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“Meeting on The Same Errand”—Origins of Mental Hygiene (cont.)

When Meyer agreed to help Beers edit his book, he encouraged the younger man to soften the harsh portrayal of individual doctors and other professionals, redirecting blame toward understaffing and lack of funds. He also encouraged Beers to shift the emphasis to prophylaxis. Daily letters and express packages shuttled revisions between the pair, according to Eunice E. Winters who edited Meyer’s collected papers.

Beers wrote to Meyer: “Your suggestions (for which I thank you)…now appear in my final version.” The book remains, however, a very personal memoir, chronicling Beers’ harsh, and at times sadistic, treatment. It’s hard to imagine him having “softened” his portrayal of the doctor he referred to as Jekyll-Hyde.

“On many things we saw alike; there were others, perhaps, on which our points of view were somewhat different,” Meyer tactfully said years later. Meyer did succeed in helping redirect Beers’ passions from institutional reform only to a focus on a national mental hygiene movement that called both for preventive services based on a public health approach and the improvement of the care of the seriously mentally ill. The book, published in 1908, was an immediate success and helped to forge public support for the mental hygiene movement.

As a neuropathologist in Kankakee, Ill., in 1893, Meyer developed his theories that emphasized patients’ life experiences.

The following year, Beers, Meyer, and others launched the National Committee on Mental Hygiene (see sidebar). By late 1910, however, Meyer would resign from the committee. The energetic, excitable Beers proved to be a dynamo that the reserved psychiatrist could not control. Beers, a natural fundraiser who sometimes referred to himself as the “high priest of mental hygiene,” had grand ideals but no specific plans. Meyer wanted the organization to tackle small projects and build a base of scientific research. Beers’ erratic finances also worried Meyer, whose resignation was inevitable.

Despite Meyer’s departure, the movement was achieving the kind of recognition he had long sought for mental hygiene. Ever since a late 1890s meeting of the Child Welfare League, Meyer had been convinced of the ubiquitous nature of mental disorders and the need for a population-based approach to prevention—at that point focusing on protecting children. He came to Baltimore in 1910, appointed as the first director of the Henry Phipps Psychiatric Clinic at Johns Hopkins Hospital.

At Phipps, Meyer continued to refine his theory that studying patients in their cultural or social settings was as important as examining brain lesions or other physiological defects. Meyer also felt that psychiatrists should work with teachers, ministers, and others in the community to promote mental health, according to Elizabeth Fee’s 1987 history of the School, Disease and Discovery. “In Meyer’s view, mental hygiene was the social agent of psychiatry and a civic responsibility,” Fee wrote.

Thomas W. Salmon, the first medical director of the National Committee, agreed with Meyer’s views and envisioned a “new psychiatry” that would move from institutions to the world at large. Psychiatry began to move into the community, and psychiatrists began to pay closer attention to statistical analysis.

When the School was founded in 1916, the country had only just begun to see mental health within the context of public health. In the 1840s, a physician named Edward Jarvis began analyzing disease-related data gathered by the census bureau and categorizing mental disorders.

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