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Can you reduce stigma by teaching people about mental illness? In 1951 social biologist Elaine Cumming and psychiatrist John Cumming travelled to Indian Head, Saskatchewan, to test that idea. They exposed unwitting local residents to educational materials about mental health, then evaluated their attitudes. In a turn of unparalleled irony, the townsfolk grew hostile towards the Cummings and the mayor told them to leave. Draw your own conclusions about this early anti-stigma project by looking at sociologist Kathleen Kendall’s study of the Cumming’s experiment.
Mental health education was a key aspect of efforts toward establishing community psychiatry in the 1950s. Before patients could be safely released from mental hospitals into Canadian communities, it was believed necessary to cultivate public support for deinstitutionalization and to foster tolerance and understanding of individuals with mental health problems. Such conditions, mental health “experts” claimed, would help patients to reintegrate into society as well as experience fewer relapses and readmissions. Furthermore, public education on “mental hygiene” (the science and practice of mental health, as it was then called) would prevent individuals from becoming unwell in the first place.
Good mental hygiene was considered to be particularly important in the post-Second World War period. Recovering from the trauma of battle, Canada now faced a new kind of “cold war” ushered in by the atomic age. Poor mental hygiene, leading psychiatrists, psychologists and social scientists said, had contributed to the development of fascism and Nazism. The prevention of emotional instability and disorder, therefore, was regarded as necessary not only for global peace but also for human survival. The goal of creating a stronger, healthier democratic nation by using science to shape or engineer society was shared by powerful philanthropic, charitable, psychiatric, academic and government bodies. Alliances, therefore, were formed with the express purpose of creating ideal citizens by educating Canadians in the principles of good mental hygiene, at least that was the theory.
Central to the educational message promoted by these coalitions was the notion that childhood experiences profoundly shape later life. Poor mental health, it was argued, was rooted in a bad childhood for which parents were largely blamed, although schools were sometimes held accountable too. Girls and boys with problematic upbringings, whether authoritarian, neglectful or overly permissive, were said to be at risk of abnormal development and behaviour. However, definitions and understandings of what was considered to be “normal” and “abnormal” reflected the biases and prejudices of the “experts” who made such determinations. For example, mental health education typically represented the ideal family as being white, nuclear and based on heterosexual marriage, with a clear sexual division of labour. The notion of “mental hygiene” was often informed by eugenics.
In the years following the end of the war, Canadians were exposed to a proliferation of mental health educational programs via radio, newspaper, magazines and film. To determine the impact of these campaigns, the “experts” involved in promoting deinstitutionalisation and mental hygiene felt it important to gather some hard data through research. The Indian Head experiment, highlighted in this exhibit, was the most extensive and intensive of such studies to be undertaken in the early post-war period, and possibly since.
The Indian Head Experiment demonstrated that although the efforts of researchers John and Elaine Cumming to change attitudes did have some impact upon citizens, it was not in the ways they expected. The mental health education program they implemented was ignored by many of the town’s occupants and vigorously challenged by some others. Critical scholars influenced by the French philosopher Michel Foucault, have come to see educational efforts designed to create ideal citizens as examples of what they term “governmentality.” By this, they mean that instructional activities and the media can be used to regulate people so that they behave in ways desired by those in authority. In such a way, power operates not through force but by encouraging people to believe in the ideas being communicated to them by “experts” and to live their lives in alignment with these understandings. However, the concept of governmentality also holds that “ordinary” men and women can resist efforts to control them and exert their own, although limited, power. The Indian Head project can be seen as an example of governmentality along these lines.
The Cummings in Indian Head
Beginning in 1951, social biologist Elaine Cumming and psychiatrist John Cumming, a married couple, led a mental health education experiment in Indian Head, Saskatchewan. The Cummings worked in the Psychiatric Service Branch (PSB) of the provincial Department of Public Health at the time and the idea for the project arose from discussions between the PSB and the Canadian Mental Health Association about research that would support deinstitutionalisation and related policies. The Commonwealth Fund, an American philanthropic organization with a specific interest in mental hygiene, backed the study financially.
The project sought to determine whether negative attitudes toward mental illness could be changed through commonly used educational means, including newspaper articles and advertisements, pamphlets and booklets in the local library, study groups, speaking engagements, debates, films and radio. Although similar instructional activities had been carried out elsewhere, none were as far-reaching and concentrated as in Indian Head.
Indian Head (given the pseudonym “Blackfoot”) was chosen because of its proximity to Regina in southeast Saskatchewan where the PSB headquarters was situated. Another key reason was that its population numbered only 1,500. This relatively small size meant that the educational program could reach everyone in town and that it was possible to survey all of the adults. The town was English-speaking, largely white and comparatively wealthy, boasting a federal Experimental Farm and a Forest Nursery Station. The Cummings perceived the settlement to be largely conservative and “less progressive” than other communities in the province. Yet, this fact made Indian Head even more attractive to them because they believed that if they could change attitudes here, they could change them anywhere.
Interviews and a survey of attitudes were conducted with local townspeople before and after the experiment in order to measure its effectiveness. Residents of the town of Moosomin, located in the same southeast section of the province, were used as a control group (the town was given the pseudonym “Deerville”). Unfortunately, not only did results indicate that attitudes remained unchanged, but in fact the town appeared to close ranks against the Cummings and their team. Near the end of the experiment the researchers felt that the citizens of Indian Head had become cold and withdrawn, even hostile, toward them. In the end, the mayor told them to leave town.
The Cummings wrote about this study in the book titled Closed Ranks: An Experiment in Mental Health Education. It was published by Harvard University Press in 1957 and remained in print for 25 years. The authors developed a sophisticated sociological model to explain their findings and the Indian Head experiment continues to be regarded as a landmark study. Elaine and John each became very successful researchers and policy-makers in both Canada and the United States. However, because of the negative findings, their research in small town Saskatchewan delayed plans for deinstitionalization in the province and contributed to a temporary decline in mental health education campaigns more broadly.
