effects of ethnicgroup concentration upon educational process

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VOL. 56, No. 5 407 Effects of Ethnic Group Concentration Upon Educational Process, Personality Formation, and Mental Health CHARLES A. PINDERHUGHES, M.D. Chief, Psychiatry Service, Veterans Administration Hospital, Associate Clinical Professor of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts INTRODUCTION CURRENT controversy over the nature and psychological effects of separation and seg- regation of groups has led to a reexamination of earlier contributions of historians, psychologists, sociologists, psychiatrists, and other social and behavioral scientists in this field. This paper examines some of the pervasive and deeply in- grained deleterious effects of ethnic group con- centration, with special reference to Negroes, from a psychiatric point of view. For seven decades psychiatrists have shown in- tense interest in understanding the forces which have impact upon behavior and which determine the characteristic patterns of strivings and re- sponse each individual shows. Ordinarily, this interest has been confined to the life space of an individual, usually a patient, and broader social influences have been left for examination by other behavioral scientists. First in the mental health movement1, and more recently in the developments of social psychiatry and community psychiatry2, psychiatrists have employed their resources in syn- chrony with those who apply other behavioral sciences. The result, for psychiatrists, has been an increasing interest in social and cultural forces and a growing sense of responsibility for in- creased involvement. Social and cultural forces manifest themselves in pervasive ways as integral parts of personalities and institutions. Just as the forces which are active within personalities in the present can more fully be understood by study of their sources and evolution from the past, so social and cultural forces, such as high ethnic group concentration or segregation, can be better understood by examina- tion of their recent and remote antecedents. The findings of a broad spectrum of social scientists have already been applied to diagnose the ailments that accompany the practice of segregation in the South4, and in the North5. The term "de facto segregation" has been employed where patterns of segregation are found without sanction under law and has been applied almost exdusively to Negroes. Some facets of this issue are of critical importance in personality development and thus are properly in the professional province of phy- sicians as well as that of educators, politicians, and lawyers. Indeed, the issue has become a legiti- mate concern of the residents in most large cities of the United States. It is the purpose of this paper to contribute to understanding of this issue rather than to provide solutions. EFFECTS OF ETHNIC GROUP CONCENTRATION UPON EDUCATIONAL PROCESS The Schools axtd De Facto Segregation of Negroes The former superintendent of Boston Public Schools, Dr. Frederick J. Gillis, in his annual re- port of 1961-19626, described Boston as one of 14 great cities in America which have unique problems involving the core city where culturally deprived immigrants, handicapped with a second- dass education or illiteracy, persons unsuited for the skilled labor market, a pool of unemployables, many persons on welfare, rot of moral fibre, squalor, disease, high incidence of learning prob- lems and pupil dropout, juvenile delinquents, and unwed mothers exist in quantity. He further de- scribed the demoralizing economic and social fac- tors which stamp the citizens as second-class, in- adequate, and wholly without significant aspira- tional goals. He described the need for teachers who are better than average, the need for vast adjustments on the part of schools, and the need for greater expenditures per pupil than those required in the education of children from middle- class homes. In addition, he delineated the need for introduction to cultural facilities, the need for trips to museums, libraries, and "to any and every place that will contribute to giving him (the pupil) a sense of belonging and to raising his aspirational goals".

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VOL. 56, No. 5 407

Effects of Ethnic Group Concentration Upon Educational Process,Personality Formation, and Mental Health

CHARLES A. PINDERHUGHES, M.D.

Chief, Psychiatry Service, Veterans Administration Hospital,Associate Clinical Professor of Psychiatry, Tufts University School

of Medicine, Boston, Massachusetts

INTRODUCTION

CURRENT controversy over the nature andpsychological effects of separation and seg-

regation of groups has led to a reexamination ofearlier contributions of historians, psychologists,sociologists, psychiatrists, and other social andbehavioral scientists in this field. This paperexamines some of the pervasive and deeply in-grained deleterious effects of ethnic group con-centration, with special reference to Negroes,from a psychiatric point of view.

