THE SMITH COLLEGE EXPERIMENT IN TRAINING FOR PSYCHIATRIC SOCIAL WORK By W. A. NEILSON, LL.D. President of Smith College THE NATIONAL COMMITTEE FOR MENTAL HYGIENE, Inc. 50 Union Square New York City 1919 REPRINT NO. 46. Rational Committee for Jttental FOUNDED 1909 INCORPORATED 1916 50 UNION SQUARE, NEW YORK CITY President DR. LEWELLTB F. BARKER CHARLES W. ELIOT Vice-Presidents DR. WALTER B. JAMES Treasurer OTTO T. BANNARD DR. WILLIAM H. WELCH Executive Committee DR. WILLIAM L. RUSSELL, Chairman DR. LEWELLTS F. BARKER DR. WALTER E. FERNALD DR. GEORGE BLUMER MATTHEW C. FLEMING DR. OWEN COPP DR. GEOHGE H. KIRBT STEPHEN P. DUGGAN Committee on Mental Deficiency DR. WALTER E. FERNALD, Chairman DR. L. PIERCE CLARK DR. CHARLES S. LITTLE Finance Committee DR. WALTER B. JAMES, Chairman OTTO T. BANNAHD RUSSELL H. CHITTENDEN * DR. WILLIAM B. COLET STEPHEN P. DUGGAN WILLIAM J. HOGGSON War Work Committee DR. CHARLES L. DANA, Chairman DR. FRANKWOOD E. WILLIAMS, Vice-Chairman Executive Officers DR. THOMAS W. SALMON, Medical Director DR. FRANKWOOD E. WILLIAMS, Associate Medical Director CLIFFORD W. BEERS, Secretary MEMBERS MRS. MILO M. ACKER, Hornell, N. Y. JANE ADDAMS, Chicago EDWIN A. ALDERMAN, Charlottesville, Va. MRS. A. A. ANDERSON, Greenwich, Conn. DR. PBARCB BAILEY, New York DR. CHARLES P. BANCROFT, Concord, N. H. OTTO T. BANNARD, New York DR. LEWELLYS F. BARKER, Baltimore DR. ALBERT M. BARRETT, Ann Arbor, Mich. DR. FRANK BILLINGS. Chicago SURO. GEN. RUPERT BLUE, Washington DR. GEORGE BLUMER, New Haven DR. G. ALDER BLUMEH, Providence WILLIAM H. BURNHAM, Worcester DR. C. MACFIE CAMPBELL, Baltimore RUSSELL H. CHITTENDEN, New Haven DR. L. PIERCE CLARK, New York DR. WILLIAM B. COLBY, New York DR. OWEN COPP, Philadelphia DR. CHARLES L. DANA, New York C. B. DAVENPORT, Cold Spring Harbor, N. Y. STEPHEN P. DUGGAN, New York CHARLES W. ELIOT, Cambridge DR. CHARLES P. EMERSON, Indianapolis ELIZABETH E. FARRELL, New York W. H. P. FAUNCE, Providence KATHERINB S. FELTON, San Francisco DR. WALTER E. FERNALD, Waverley, Mass. JOHN H. FINLEY, Albany IRVINO FISHER, New Haven MATTHEW C. FLEMING, New York HOMER FOLKS, New York DR. CHARLES H. FRAZIER, Philadelphia JAMES, CARDINAL GIBBONS, Baltimore ARTHUR T. HADLEY, New Haven DR. WILLIAM HEALY, Boston DR. ARTHUR P. HERRING, Baltimore HENRY L. HIGGINSON, Boston DR. AUGUST HOCH, Santa Barbara, Cal. WILLIAM J. HOGOSON, Greenwich, Conn. DR. WALTER B. JAMES, New York MRS. WILLIAM JAMES, Cambridge HARRY PRATT JUDSON, Chicago DR. CHARLES G. KBHLEY, New York DR. GEORGE H. KIHBY, New York FRANKLIN B. KIRKBRIDB, New York DR. GEORGE M. KLINE, Boston JOHN KOREN, Boston JULIA C. LATHROP, Washington ADOLPH LEWISOHN, New York SAMUEL McCuNE LINDSAY, New York DR. CHARLES S. LITTLE, Thiells, N. Y. GEORGE P. MCLEAN, Simsbury, Conn. V. EVERIT MACY, Scarborough, N. Y. MARCUS M. MARKS, New York MRS. WILLIAM S. MONROE, Chicago DR. J. MONTGOMERY MOSHEH, Albany DR. FRANK P. NORBURY, Jacksonville, 111. WILLIAM CHURCH OSBORN, New York DR. STEWART PATON, Princeton DR. FREDERICK PETERSON, New York HENRY PHIPPS, New York GIPFORD PINCHOT, Washington FLORENCE M. RHETT, New York DR. ROBERT L. RICHARDS, Talmage, Cal. MRS. CHAS. C. RUMSEY, Wheatley Hills, N. Y. DR. WILLIAM L. RUSSELL, White Plains, N. Y. JACOB GOULD SCHUHMAN, Ithaca DR. ELMER E. SOUTHARD, Boston DR. M. ALLEN STARR, New York DR. HENRY R. STEDMAN, Brookline, Mass. ANSON PHELPS STOKES, New Haven DR. CHARLES F. STOKES, Briarcliff, N. Y. DR. FREDERICK TILNEY, New York VICTOR MORRIS TYLER, New Haven MRS. WILLIAM K. VANDERBILT, New York HENRY VAN DYKE, Princeton DR. HENRY P. WALCOTT, Cambridge LILLIAN D. WALD, New York DR. WILLIAM H. WELCH, Baltimore BENJAMIN IDE WHEELER, Berkeley, Cal. DR. WILLIAM A. WHITE, Washington DR. HENRY SMITH WILLIAMS, New York ROBERT A. WOODS, Boston ROBERT M. YEHKES, Minneapolis CHIEF PURPOSES: To work for the conservation of menial health; to promote the study of mental disorders and mental defects in all their forms and relations; to obtain and disseminate reliable data concerning them; to help raise the standards of care and treatment; to help coordinate existing agencies, federal, state and local, and to organize in every state an affiliated Society for Mental Hygiene. n [Reprinted from MENTAL HYGIENE, Vol. Ill, No. 1, pp. 59-64, January, 1919.] THE SMITH COLLEGE EXPERIMENT IN TRAIN- ING FOR PSYCHIATRIC SOCIAL WORK* W. A. NEIL8ON, LL.D. President of Smith College T FEEL somewhat apologetic in appearing here as a mere lay- 1 man in the company of experts and special students, because professionally I know