Current Status of Ecological Research in Mental Disorder

Abstract

O UR main purpose in this paper is to evaluate recent studies and criticisms which have appeared dealing with the ecology of mentaldisorder. The earlier studies dealingwith the spatial distribution of had a more limited influence than have the more recent studies possibly because of the then infant character of the developing field of psychiatry. However, almost forty years ago MacDermottl raised the interesting question as a result of his study dealing with the distribution of in England. He asked, why it was if there was a specific diathesis governing that there should be such vast differences in its geographical distribution? Such a question points up the fact that the distribution studies of any earlier day tended to be used and thought of in much the same way as the current studies even though the latter generally have been cloaked with the conceptual framework of human ecology. However, MacDermott's question is of more than passing interest for it serves to indicate that the problems raised by the more recent studies are often more numerous than those which they answer. By this remark, I do not mean to throw the baby out with the bath but I intend rather to point up two items: (1) that these ecological studies have definite limitations in enabling us to get closer to the specific etiological factors involved in mental disorders, and (2) that these studies have a significance over and beyond that of bringing us closer to these causative factors. Thus, specifically in this paper, we wish to do the following: (1) to point to the solid findings and the emerging problems as a result of these studies; (2) to evaluate the criticisms which have been made concerning them; and (3) to give some estimate of the significance of this research both in throwing light on the etiology of mental disorder and in contributing to our knowledge of the society in which we live. Almost a decade has passed since Faris and I completed the ecological studies of mental disorder in Chicago and Providence. Since that time several other studies have appeared which have served to check the results obtained for Chicago and Providence. Here, I refer to the studies of Green,2 Queen,3 Shroeder,4 Mowrer,5 Tietze,6 and Hadley.7 Since the major findings of our ecological studies in Chicago are generally known, it seems pointless to repeat them here. My chief concern will be rather to examine the other studies which have appeared to find out the extent to which they test the findings for Chicago. The one point on which all of the ecological studies of mental disorder so far are in agreement is the fact that all types of mental disorder show a wide range of rates in their distribution and that the high rates are invariably concentrated in at the center of the city with the rates declining in magnitude toward the periphery. Thus, Schroeder concludes in his summary of the evidence that insanity areas have been shown to exist. To date ecological studies in nine cities support this finding. However, when one turns to the distributions of the different types of psychoses, one finds it necessary to be more tentative with respect to agreement of the different studies. In this connection the major finding of the Chicago study was that the schizophrenic cases showed a high degree