Are Americans Well Adjusted?

An assessment of a 1957 survey of the nation's mental health
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More than half of all hospital beds in the United States are occupied by patients with mental disorders. Nine million Americans suffer from serious mental troubles, and the number is on the increase. Estimates of the direct and indirect cost mental illness in this country range from $3 billion to as high as $12 billion a year. Meanwhile, there is a growing shortage of trained psychiatrists—there is not more than one for every 16,500 Americans. Such, in brief, was the disturbing picture which prompted Congress, in 1955, to pass an act authorizing an elaborate study of the nation's mental health.

The most arresting product, to date, of this unprecedented investigation is a 444-page document entitled Americans View Their Mental Health (Basic Books), which presents the findings of a nationwide interview survey conducted by the University of Michigan Survey Research Center. Three social scientists on the staff of the Research Center are the authors of the published report, Doctors Gerald Gurin, Joseph Veroff, and Sheila Feld.

As its title indicates, Americans View Their Mental Health is concerned with self-diagnosis, with people's own estimates of their well-being and their troubles. Such estimates are apt to be colored by defenses and failures of insight, but the authors are right in emphasizing their relevance to the study of mental health, since it is subjective evaluations which decide what the ordinary person does about his emotional difficulties. The sample selected—2460 Americans over twenty-one, living in private dwellings—is intended to be "an accurately proportioned miniature of the 'normal,' stable adult population" (my italics). It excludes, among others, all inmates of prisons and mental hospitals, and therefore does not represent the people who are most violently disturbed. Thus, the survey can be summed up as an attempt to discover how well or how badly adjusted normal Americans consider themselves, to be, and what they do about their difficulties.

Before plunging into the findings of this remarkable document, it might be as well to register some general reservations about the school of sociology of which it is a product. Leading representatives of this school have defined their function in terms that conjure up a new imperialism, whose version of the white man's burden is the application of "scientific procedures" to areas of human affairs which, as Dr. Paul F. Lazarsfeld has put it, "have remained undeveloped in this respect." The troops and colonizers of the new imperialism are interviewers and "study groups of research technicians," its armament is the almighty computer, and its monuments are volumes of statistics. Its spokesmen report that the natives are friendly: only 8 per cent are unwilling to be interviewed.

One of the few areas which exponents of "empirical scientific" sociology consider properly developed is the study of public opinion. A few years ago, Bernard Berelson of the University of Chicago announced that this field had, been completely rescued from the hands of scholarship and was now "part of science." It has become, he boasted, in the repellent jargon of the sociologizers, "technical and quantitative, a-theoretical, segmentalized and particularized, specialized and institutionalized, 'modernized' and 'group-ized.'" Any area of human behavior, Dr. Lazarsfeld has blandly asserted, could in the same way be made the object of a science of its own: "It would not be more difficult and not even more expensive to collect happiness ratings than to collect data on income, savings, and prices."

A good many laymen, and sociologists, for that matter, believe that missionaries of the statistical approach have arrogantly overstated the scientific character and possibilities of their work. The claim made by Dr. Kinsey and others that their findings are "an accumulation of scientific fact" is at best an exaggeration; the data collectors themselves concede that imponderables—the way a question is worded, the skill of an interviewer—influence their results. Plainly, the application of the quantitative method to the study of human beings has serious limitations, since feelings, beliefs, and states of mind are still beyond the reach of precise measurement. You cannot take the temperature of happiness or calculate its mass.

Empirical sociology prides itself on being atheoretical, but actually it often deals in theories, preferences, and assumptions under the counter. (Dr. Kinsey, after rejecting concepts of sexual normality as a barrier to scientific research, proceeded to write as though the sexual behavior of animals constituted a norm for human beings.) Perhaps the most annoying failing of the sociologizers is a form of pedantry which consists in proceeding as though nothing were trivial or obvious. A considerable part of their effort is devoted to establishing, with sometimes dubious statistics, what everybody knows to be true.

By and large, these remarks apply to the mental health survey, but with important qualifications. The authors have the grace not to keep flaunting the flag of science. And although they sometimes make much of the obvious or the predictable—notably their confirmation of another survey's unremarkable discovery that the rich use psychiatry more than the poor—a sizable number of their findings are news.

The mental health survey was confronted at the outset with a formidable problem—the lack of agreement among the various schools of psychiatry and psychology as to the concepts which best define mental health. The authors decided not to commit themselves to any particular doctrine, but attempted instead to straddle two widely accepted approaches: the approach which puts the emphasis on adjustment, and that which stresses "investment in life" and self-realization. Two sets of criteria—happiness or satisfaction (which are taken as signs of adjustment), and worries, problems, feelings of inadequacy (which are seen as tokens of involvement as well as of distress)—were applied to four areas of people's lives: general well-being, marriage; parenthood, and work.

This two-directional approach reveals a clear-cut contrast between people's evaluation of their happiness and their estimate of their worries, problems, and feelings of inadequacy. More than one in four of those who described themselves as "very happy" or "pretty happy" said they did a great deal of worrying; one in three of the "not too happy" worried little or not at all. It was found, too, that worry is apt to be linked to optimism unhappy people who do not worry do not expect to be any happier in the future; happy people who worry a lot expect to be happier. All this points to the conclusion that, in our culture, happiness, so far from being identified with peace of mind, is generally associated with a strong commitment to life which brings with it worries, problems, arid feelings of inadequacy.

Three themes run through the survey's findings Superior education is consistently associated with more happiness—43 per cent of the college educated rated themselves "very happy," as against 23 per cent in the grade school group—but also with more worries, problems, and except in the job area) feelings of inadequacy. Almost the same pattern is found among the young, at every educational level, the one difference being that they express less satisfaction with their work than older people. Third, women, though they do not differ significantly from men in their evaluation of their happiness, seem to experience considerably more stress: they are more worried, more aware of problems in their marriage, more likely to have felt a nervous breakdown impending.

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