SPECIFIED DISEASES AND DISABILITIES
The specified diseases and disabilities selected for discussion in this chapter are for the most part conditions referred to as "chronic." A person is chronically ill either when the duration of illness exceeds a given time-span, or if, when he has passed the "acute" stage of the illness, he is, or seems likely to be, ill for a prolonged period thereafter. The illnesses of the chronically ill are sometimes characterized by recurrent acute phases or continued sub-acute conditions.
Patients with chronic illnesses occupy for long periods of time more than half of our hospital beds. They are usually unable to follow the customary activities of the average person, and they may need health services even though they are not disabled as a result of the illness or impairment.
The selection of topics for discussion was necessarily arbitrary. In general, each topic involves unsolved scientific and social problems and a number of organized efforts designed to solve them. In each section covering a problem area the major governmental and voluntary health programs are reviewed. In some sections data on costs are included to give an indication of the magnitude of a particular program. No attempt was made to make an extensive analysis of the cost and financing of these programs.
Until quite recently the field of mental health in the United States related almost exclusively to the institutionalization of the "insane." The terminology and procedures were those of the criminal law; the remedy applied by the courts was the incarceration of the insane for the protection of society. Medical treatment was either unavailable or was a consideration secondary to the isolation of the individual from society. The concept of isolation limited the institutional development to almshouses, asylums, and other places of detention.
Leaders in the fields of social welfare and medical science have gradually changed the thinking of the public about the mentally disordered. Today, in many states individuals in mental institutions are regarded primarily as medical problems. The hospital care of the mentally ill is thus a major part of the field of mental health.