Modern American Mental Health Systems
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To understand modern American mental-health systems, it is necessary to realize how relatively young the very concept of organized and humane mental-health treatment is in Western civilization. Dr. Benjamin Rush, one of the signers of the Declaration of Independence, is credited with being the father of American psychiatry, partly on account of his advocacy of humane and systematic treatment of the mentally ill. Rush's Medical Inquiries and Observations upon the Diseases of the Mind was published in 1812, the first American work on psychiatry ("Rush," Funk & Wagnalls, 1975). Rush appears to have taken a practical, clinical approach to treatment, as evident in his encouraging patients to keep a journal of their symptoms (Riordan, 1996); in the modern period, so-called scriptotherapy is suggested as an adjunct to counseling. The specifics of some of Rush's views have been interrogated by subsequent research. For example, Rush viewed alcoholism in moral and physical terms and published anti-bingeing tracts as head of Philadelphia's Pennsylvania Hospital (Burke & Clapp, 1997; Katchner, 1993). However, on the whole Rush's work, which specialized in the treatment of mental disorders, can be associated with a tendency in the earliest decades of the U.S. republic toward social and personal improvement for which public and private institutions were well suited. As Wiltse comments:There were few social evils that were not challenged by some inspired St. George or well-meaning Don Quix
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p. 9).
The formulation is based on the assumption that modern society and institutions are highly complex and may overwhelm individuals. Thus they require intervention of professionals familiar with institutional systems to assist individuals and family members in interacting effectively within it, for the benefit of both individual and the integrity of the systems themselves.
The role of the social worker, in this view, is that of facilitator or agent of appropriate interaction between society and individual. Pincus and Minahan cite four basic "systems" of social work practice: the change agent system, the client system, the target system, and the action system. In the change agent system, the social worker becomes the pivot of interaction between wider society and the individual who may need help coping with it. In the client system, the change agent figures as the professional providing services to a range of individuals or organizations seeking integrative services. The target system may broadly be taken as the institutional structures the social worker addresses with a view toward maximizing individual integration within society; sometimes client and target are the same. Finally, the action system refers to the network of in
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Approximate Word count = 3525
Approximate Pages = 14 (250 words per page)
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