34* M E N T A L B Y G IE N E

Engineering Foundation is fu ll o f promise. In a recent article in the Engineering News

Record, M iss Frances K cllo r says:*
T h e application o f m anpower to production in it s essence is th e province o f science to solve ju st
as m uch a s th e application of heat power an d electric pow er to production was th e province of science to
so lve........... N o th in g bu t science has ever been able to understand power o f an y kin d . Engineering is th e
o n ly m ethod th a t holds out an y prom ise of ultim ate success. Increasingly the engineer untrained in m an
pow er, bu t h av in g th e essential ground w ork, is becom ing the m anager o f men.

T here can be no doubt th a t, as the field o f stu d y and practice in mental hygiene
o f in dustry develops, the social w orker (w hether so called or otherwise named is a
m atter of no consequence) w ill be required. T here is likely to be a demand for a large
number o f psychiatric social workers trained in the general technique of social investi
gation and treatm ent and the special technique of personality study. T h e same
training th a t has been found indispensable to the adjustm ent of individuals here and
there who h ave com e to the attention o f social agen cy or hospital w ill be required for
a n y extensive program of personality adjustm ents w ithin an industry. T h e social
w orkers knowledge of fam ily and com m unity relations and special skill in securing
personal histories and in handling people should form the best possible foundation for
personnel w ork. W ith additional instruction and training in m atters pertaining to
industrial organization, the social worker is likely to p rove an asset to industry.

B IB L IO G R A P H Y

I . W h itin g W illiam s, Human Relations in Industry. U n ited S tates D epartm en t o f Labo r, 1918.
a. W . M . Lciserson, Employment Management, Employee Representation, and Industrial Democracy.
U nited S tates D epartm en t o f Labo r, 1919.
3. H erm an M . A dler, M .D ., U nem ploym ent and P e rs o n a lity ," M ental Hygiene, Janu ary, 1917.
4. M a ry C . J a rre tt. T h e P sych o p ath ic E m p lo yee, Medicine and Surgery, Septem ber. 19 x 7, p. 737,
5. Frances A . K ellor, A L ea f from L en in es P o lic y o n M a n p o w er, Engineering Nevis Record.
M arch 1 1 ,1 9 3 0 .

