Medicine: Hope for Sanity

Most psychiatrists’ reports are woven around the tortured braggings of a paranoiac, the sullen stupors of a schizophrenic. Few ever bother with such broader problems as the relation of insanity to unemployment, to age, to sex, to alcohol. And no one has seriously answered the crucial questions: Is insanity in the U. S. increasing, and if so, why?

During the past twelve years, Psychiatrist Neil Avon Dayton of Boston’s Tufts College, with a grant of $140,000 from the Rockefeller Foundation, has run these questions down. With 24 social workers, he dug into the records of 89,000 mental patients who had passed through Massachusetts hospital doors in the turbulent years 1917-33. Last week he published New Facts on Mental Disorders (C. C. Thomas; $4.50), a statistical treatise on insanity in the U. S. His facts were startling, his conclusions encouraging. No groaner, Dr. Dayton believes that “the great mass of the population possesses a mental balance . . . truly remarkable.”

Unemployment. From 1921 to 1931, as employment throughout the U. S. decreased, the number of mental patients admitted to mental hospitals showed a “striking” increase. From 77 admissions per 100,000 population in 1921, the rate increased to an all-time high of 86 in 1931. “A drop to 85 occurs in 1932 and the same rate is held in 1933. The more substantial increases in admission rates had occurred between 1923 and 1929 when more than 100,000 workers were laid off. In the period following 1929 nearly twice as many additional workers were laid off, yet only a slight increase in new cases of mental disorder is observed.” Reason: Widespread relief began after 1931, and relief staved off insanity.

Alcohol and Prohibition. More than a fifth of all U. S. mental patients are alcoholics. In 1920, the first bone-dry Prohibition year, the number of admissions to mental hospitals dropped from 85 per 100,000 of the population to an all-time low of 72. Prohibition did it, says Dr. Dayton. By 1921, when bootlegging had begun, admissions rose to 77; the following year they climbed to 82. Dr. Dayton, who firmly believes that liquor makes lunatics, accuses psychiatrists of neglecting this important problem.

Age. Most widespread U. S. mental disorder, according to expert opinion, is dementia praecox, or schizophrenia (split personality). Dr. Dayton’s statistics tell a different story. Mental disease No. 1 is senile psychosis, the madness of old age. Causes: hardened arteries, threadbare nervous system, worn-out brain, tired heart, “outrageous fortune.” From 1917 to 1933, there was an average of 2,000 senile psychotics per 100,000 population; schizophrenics averaged only 538.

“Mental disorder,” concludes Dr. Dayton, “is a disease of old age. . . . The younger ages demonstrate actual decreases in mental disorders.”

Increase v. Decrease. Are U. S. citizens getting crazier? Dr. Dayton thinks not. Re-admissions to mental hospitals, he found, “have been decreasing. This is of tremendous significance.” Hospital care, he suggests, is probably more successful than most people think. As for new cases, “the increase . . . over the period 1917-1933 is at the rate of less than one-quarter of one percent per year. Mental disorders are increasing but so gradually that all apprehensions as to the seriousness of the situation may be discarded.”