Psychiatric Aspects of Environmental Stress

Abstract

There is a long tradition in psychiatry of regarding external stress as etiologically related to morbiditya view embodied in the principle of moral treatment, which was influential for many years, beginning in the latter part of the 18th century. Insanity was then seen as needing to be managed in the environment of special institutions in which withdrawal from social responsibilities, a benevolent but firm regime, and undemanding diversions and occupations would promote a healing process. In today's terms, this can clearly be seen as a form of protection from environmental stress, though it was a model originally constructed in England on the basis of Quaker theology [1]. Contemporary psychiatry regards the etiology of mental disorder as almost always multifactorial, and within the scheme, whatever contribution is not genetic must, in a general sense, be environmental. For scientific purposes, however, this view would generally be too broad to be useful. A psychiatry of the environment should therefore be concerned with those aspects of people's physical and social surroundings for which there are some empirical grounds for anticipating that they are likely to influence mental health. So far, this has remained a very neglected area, lacking both scientific data and properly defined concepts; but a start, at least, has been made to organize it as a discipline [2]. The neglect is not confined to psychiatry: the physical environment has been little explored by sociologists, and architects, planners,