For seven decades psychiatrists have shown in-tense interest in understanding the forces whichhave impact upon behavior and which determinethe characteristic patterns of strivings and re-sponse each individual shows. Ordinarily, thisinterest has been confined to the life space of anindividual, usually a patient, and broader socialinfluences have been left for examination by otherbehavioral scientists. First in the mental healthmovement1, and more recently in the developmentsof social psychiatry and community psychiatry2,psychiatrists have employed their resources in syn-chrony with those who apply other behavioralsciences. The result, for psychiatrists, has beenan increasing interest in social and cultural forcesand a growing sense of responsibility for in-creased involvement.

Social and cultural forces manifest themselvesin pervasive ways as integral parts of personalitiesand institutions. Just as the forces which areactive within personalities in the present can morefully be understood by study of their sources andevolution from the past, so social and culturalforces, such as high ethnic group concentration orsegregation, can be better understood by examina-tion of their recent and remote antecedents. Thefindings of a broad spectrum of social scientistshave already been applied to diagnose the ailmentsthat accompany the practice of segregation in theSouth4, and in the North5. The term "de facto

segregation" has been employed where patternsof segregation are found without sanction underlaw and has been applied almost exdusively toNegroes. Some facets of this issue are of criticalimportance in personality development and thusare properly in the professional province of phy-sicians as well as that of educators, politicians,and lawyers. Indeed, the issue has become a legiti-mate concern of the residents in most large citiesof the United States. It is the purpose of thispaper to contribute to understanding of this issuerather than to provide solutions.

EFFECTS OF ETHNIC GROUP CONCENTRATION

UPON EDUCATIONAL PROCESS

The Schools axtd De Facto Segregation of Negroes

The former superintendent of Boston PublicSchools, Dr. Frederick J. Gillis, in his annual re-port of 1961-19626, described Boston as one of14 great cities in America which have uniqueproblems involving the core city where culturallydeprived immigrants, handicapped with a second-dass education or illiteracy, persons unsuited forthe skilled labor market, a pool of unemployables,many persons on welfare, rot of moral fibre,squalor, disease, high incidence of learning prob-lems and pupil dropout, juvenile delinquents, andunwed mothers exist in quantity. He further de-scribed the demoralizing economic and social fac-tors which stamp the citizens as second-class, in-adequate, and wholly without significant aspira-tional goals. He described the need for teacherswho are better than average, the need for vastadjustments on the part of schools, and the needfor greater expenditures per pupil than thoserequired in the education of children from middle-class homes. In addition, he delineated the needfor introduction to cultural facilities, the need fortrips to museums, libraries, and "to any and everyplace that will contribute to giving him (thepupil) a sense of belonging and to raising hisaspirational goals".

408 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION SEPTEMBER, 1964

While some of the ills described can be curedor at least alleviated by compensatory educationprograms and vigorous urban renewal, there re-mains a core of problems which relate to a factomitted from Dr. Gillis' report. Many of the per-sons referred to are Negroes, living in a relativelysharply delineated area in high concentration andwith restricted opportunity for movement. Inareas which are heavily populated by a singleethnic group, the enrollment of some schools maybe predominantly or completely of one group.The term "de facto segregation" may be appliedto such situations even where there is opportunityfor free movement of individuals if desired, al-though the term is commonly reserved for circum-stances in which there is restriction of opportuni-ties for movement.

The Hidden CurriculumThere is a hidden curriculum in every school

which teaches, in addition to reading, writing andarithmetic, how to get along with one's fellow-man and how to think about and evaluate oneselfand others. Individuals within a school serve asmodels for imitation and identification, and eachstudent is pressed to conform to the kinds ofattitudes, beliefs, mores, and behavior which sur-round him. The areas and styles of conforming,competing, rebelling, and cooperating are part ofthis hidden curriculum. Such observations, legends,and myths as support this curriculum are alsoincluded.School Counseling Supports Prevailing PatternsA part of the hidden curriculum includes an

education and training toward conformity notonly to the mores within the school but to thosemores existing in the community at large. No-where is this more clearly evident than in theguidance and counseling areas. Since one of thegoals of education is to provide opportunity forthe student to develop a place for himself in thewider social family into which he goes, counsel-ing is of critical importance. The counselor mustrealistically assist students toward the realizationof their potentials on one hand and toward suchopportunities as exist on the other. A Negro childand a white child of equivalent equipment andpotential when realistically counseled toward exist-ing opportunities have often been counseled to-ward different occupations in which there werediffering rewards. The school system thus func-tions as an intimate part of a larger social system

