Child Guidance and Mental Health in the Netherlands

Abstract

In the Netherlands, as in the United States, the introduction of the concept of ‘mental health’ in education is closely related to the development of a network of child guidance clinics. The first of these was established in Amsterdam in 1928. However, a substantial movement to actively promote mental health did not come into existence until after the Second World War. Unlike in the USA, at the time in the Netherlands the school was considered of only little importance in the crusade for the prevention of mental illness. Teachers and school physicians alike were at the same time recognized as helping forces in the promotion of mental strength and conceived of as inadequately equipped to diagnose problem children. The tradition of labelling the school as a sick‐making institution appears to have been an important asset for the child guidance clinics’ lobby to successfully discredit the institution. Parents’ educational competence was likewise undermined by the infiltration of child‐psychiatric theory, concepts and categories of discourse. The mental health movement promoted an attitude towards the family that was even more disturbingly ambiguous. On the one hand the family was considered a most powerful medicine against what was consistently diagnosed as the moral crisis of society. On the other hand contemporary child‐psychiatric theory pointed at parenting as the prime seedbed of neurosis. Inspired by Sol Cohen’s new cultural history of education the author traces the origins and the initial success of the child guidance approach as part of a larger process of ‘medicalization’, accompanied by ‘neurotization’ as an effect of the growing influence of psychoanalysis. She argues that these processes created the conditions for the Dutch child guidance clinics to monopolize the care, treatment and knowledge of problem children. After discussing the growing ambiguity as to parents’ and the school’s competence in preventing mental illness, the establishment and early development of the Dutch child guidance clinics are described. Finally, an analysis is given of the clinics’ diagnoses and treatment of ‘difficult’ children at the height of the mental health movement’s success, immediately after the war. The child guidance clinics’ work was presented as a blessing for individuals, for society and for the public purse. The self‐image of the institution emphasized its role in the prevention of adult crime and psychiatric treatment. Moreover, the clinics were supposed to prevent much more expensive hospitalization of children in reformatories and children’s homes. In reality, however, they selected for treatment primarily those cases that fitted their approach. In doing so, they could further promote the belief in the mental health movement’s central idea of mental illness as a widespread disease. The child guidance clinics’ lobby succeeded in providing itself with a key role in the theatre of children’s mental health, the expert answer to what was conceived of as a serious crisis in society. Moreover, the lobby claimed to be the solution to the existing ambiguities as to the family and the school as child‐rearing milieux. Therefore, the way the child guidance clinics succeeded in promoting their own approach at the expense of the status and competence of other educational professions and institutions was both enabled by medicalization and neurotization and was itself another step in these processes.