nothing about mental hygiene and nothing about psychiatry, and am only a college administrator whose fortune it was last summer, under the stress of the war, to come into contact with the special study that brings you together here today. Last spring the authorities of Smith College felt disturbed, like their colleagues in other institutions, at the prospect of lying idle through the summer when everyone in the country was doing an extra share in the war emergency. The result of their looking about for a profitable way to employ their equipment and their resources in summer was that they came under the advice of a sub-committee of The National Committee for Mental Hygiene; and, with the aid of the Psychopathic Department of the Boston State Hospital, especially under the influence of Dr. E. E. South- ard, they undertook an entirely new experiment for them, and in some respects, as regards scale at least, a new experiment for the country as a whole. They attempted to establish a method for the training of psychiatric social workers a phrase which I con- fess terrified my constituency until they learned how to spell it. The purpose in view was to educate women so that they might help in getting up the social history of cases presented for diagnosis to psychiatrists, that they might be of use in the treatment of such cases, and that finally they might serve in the social read- justment of psychopathic cases discharged from hospitals. The interest of the moment was of course in mental and nervous dis- orders resulting from the war, but they were assured that this class of disorders was by no means confined to war conditions and * Read as part of a symposium on mental hygiene and education at the annual meeting of the Massachusetts Society for Mental Hygiene, Tremont Temple, Boston, January 16, 1919. The other papers in the symposium were: "The Need for Instruction in Mental Hygiene in Medical, Law and Theological Schools," by Dr. H. Douglas Singer; "Mental Hygiene and the Public School," by Dr. Arnold Gesell; "Facts of Mental Hygiene for Teachers," by Dr. Walter F. Dearborn, and "Nervous Children and Their Training," by Dr. C. Macfie Campbell, pages 4, 11, 16, 24, MENTAL HYGIENE, Vol. Ill, No. 1 1 2 MENTAL HYGIENE that the profession for which they proposed to train would be a permanent one. It was clearly understood from the beginning that we were not to make psychiatrists and that we were not making half -doctors. These women were to be aides to experts. The first lesson that was taught all the members of the school was professional mod- esty. The training given was of a variety of kinds, but closely related. The center of them all was psychiatry. The students were made familiar with the various forms of mental and nervous disorders. They were taught the more obvious symptoms, the ruling causes. They learned the vocabulary of the profession, and much of the external aspects, and a good many of the internal reasons. The idea was to make them intelligent cooperators with the psychiatric doctors. Along with this went the training in social case-work, from which they learned the method of in- vestigating the domestic, social and industrial environment of these cases, and the influences coming from these various sources having a bearing upon the disease in question. Along with psychiatry was taught a good deal of normal psy- chology; then, further outside, they had courses in sociology. Just as they learned the normal activities of the human mind in the courses in psychology as against the morbid ones hi the psychiatric courses, they learned the normal organization of society, in order to know into what particular social fabric they were to aim to replace the cases that were to come under then- care later. The members of the school were mainly graduates of the wo- men's colleges. They were selected carefully, largely by personal interview, but in some cases by correspondence. Some seventy women were collected from all over the country, twenty different states and twenty different colleges being represented. About a dozen of the seventy had not been through college, but had had what we are pleased to call the equivalent of a college education. These were mostly women who had had a good deal of social experience. The didactic part of the course lasted for eight weeks, from the first week of July to the beginning of September, followed by six months' practical application of what had been learned, in hos- pitals and other social agencies in Boston, New York, Philadelphia and Baltimore. Of the