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N this looking forward which you have asked me as a representative of psychiatry and medical mental hygiene to do, perhaps you have chosen someone with too little faith. I can foresee no immediate fulfillment of the hopes of a yearning world for the miraculous solution of our emotional problems. Psychiatry has probably sold mental hygiene too well and perhaps too early.

Troubled people have grasped eagerly at the chance to see the promised land. Our psychiatric enthusiasm to show them the green pastures has pushed us with the running steps of speculation and theorizing instead of the painstaking plodding of fact-finding and experimental evidence. It may be excusable, if psychiatry has let its enthusiasm run beyond its capacity to produce a promised body of sound facts and effective workable methods.

If I appear to you as a pedestrian instead of a winged fleet-footed Mercury, I can only plead the evidence of the history of successful medical progress. Preventive medicine has become possible only when we have learned the causes of disease. The successful treatment of physical disease has only been possible after painstaking and painfully slow research and investigation. Psychiatry today knows extraordinarily little more about the cause of the major mental diseases than it did 50 years ago. It has produced a wealth of theories, but a paucity of facts.

More knowledge required

The violent debates of the protagonistic psychiatric theorists bespeak their lack of facts. The rest of medicine can show a united front because there are larger areas where investiga

tive research has led to logical, irrefutable knowledge. That united front will come to still the babel of voices when psychiatry has comparable knowledge.

Psychiatry and mental health have only just begun to take the pathway of scientific research and investigation. Here and there one sees the beginnings of the quest for real, basic facts and the desire and willingness to subject theory to experimental investigation.

Looking at our hurried false starts should not blind us to the very significant contribution which psychiatry and the mental-health movement have made in this period of their enthusiastic infancy. They have brilliantly centered interest on the study of personality and personality structure.

Although the psychopathology of mental disease is only hypothetically understood, the study of its manifestations have brought into the focus of attention many phases of normal psychology which were dimly lighted before.

Light from different sources

Our studies of the abnormal mind have made possible a dramatic presentation of many facts that must surely have their representation in normal psychology.

We have called upon our young sister sciences of cultural anthropology and sociology to aid us in the proof of this thesis. Furthermore, our hypothesis that psychologic facts do profoundly change personality structure and personality response has been proven for us through investigation by the cultural anthropologists.

Given at the National Conference on Family Life, Washington, D. C., May 6-8, 1948.

I fear that educators and social scientists have been so swept by our promises and our theoretical constructs that they are little more than blind, enthusiastic followers of psychiatrists. Not all try to follow the same theoriesthere are enthusiastic followers of all psychiatric camps-but they are all trying to put into corrective practice in the normal what the various schools of psychiatry have said was wrong with personality.

Again, like Cassandra, I moan, if only we could guide them with an established body of proven, sound data!

We must, I am convinced, undertake in the near future many long-range, painstaking studies.

We must try to get answers

1. We need investigative research to instruct us whether we are right in thinking that healthy emotional maturity and balance may be achieved by the present fashionable permissive attitudes or whether directive attitudes in education, especially of the emotions and emotional attitudes, will produce the type of emotional balance we need. 2. We must be able to answer with

evidence the question whether human psychologic healthy development is governed, as one theory insists, only by the avoidance of so-called anxiety or conflict; or whether according to another theory it takes place by a more vital dynamic emergence of positive and trainable drives and action patterns.

The answers to such questions are vital and at the core of our problem of mental health.

That we can influence personality structure by environmental circumstance is established, but that is far

from knowing when and how it can be altered.

3. We must be able to answer many fundamental questions about the relative importance and influence of early life experience on final personality structure and reaction.

Are we right about the time element?

Perhaps future investigation may show that the later unfolding of latent patterns of behavior may play as decisive a role in personality structure as infancy and early-childhood influences. There is some evidence that this hypothesis of later unfolding may be even more important. This is clearly open to in

whether they are capable of modification and resynthesis.

6. What impact will our expanding of the school period from very early childhood to very late adolescence have upon the family and its importance in the life story of our people? Will this strengthen or weaken the home and family?

7. Is the purpose of our present emphasis on the importance of love and security attainable in a system where less and less of the education and recreation of children and young people takes place within the family structure? Can we substitute qualitative for quantitative participation in family living

can point the way to the study of health, but ultimately it will be the study of normal growth and development that will produce the techniques for healthy living.

I believe that an experimental sociology, an experimental, cultural anthropology, and an experimental individual psychology offer most of our hopes for the future of the development of mental health.