and often assists in perpetuating its ills. Wemight ask whether counselors should have "un-realistically" encouraged Negroes to prepare forareas in which there is aptitude, whether or notthere is opportunity. This might have constituteda disservice to individual students. On the otherhand, the absence of "qualified' 'Negroes at pres-ent is in part related to our educational systemwhich prepares the students for the outside world,including the values and mores which exist there.

Importance of School ClimateFor more than a decade we have recognized the

importance of intangibles such as the reputationand influence of a school, of its teachers, of itspupils, and the nature of its neighborhood. Su-preme Court decisions on the quality of educationhave been based upon such factors in 1950 and1954. Such factors provide a basic matrix whichcontributes to the tone and character of the edu-cational program as well as to comparative ratingsand to public opinions. Unfavorable rumors, trueor false, concerning inferiority of schools, ofteachers, or of pupils have devastating effects andfurther demoralize teachers, pupils, and parents.Moreover, judgment of the adequacy and superiorworth of some schools gained from the existenceof other schools rumored to be inferior leads toan unrealistic and unadaptive appraisal based oninvidious comparison rather than upon personalgrowth and development7.The recent spotlight upon schools has been di-

rected less upon the formal curricula and moreupon the informal education, the classroom "at-mosphere" and "climate", and upon the psycho-logical and cultural traits of students, all of whichmay show considerable variation from school toschool even when curriculum and teacher activitymay be relatively standardized. As much atten-tion should be directed to the educational processbetween pupils as is currently given to the educa-tional process between teachers and pupils.

Importance of Peer-LearningPeer-learning in school is never stressed and

especially needs to be examined in areas of racialimbalance. While there is always a relationshipbetween peer-learning and teacher-to-pupil learn-ing, the extent to which the relationship is com-plementary or supplementary, or frankly antago-nistic is of prime importance. A larger group,emotionally disturbed students, disrupting stu-

VOL. 56, No. 5 Crowding and Mental Health 409

dents, and lack of group cohesion cause a shift ineducational process from teacher-to pupil learningtoward peer-learning. Similar factors may promotea peer-learning situation which is frankly antago-nistic to the teacher-to-pupil learning. In his re-port, former Superintendent Gillis clearly de-scribed such situations.

Discriminating parents who have opportunityto make choices regularly evaluate the informalfeatures of schools as well as the formal aspects.They wish to know the range of interests and mo-tivations of other students in the school becausethese may strongly influence the manner in whicha child relates to the formal content of school.The range of interests of other students may deter-mine whether a child pursues activities which arein line with, tangential, or deviant to the formalschooling. How a child uses his after-school timeand weekends may have much to do with what heinformally learns from fellow students.What do the pupils learn from one another in

the unplanned informal curriculum? Certainlyteachers are not teaching students to drop out andto misuse their educational opportunities. Pupilslearn such things from other pupils. Other stu-dents serve as models to be imitated, as modelswith which to identify.

Each individual has both constructive and de-structive potentials available for development.Which potentials are reenforced into dominancedepend greatly upon the interaction with the en-vironment. In their struggle to become accepted,protected, and a part of the school group in whichthey find themselves, pupils may find learningfrom peers to be far more practical than learningsubject matter for seemingly distant future appli-cation. Disobedience and competitive mischief-making may be required to secure safety andrespect from peers in those situations where pupilleadership is strong in these directions.What students learn from their interaction with

peers may be in direct conflict with the instruc-tion and training of their teachers and may sabo-tage the planned educational process. Dr. Benja-min C. Willis, Superintendent of the ChicagoPublic Schools and Director of a MassachusettsEducation Study, in his address to the Massachu-setts Congress of Parents and Teachers in Swamp-scott, Massachusetts on October 25, 1963, indi-cated that the three factors essential to qualityeducation are those who teach, the tools they

work with, including the building they work in,and the leadership provided. While agreeing withthis statement the author believes that our mindsdo not ordinarily conceptualize the pupils asleaders. While the teacher is the designated leaderof the class, there are times when students exerciseleadership roles either for cliques in the class orfor the entire class. The leadership provided bythe students may be in support of the teacher ormay run counter to the teacher's efforts.