T H E IN D U S T R IA L C O S T O F T H E P S Y C H O P A T H IC E M P L O Y E E

M rs. Margaret J . Powers, Social Service Director, M enial Hygiene Committee,

Stale Charities A id Association, New York
In these d a y s when production is a facto r in every one of the problem s which
beset society, I wish to ca ll attention to a source of w aste in in dustry through psycho
pathic individuals. In pre-war d ays m anufacturers were turning their attention to
a number o f system s, the purpose of which was to increase the efficiency of their
factories. T h e y found th a t the expense incurred in allow ing an y portion of their
m achinery to remain idle, and b y so doing to deteriorate, was lessened production
and thus increased cost. T h is increased expenditure not infrequently w as so h e av y as
to spell failure for a num ber o f concerns.
In spite of the am ount of tim e, money, and energy em ployed in this efficiency
cam paign, the results were proportionately meager, largely because the same attention
which was given to capital was n ot so system atically applied to labor. I have often
wondered w hat became of the man Schm idt, whose labor output, T aylo r, the father of
the efficiency m ovem ent, raised from something like tw o to tw elve tons of pig iron a
d a y . N obody seems to have made a scientific study of the effect of the efficiency
system on the laborer, although labors resentm ent against it is outspoken. I t took
 COST OF TBE PSTCBOPATBlC EMPLOYEEPOWERS 343
such an impetus as the world-war to bring to mens notice, not alone the fact that they
had been merely ignoring the idler and discharging the inefficient, but also that the
product of even these misfits is of value.
B u t there is also a social aspect of this problem: namely, the reaction of the idle or
inefficient worker upon the com m unity in which he lives. This aspect too was ignored,
in a policy that forced the idler back upon a com m unity where he had to be supported
either directly or indirectly b y the workers. T h e w ar's demands upon men made it
necessary to supplement the efficiency campaign b y another one which trained the
inefficient and forced the idler to work. A t present there is such a shortage of labor
that it seems unlikely that unemployment or competition in jobs w ill arise for years;
but there must soon be a redistribution of the available labor supply.
In helping psychopathic individuals toward social adjustm ent, the mental
hygiene worker is frequently confronted with a v e ry difficult problem in tryin g to
assist these patients in finding work which is consistent w ith their abilities and their
personal peculiarities. N o t infrequently the individuals rehabilitation rests upon
intelligent help in his vocation, not alone upon finding employment but upon encourage
ment in keeping a t it. I t has frequently been our experience that if the mental hygiene
worker does not explain to an employment manager the peculiarities of her patient
she is accused of insincerity. I f she does explain, the chances are that the man will
either be refused employment or else discharged as hopeless a t his first manifestation
of difficulty. Instead o f giving him more than an average chance he is often given
less. So long as employment managers are ignorant of how to deal understanding^
w ith the psychopathic employee, the mental hygiene worker prefers to run the risk
of a charge of unfairness rather than put into the employment m anagers hands a tool
which he does not know how to use and often misuses. A n employment agent recently
telephoned m y office regarding a patient whom I had sent to her saying, **I couldnt
bother with a person like th at, he go t on m y nerves. T h e irritating factor in the case
of this patient proved to be the frequency w ith which he returned asking for a change of
employment.
B y the term psychopathic em ployee we mean those individuals whose voca
tional failures can be largely attributed to defects in their personality due most often
to bad emotional methods of adjusting themselves to their environment. D r. Adler,
in a study of 100 such cases reported (in Mental Hygiene, January, 1917) that the
treatm ent of their unemployment m ust be guided b y a knowledge o f their tendencies
so that environment, on the one hand, can be suitably influenced or chosen for them,
and that the individuals themselves m ay be trained to counteract their impulses to some
exten t. T he following cases have come to m y personal attention and have been
selected as examples largely because of the prominence of their difficulties in vocational
adjustm ent. T heir social inadequacies manifested themselves in such difficulties as
arm y S.C .D ., begging, estrangement from relatives, excessive borrowing, friendlessness,
grafting, sexual difficulties, improvidence, irregular employment, panhandling, quarrel
someness, vagrancy, and suicidal threats.
C ase 1. P atien t is an Am erican tw enty-six years old, single. D iagnosis con stitution al inferiority.
H e le ft school after com pleting the seventh grade, and after six months a t a business college le ft home to
go to work. H is first position was th a t o f clerk in a newspaper office, where he stayed tw o and a half years,
the longest tim e he has ever spent a t any one place. Although he was capable o f earning good m oney in
h is various subsequent positions, he seldom stayed long enough to do so. W hile in th e service of the
U n ited States A rm y, he was thrown from a horse and rendered unconscious for a few m inutes. He received
344 M E N T A L H Y G I E NE