fifty or more students who completed the didactic course, forty-seven are now being trained under observa- TRAINING FOR PSYCHIATRIC SOCIAL WORK 3 tion, with occasional instruction and criticism, in institutions in these four cities. By March there will be about fifty-five more trained social workers in the psychiatric field than there were a year ago, through this particular experiment. The methods of instruction were the usual ones : lectures, read- ings, discussions, clinical demonstrations at the neighboring state hospital for the insane, with lectures attached to these clinical observations. The advantages of the particular experiment were, first of all, those coming from the comparative isolation of the group. The college of ordinary times of course was not there. It was during the summer vacation. These seventy women were in possession not only of the campus but also of the town. They were all doing the same kind of work. They were supposed to be active in it eight hours a day, and were in fact on the average active in it much more than that time. There were no college activities, no distractions; there was no suggestion that what they were doing in their regular work was a task and that something else was re- laxation. They enjoyed their work to a degree that caused grave reflection hi the minds of any person professionally engaged in education who had the advantage of beholding them. The con- trast with the ordinary situation in an American so-called institu- tion of learning was a cheering contrast as far as this school was concerned a most depressing contrast when our ordinary insti- tutions are considered. I should dislike to be forced to say how many weeks of regular winter work it would take to equal what was accomplished in these eight weeks in summer. The isolation and these other circumstances mentioned led to a very great intensity in their operations. The homogeneous nature of the group was also a great aid ; for although their ages ran from twenty to forty-six or so, and although some of them were just out of col- lege and others had seen a great deal of life, they were bound together for the time by this dominating interest. A great many incidental questions were settled by the experi- ment. The kind of subject matter which was brought to their notice was quite frequently the kind that is not supposed to b talked about in the presence of young girls much less, said to them. There was no nonsense among these students. There was no evidence of morbidity of any kind. They were there to learn to be of service to the community. They took their work seriously. Their intellectual curiosity was kindled and they 4 MENTAL HYGIENE learned a great deal and went out ready to apply it in the spirit of active social service. This was made possible by generous cooperation. The Perma- nent Charity Fund of Boston provided part of the financial means. A good many of the staff of the College remained through the summer and gave their services. A very large number of dis- tinguished psychiatrists, from the Pacific Coast to the Atlantic, came and gave one or two lectures each through the summer. There was no distinction between those who were working for a wage and those who were not, because everyone was absorbed by the interest of the experiment and the magnitude of the possible service. There was no sentimentality about the undertaking. The stu- dents were taught and shown the particular kind of needs that they were meant to serve; they were constantly faced by un- pleasant facts, and there was no need for any artificial working up of the sentimental emotions. Any decent woman would have responded as they did to the necessity for acquiring as exact knowledge as possible, and as much of it as possible, for the meet- ing of those needs. Of the seventy, some three or four fell out at once, fortunately recognizing that it was no place for them. A few more, it devel- oped, did not have the physical strength. Two or three were found not up to the mark at the examinations. The tests that were applied were as severe as the ordinary academic tests. The certificates issued to those who were to be allowed the privilege of going on with practical work were given after severe scrutiny, and all of the body of women who went out enjoyed the confidence of the lecturers who had taught them. The universal testimony of the visiting lecturers was that they had seldom had the privilege of addressing so intelligent an audience and one that seemed so worth their while. This piece of work was done, as you