This vast, complex field of student interactions,of informal unscheduled learning processes, andof identifications which are occurring in everyschool has seldom been seriously considered bypublic schools as a part of the educational pro-cess. Private and parochial schools have generallyshown more interest in this field. The interactionsbetween students in public schools are more aptto be viewed as areas to be wrestled with, masteredand controlled so that formal education can pro-ceed. Indeed this might be a fertile communityarea for application of psychiatric concepts ofgroup dynamics8.

It is important to distinguish the child whodirects himself predominantly from within fromthe one who is easily influenced and directed bythose around him. The informal peer education isnot crucial to the development of the inner-di-rected child since he can more successfully deter-mine his own course. For the child who reliesupon others for control, for guidance, for struc-ture, and for decisions, the informal educationoccurring between pupils may provide criticalfeatures in forming the cast of his character andthe directions of his life.

In general, the younger the pupil the greater isthe dependence upon persons in the environmentto provide values and to determine direction.Ordinarily students in preschool, kindergarten,and the early grades are very responsive to theimpulses arising within themselves or in theirimmediate vicinity. They learn from those aroundthem the values and attitudes which influencetheir perception and their management of innerfeelings and ideas as well as those they encounterfrom others.

EFFECTS OF ETHNIC GROUP CONCENTRATION

UPON PERSONALITY FORMATION

The Cultural BrainwashThe interaction of the child with his environ-

410 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION SEPTEMBER, 1964

ment develops his personality and the culturalattributes of the groups in which a child is rearedexert a molding effect. Not to be forgotten is thefact that physiological functioning and physicalhealth are influenced by interpersonal interactionssince emotional responses are accompanied byfunctional reactions in body organs.

Each ethnic group induces its warp on the in-dividuals within it, producing large numbers ofindividuals with a similarity in personal character-istics. These traits are selectively developed fromthe many potentials which are available. Each in-dividual thereby develops many traits in commonwith others in his group and experiences the ad-vantages and disadvantages of the culture he iswithin and with which he identifies.Of all the ethnic groups in the United States

only one group, the Negro, has presented a strongcomplaint that it receives an inferior education asa direct result of a heavy concentration of its owngroup in neighborhood schools. How can it beexplained that a harmful effect can result in onegroup which does not result in the others? Therich resources of Frazier9, Clark'0, Myrdal", Kar-diner and Ovessey12, and Elkins'3, proved helpfulin formulating the following partial answers tothis question. Emphasis has been placed upon thecentral role played by institutionalized educationin determining the manner in which Americanculture has affected personality formation inAmerican Negroes.The difference between communities of Ameri-

can Negroes and communities of all other ethnicgroups are extensive, but usually overlooked. TheAmerican Negro is the only minority group in theUnited States without a culture of its own. Allother groups have a religion, an internal source ofauthority and group cohesion, a special language,traditions, institutions or other roots which aretraceable to a lengthy group existence, usually inanother country. American Negroes have none ofthese.

The Southern CompoundThe numerous languages, family and group ties,

and all prior cultural institutions of the millionsof slaves brought to America were destroyed. Anestablishment for producing docility and for train-ing slaves was developed. Laws guaranteed themaster absolute power over his slaves and per-mitted unlimited physical and psychological disci-

pline to break and train slaves to unquestioningobedience. The machinery of the police and courtswere not available to slaves, and owners tried andexecuted sentences upon them. Marriage was de-nied any standing in law, and laws decreed thatfathers of slaves were legally unknown. Childrencould be sold without their mothers except inLouisiana, which kept the mother-child relation-ship preserved until the child reached ten years ofage. There was a general belief that educationwould make slaves dissatisfied and rebellious, sodistribution of books, including the Bible, orteaching of slaves was prohibited by law in someStates.

