Community Mental Health Ideology, Dogmatism, and Political-Economic Conservatism Frank Baker, Ph.D. Herbert C. Schulberg, Ph.D.
ABSTRACT: The Community Mental Health Ideology (CMHI) Scale, an abridged version of Rokeach's Dogmatism (D) Scale, and the five-item form of the Political-Economic Conservatism (PEC) Scale were administered to 14o members of the Massachusetts Citizen Mental Health Area Boards. The results indicate that degree of adherence to community mental health ideology as measured by the CMHI Scale is significantly negatively correlated with dogmatism and political-economic conservatism. The sample of nonprofessional citizens scored higher on the CMHI Scale than did groups of r health professionals who had been previously studied. They also obtained scores on the D Scale and PEC Scale indicating that these lay members of mental health area boards are less dogmatic and less conservative than the groups with which these scales were originally developed. Ideological differences have characterized the mental health field for many years and a variety of studies have demonstrated the relationship of ideological orientation to the manner in which the dinician functions and programs develop (Gilbert & Levinson, 2957; Sharaf & Levinson, 2957; Hollingshead & Redlich, 2958; Strauss, et al., 2964). Although these relationships are also affected by the individual's position in his organization's hierarchical structure and his administrative style, the person's ideological orientation must be considered as a key variable since it very much reflects inner personality characteristics and choices in role definition. The most recent ideological movement in the mental health field is that of community mental health. The authors (2967) have found that it is viewed by many professionals as an open and liberal ideological perspective which is particularly concerned with such issues as: assuming responsibility for the entire population rather than for the individual patient only; primary prevention of mental illness through the amelioration of harmful environmental Dr. Baker is head, Program Research Unit, Laboratory of Community Psychiatry, Department of Psychiatry, Harvard Medical School, 58 Fenwood Road, Boston, Mass. o2Iz5. Dr. Schulberg is associated with United Community Services, Boston. The study reported in this paper was supported by NIMH Special Grant MH-o92z 4. Community Mental Health Journal, Vol. 5 (6), 1969
433
434
Community Mental Health Journal
conditions; treating patients with the goal of social rehabilitation rather than personality reorganization; comprehensive continuity of care and responsibility for the mentally ill; and total involvement of both professional and nonprofessional community helpers in caring for the mentally ill. The cohesiveness of this ideology was demonstrated when the authors (2967) developed a valid and reliable unifactorial Community Mental Health Ideology (CMHI) Scale. Recent applications of the scale indicate that it is sufficiently sensitive to varying ideology patterns to discriminate among work groups and professional departments at a changing mental hospital (Baker & Schulberg, 2968 ). The present study is directed toward an examination of the relationship between community mental health ideology and other personality and idea systems. Since community mental health ideology included many nontraditional beliefs aiming at greater societal involvement with persons experiencing difficulty in adjusting to their environment, it was thought particularly relevant to measure the relationship of this ideology to the variables of dogmatism, and liberalism versus conservatism. Rokeach 096o) and Vacchiano, et al. (2968) have contended that dogmatism is a general personality trait related to one's ability to form new conceptual systems, while the dimension of liberalism versus conservatism was found to be integral to the assessment of the authoritarian personality (Adorno, et al., "r95o). METHOD The subjects in the study were i4o adults who had agreed to serve on Citizen Mental Health Area Boards in various parts of eastern Massachusetts. They had been appointed to the boards because of their interest in and knowledge about mental health programs and were charged with the responsibility of advising the professional staff of local centers about the mental health needs of their areas. As part of a larger mailed questionnaire study, the area board members completed the 38-item Community Mental Health IdeologyScale, an abridged 2o-itern form of Rokeach's Dogmatism (D) Scale (Troldahl & Powell, 2965), and the five-item form of the Political-Economic Conservatism Scale which had been developed by Adorno, et al. (z95o) to measure political-economic liberalism-conservatism. RESULTS The response patterns of the subjects studied are presented in Table 2. The mean score obtained on the CMHI Scale by the sample of concerned nonprofessional citizens is higher than the mean obtained by national random samples of mental health professionals. This sample of citizens did not, however, score as high on the scale as have groups composed of community mental health specialists (Baker & Schulberg, 2967). When adjustments are made for differing scoring procedures on the D Scale and the PEC Scale, it is evident that the present subjects are less dogmatic and less conservative than the groups with whom the scales were originally developed. Community mental health ideology, dogmatism and political-economic conservatism are significantly intercorrelated (P < .o2). The product-moment
