OCCUPATIONAL PSYCHIATRY (Industrial Psychiatry)

The practice of psychiatry in a work setting, on either a full-time or consultative basis.This growing field represents “a promising meeting-ground between preventive psychiatry and occupational medicine” (Powles and Ross, 1966). It offers the psychiatrist a unique opportunity to provide a variety of mental health services, since practically all men and a large percentage of women spend half their waking hours in an office or plant. Some of these services are “patient- centered,” others “environment-centered.” The patient-centered services take the form of emergency psychiatric treatment, diagnosis, case-finding, and referral to clinics or social agencies. The psychiatrist also acts as a consultant to the plant physician, and may advise or serve as referee in disability and compensation cases.Environment-centered services are of two general types. First, the psychiatrist will be concerned with reducing the physical and psychological risks in the plant by drawing on his knowledge of the effects of noise, ionizing radiation, toxic substances, air pollution, etc. Second, he will be concerned with the “psychosocial matrix” of the plant, and will seek to establish constructive relationships on all levels—between executives and supervisors, between foremen and workers, and between the workers themselves. In so doing, he will call upon his knowledge of such matters as group dynamics, morale factors, the importance of “ventilating” grievances, and the nature and effects of defense mechanisms. He will be particularly aware that the attitudes of the supervisor, such as coldness and irritability, may foster unhealthy reactions not only in an individual but in a whole group of workers. He will also be concerned with out-of-plant situations, since marital and other home problems may seriously affect productivity and relationships on the job. His objective will be to handle, or see that others handle, all types of mental health hazards, so that both the neurotic and the average worker will function as well as possible in the work environment. In carrying out these functions, he must be able to “communicate with non-psychiatrists” and with individuals and groups on management, supervisor, and worker levels.Powles and Ross offer a “suggestive list of syndromes” to indicate more specifically the range of problems on which the occupational psychiatrist may apply his professional knowledge. They include: absenteeism, accident syndrome, back disabilities, cardiac difficulty, compensation neurosis, executive neurosis, grievance proneness, group phobias, intoxications, moonlighting (compulsive working after hours), pulmonary disorders, prejudice, retirement concerns, supervisor neurosis, “traumatic” neurosis, wildcat strikes, and problems of women and younger employees. See ACCIDENT PRONENESS, SAFETY PSYCHOLOGY, COMPENSATION NEUROSIS, VENTILATION CONDITIONS, NOISE CONDITIONS, CARBON MONOXIDE POISONING, LEAD POISONING, MORALE (INDUSTRIAL), PREJUDICE, AGING, OCCUPATIONAL NEUROSIS, GROUP DYNAMICS.