Psychiatry, with its study of the abnormal, will be an increasingly valuable helper, a stimulator, and a corrector. It must develop positive, factual, and experimental investigation to fortify itself in the scientific investigation and interest in human mental health which it has started.

Psychiatry is started in its scientific, investigative attitude but it can only do its rightful job if the Nation furnishes it with facilities for investigation and enough money to attract a growing group of young investigators. What can we do at once?

As I see it, the immediate contributions that mental hygiene can offer are: 1. Increasing use of group discussions for parents and children. It has high hope of objectifying tensions and problems.

2. Increasing use of sex educationfor facts and attitudes.

3. Training of youth for parenthood by practical, thorough courses in child training, with the use of actual nursery schools in high schools.

4. Wide extension of counseling serv ices in schools and in the community. 5. Public discussion by radio, magazines, newspapers, and group discus

vestigation and should be investigated in animals as well as human beings.

4. We need to know if mass cultural impacts on youth, such as those produced by the Nazification of German. children are lasting and permanentor are they modifiable?

5. We need to know whether the similar although not deliberately planned cultural impacts in these United States of increasingly more constricted housing, enlarged cities with more and faster automobiles, more and more out-of-thehome meetings of youth are permanently destructive of family life or

and still maintain the valuable influences of the family? If so, how can we develop techniques for this new kind of concentrated family influence?

8. Will mental health be increased or decreased by decreasing or increasing the family strength? Again I say, we do not know. Cold, hard facts and investigation alone can give the answers.

Of one thing we can be certain. The ignorance of blind conviction or even noble prejudices will not give the answers. Psychiatry as such will always of necessity be concerned primarily with psychopathology. The study of disease

to break up paranoid belief systemspolitical, social, economic-which so disrupt our community solidarity.

6. Frank facing of the possibilities of war and the use of training for both possibilities-peace and war.

7. Extension of mental-hygiene clinic facilities to all areas of these United States, to aid in diagnosis and prescription for treatment; to make evident the need for more facilities for better special education and techniques; and the great extension of boarding-home facilities-to salvage children when the home has failed.

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Po

ARENTS and children should, of course, have the opportunity to remain together if they have the will and a reasonable possibility to do so. However, as long as society is subject to its present ills, some children will have to be cared for by other than their natural parents, and children's agencies will try to place them in foster care-in a family home or in one of the many forms of group or institutional care.

The type of placement determines in some measure what rights and responsibilities the parent retains or relinquishes when separated from the child. The very nature of placement service is such that the rights of the individuals affected can easily be violated unless the agency that provides the service, as well as the citizens who support it, are aware both of the nature of separation and placement and the rights that may be threatened.

Let us first look at the purpose of the children's agency. It has no legal authority, unless the law specifically grants this. The agency's purpose is to serve individuals-parents and children.

It is parents who first come to the agency, hoping that solution of their

problem lies in placement of the children. The problem may result from illegitimate pregnancy, physical or mental illness of one parent, desertion, separation, or other conditions. More often than not it mirrors a combination of subtle and complicated factors—marital difficulty, rejection of children, immaturity of parents, and inability to accept parental responsibilities.

Whatever impels a parent to seek placement of his children, he has a right to know what placement will mean to him and his children. The agency has a responsibility to help him consider what both must give up, as well as what both may gain.

And indeed any parent who places a

child does give up a great deal. He cannot see to the child's day-by-day care and all that goes into it. He has no control of the child's activities, his friendships, or the affectional ties that may develop. He must comply with rules on visiting and on payments for board, and he is limited regarding the gifts and recreation he may provide. Such deprivations are inherent in separation and successful placement.

Then there are rights that a parent must not be denied except by a court of proper jurisdiction-the right to see his child, to provide financial support, and to terminate the placement when he sees fit.

Many questions arise

Besides these tangible matters, there are subtle ones, even more serious. Does the parent know how he will feel about having his children cared for by someone else? Does he feel that in placing his children he advertises to the world his failure as a parent? What about his feeling of worthlessness? Does he know that his children may on the one hand despise him for what he has done, and on the other feel that they are "bad" and unworthy of the love of even their own parents? Does he know that his children may resist foster care in unspoken ways, ranging from wetting the bed to stealing? Is he prepared to work with the agency down the long and rocky road to happy, successful placement?

Parents and children have a right to know what is involved. They have a right to expect help and understanding in thinking through their conflicts about this all-important decision, just as they have a right to expect help in supporting the child in foster care if this is decided upon.

Condensed from paper given at Louisiana State Conference of Social Welfare, Baton Rouge, March 1948.