Frank Baker and Herbert C. Schulberg
435
correlation between the CMHI Scale and the Dogmatism Scale yielded r = .38; between CMHI Scale and the PEC Scale, r - - - - . 4 o ; while the correlation between Dogmatism and the PEC Scales was .66. TABLE x Responses on CMHI Scale, D Scale and PEC Scale (N=z4o)
CMHI Scale D Scale* PEC Scale*
Mean
SD
Range
219.~ 55.2 24.a
26. 3
"T57-265 28-99
:~3.8 4.2
5.28
*Basic statistics inflated in terms of absolute numbers because of response format ranging from +7 to +z rather than +3 to -3. DISCUSSION The results indicate that degree of adherence to community mental health ideology is significantly related to the general personality trait of dogmatism, and to the liberalism-conservatism idea system. A high orientation to the most recent mental health ideology is associated with a low degree of dogmatism and with a low adherence to conservative principles. Similarly, the highly positive correlation obtained between the D Scale and the PEC Scale indicates that closed-minded persons tend toward a conservative rather than liberal orientation in their political philosophy. A similar relationship between dogmatism and conservatism was reported by Rokeach (x96o, p. xz2) in his study of college student populations. The fact that Rokeach obtained lower positive correlations between the full Dogmatism Scale and the five-item PEC Scale among his subjects may have stemmed from his use of students who were predominantly right rather than left oriented in their political views. The data of the present study are also consistent with those reported by Vacchiano, et al. (x968). They examined dogmatism as a personality trait and concluded that dogmatic individuals are "cautious and compromising in regard to new ideas, generally going along with traditions" (p. 84). Community mental health ideology may be viewed as an innovative idea system which espouses many novel theoretical principles and program directions which :sharply depart from earlier conceptions of proper treatment for the mentally ill. The present data clearly suggest that the nontraditional aspects of community mental health ideology will be most fruitfully received among individuals whose general personality disposition is nondogmatic, and whose idea systems are receptive to liberal concepts of social concern and responsibility for the mentally ill. It is important to note also that community mental health ideology may take more fertile root within selected nonprofessional citizen groups than
436
Community Mental Health Journal
among random groupings of psychologists and psychiatrists. The scores obtained by the samples of citizens on the measures employed in this study suggest that as a group, upon their selection to area boards, they already favored community mental health principles, were open-minded in personality, and rpolitically liberal. The fact that the citizen's mean CMHI Scale score exceeds that of many mental health professionals perhaps foreshadows a situation in which the impetus for planning innovative community-oriented services may !stem from citizens rather than from professionals. If this should be the case, it would highlight once again the fact that if progressive novel programs are to develop it is as necessary to shatter the ingrained conservatism and traditionalism of supposedly enlightened professionals as it is to educate an allegedly reactionary citizenry. REFERENCES Adorno, T. W.; Frenkel-Brunswick, Else; Levinson, D. J.; and Sanford, R. N. The authoritarian personality. New York: Harper, ~95o. Baker, F., and Schulberg, H. The development of a community mental health ideology scale. Community Mental Health Journal, x967, 3, 2z6-225. Baker, F., and Schulberg, H. The community mental health ideology patterns of staff members at a changing mental hospital. (Mimeo.)December,I968. Gilbert, Doris C., and Levinson, D. J. "Custodialism" and "Humanism" in staff ideology. In Greenblatt, M.; Levinson, D. J.; and Williams, R. H. (Eds.), The patient and the mental hospital. Glencoe,II1.: The Free Press, ~957. PP. 2o-36. Hollingshead, A., and Redlich, F. Social Class and Mental Illness. New York: John Wiley, I958. Rokeach, M. The open and closed mind. New York: Basic Books, x96o. Schulberg, H., and Baker, E. Varied attitudes toward community mental health. Archives of General Psychiatry, ~967, I7, 658-663. Sharaf, M. R., and Levinson, D. J. Patterns of ideology and role differentiation among psychiatrist residents. In Greenblatt, M.; Levinson, D.J.; and Williams, R. H. (Eds.) The patient and the mental hospital. Glencoe,Ill.: The Free Press, x957. Pp. 263-285. Strauss, A. Psychiatric ideologies and institutions. New York: The Free Press of Glencoe, 1964. Troldahl, V. C., and Powell, F. A. A short-form dogmatism scale for use in field studies. Social Forces, x965, 44, 211-214. Vacchiano, R. B.; Strauss, P. S.; and Schiffman, D. C. Personality correlates of dogmatism. Journal of Consulting and Clinical Psychology, I968, 3z, 83-85.