Thus, by means of one of the most coercivesocial systems on record the character of AmericanNegroes, and the nature of their families and ottheir groups were clearly and rigidly defined ina closed system which supplied the training andsanctions needed to produce recognizable personal-ity types. Such stereotyped characteristics were pro-duced by this environmental pressure that somepersons, viewing the products of this system,have gained the erroneous impression that thecharacteristics were inherent in the people ratherthan induced. For eight generations of slaves ina closed family-like system, every vital concernfocussed upon the master as an omnipotent fatherwhose establishment molded the character and be-havior of his slaves. The child-rearing practices ofthe slave mothers constituted his most importanttraining school, and produced obedient, docileslaves whose aggressions were directed primarilyagainst themselves. In time, child rearing prac-tices became stereotyped into life and death strug-gles to inhibit and reverse all assertiveness or ag-gression, especially in male children.

After emancipation from slavery, segregativepractices kept the Negro captive in his compound,and continued his training to his dependent, andlow-caste servant role.

Even as large immigrating groups of English,West Indian Negroes, Irish, Jews, Japanese, PuertoRicans, French, Chinese, Italians, Africans, In-dians, Germans, or others carry with them manycentral and residual elements of their prior cul-tures, so also large numbers of American Negroesmigrating from the South to Northern cities havecarried with them patterns which originated inthe South.

VOL. 56, No. 5 Crowding and Mental Health 411

The Northern CompoundWith the migration of Negroes to the North,

no rigid, formal segregation supported by lawwas needed. The Negroes from the South werewell trained to support and perpetuate the sys-tem to which they had accommodated. They hadbeen taught a way of relating to the world inwhich white people were central, and they couldnot see that the Northern white person differedinside from the ones known in the past.

It is commonly recognized that persons whohave felt inferior, criticized and discriminatedagainst in one situation unconsciously carry thesefeelings with them into new situations wherethey behave as if they were still subjected to thesame treatment. Negroes forged into a low-castegroup in the South have, upon migrating, un-consciously induced relationships in the Northsimilar to those in the South. With "segregationde jure" stamped into and thoroughly interwovenin the culture and into the personalities of South-ern Negroes, it was inevitable that it should becarried northward to precipitate as "de factosegregation".

They formed their compounds in the Northerncities, and in these de facto segregated communi-ties they reproduced and passed on the only cul-ture they had to pass on, with the only childrearing practices they knew, in the matrix of theonly family structure and group organization theyhad known. Over many years a culture had beendeveloped in the compound which kept the peoplethere functioning in the same old ways. The pat-terns and codes reached every member and sankdeeply into many personalities. Older ones can-not be persuaded to change - they have beentrained too long and too well.To be born in the compound is to feel inferior,

to behave as if one is inferior, and in many in-stances to be trained to function in inferior ways.To Negro teachers to whom they feel close Negrochildren often express their wonder of why thereare fewer and fewer white children, or none ofthem at all. They feel something must be wrongwith them and what they have. Some Negrochildren who comfortably express themselves toa Negro teacher are non-communicative with awhite teacher. One skillful white teacher hadseveral such children in an all Negro class. To-ward the end of the year with these sixth graders,while discussing why people don't talk, one regu-

larly silent child spoke out, "Because they areafraid". When the teacher asked how many feltthe same way 11 pupils raised their hands. Teach-ers with similar personalities may evoke differingresponses in the same pupil based on the factthat one teacher is white and one is colored.

Personality in the Negro CompoundIn this context, the Negro ghetto and its ac-

companying predominantly Negro neighborhoodschools can more easily be seen as agents whichhave adverse effects upon self-esteem, value sys-tems, motivations, aspirations, and behavior ofpupils. Such adverse effects prevailing in manystudents can seriously impair the educational pro-cesses in a school despite the presence of excellentteachers and adequate facilities.

Although the gate to the compound in theNorthern city is open, few find it. Many havebeen so trained not to reach out, or to so detearthemselves that they must persistently fail at justthose points where constructive changes are pus-sible. Most of them do not believe that the gareis open even when they are told and offered en-couragement to walk through. Some who believehave so renounced any capacity for initiative orconstructive assertion as to be immobilized andapathetic.