Furthermore, the agency can fulfill its purpose of serving parents and children only if it recognizes the right of the parent to decide whether or not placement is a desirable solution to his problem. This means that the parent makes his decision to place or not to place, without pressure, threats, or persuasion by the worker. So long as the parent has full custody of his child, the decision rests with him, not with the agency. He has a right to decide what is best for him and his children unless the right is legally denied him. In a democracy that right can be denied only by a court of competent jurisdiction.

Yet parents are sometimes denied the opportunity to make this decision. We social workers sometimes stress the advantage of placement, hoping that we can keep the parent satisfied with an arrangement he does not understand and which is not really his. It is beside the point to say that such placements are doomed to failure.

We must not deny parental rights

To assume that we know best is to take liberties with the complicated relationships between children and parents. This not only denies parental rights but is contrary to the agency's duty to provide services that parents are free to utilize or reject so long as their legal authority concerning their children remains intact.

To reiterate, the responsibility for the decision to place or not to place rests with the parent as long as he has his full legal rights concerning his child. The responsibility of the children's agency is to help the parent come to a decision that is right for him and his child and to help him live with his own feelings. This implies acceptance on the part of the agency of the client's decision and his feelings about it. It is very different, and requires more skill

and self-discipline than making a decision for the client according to what the worker may consider desirable. So long as the right to make the decision rests with the parent, the agency must respect that right.

Recognition of the right of parents to make decisions in behalf of their children does not in any way deny the responsibility of the agency. This is to apply case-work skills in helping parents to see what alternatives are open to them and where these alternatives may lead. It is to help the parents recognize, understand, and indeed live with their mixed feelings about caring for or placing their children. This responsibility is also binding on the agency after placement. These responsibilities are important, for few if any parents, regardless of how derelict they may be in their parental roles, are totally without feeling or concern for their children.

So far as we have considered the problem of parents whose legal authority concerning their children is not in question. For these parents, who voluntarily seek help with respect to their children, the agency's part is to provide case-work service, which may include placement if parents and agency agree upon it. When they agree upon a plan for care, the agency must take responsibility for its soundness and success.

This does not mean, however, that the agency passes judgment on plans of which it is not a part. If a parent decides to place a child with Great-aunt Susie, a plan that the worker believes is

agencies do not have the authority or function to control the lives of children whose parents voluntarily bring their troubles to an agency, it is because of the widespread misconception in this area. Furthermore, if we are clear on the rights of parents who retain full authority over their children, I think we can see more clearly the rights of parents and the responsibility of agencies when a court steps in to alter the natural status of parents and children. Here I should like to consider both families where parental rights are in question and those in which legal action has already restricted or transferred certain parental rights.

Space does not permit full discussion of the so-called "protective" function sometimes assumed by children's agencies. In brief, we might say that families affected by this rather undefined function are those in which the right of the parents to retain full responsibility for their children is questioned, at least by some part of the community, though legal action may not have been taken. Perhaps it is with regard to this group more than any other that we see misunderstanding of the rights of parents and children and of the purpose of children's agencies.

For example, there is Mrs. B., who calls up an agency demanding that a worker come and get the J. children next door and place them in an institution or foster home. Her reason may be almost anything, ranging from the

children's being left alone without food to their pulling up the plants Mrs. B. has just set out. The important thing is that Mrs. B. disapproves of the way the J. children are being reared; she thinks they can never become "decent citizens," so there must be "a law against it." The children's agency, for which she pays taxes, or to which she contributes through the Community Chest, must have authority to enforce her will to do something about the situation.

Then Mrs. S. calls up. She is indignant about the drinking and immoral behavior of Miss W. The agency had placed Miss W.'s baby, born out of wedlock, and Mrs. S. feels that the agency is encouraging immorality by relieving Miss W. of her responsibility. The proper treatment for Miss W., says Mrs. S., is a good jail sentence to teach her a lesson, and close supervision thereafter by the agency to see that she takes care of her child.

The Mrs. B.'s and Mrs. S.'s, however, are usually reasonable people. When they realize what their request involves, they are horrified, for they would not wish to live in a society where parents' rights could be taken away without due process of law.

To the extent that we, as social workers, are clear on the rights of parents, and the purpose of our agencies, we can hope the Mrs. B.'s and the Mrs. S.'s will direct their energies into more productive channels. And let us not forget that Mrs. B. and Mrs. S. are as much our

Every client deserves our respect.

The fact that a parent brings his problem to an agency does not give the agency authority or license to determine the course of a child's life. So long as parental plans are within the law, the agency has no more right to say where children shall live than to say where they shall go to school, or whether or not they shall have their teeth straightened.

