THE SERVICES OF THE MILITARY MENTAL HYGIENE UNIT
Authors: HARRY L. FREEDMAN
Journal: American Journal of Psychiatry (1943)

The experience of the mental hygiene unit has been one of progressive expansion and experiment. Methods and procedures have been developed and created under the pressure of new problems and a greatly increased case load. However, the areas of the unit's responsibilities, as defined by directives promulgated nearly two years ago, have remained fundamentally fixed. It is, of course, only one of the sections within the command whose ultimate purpose is to achieve the best possible utilization of man power assigned here for training. It is important to emphasize that a psychiatrist in the army is basically seen as another officer. It is neither sufficient nor possible to stand on one's professional or clinical experience, as may be possible in civilian life. It has been difficult to indicate sufficiently clearly in the body of this report the tremendous debt the unit owes to Brigadier General Edgar L. Clewell and to the line officers of his command. It would be evading the truth to deny that any such clinic must, quite properly, prove itself before being accepted or to deny, either, that there is a certain skepticism of professional ways of thinking and doing. Nevertheless, the mental hygiene unit has found only the most complete cooperation and what measure of success it can report is part of the success of the entire command. It does not mean that the clinic has been unchanged by the impact of the opinions of the command. Rather, there has been a mutual accommodation, based on a genuine desire to work for the army, which has even more important results in store for the future. The soldier referred to the unit for reclassification, but found to be a schizophrenic, is a spectacular case, it is true, in demonstrating the importance of having such a unit in an army setting. Of greater import, however, is the fact that of 1089 men seen by the unit in the seven months' period from June I to December 31, 1942, over 80 per cent were able to continue and complete their training in the replacement training center. This was primarily the result of the careful selectivity of the manifold services which the unit has to offer, both in its personnel and in the resources which it has found available in the army. Such a unit as is described in abbreviated form in this paper can function successfully only if it is an integral part of the command. That this working relation has been possible is due to the Commanding General's recognition of the need to give special consideration to the types of problems discussed in this report. The keynote of the unit's work has been the use of professionally trained workers, the psychiatric social worker, psychologist and psychiatrist functioning as a clinical team. Some of its methodologies are new to the work of a replacement training center. Many represent ways of meeting problems for which there were no other facilities. None of these methods contradicts or duplicates already established procedures. It is true however that the military psychiatrist and mental hygiene worker have had to adapt their functions in terms of new demands and a new setting, and that more changes will be necessary. Of particular importance has been the liaison provided with the replacement training center's total program in the original directive setting up the clinic. This coordination with all other sections is made possible through the officially defined character of its mission and has enabled the clinic to call upon the widest possible resources. This report is an outline of the structure and application of professional skills as they have been adapted toward the fulfillment of this replacement training center's mission. It is perhaps not too much to term it a small aspect of the entire democratic approach which has characterized the formation and training of the army. While the responsibility has been accepted for training the best possible soldiers in the best possible army, the rights and personality of the individual soldier have always been respected. Through the mental hygiene unit here described, it is believed that a foundation for service to thousands of American soldiers has been made.