It is for these reasons, as well as for economicones, that open enrollment plans for improvedintegration of schools on an optimal basis will notwork for those who need it most. It is also un-realistic to leave the burden for change uponNegro parents when basically the American Ne-gro family has been disrupted and made impotentas a source of initiative and purposeful action.Many Negroes have so internalized into their

own thinking and feelings the sense of bondagethat it is felt even where external bondage maynot exist. While most conscious of the struggleagainst external discrimination and suppression,Negro participants in the struggle for socialchange are necessarily throwing off internal bondsof silence, passivity, and compliance. Active de-mands, open expression, and demonstration func-tion as an important necessary transitional stagein moving from a state of internal and externalbondage toward free social participation as a peergroup.

Segregation Perpetuates Existing CasteThe essence of the problem we face is not race

412 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION SEPTEMBER, 1964

and not color. American people, by a coerciveslavery system and by miscegenation, grossly al-tered American Negroes into a group whose char-acteristics were so shaped as to prevent participa-tion in the American life as defined by the Con-stitution. What used to be a slave group contain-ing stock from several races has been perpetuatedas a low caste servant and labor group, for themost part isolated in its compound. The colorprimarily helps us to identify the low caste andto know whom we should not touch. When aCaucasian and a Negro can together produce achild who is considered to be a Negro in race,we are dealing with sociological rather than logi-cal thinking. Such thinking is one of many resid-uals of slave culture days. It ensures that thelow caste elements remain clearly defined nomatter how intermixed and unrecognizable theybecome. It also contains the implicit censure thatwhosoever touches one becomes one.

It is for these reasons that so many whitepersons and so many middle-class Negroes donot wish "their" schools to have a significant in-flux of Negro students. It is for these reasonsthat so many desire not to associate with Negroesin large numbers and will actually reject, impede,or show inaction toward plans for integration.That some white persons flee as if from a plaguewhen Negroes move near them is a product oftheir life experience and education. Increased inte-gration in education starting at early ages will domuch to prevent the emergence of another genera-tion of hurt, frustrated, disillusioned and angrycoloreds, and guilty, panic-stricken, perplexed,and angry whites.14

Neither words nor pictures nor large amountsof intellectualized information will substantiallymodify the Negro compound without the cor-rective emotional experiences of increased integra-tion. Unless the compound is broken up it willgo on reproducing its own kind, even as communi-ties of other ethnic groups keep reproducing theirown.

Racially imbalanced schools in predominatelyNegro neighborhoods function therefore as amold which produces and perpetuates an unfavor-able stamp. Although schools in communitiesheavily populated by other ethnic groups alsoserve as vehicles for transmitting group character-istics to individuals, the stamp imparted in suchschools is more adaptive and more often of posi-

tive value.Education is central in all of this. Certainly

slavery was an educational matter as well as apolitical, economic and moral matter. Perpetuationof a caste is also an educational matter, and modi-fication of a caste finds education at the heart ofthe process.

EFFECTS OF THE ETHNIC GROUP CONCENTRATION

UPON MENTAL HEALTH

The dilemma surrounding segregation and inte-gration encompass far more than social classes,castes, and races. Whenever any agents frompreviously separate compartments come togetherand experience conflict, questions arise about con-flict resolution by reinforcing the compartments.Some question whether collaboration or peacefulco-existence is possible for disparate and conflict-ing agents. Furthermore, it seems quite clear thatsegregation in fact, or under law may at times beuseful in the accomplishment of some objectivessuch as temporary control of dangerous or destruc-tive persons, for example.

It is commonly recognized that segregation maybe useful as a method of mastering and control-ling something undesirable, threatening, or other-wise posing a problem. Segregation of thoughtsand feelings occupies a prominent place in earlymental processes. In fact, small children use asegregating method of thinking as a basis forgoverning their behavior. All things around orwithin them become viewed grossly in an either/or way, as good or bad, right or wrong, black orwhite. As they mature the same children developa capacity to employ segregating mechanisms on alimited and temporary basis in discrete situationswhere appropriate. Later, segregating tendenciescome to exist in dynamic conflict with unifying,affiliative, integrating tendencies within individ-uals just as they do in social systems. In the mostmature personalities integrating tendencies trans-cend segregating ones.

