EUGENIC TENDENCIES IN POPULATION 269 



The total number of patients with mental disease, resident in state 

 hospitals, has increased from 31,973 in 1880, to 159,096 in 1910, to 222,406 

 in 1922, to 264,511 in 1928, and to 272,527 in 1929. The ratio of total 

 patients with mental disease per 100,000 of the general population was 63.7 

 in 1880, 173.0 in 1910, 204.0 in 1922, 222.3 in 1928, and 225.9 in 1929. 



A considerable part of the apparent disproportionate increase of mental 

 disease may be accounted for by the more general use of hospitals in recent 

 years, and the better diagnosis of mental disorders. The transformation of 

 asylums and other custodial institutions into hospitals for the treatment of 

 mental disease is a factor of great importance in explaining the increase in 

 mental patients. The American people now generally recognize the effi- 

 cacy of institutional care in psychopathology and have broken down much 

 of the prejudice against institutional care. 



Another significant factor in explaining the increase in mental disease is 

 the growth of urbanity at the expense of rurality in the United States. 

 Many forms of mental disease are more prevalent in cities than in rural 

 communities. This may be accounted for by the greater prevalence of 

 alcoholism and venereal diseases in cities. This situation may also be ex- 

 plained by the conflicts of culture patterns, mores and artefacts that rural 

 people and immigrants who flock to the already congested cities are con- 

 fronted with, as they try to adjust themselves to the new environment. 

 Many of them succumb and become psychotic. 



Furthermore, the decline in the birth rate and the constancy of the death 

 rate, as already indicated, reflect themselves statistically in larger higher 

 age groups, in which groups many more mental diseases manifest themselves 

 than in the younger age groups. The sciences of medicine, hygiene, and 

 sanitation have worked wonders in increasing the longevity of men, but 

 with the concurrent effect of enabling various mental disorders to manifest 

 themselves in later middle life which might not otherwise have the opportu- 

 nity of developing. 



The foreign-born have two and one-half as many psychotics as they 

 should have. Of the 244,968 resident white patients, 169,296, or 69.1 per 

 cent, were native; 69,984, or 28.6 per cent, were foreign-born; and 5,688, or 

 2.3 per cent, were unknown with respect to their nativities. That as much 

 as 87.7 per cent of the white population of the United States were native 

 and 12.3 per cent were foreign-born was revealed by the general census of 

 1930. The rate of mental disease for native whites of native parentage is 

 159.8 per 100,000 of the same class; for native whites of foreign parentage, 

 207, and for native whites of mixed parentage, 135.8. The rate for foreign- 

 born white patients was 513.9. Our restrictive immigration laws should 