treatment for a year a t a hospital where it was said that he had sustained no organic injury and the treat
ment was for the purpose of giving the patient a better equipment with which to secure his social recovery.
For several months following his discharge he worked, then re-enlisted fraudulently in the United States
Array, receiving his second S.C.D . From January to October he held five different positions, one in a
m unitions plant at $9 per day, which he held only three weeks. It was at this time that he came under
social service supervision and during the following year an attem pt was made to stabilize him. He kept
no position over a month. H is best work is done under the stimulus of rather romantic conditions, such
as booking shows for theatrical companies, disp lay advertising, and sensational newspapers.
Case 2. Stenographer, about forty years of age. Single. Diagnosis paraphrenia. T his case was
referred by an organization which had been obliged to discharge her because of her difficulties with other
employees. She is a small, spare woman with nervous motions, and is quick in taking offense. She has a
tendency to be jealous of other employees and thinks she is not fairly treated. She is always straightening
out papers and arranging and rearranging things to suit herself. Although she is a first-class stenographer
and typist she seems unable to adjust to any environment. The Y.W .C-A. employment registry have known
her for three years, and have secured for her twenty-five positions. In securing these she was sent to
seventy-two firms to make application for work. Her longest period at any one position was one month,
the shortest period two days, and whereas an average stenographer of her training and ability should earn
about $25 per week, she seldom made over $15. W ith succeeding failures her peculiarities have become
more exaggerated until at the present time it is doubtful if anything remains to be done other than commit
her to a state hospital. In a woman of her intelligence, an earlier attempt at an understanding of her
personality difficulties would in all probability have made her a happier human being and have saved to
society a useful person.
Case 3. Young man, thirty years old, of Irish-American parents. Diagnosis paranoid dementia
praecox. T he fam ily have long been known to the charity organization society of a large city where the
patients father owned a good business. He was later a saloon-keeper, and eventually ended up as janitor
or doorman at a public building, which position was a reward for long years as a hanger-on to the political
machine. Patient was graduated from grammar school at the age of fourteen, after which he went to
work in a lawyers office, having a political carecr as his aim, and Charles F. M urphy as his idol. His father
had been a heavy drinker and during the last years of bis life developed tabes. H e committed suicide as
a result, according to his son, of Tam manys going back on him in the matter of his job. Patients mother
cut her throat, with fatal result, the day of her husbands funeral.
After his fathers death in 1910, the patient began a life of wandering from one job to the next.
He has lived in nearly every large city in the northern states. He remembers his home as one of constant
friction between his parents. His mother never sympathized with her husbands party affiliations, nor
with his Catholic religion, she being a Protestant. He lived on political gossip and the doings of those in
high places and his mental trouble seems to have gradually followed the trend of his fathers. A ll of his
difficulties are due to the revengeful hand of Tammany which has tried to thwart him wherever be goes,
because, when they turned on his father, the family threatened to show up the fraudulent methods by
which the Democrats had done Hearst out of the governorship. Due to the patients mothers entreaties
and the fact that they would become unpopular they refrained from telling their secret, though the patient
states that he has all the information in his possession and some day he may be forced to use it. His
justification for his vocational failure is that every job is made impossible by the political gang of his native
city who will eventually smash even such organizations as the Mental Hygiene Committee for trying to help
him. He has kept an elaborate work record from 1910 to 19x9, showing 123 jobs, the year in which he held
them, the city, type of work, name of employer, wages received, length of employment, and whether he
was discharged or left voluntarily. M ost of these positions have been verified and the statistics which they
present are of especial interest to the problem under discussion. The 123 jobs represent 103 different
firms for whom he worked and 33 different occupations which he followed. His longest period at any one
job was eight months, his shortest period of work being one day, with an average of x 2} days spent at each.
H e worked a total number of 1,545 days for the time covered, or about one day out of every two. He was
80 times discharged, resigned 20 times, and 19 of the positions were at temporary work. His total earnings
for the ten years were $3,3x6.21.
The kinds of work which this patient did can be grouped under three main headings, jobs as laborer,
of which there were 30, clerical positions 32, and jobs as a semi-skilled worker where proficiency is obtained
after a few months experience, 33. Satisfactory estimates or studies of the cost of breaking in men are
very scarce. Those which are available have been made by personnel managers and experts connected
with ccrtain industries and are more in the nature of roughly assumed estimates than scientific statistical
studies. Using a sca le which is considered conservative as a basis for computing the cost of the labor
* Siichter, Turnover of Factory Labor.
 CO ST O F T H E P S Y C H O P A T H IC E M P LO Y E E PO W ER S 345
turnover for this one individual, his cost of hiring can be estim ated a t I 4 7 .S 0 , co st o f training $960, wear
and tear $392, reduced production $1,870, o r a total of $3,608.50, & sum which exceeds his earnings b y
about $300. I f w e estim ate the normal earnings of a man of this class a t $1,200 per year, then the total
wages which he should have received for th is tim e, or $x 2,000, m ust be added to the foregoing in calculating
his cost to society. T h e statistics used here do n ot include th e co st o f rehiring b y the same firm. T h is
occurred 12 tim es, m ostly in eases of newspaper press rooms where the night work afforded him lodging.