ABSTRACT: The Community Mental Health Ideology (CMHI) Scale, an abridged version of Rokeach's Dogmatism (D) Scale, and the five-item form of the Political-Economic Conservatism (PEC) Scale were administered to 14o members of the Massachusetts Citizen Mental Health Area Boards. The results indicate that degree of adherence to community mental health ideology as measured by the CMHI Scale is significantly negatively correlated with dogmatism and political-economic conservatism. The sample of nonprofessional citizens scored higher on the CMHI Scale than did groups of r health professionals who had been previously studied. They also obtained scores on the D Scale and PEC Scale indicating that these lay members of mental health area boards are less dogmatic and less conservative than the groups with which these scales were originally developed. Ideological differences have characterized the mental health field for many years and a variety of studies have demonstrated the relationship of ideological orientation to the manner in which the dinician functions and programs develop (Gilbert & Levinson, 2957; Sharaf & Levinson, 2957; Hollingshead & Redlich, 2958; Strauss, et al., 2964). Although these relationships are also affected by the individual's position in his organization's hierarchical structure and his administrative style, the person's ideological orientation must be considered as a key variable since it very much reflects inner personality characteristics and choices in role definition. The most recent ideological movement in the mental health field is that of community mental health. The authors (2967) have found that it is viewed by many professionals as an open and liberal ideological perspective which is particularly concerned with such issues as: assuming responsibility for the entire population rather than for the individual patient only; primary prevention of mental illness through the amelioration of harmful environmental Dr. Baker is head, Program Research Unit, Laboratory of Community Psychiatry, Department of Psychiatry, Harvard Medical School, 58 Fenwood Road, Boston, Mass. o2Iz5. Dr. Schulberg is associated with United Community Services, Boston. The study reported in this paper was supported by NIMH Special Grant MH-o92z 4. Community Mental Health Journal, Vol. 5 (6), 1969
433
434
Community Mental Health Journal
conditions; treating patients with the goal of social rehabilitation rather than personality reorganization; comprehensive continuity of care and responsibility for the mentally ill; and total involvement of both professional and nonprofessional community helpers in caring for the mentally ill. The cohesiveness of this ideology was demonstrated when the authors (2967) developed a valid and reliable unifactorial Community Mental Health Ideology (CMHI) Scale. Recent applications of the scale indicate that it is sufficiently sensitive to varying ideology patterns to discriminate among work groups and professional departments at a changing mental hospital (Baker & Schulberg, 2968 ). The present study is directed toward an examination of the relationship between community mental health ideology and other personality and idea systems. Since community mental health ideology included many nontraditional beliefs aiming at greater societal involvement with persons experiencing difficulty in adjusting to their environment, it was thought particularly relevant to measure the relationship of this ideology to the variables of dogmatism, and liberalism versus conservatism. Rokeach 096o) and Vacchiano, et al. (2968) have contended that dogmatism is a general personality trait related to one's ability to form new conceptual systems, while the dimension of liberalism versus conservatism was found to be integral to the assessment of the authoritarian personality (Adorno, et al., "r95o). METHOD The subjects in the study were i4o adults who had agreed to serve on Citizen Mental Health Area Boards in various parts of eastern Massachusetts. They had been appointed to the boards because of their interest in and knowledge about mental health programs and were charged with the responsibility of advising the professional staff of local centers about the mental health needs of their areas. As part of a larger mailed questionnaire study, the area board members completed the 38-item Community Mental Health IdeologyScale, an abridged 2o-itern form of Rokeach's Dogmatism (D) Scale (Troldahl & Powell, 2965), and the five-item form of the Political-Economic Conservatism Scale which had been developed by Adorno, et al. (z95o) to measure political-economic liberalism-conservatism. RESULTS The response patterns of the subjects studied are presented in Table 2. The mean score obtained on the CMHI Scale by the sample of concerned nonprofessional citizens is higher than the mean obtained by national random samples of mental health professionals. This sample of citizens did not, however, score as high on the scale as have groups composed of community mental health specialists (Baker & Schulberg, 2967). When adjustments are made for differing scoring procedures on the D Scale and the PEC Scale, it is evident that the present subjects are less dogmatic and less conservative than the groups with whom the scales were originally developed. Community mental health ideology, dogmatism and political-economic conservatism are significantly intercorrelated (P < .o2). The product-moment