There is a close interrelationship between thepsychological system inside an individual, thefamily system of which he is part, and the socialsystems beyond the family. Persons who viewthings in terms of rigid compartments tend tocreate and structure the space around them insimilar terms. Likewise, children reared in rigidlycompartmentalized social systems tend to intern-alize them and to develop psychological compart-

VOL. 56, No. 5 Crowding and Mental Health 413

ments - boxes - which interfere with abilities torelate, to form ideas, and to process feelings.

Because of the endless variables and extremecomplexity in the intrapsychic, interpersonal, andwider social fields, this limited discussion will beconducted in abbreviated form. In the communitywhere it exists heavy ethnic group concentrationwill have the following effects upon mentalhealth:

1. Characteristic group elements will be induced inthe personalities of many group members. These willinfluence problem solving and adaptation in differentways, sometimes facilitating and sometimes complicatingadjustment. Since more rigid control and compartment-alization of the environment will sometimes buttress ashaky or poorly organized personality, a subjective feel-ing of comfort may be produced by segregation. A de-velopment confined to a single group often makes pos-sible comfortable relationships with one's group, anxietyor inappropriate behavior in relationships with others.

2. A framework is offered for adolescent groupformation. During the period when identity is beingdetermined, roles being clarified, and mating takingplace, most adolescents turn toward what they perceiveas their own kind. The ethnic group will continue tooffer important contributions to the solution of theseand other life tasks. Even where ethnic group membersare dispersed in the community, a re-grouping accord-ing to similar identifications occurs in the social activityof adolescents. This regrouping in adolescence alongethnic lines is not dependent upon a segregated situ-ation.

3. Some antisocial feelings and thoughts which arisein early childhood situations (associated with aggressionand hostility toward family members) are reinforcedand attenuated. There is a reduction of ability to accept,identify, and relate with individuals in other groups.One is encouraged to view people in categories whichemphasize differences rather than similarities betweengroups. Thinking is conditioned toward concepts ofseparating and keeping apart, and people learn howto live this way. This may be quite adaptive whereone can live his life in his own community with hisown group, but there are few people who can live insuch provincial ways in today's world.

4. A dehumanized view of people is encouraged.some are seen as sub-human, non-human, or super-human; that is, anything but simply human like one-self.

5. Perception and thought content are stronglylimited by the values and codes of one's group. What-ever is not consonant with the group's particular stand-ards can be entertained only with painful conflict orwith a sense of disloyalty to one's group. So much maybe kept from consciousness or denied that the viewof reality may be greatly impaired.

6. Lack of understanding, misunderstanding, and con-flict between members of different groups occur.

7. The education provided in the closed setting ofa single ethnic group usually emphasizes conformity to

a degree, where ties to the group greatly limit indi-vidual freedom including freedom of thought and ofspeech.

8. Opportunity for negotiation and constructive in-terplay between individuals and their society is re-duced.

9. Prejudice and delusions are fostered which sup-port denial of personal inadequacy and projection ofcriticism outward toward others.

10. There is an absence of suitable social forumsfor expression, feedback, and corrective intergroup ex-perience.

In summary, while high ethnic group concen-tration has some effects which are of positivevalue to mental health, many effects are constrict-ing, or crippling and result in serious limitations.In communities where ethnic groups are dispersed,the existence of religious, social, or other culturalinstitutions can satisfy community needs for cul-tural ties along ethnic group lines. Where peopleare schooled in and living most of their lives incompartments, they will have closed minds with-out recognizing it. What is alien to their experi-ence will be seen as false, unreal, and unaccept-able.

Tendencies to stabilize, control, and fix struc-ture exist in dynamic interplay alongside tenden-cies to restructure in a free society. A segregatedsituation interferes with opportunities to restruc-ture, and tends to produce a closed situation withloss of freedom.Some prevailing patterns of social organization

fail to achieve their designated objectives. Thereis much to suggest that the massive and general-ized restructuring of social institutions now takingplace requires a preliminary stage in which theold patterns are shaken and unsettled to introduceflexibility where systems have grown insensitiveor rigid, the by making useful changes possible.With the gkowing awareness of these circum-

stances, there his developed an intense search forpractical remedies. Such creative innovations asdevelop under the stimulus of the problems asso-ciated with ethnic group concentration will un-doubtedly promote the welfare of all groups.

