The Need and Demand for Psychiatric Care among Neuropsychiatric Rejectees andDischargees. A preliminary report for the committee on Psychiatric Needs in Rehabilitation--Subcommittee of N. Y. C. Committee on Mental Hygiene of the State Charities Aid Assoc. a Lawrence S . Kubie, M. D. Testimony before the Subcommittee of the Committee on Military Affairs, U. S. Senate, 79th Congress, pursuant to S. R. 107 of the 78th Congress and S. R. 146 of the 79th Congress, pp. 606407.
ARLY in 1941, when the Selective Service Act was still young in operation, E the fact began to be apparent to thoughtful persons that unless adequate safeguards could be devised for identifying and screening out from military service men with potential as well as full-blown psychiatric problems, the country would again incur, but in vastly greater measure, all the penalties of the last World War in needless increase in the rate of mental breakdown, and the pyramiding of post-war pension costs for the taxpayer.Among those who foresaw the dangers involved, were members of the staff and executive board of the New York City Committee on Mental Hygiene. Recognizing that no beginning would be negligible which was capable of lending even a partial solution to the problem, the Committee cast about for ways in which local civilian agencies could turn their resources to the use of the Selective Service Administration. One of the first opportunities for exploration came through Dr.Richard M. Brickner, a psychiatrist, who was attached to one of the Selective Service medical advisory boards in the city. Faced with the task of classifying men referred from nine local draft boards, because of questions of mental status, he felt that the accuracy of his decisions would be greatly enhanced if he could have psychiatric social work help in obtaining histories on the more obscure cases of his total group. Arrangements were made for the desired psychiatric social work time, and in March 1941 there began an experiment in history-taking for this individual medical advisory board, which continued until January I , 1942. The New York City Committee on Mental Hygiene in the interval pursued the problem of adequate psychiatric screening in other areas, and arrived a t increasingly clearer definitions of general procedure. This paper is devoted to the pathfinding aspects of this original experiment, which were considerably represented in the Committee's later conclusions.By way of background, it may be said that New York City has 280 local draft boards, responsible in groups to 26 medical advisory boards. During the March to January period, it was the function of the former to make the full provisional classification of selectees, ruling out on the basis of responsibility for dependents, employment in defense industries, and unfitness for military service. Questions of medical unfitness were referrable for more careful review to the 26 medical advisory boards, and since each of the latter included one or more psychiatrists in addition to other specialists, dubious psychiatric problems could be referred as appropriately as eye defects or suspected tuberculosis. Each local board included medical examiners who performed routine physical examinations on all 603 This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
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