Frank Baker and Herbert C. Schulberg
435
correlation between the CMHI Scale and the Dogmatism Scale yielded r = .38; between CMHI Scale and the PEC Scale, r - - - - . 4 o ; while the correlation between Dogmatism and the PEC Scales was .66. TABLE x Responses on CMHI Scale, D Scale and PEC Scale (N=z4o)
CMHI Scale D Scale* PEC Scale*
Mean
SD
Range
219.~ 55.2 24.a
26. 3
"T57-265 28-99
:~3.8 4.2
5.28
*Basic statistics inflated in terms of absolute numbers because of response format ranging from +7 to +z rather than +3 to -3. DISCUSSION The results indicate that degree of adherence to community mental health ideology is significantly related to the general personality trait of dogmatism, and to the liberalism-conservatism idea system. A high orientation to the most recent mental health ideology is associated with a low degree of dogmatism and with a low adherence to conservative principles. Similarly, the highly positive correlation obtained between the D Scale and the PEC Scale indicates that closed-minded persons tend toward a conservative rather than liberal orientation in their political philosophy. A similar relationship between dogmatism and conservatism was reported by Rokeach (x96o, p. xz2) in his study of college student populations. The fact that Rokeach obtained lower positive correlations between the full Dogmatism Scale and the five-item PEC Scale among his subjects may have stemmed from his use of students who were predominantly right rather than left oriented in their political views. The data of the present study are also consistent with those reported by Vacchiano, et al. (x968). They examined dogmatism as a personality trait and concluded that dogmatic individuals are "cautious and compromising in regard to new ideas, generally going along with traditions" (p. 84). Community mental health ideology may be viewed as an innovative idea system which espouses many novel theoretical principles and program directions which :sharply depart from earlier conceptions of proper treatment for the mentally ill. The present data clearly suggest that the nontraditional aspects of community mental health ideology will be most fruitfully received among individuals whose general personality disposition is nondogmatic, and whose idea systems are receptive to liberal concepts of social concern and responsibility for the mentally ill. It is important to note also that community mental health ideology may take more fertile root within selected nonprofessional citizen groups than
436
Community Mental Health Journal
among random groupings of psychologists and psychiatrists. The scores obtained by the samples of citizens on the measures employed in this study suggest that as a group, upon their selection to area boards, they already favored community mental health principles, were open-minded in personality, and rpolitically liberal. The fact that the citizen's mean CMHI Scale score exceeds that of many mental health professionals perhaps foreshadows a situation in which the impetus for planning innovative community-oriented services may !stem from citizens rather than from professionals. If this should be the case, it would highlight once again the fact that if progressive novel programs are to develop it is as necessary to shatter the ingrained conservatism and traditionalism of supposedly enlightened professionals as it is to educate an allegedly reactionary citizenry. REFERENCES Adorno, T. W.; Frenkel-Brunswick, Else; Levinson, D. J.; and Sanford, R. N. The authoritarian personality. New York: Harper, ~95o. Baker, F., and Schulberg, H. The development of a community mental health ideology scale. Community Mental Health Journal, x967, 3, 2z6-225. Baker, F., and Schulberg, H. The community mental health ideology patterns of staff members at a changing mental hospital. (Mimeo.)December,I968. Gilbert, Doris C., and Levinson, D. J. "Custodialism" and "Humanism" in staff ideology. In Greenblatt, M.; Levinson, D. J.; and Williams, R. H. (Eds.), The patient and the mental hospital. Glencoe,II1.: The Free Press, ~957. PP. 2o-36. Hollingshead, A., and Redlich, F. Social Class and Mental Illness. New York: John Wiley, I958. Rokeach, M. The open and closed mind. New York: Basic Books, x96o. Schulberg, H., and Baker, E. Varied attitudes toward community mental health. Archives of General Psychiatry, ~967, I7, 658-663. Sharaf, M. R., and Levinson, D. J. Patterns of ideology and role differentiation among psychiatrist residents. In Greenblatt, M.; Levinson, D.J.; and Williams, R. H. (Eds.) The patient and the mental hospital. Glencoe,Ill.: The Free Press, x957. Pp. 263-285. Strauss, A. Psychiatric ideologies and institutions. New York: The Free Press of Glencoe, 1964. Troldahl, V. C., and Powell, F. A. A short-form dogmatism scale for use in field studies. Social Forces, x965, 44, 211-214. Vacchiano, R. B.; Strauss, P. S.; and Schiffman, D. C. Personality correlates of dogmatism. Journal of Consulting and Clinical Psychology, I968, 3z, 83-85.
