Horatio M. (Horatio Milo) Pollock - Eugenics as a Factor in the Prevention of Mental Disease

Eugenics as a Factor in the Prevention
of Mental Disease

By
HORATIO M. POLLOCK, Ph.D.
Statistician, New York State Hospital Commission

THE NATIONAL COMMITTEE FOR MENTAL HYGIENE, Inc.
370 Seventh Avenue
New York City
1921

The National Committee for Mental Hygiene

The National Committee for Mental Hygiene and its affiliated state societies and committees are organized to work for the conservation of mental health; to help prevent nervous and mental disorders and mental defect; to help raise the standards of care and treatment for those suffering from any of these disorders or mental defect; to secure and disseminate reliable information on these subjects and also on mental factors involved in problems related to industry, education, delinquency, dependency, and the like; to aid ex-service men disabled in the war, to coperate with federal, state, and local agencies and with officials and with public and private agencies whose work is in any way related to that of a society or committee for mental hygiene. Though methods vary, these organizations seek to accomplish their purposes by means of education, encouraging psychiatric social service, conducting surveys, promoting legislation, and through coperation with the many agencies whose work touches at one point or another the field of mental hygiene.

When one considers the large groups of people who may be benefited by organized work in mental hygiene, the importance of the movement at once becomes apparent. Such work is not only for the mentally disordered and those suffering from mental defect, but for all those who, through mental causes, are unable so to adjust themselves to their environment as to live happy and efficient lives.

[Reprinted from Mental Hygiene , Vol. V, No. 4, October, 1921, pp. 807-812.]

EUGENICS AS A FACTOR IN THE PREVENTION OF MENTAL DISEASE

HORATIO M. POLLOCK, Ph.D
Statistician, New York State Hospital Commission

The burden of mental disease is each year becoming heavier. State hospitals for mental disease throughout the country are overcrowded, and the construction of new hospitals does not keep pace with the increase of patients. Fairly complete censuses show that the number of patients with mental disease under treatment in institutions increased from 74,028 in 1890 to 232,680 in 1920. The rate per 100,000 of population increased from 118.2 to 220.1. Careful estimates based on statistics of the New York State Hospital Commission indicate that approximately 1 out of 25 persons becomes insane at some period of life. The economic loss to the United States on account of mental disease, including loss of earnings as well as maintenance of patients, is now over $200,000,000 per year. Although much of the apparent increase in the prevalence of mental disease may be due to causes that do not involve weakened resistance to the stresses of life, the load born by the public is clearly becoming more oppressive.

Associated burdens are those of mental defect, epilepsy, dependency, and delinquency. These combined cause an economic loss even greater than that caused by mental disease.

Taxpayers are groaning under excessive loads and calling in vain for relief, but their cries are faint compared with those of the persons whose relatives are mentally diseased or defective.

As less than one-fourth of those who develop psychoses can be cured by present methods of treatment, we cannot hope for any permanent relief by treating patients in hospitals. The most skillful treatment should of course be given, but the problem must be attacked in other ways before any adequate solution can be hoped for.

The fact of inheritance of the neuropathic constitution may be taken for granted. Much evidence has been adduced to prove that such inheritance occurs in accordance with Mendelian laws, but the subject is so complicated that more comprehensive studies must be made before we may consider the matter as settled. The application of skillfully devised measures of intelligence has shown us that there are many grades of intelligence between the idiot and the super-average. The so-called normals represent many types, the extremes of which are as far apart as the moron is from the low-grade normal. Recent studies of temperamental abnormalities have also revealed a wide variety of types and combinations. These abnormalities or marked peculiarities seem to be more or less dissociated from intellectual capacity. Children with super-average intelligence are frequently seclusive and morons often seem to be temperamentally normal. It becomes difficult, therefore, to establish standards of normality and to draw fixed lines between the normal and the neuropathic. This is especially true in studying family histories, when judgment must be based on reports of untrained observers. Mental disease may occur in a person of almost any type of intellectual or temperamental make-up. This fact was clearly demonstrated during the recent World War. Men of strong intellect and of exceptional poise who had withstood the strain of intense warfare for several months at last succumbed when weakened by wounds and deprivation of food and drink. These were extreme cases, but they illustrate the important principle that all men have limitations and may develop a psychosis or expire when their limit is reached. Psychopathic personalities give way to the common stresses of life, while stronger personalities yield only to extraordinary mental strain. It is evident, therefore, that the whole etiology of a case of mental disease must be carefully studied before the related family stock can be safely discredited.

The data we have collected in the New York State Hospital Commission relative to the family history of patients seem to indicate that slightly more than half of our ascertained cases have no discoverable hereditary basis. If more thorough inquiries were made, the proportion of patients with unfavorable family history might be increased, but the significance of the history in relation to the family stock is open to question in many cases.

In our hospitals for some years past, we have studied both the intellectual and temperamental make-up of the first admissions and have tried to apply uniform standards throughout the service. In 1920 it was found that of the ascertained cases 61 per cent were temperamentally normal and 88 per cent were rated as intellectually normal. Only about 7 per cent of the patients were both temperamentally and intellectually abnormal. The proportion of patients with abnormal make-up varied considerably in the different groups of psychoses. For example, in the dementia-praecox group in 1920, 61 per cent were rated as temperamentally abnormal while in the manic-depressive group only 33 per cent were so rated.