Psychology And Psychiatry In Pediatrics - The Problem

WHlt H JSE CONFERENCE ON CHILD HEALTH t t AND PROTECTION Called by President Hoover PUNNING COMMITTEE I EXECUTIVE COMMITTEE SECTION I MEDICAL SERVICE SAMUEL McC. HAMILL, M. D., Chairman Committee on MEDICAL CARE FOR CHILDREN PHILIP VAN INGEN, M. D., Chairman PSYCHOLOGY AND PSYCHIATRY IN PEDIATRICS THE PROBLEM II For every child understanding and the guarding of his personality as his most precious right From THE CHILDRENS CHARTER Dedicated to THE CHILDREN OF AMERICA WHOSE FACES ARE TURNED TOWARD THE LIGHT OF A NEW DAY AND WHO MUST BE PREPARED TO MEET A GREAT ADVENTURE SECTION I MEDICAL SERVICE SAMUEL McC, HAMILL M. D. Chairman Philadelphia COMMITTEE C MEDICAL CARE FOR CHILDREN PHILIP VAN INGEN, M. D.., Chairman New York City SUBCOMMITTEE ON PSYCHOLOGY AND PSYCHIATRY BRONSON CROTHERS, M. D., Chairman Assistant Professor of Pediatrics, Harvard University Medical School, Neurologist to Childrens Hospital, Boston JOHN E. ANDERSON, Ph. D., Director, Institute of Child Welfare, University of Minnesota, Minneapolis DAVID M. LEVY, M. D., Chief of Staff, Institute for Child Guidance, New York City ADOLF MEYER, M. D., Professor of Psychiatry, Johns Hopkins University School of Medicine Psychiatrist-in-Chief, Johns Hopkins Hospital, Baltimore, Maryland JAMES S. PLANT, M. D., Director, Essex County Juvenile Clinic, Newark, New Jersey ESTHER CORING RICHARDS, M. D., Associate Professor of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland EDWARD A. STRECKER, M. D., Professor of Nervous and Mental Diseases, Jefferson Medical College of Philadelphia DOUGLAS A. THOM, M. D., Director of Division for Mental Hygiene, Massachusetts Department of Mental Diseases, Boston CONTENTSPAGE INTRODUCTION 3 DEFINITION OF FIELD 12 EXTENT OF PROBLEM 20 PRESENT PROCEDURE 25 Organized Clinics for Children 25 The General Psychiatric Clinic 26 Psychiatric Work in Direct Connection with General and Childrens Hospitals .27 PLACE OF THE GENERAL PRACTITIONER .... 29 DEFICIENCIES IN PRESENT PROCEDURE .... 35 Attitude and Practice of Pediatricians .... 36 THE ATTITUDE OF PSYCHIATRISTS TOWARD PEDIATRICIANS 40 CONCLUSIONS 42 EXTRACTS FROM DISCUSSION ....... 44 APPENDIX 61 METHODS OF OBTAINING INFORMATION . . . .61 TYPICAL GROUPS PRIMARILY EDUCATIONAL . . 67 The Merrill-Palmer School 67 CLINICS WITH DEFINITE RELATION TO COURTS . . 72 Institute for Child Guidance ...... 73 Essex County Juvenile Clinic . . . 119 PSYCHIATRIC SOCIAL WORKERS . . . . . . . 125 VISITING TEACHERS 136 LETTERS DESCRIBING TYPICAL PROGRAMS . . . 137 PSYCHOLOGY AND PSYCHIATRY IN PEDIATRICS THE PROBLEM PSYCHOLOGY AND PSYCHIATRY IN PEDIATRICS THE PROBLEM INTRODUCTION THIS Subcommittee realizes that no useful purpose will be served by a general discussion of psychiatry and psychology. It has confined its investigation to those aspects of these subjects which are of direct interest to physicians in charge of the medical care of children. It has been clear to all of us from the start that peril ous and fascinating fields of study are open to anyone who expresses interest in psychiatry and psychology. Eager guides are ready to show him that the prevention of in sanity, the control of crime and the conduct of education are of such great importance and complexity that the troubles of the individual doctor and the individual child in distress are simple in comparison. For the purposes of this report, however, we areconfining our efforts to the more restricted field. It is evident that unless we can avoid interminable discussion as to definitions we are helpless in presenting a point of view. It is also clear that we should be rash indeed to insist that these definitions are accurate enough to stand under all circumstances. Psychology is a science dealing with mental processes and human behavior...