perceive, under great pres- sure, like nearly all the war work of the colleges. The teaching part of it was condensed into eight weeks; the practical part crowded into six months. These terms would not have been chosen in ordinary times, but we did not know how dire the need might be by the coming spring for service of this kind. As it turns out, the need is not going to be so great as we feared. We come, then, to face the normal situation of peace times the call from psychiatrists for intelligent, trained social workers to TRAINING FOR PSYCHIATRIC SOCIAL WORK 5 aid and support them, and to carry out their treatment in ordi- nary civil cases. The question that naturally would be asked is whether this experiment is, on the part of the college, to remain an isolated one, or whether we are to go on doing this kind of thing. The answer will depend, first of all, upon the readiness with which hospitals and psychiatrists avail themselves of the services of these women when their training is finished. Some of them, those who had had social training before they came in the summer, have already been placed. Places are waiting for a number of those who are now taking the social training; and some of the others are still looking about. We expect, with a good deal of confidence, that, by the end of spring when all the students have finished, each will have found his opportunity. In this expectation we are naturally going on with further plans. The first question that comes up is whether we should continue to try to do the thing in as great a hurry as before. It seems wise to expand it to some extent. Much of the special advantage of the situation would be lost if we attempted to bring such a group together in term time, when they would be surrounded, and I may say swamped, by two thousand undergraduates. The particular conditions, I think, can only obtain if they are there by them- selves, or at least accompanied only by other workers preparing for a profession in somewhat the same spirit. The scheme which is under preparation at the moment is to go on with this training if your experts encourage us, but to have one course of eight weeks this coming summer on the same lines as before, followed by a whole winter of practical work, more system- atically supervised if possible, and with some lecture work in- terspersed, and completed by a second summer of eight weeks, when we shall be able to deal with these students after they know much more of the problems concerned from actual experience. This means that the ordinary college graduate who wishes to go into psychiatric work will need to add only fourteen months to her training for her bachelor's degree. That is, she will be able to begin her profession practically one year later than she normally would. Instead of beginning it in September of the year in which she graduated, she would be open for a position in Septem- ber of the following year, having had, however, four months of very solid and highly concentrated specialist instruction in the classroom, and eight or nine months of practical training in the field. This would remove the training from the class of war 6 MENTAL HYGIENE emergency work; it would no longer be hurried or a short cut to a profession. The possibility of this kind of concentrated training arises partly from the external conditions I have tried to describe, but also from the fact that we are dealing with women who have learned how to study. They are trained minds, selected minds; they know what they want. They are engaged in this work, all of them, not in order to get diplomas or degrees or for "college life," but because they want to be equipped. Therefore all their energies are devoted to this one aim, and they are free from the demands of varied studies, from the feeling that it is necessary for them "to play" a large part of their time, and from the distrac- tions of a large city. The remoteness of Northampton is a distinct advantage in this respect. From the point of view of climate, it turned out to be entirely possible. It was tried out in a pretty hot summer. The students stood it, and there is no reason to believe that they could not stand it every summer. How long the work will be continued, how far it will be devel- oped, depends entirely upon the reception given to the products of the school by the profession, and the supply of material. I think there will be no difficulty in getting the material. The profession is one of absorbing interest, of enormous usefulness; and it can only be a matter of a short time