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Abstacts: Ethics, History and Mental Disorder

Jonathan Toms (Wellcome Trust Centre for the History of Medicine, UCL)
Mental Hygiene, History and the Moral Order


Mental hygiene was a psychiatric strategy institutionally established during the inter-war period. Surveillance of the population for incipient mental disorders, early treatment and the promotion of healthy mental 'adjustment' were its hallmarks.

Mental hygiene was a significant element in psychiatry's mid-twentieth century move away from the mental hospital towards the construction of community mental health services. Some historical sociologists and philosophers, particularly those influenced by Michel Foucault, have traced the history of these developments in terms of a 'tutelory relationship' or an extension of 'moral therapy' to the 'masses'. I want to take up this theme of moral therapy for the masses in this talk. I will argue that, if mental hygiene can be considered a moral therapy, it was one that relied on history for much of the foundation of its authority. Historical delineations of individual and societal development underpinned mental hygienist's claimed expertise in promoting 'social adjustment' and 'responsible citizenship'.

Mental hygiene as a movement and a concept met its final demise around the 1970's. But 'moral therapy for the masses' endures in some surprising places, not least the discipline of history, and even in apparently 'radical' strong social constructionist critiques of the 'psy' disciplines. What these contemporary manifestations share with mental hygiene, I argue, is a fear of the 'history-less' person as a threat to the moral order. The 'history-less person', that is, lacks a proper ethics.