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“Meeting on The Same Errand”—Origins of Mental Hygiene (cont.)
A 1909 photograph reveals the bleak conditions endured by a mentally ill woman in the Baltimore County (Md.) Almshouse.
However, it wasn’t until the 1920s that doctors and epidemiologists began to look seriously at conditions in a community—economics, education, employment, family situation—as risk factors that could predict delinquency and behavioral problems in children, substance abuse, schizophrenia, and other psychiatric disorders.
By 1918, “social and mental hygiene” was listed in the School’s course catalog as an area for study. Dr. Esther Loring Richards, chief physician at the Phipps clinic, was appointed lecturer in mental hygiene in 1926, the first faculty appointment in the field.
Psychiatrist Ruth Fairbank charted the Eastern Health District’s psychotics, delinquents, and “maladjusted” in one of the first epidemiologic studies of mental health.
One of the School’s first laboratories was in its own neighborhood. A one-square-mile area adjacent to the School was established as the Eastern Health District in 1932. It was jointly administered by the Baltimore city health department and the School. A 1933 survey of the district involved 56,044 poor and middle class individuals. Within this group, Dr. Ruth Fairbank, the psychiatrist in charge of the mental hygiene portion of the study, reported that 3,881 persons “presented problems of mental ill-health of sufficient severity to have them recorded by some agency or institution.” The issues included psychotic cases, school and social problems, and juvenile and adult delinquency. There were also 1,444 people who were labeled “maladjusted individuals,” including alcoholics, those with suicidal tendencies, and people with sexual, marital, or adjustment problems. In a 1937 presentation, red and black pins on maps of the district marked the residences of psychotics, delinquents, and the maladjusted. They clustered on the district’s western and southern areas, which were full of saloons, brothels, and gang hangouts.