THE ORIENTATIONS OF LEADERS IN AN URBAN AREA TOWARD PROBLEMS OF MENTAL ILLNESS
BRUCE P. DOHRENWEND PH.D.,
VIOLA W. BERNARD M.D., , and
LAWRENCE C. KOLB M.D.1
1 Dept. of Psychiatry, Columbia University, New York 32, N. Y.
It is necessary to sound a note of caution about these results. They are obtained from interviews with leaders in only one urban area. Viewed as a case study, our findings provide knowledge of the leaders in this area. Viewed as evidence for general contrasts among leaders in different spheres of activity, our work requires replication in other settings. At the very least, however, the differences we have described should provide hypotheses for further research.
Our results suggest that orientation towards problems of mental disorder does vary with the individual's order of leadership activity. The differences cannot be accounted for by such factors as educational level, but appear traceable, in large part to the norms governing activities in these orders and serving as major bases for appraising deviant behavior.
That these frames of reference dictate orientations varying greatly in the degree to which they are compatible with psychiatric views may well have strong implications for community programs. Leaders are important both as agents of existing social norms and as potential innovators. Their appraisals of problems of mental disorder are thus factors to be reckoned with by agencies planning and coordinating community services for prevention, treatment, and rehabilitation. The leaders' orientations also have implications for the content, methods, and direction of mental health education aimed at more effective communication between the mental health professions and the community. Certain of our findings are especially relevant to programs in both service and mental health education. The political-legal leaders, with strong reputations for influence in the community, showed high tendencies to recognize mental illness in case descriptions of mental disorder, and to advocate help from the mental health professions. Yet it is the educational leaders, low in reputation for influence, who have the orientation most congruent with a psychiatric frame of reference; least congruent with psychiatric views are the orientations of the economic and religious leaders. The former are high in reputation for influence, and the latter are those most likely to be called upon to deal with problems of mental disorder by virtue of their leadership positions.