before its value will appear so obvious to the community at large as to insure a demand greater than the supply. UC SOOJjBM I qslMM! llBmv tmu A 000 494 969 9 LIBRARY. - THE UNIVERSITY OF CALIFORNIA SANTA BARBARA PRESENTED BY Frances Hoi den MENTAL HYGIENE QUARTERLY MAGAZINE OF THE NATIONAL COMMITTEE FOR MENTAL HYGIENE, INC. EDITORIAL OFFICE: PUBLICATION OFFICE: 50 UNION SQUARE, NEW YORK CITY 10 DEPOT STREET, CONCORD, N. H. EDITORIAL BOARD THOMAS W. SALMON, M.D., Medical Director, The National Committee for Mental Hygiene FRANKWOOD E. WILLIAMS, M.D., Associate Medical Director, The National Committee for Mental Hygiene GBOHOB BLUMEB, M.D., Dean of the Yale Medical School WALTER E. FERNALD, M.D., Superintendent, Massachusetts School for Feebleminded C. MACFIE CAMPBELL, M.D., Associate Professor of Psychiatry, Johns Hopkins University AUGUST HOCH, M.D., Former Director, Psychiatric Institute, N. Y. State Hospitals STEPHEN P. DUQQAN, PH.D., Professor of Education, College of the City of New York STEWABT PATON, M.D., Lecturer in N euro-biology, Princeton University INDEX Editorial 1 Mental Hygiene and the Public School Arnold Gesell 4 Facts of Mental Hygiene for Teachers Walter F. Dearborn 11 Nervous Children and their Training C. Macfie Campbell 16 The Need for Instruction in Mental Hygiene, in Medical, Law and Theological Schools H. Douglas Singer 24 Rehabilitation and Reeducation Physical, Mental and Social Shepherd Ivory Franz 83 The Right to Marry; What can a Democratic Civilization Do about Heredity and Child Welfare? Adolf Meyer 48 The Smith College Experiment in Training for Psychiatric Social Work W. A. Neilson 59 The Social Service Bureau at Sing Sing Prison Paul Wander 65 Annual Census of the Insane, Feebleminded, Epileptics and Inebriates ( Horatio M . Pollock in Institutions in the United States, January 1, 1918 \ Edith M. Furbush 78 Notes and Comments 108 Abstracts The Scope and Aim of Mental Hygiene. By William H. Burnham 133 Psychiatric Material in the Naval Prison at Portsmouth, N. H. By A. L. Jacoby 187 A Statistical Study of 164 Patients with Drug Psychoses. By Horatio M. Pollock 141 Mental Defectives and the Law. By Francis D.Gallatin 144 In Defense of Worry. Editorial in The Outlook 147 Book Reviews Medical and Surgical Therapy: Volume 2: Neuroses. Edited by Sir Alfred Keogh C. Macfie Campbell 150 The Philosophy of Conduct; an Outline of Ethical Principles. By S. A. Martin . . E. E. Southard 151 Practical Medicine Series: Volume 10: Nervous and Mental Diseases. Edited by Hugh T. Patrick and Lewis J. Pollock Clarence 0. Cheney 153 The Third and Fourth Generation; an Introduction to Heredity. By Elliot Rowland Downing Charles B. Davenport 153 The Unmarried Mother. By Percy G. Kammerer Ernest R. Groves 154 The Mental Survey. By Rudolf Pintner Thomas H. Haines 155 Die Psychopathischen Verbrecher (The Psychopathic Criminal). By Karl Birnbaum Bernard Glueck 157 Books Received 167 Current Bibliography Mabel W. Brown 169 Directory of Societies and Committees for Mental Hygiene 176 MENTAL HYGIENE will aim to bring dependable information to everyone whose interest or whose work brings him into contact with mental problems. Writers of authority will present original communica- tions and reviews of important books; noteworthy articles in periodicals out of convenient reach of the general public will be republished; reports of surveys, special investigations, and new methods of preven- tion or treatment in the broad field of mental hygiene and psychopathology will be presented and dis- cussed in as non-technical a way as possible. It is our aim to make MENTAL HYGIENE indispensable to all thoughtful readers. Physicians, lawyers, educators, clergymen, public officials, and students of social problems will find the magazine of especial interest. The National Committee for Mental Hygiene does not necessarily endorse or assume responsibility for opinions expressed or statements made. Articles presented are printed upon the authority of their writers. The reviewing of a book does not imply its recommendation by The National Committee for Mental Hygiene. Though all articles in this magazine are copyrighted, others may quote from them freely provided appropriate credit be given to MENTAL HYGIENE. Subscription: Two dollars a year; fifty cents a single copy. Correspondence should be addressed and checks made payable to "Mental Hygiene," or to The National Committee for Mental Hygiene, Inc., 60 Union Square, New York City. Copyright, 1918, by the National Committee for Mental Hygiene, Inc.