventh annual report for the year 1944 / [Cardiff City Mental Hospital]. Source: Wellcome Collection.
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![any apparent realisation of the necessity for preventive or research activities designed to combat the dead weight of chronicity which has been a feature of psychiatry for generations. Signs are not wanting that the more speciali ed bodies dealing with the subject are alive to their responsibilities but unless the measures they advocate are translated into the sphere of practical politics, i.e., by extending the psychiatric services into the general hospitals of the country and making them part and parcel of a general medical service under expert psychiatric direction from the top down, then all attempts at prevention will fail. The problem of mental disorder is a vast one ; it m&y briefly be considered under the following headings : (1) The Psychonev roses, estimated to affect some 2% of the popu¬ lation are numerically the most important group, and constitute one- third of all sick people in the community. These are the people who suffer from what are popularly called “ nerves,” that is, states of emotional maladjustment which prevent them from facing up the the real issues and demands of life. Just as peace is indivisible so also is mind and body, and however much we like to think of them as separate entities we are so created that friction in one inevitably leads to disharmony in the other. One result of this is that when things go wrong in our lives, when dis¬ satisfactions arise from faulty adaptation to our work, our domestic situations or in our social relations, internal tensions are set up which tend to express themselves as bodily, that is, neurotic symptoms which simulate the symptoms of organic disease. Paradoxically enough, know¬ ledge of how these bodily symptoms arise is generally hidden from the patient, for the emotional causes are below the level of consciousness, so that it will be readily seen that for treatment to be effective, the symptoms must be traced to their hidden source and the emotional skein unravelled before conscious readjustment can be made and psycho¬ logical health restored. The diseases listed under the heading psycho¬ neuroses include anxiety states, hysteria, various fears and obsessions, sexual maladjustments and abnormalities and feelings of inferiority and inadequacy. It is now statistically accepted that one out of every three persons who seek the services of hospital and doctor for the relief of symptoms of any nature is realty suffering from one or other of the neuroses. In addition, very many patients who are suffering from organic disease have associated with it emotional factors which are more distressing than the organic disease itself and there are few doctors who would to-day deny that diseases such as migrane, asthma, gastric and duodenal ulcer, and essentia] hypertension have each in their own way underlying psychic factors which play an important part in their etiology or maintenance. (2) The Psychoses or Insanities. These are a much lesser problem numerically than the ps3^choneuroses, but are more widely publicised and recognised. There are approximately 160,000 notified insane persons in mental hospitals in England and Wales, i.e., 3-9 per thousand of the population. There are, in addition, many thousands of psychotic persons who, because their insanity does not lead to abnormal behaviour, are living at home and leading lives of varying degrees of usefulness. The cost of the upkeep of mental hospitals in 1939 was estimated at some 12 million pounds. Some 60 to 70% of the ordinary mental hospital population consists of chronic patients. To assume from these figures that insanity is an irrecoverable condition would be a mistake. Just as there are many different kinds of fever so there are many different forms of insanity and with modern advances in treatment many insanities formerly considered incurable are to-day quickly and easily cured. The reasons for the preponderance of chronic patients in the mental hospital](https://iiif.wellcomecollection.org/image/b30299834_0011.jp2/full/800%2C/0/default.jpg)
