CHAPTER XXVII
THE INSANE--THE FEEBLE-MINDED

THESE two disabilities, of insanity and of feeble-mindedness, carry us still farther than that of inebriety into the territory where medical and social data are not easily separated. It cannot be too emphatically stated, however, that the questionnaires here given can in no sense enable a social worker to make a medical diagnosis; the diagnosis of mental disease and of mental defect must be regarded always as primarily medical, though social data of the right kind can suggest the need of a physician in the first place and may be serviceable to him later in making an inclusive examination of his patient.

Insanity is a term describing a legal rather than a medical concept. It is loosely applied to mental disorders differing widely in their origins and in their manifestations. Obviously no one questionnaire would be equally applicable to persons suffering from senile mental reduction, those exhibiting undue pressure of mental and physical activity, and those in whom slow distortions of mental life are taking place. From the alienist's point of view, the present outline merely suggests general lines of inquiry; for the social worker, however, its questions are not routine questions and must not be so understood.

The social worker without medical training is sometimes ill fitted to face the ugly facts of defect and disease. To keep his sense of values keen and true, his must be a spirit of sane helpfulness. No one has described the right attitude better than Dr. Adolf Meyer, who, five years ago, sent the writer the following comments, among others, in criticising a discouraging record of social work with a family of defective mentality.

We meet here a very difficult problem. As far as I can see, the social worker like the physician must learn to accept human nature and human doings as they are before rushing in with the superior knowledge of how they ought to be. The first need is to know what they are. . . . The motto of every social worker and in-

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