If I labor the point that children's

clients when they bring us these problems as if they brought us problems concerning their own children. They have the same right to our respect and understanding about the implications of their requests.

All citizens, and particularly social workers, should have a sense of responsibility for the well-being of all children. We know that there will always be some parents who misuse their parental rights, just as there will always be some individuals who violate the rights of others. And society must protect itself by placing limitations on the individual who is unable to exercise his own rights without violating those of others. In a free society we delegate to the courts the duty of making the decision as to whether certain of an individual's rights shall be limited, or removed, in the broader interests of society. It cannot be different with parental rights.

Public opinion rules

We have in this country some vague idea of a level of care and opportunity for children that should be the minimum, and this is translated into law with varying degrees of definiteness. The level is interpreted differently in different communities, in different economic strata, and in different races. And I suspect that in a given community it represents pretty generally what the majority of the people in that community want.

And so the Mrs. B.'s and Mrs. S.'s have a right to take situations to court when they feel that children are denied what they consider a minimum of opportunity. We should hope that the community could provide services to enable the families in question to meet the minimum needs of their children if they have the desire and ability to do so. We should also hope that the agency that received such complaints would have a sufficiently careful screening process so that the agency will not intrude upon the family's right of privacy without justification. We should further hope there is general understanding throughout our citizenry that children's troubles are not over when a judge orders separation from their parents and that placement is not the answer for all children whose parents have difficulty in caring for them.

When a court of proper jurisdiction decides that parents have violated, or are unable to exercise, their right of care and control over their children, the court may transfer this right to an agency or an individual. This transfer of custody places with the agency the right and responsibility to determine, and provide the child with, a suitable living plan. The parent has a right to know where his child is, to visit him in accordance with established arrangements, and to maintain his relationship with him, unless specifically forbidden by a court. The latter restriction is rarely placed on parents except in spectacular situations where the child or the person caring for him is physically endangered. When a court removes the child from the parent's custody, the latter may not regain it except as restored by the court. However, the parent has the right at any time to request the court to consider the return of custody. The agency has no right to discourage a parent from making this request.

Before considering the agency's responsibility for helping parents and children whose natural status has been altered, it seems fitting that we as social workers examine our own feelings about courts and their authority.

If we, as social workers, recognize the court as the instrument of our society for dealing with misused rights of parents, then we should be able to use it as objectively as any other resource. If we honestly believe the rights of children are threatened, and we have been unsuccessful in helping parents, do we not have a responsibility to bring the matter to a court's attention?

Agency must be fair with parents

It seems to me that as social workers we have too often looked upon the court as a last resort. To use it was to admit failure. I fear we have at times assumed court authority ourselves in insisting that people do as we thought they should, by taking advantage of an emergency to place a child ourselves, and all but refusing to return him if we thought the parent might give improper thought the parent might give improper

care.

We have talked about losing our relationship with the client if we went to court. It has been my experience that in most such cases there is not much "relationship" to lose. Usually the work

er has long since lost any possibility of a constructive relationship through her tenacious efforts to inveigle the parents into placing their child. Hence, by the time she gets to court, her own feelings are involved, and the parents' belief that going to court is a hostile act by the agency is not entirely unjustified.

I've been thinking a good deal during the last few years about courts, as have many other children's workers. I believe children's agencies have come a long way in making more objective use of the courts. But I fear that we still ask the court to agree with us and to force the parent to do what we think should be done.

It seems to me that our duty is to place the facts, as we see them, clearly and objectively before the court. To expect a court to accept our statement without also giving the parent an opportunity to do so is to deny the purpose of a court.

And above all, when it becomes our responsibility to bring a matter involving parents and children before a court, let us be fair. Do not parents have a right to know the step we are taking and the reason for it?

I am convinced that only if the worker is clear, first about parental rights, and secondly about her responsibility to her agency and her profession can she avoid the role of prosecuting attorney. When the worker has clarity, objectivity, and conviction about what she does, she can usually transmit her sincerity of purpose to parents; then there is a basis for working together. The parent may be angry and distressed, but a groundwork for respect and trust is laid.

Let me tell you about a mother, Mrs. M., to whom life has dealt heavy responsibilities, but few inner resources with which to meet them. Her children became the victims. A worker tried to help her; but she could take no definite step, either toward changing her situation within the home or planning for the children away from her.

The worker recognized Mrs. M.'s difficulties. She saw that the agency had not been able to give this mother the kind of help that would enable her to care for her children as the community expected them to be cared for. And in such situations it becomes the responsibility of a judge to make the decision.