Such efficiency methods as have been used in the past take care of only normal
individuals, but the so-called normal workers make up only a certain percentage of the
labor supply. T h e psychopathic employee is not sufficiently normal to fit into efficiency
methods nor is he subnormal or abnormal enough to be committed to an institution.
Hence he is forced into a life of wandering which eventually works to his own detriment
and that of society. Receiving no help toward a more successful handling of his
difficulties, he repeats his experience w ith an endless number o f positions to the great
cost of productive labor and capital. T h e case ju st cited shows clearly the extent of
waste in present methods of handling such people. T his man only earned $3,316.21
in the past ten years; the rest of the time he has lived upon contributions made b y
charitably inclined persons who were m oved to p ity b y his hard-luck stories, or else
b y social agencies. W hen these were not sufficient, he resorted to graftin g, pan
handling, borrowing, etc. His waste to industry is shown b y the fact that his earnings
were less than the cost of labor turnover. And his cost to society is much greater than
the cost of m aintaining him in a state hospital for the entire period.
Such cases as the foregoing are illustrative o f the psychopathic employee. I t is
not possible to estimate a t present the exact percentage of labor constituted b y such
individuals, but that they m ake an appreciable number is certain. One industrial
organization, which is beginning to appreciate the existence of the problem, recently
expressed the opinion that they feared to open a psychiatric clinic for fear of being
swamped.
Since such individuals exist in such large numbers, some plan m ust be created
to make use of them . T his can only be done through education of the public generally,
as well as employers and em ploym ent managers specifically, in the understanding of
human nature from a psychiatric viewpoint. Such a program m ust necessarily be
slow, since the ignorance and prejudice of the public a t large is one of the greatest
factors in the problem. Society's own resistance to an insight into its own makeup
leads it to treat as mysterious and dangerous all m ental abnormalities. T h a t the
correction of society's state of mind is one of the tasks of m ental hygiene is self-
evident.
I t is not necessary, however, to aw ait the general awakening on the part of the
public a t large before undertaking more practical measures to deal w ith the employ
ment problems of the psychopathic worker. There are already in existence a number
of excellent courses which train workers in the recognition of m ental symptoms,
something o f their causation, and the means o f assisting such individuals toward
social and vocational adjustm ent. Psychom etric tests are of value and mark a decided
step in advance, but since they do not take into account the emotional nor personality
factors in the situation they are not a solution of the problem. In order to identify
the psychopath in industry and effectively utilize him, each employment department
should have on its staff a t least one person who has been trained to recognize and
handle such individuals, not alone for the purpose of placing him a t work but of
securing an adjustm ent to that work which w ill insure his maximum of productivity
346 M E N T A L H Y G IE N E

to industry and of satisfaction to himself. The cost of training one member of the
staff of each employment department in mental hygiene principles is infinitesimal
compared to the money wasted in allowing present methods to continue.
The United States Commissioner of Labor Statistics1 has said that unemploy
ment, although not yet recognized as an industrial accident, nevertheless causes more
slowing down of production, demoralization, and suffering than all other industrial
mishaps. Among the various causes of unemployment he mentions the lack of a
properly balanced organization of industry, lack of an intelligent employment policy
for hiring and handling men, failure to gain the good will of employees, failure to make
use of the tremendous latent force lying dormant in the workers. Each one of these
causes has a special significance to those who earnestly believe that in scientific inquiry
and in more understanding of the needs and creative possibilities of the psychopathic
states in human nature lies an effective weapon for striking a t the roots of the current
unrest.

T H E PER SO N AL PR O BLE M S O F A G ROUP OF W O R K ER S

Dr. Anne T . Bingham, Phipps Psychiatric Clinic, Johns Hopkins Hospital, Baltimore
It may be interpreted as an indication of real progress that many among those who
are dealing with the complicated subject of industry are beginning to appreciate the fact
that a consideration of the personal problems of workers often has a practical bearing
on their subsequent efficiency, and that it is of definite practical benefit to get at the
causes for individual discontent and personal maladjustment existing among their
employees. It was to be expected that physical needs of workers would receive
attention before their mental ones, as this order has obtained in many other welfare
movements.
W e believe that heretofore there has been too little attention paid to the emotional
lives of people, to their instinctive needs, to their groping attempts at self-
understanding which too often lead to tragic misunderstanding. The tendency to ignore
emotional needs has of course a pretty general application, but since this paper is
mainly concerned with a group of workers, emphasis will be laid on specific cases
which have recently been under the writers observation.
In M ay, 1919, there was established in New York for an experimental period of
eight months a so-called Conference Center, financed by the Social Morality Committee
of the War Work Council of the National Board of Young Womens Christian Associ
ations. The latter organization has long provided departments for meeting physical
needs. The Conference Center was designed to supplement the former by dealing with
mental needs. When first planned it was hoped that in addition to working with
individual cases of maladjustment there would be an opportunity to function in
connection with large manufactories where a study of personal assets and liabilities
might receive practical application in placement, but this part of the project did not
materialize. The work actually done concerned itself with girls and women who had
been problems in some way to themselves or to others, but who for the most part
were not incapable of carrying on some form of work.
Knowing the hypersensitive condition of many of these patients and their unwill
ingness to go to regular clinics, an effort was made a t the beginning to avoid all
1 Address delivered at Pennsylvania Safety Congress, March. 1939.