OCCUPATIONAL MENTAL HEALTH: REVIEW OF AN EMERGING ART

In the past decade there have been more clinicians quoting behavioral science research, more behavioral scientists quoting clinicians and greater application of the theoretical frames of reference of each of the several disciplines to practical problems within industry. Occupational medicine has largely emerged from its cocoon of emergency surgery and compensation cases with the recognition that, like internal medicine and general practice, half of its case load is made up of patients with emotional problems, either overtly displayed or in the guise of psychosomatic reactions. Borrowing concepts and clues from psychiatry, psychology and the behavioral sciences, industrial medical directors and their staffs have taken steps toward more active involvement with the policies of their organizations—policies recognized as influencing the health of employees.

Becoming involved with the physician in industry, some behavioral scientists have been studying not only the prevalence of psychosomatic disease in industrial populations, but also the influence of the industrial environment on these illnesses. Indeed, health concepts have been applied to the industrial organization itself with the "corporate personality" regarded as "sick" or "well." Factors within its subculture have been studied as one studies the individual personality. It is common to hear a group of social scientists with industrial interests discuss the "health" of a work group, a company or an industry.

The relationship of job satisfactions to mental health has been widely suggested, even assumed, although still unproven. Identification with the work organization—or with one's labors—has received great attention from occupational medicine, clinical psychology, psychiatry and behavioral science. The centrality of interest seems to have focused recently on psychosomatic reactions. The next common area of concern appears to have been the industrial accident with its illusive "human" etiology. More recently the garden varieties of emotional reaction—the psychopathology of everyday life and its relation to the work process, to the exercise of various types of authority, to the cohesive influence of the work group and to productivity—have been discussed.

Finally, we see a common interest in the fulfillment of the individual in the work setting. From each discipline come expressions of concern, research efforts and suggestions and operational programs for allowing greater understanding and fulfillment of the psychological needs of the individual at work. Each discipline has contributed. Each considers itself properly concerned. Indeed, many proprietary feelings continue in each specialty as to who should be looked to by industrial management, who should be responsible, who should direct the efforts of the others, who may "rightly" have the moral, ethical and social responsibility to study and influence these many factors which in turn can be related to the mental health of the industrial employee at whatever level.

Both the clinical disciplines and the behavioral sciences will play an increasing role in fostering healthy employees and healthy companies through increasing influence on the policies and procedures of corporate organizations.

The evidence points to an expanding role for the clinician as well as for the behavioral scientist, but with less concern for the purely clinical function of examining patient-employees. Greater emphasis is suggested at the present time on preventive health programs, research, management education and concern with policies influencing employee mental health. It is by now apparent that the trend toward prevention originally foretold by Southard, Jarrett, Adler, Campbell and Giberson continues as the main concern of occupational mental health.