The Survey of Social Attitudes Questionnaire
The survey questionnaire used by the Cummings in their mental health education experiment was designed to measure people’s attitudes toward mental illness. In particular, it attempted to measure how close a relationship respondents were willing to have with someone who had a mental illness using a “social distance scale”. Also, the questionnaire assessed responsibility - for causing another persons mental illness and for caring for him or her using a “ social responsibility scale”. The first survey was carried out in September 1951 before the start of the experiment and the second survey was conducted after the experiment ended in May 1952. A comparison of results from these two time periods showed that attitudes toward mental illness did not change.
The Cummings evaluated the impact of their experiment through questionnaires and interviews. The following questionnaire was designed to measure people’s attitudes toward mental illness. In particular, it was attempting to gauge how close of a relationship respondents were willing to have with someone who had a mental illness (social distance); and how responsible respondents saw themselves to be for causing another person’s mental illness as well as for their care (social responsibility).
Which questions do you think are asking about social distance and which ones are asking about social responsibility?
What other questions could the Cummings have asked?
What do you think your answers say about your attitudes toward mental illness?
Mental Health Education Through the Media
As is the case today, mental health education media campaigns in the early post-war period attempted to socially engineer or shape people’s attitudes and behaviour. By 1950, the mental hygiene message was being transmitted into homes of Canadians through a variety of media. Of course, the educational impact of these campaigns was mixed, for audiences sometimes resisted or reworked what they heard and read.
On January 15th, 1952, at 7:30 PM a unique radio program began broadcasting over the airwaves of Canadian Broadcasting Corporation (CBC) radio affiliate CKRM into the homes of listeners across southeast Saskatchewan. For eight weeks, audiences tuned into “Junior Jury”, a panel discussion about family life in Indian Head. Some of the shows were recorded in the homes of local residents, and young followers were offered $1 to submit questions for jury members to consider. The series was a joint effort between the research team and the local Home and School Club.
John Cumming highlighted key themes raised during five of the broadcasts in a column for the local paper, the Indian Head News.
In Search of Ourselves
In Search of Ourselves was an acclaimed radio series that first aired on the Canadian Broadcasting Corporation (CBC) Dominion network in the spring of 1948 and ran for over 6 years. It was a joint venture between the CBC and the National Committee for Mental Hygiene (later referred to as the Canadian Mental Health Association). Each half-hour broadcast dramatized a particular mental health and/or relationship issue taken from actual case files and scripted by Len Peterson. After every story, leading psychiatrists, psychologists or sociologists offered their expert interpretation of the case as a means of not only engaging listeners further but also of encouraging them to hear the intended message correctly. To extend audience participation bulletins and guides were produced and distributed across the country. Study groups used this material to help them discuss the issues raised.
Although In Search of Ourselves was not specifically part of the Indian Head experiment, townspeople would have come across it, both prior to and after the study, while listening to their radios.
Listen to two plays re-enacted from the In Search of Ourselves series and follow along with the discussion guides. You can also hear Professor Kathleen Kendall’s comments on each play, highlighting their meaning and significance within 1950s Canada.
In Search of Ourselves was only one radio program among many developed by the CBC in collaboration with the Canadian Mental Health Association and/or other mental health experts in the late1940s and early 1950s. Similar programs during this time period included: ‘What’s On your Mind’, ‘Learning to Live’, ‘In Search of Mental Health’ and ‘Life with the Robinsons’.
Although the first Canadian television station did not begin broadcasting until September 1952, the Cummings used film as a means of both entertaining and educating Indian Head audiences. The pair projected dramas and documentaries in the town meetings hall, school and theatre using films on loan from the National Film Board and other companies specialising in mental hygiene themes.
This part of the exhibit highlights one National Film Board series focused on mental hygiene issues that was available at the time the Indian Head experiment was being conducted.
Mental Mechanisms was made by the NFB for the Mental Health Division of the Department of National Health and Welfare. Psychiatrists from the Allan Memorial Institute of Psychiatry at Montreal served as expert consultants and Jack Griffin, Medical Director of the National Committee for Mental Hygiene, worked as a technical adviser.
The series was initially intended as a tool for psychiatrists and other professionals to use with their patients as a means of helping them to understand the roots of their emotional problems. However, it was soon shown more widely because it was believed that the films would help to educate parents in good child-rearing practices and alert them to any emotional disturbances their children may exhibit.
Using dramatization with professional and amateur actors, but drawing on real case histories, each film told the story of a how a particular emotional dysfunction developed through bad parenting. Films in the series include: ‘The Feeling of Rejection’ (1947), ‘The Feeling of Hostility’ (1948), ‘Overdependency’ (1949) and ‘Feelings of Depression’ (1950). Each was based around a dramatised case history demonstrating how poor mental health was rooted in poor parenting.
The Cummings showed ‘The Feeling of Hostility’ alongside other movies during a three-day film festival, titled ‘Small Fry’, in March 1952. The event attracted a total of 260 people and approximately 60 of these remained after screenings to participate in small group discussions led by John Cumming.
Feelings of Depression
In early 1951, the Provincial Director of Health Education was apprehensive about showing ‘Feelings of Depression’ to audiences because he believed that its abrupt ending might cause viewers upset. In order to prove his suspicion, a test screenings was conducted with audiences in Regina. In fact, audience polls found that his concerns were misplaced.
This exhibit is based on the following article:
Kathleen Kendall, "From Closed Ranks to Open Doors: Elaine and John Cummings' Mental Health Education Experiment in 1950s Saskatchewan," Social History 88 (November 2011), 257-286.