Social psychiatry was a mid-twentieth-century approach to mental health
that stressed the prevention of mental illness rather than its
treatment. Its proponents developed environmental explanations of mental
health, arguing that socioeconomic problems such as poverty, inequality,
and social isolation were the underlying causes of mental illness. The
influence of social psychiatry contributed to the closure of psychiatric
hospitals and the emergence of community mental health care during the
1960s. By the 1980s, however, social psychiatry was in decline, having
lost ground to biological psychiatry and its emphasis on genetics,
neurology, and psychopharmacology.
The First Resort is a history of the rise and fall of social psychiatry
that also explores the lessons this largely forgotten movement has to
offer today. Matthew Smith examines four ambitious projects that
investigated the relationship between socioeconomic factors and mental
illness in Chicago, New Haven, New York City, and Nova Scotia. He
contends that social psychiatry waned not because of flaws in its
preventive approach to mental health but rather because the economic and
political crises of the 1970s and the shift to the right during the
1980s foreclosed the social changes required to create a more mentally
healthy society. Smith also argues that social psychiatry provides
timely insights about how progressive social policies, such as a
universal basic income, can help stem rising rates of mental illness in
the present day.
