Social Class and Treatment in a Child Psychiatry Clinic

Abstract

UNDERSCORED by such pressing influences as the scarcity of psychiatric treatment facilities, the cost of therapy, and the lack of positive evidence that psychotherapy is better than no treatment at all, the focus on factors related to mental illness in recent years has turned up many provocative findings. Among these, SES (socioeconomic status) seems to play a most important role. Hollingshead and Redlich⁶ for example, conclude that ". . . treatment for mental illness depends on medical and psychological considerations, but also on powerful social variables to which psychiatrists have so far given little attention." Their data indicated, even when economic factors were controlled, that distinct class differences prevail in treatment within the same agencies; higher status patients tend to receive a disproportionately high degree of psychotherapy and particularly insight therapy, while organic therapies were applied most often to lower status patients. Reports of