SUMMARY

The effects of ethnic group concentration uponeducational process in neighborhood schools isdiscussed with special reference to the school cli-mate, hidden curriculum, and the unplanned edu-cation which students receive from other students.The importance of student interaction, of identi-

414 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION SEPTEMBER, 1964

fication and other psychological processes in thedynamics of the classroom group are stressed.The effects of ethnic group concentration upon

personality formation are described with emphasisupon the steps through which particular character-istics of American Negro personalities were devel-oped under slavery and perpetuated by segrega-tion. Factors are discussed which influence Negroesto form compounds in which existing low caste isperpetuated.

Finally an assessment is given of the partplayed by public schools in these issues and ofthe effects upon mental health.The complex interpersonal relationships and

group dynamics which mediate the severe deleter-ious effects in American Negroes are delineated,and the adverse effects of ethnic group concentra-tion in general upon total community mentalhealth are made evident.

LITERATURE CITED

1. REDENOUR, N. Mental Health in the United States.Harvard University Press, Cambridge, Mass. 1961.

2. BELLAK, L., Ed. Handbook of Community Psychia-try and Community Mental Health. Grune & Strat-ton, Inc. N. Y. 1963.

3. The Social Responsibility of Psychiatry, A State-ment of Orientation, GAP Report No. 13, July1950.

4. The Effects of Segregation and the Consequencesof Desegregation: A Social Science Statement. Ap-pendix to Appellants' Briefs in Public School Segre-gation Cases Decided in the U.S. Supreme CourtDecision of May 14, 1954.

5. Public School Segregation and Integration in theNorth. National Association of Intergroup Rela-tions Officials, N. Y. 1963.

6. GILLIS, F. J. The Annual Report of the Superin-tendent, 1961-62, School Document No. 16, BostonPublic Schools, 1962.

7. Psychiatric Aspects of School Desegregation. GAPReport No. 37, July 1957.

8. MAYO, C. and D. KLEIN. Group Dynamics as aBasic Process of Community Psychiatry, in Hand-book of Psychiatry and Community Health, Ed. byL. Bellak. Grune & Stratton, Inc., N. Y. 1963.

9. FRAZIER, E. F. The Negro In The United States.Macmillan Co., N. Y. 1949.

10. CLARK, K. B. M. Prejudice in Your Child. BeaconPress, Boston, Mass., 1963.

11. MYRDAL, G. An American Dilemma, Harper &Bros., N. Y. 1944.

12. KARDINER, A. and L. OVESSEY. The Mark of Op-pression. W. W. Norton & Co., Inc., N. Y. 1951.

13. ELKINS, S. M. Slavery. University of Chicago Press,1959.

14. KATZ, I. Review of Evidence Relating to Effectsof Desegregation on the Intellectual Performanceof Negroes," Am. Psychologist, v. 19, pp. 381-399,

V.A. HOSPITAL TUBERCULOSIS CONTINUES DROP

The number of patients with tuberculosis of the lungs hospitalized by the Veterans Administration continuesto decline. The daily average dropped by almost 900 during the past year-from 7,373 in fiscal 1962 to about6,500 in fiscal 1963. The 1963 figure may be compared with 13,902 in fiscal 1956, 9,037 in fiscal 1960, and 8,153in fiscal 1961. The downward trend in tuberculosis hospitalization which began in 1954 now has freed some 10,000VA hospital beds for use by patients with other conditions. The decrease in TB patient load can be attributedprimarily to development of effective drug treatment for the disease. In this, VA research has played and continuesto play a major part.

The VA now has five tuberculosis hospitals, as compared to 21 such hospitals in 1954. The agency nowoperates some 6,800 hospital ',3eds for treatment of TB patients, but it operated 17,000 such beds in 1954. The vastmajority of the patients with tuberculosis hospitalized by the VA is now in general medical and surgical hospitals.