Who was Clarence M. Hincks?
Dr. Hincks was more than a promoter of mental health, he was a mental illness survivor – a person, who in spite of a life of depression, is credited with leading the way to the founding of the Canadian Mental Health Association.
In 1917, Hincks left private practice, and with Dr. C.K. Clarke, then Dean of Medicine at the University of Toronto, opened the first Canadian outpatient psychiatric clinic. He quickly saw the need for an organization to assist those with mental disorders and to promote mental health.
How did CMHA get started?
In 1918, under Clarence M. Hincks’ leadership, the Canadian National Committee for Mental Hygiene came into being. Ten years later, this body was granted a Federal Charter with Clarence Hincks as its first General Director. In 1950, the body was named the Canadian Mental Health Association with the goal of promoting provincial bodies to meet local needs better.
CMHA, Ontario Division was chartered in 1952 and incorporated in 1973.
How far have we come? Revolutions in the mental health field
First revolution: Humane care of those institutionalized for mental disorders
Beginning towards the end of the 18th century, the movement towards humane treatment for persons with mental illness continued to gain support well into the 20th century. After becoming the first General Director of what is today known as the Canadian Mental Health Association, Hincks spent the next 10 years studying and reporting on the inhumane conditions in asylums (which at the time was the name given to institutions that housed persons with mental disorders), across the country. He found the conditions to be deplorable and was instrumental in getting government action for making care more humane for those in institutions in Canada.
Second revolution: Psychodynamics
The practice of psychodynamics began in the late 1800s and early 1900s, recognizing that earlier life experiences and relationships (experiential factors) play a significant role in later disorder or health. This was a new way of thinking to which Hincks responded. For example, in 1942 Hincks helped organize the Canadian Children’s Service, a group of women who embarked for Britain to establish mental health services for children who were evacuated from bombed cities. Dr. Hincks also promoted psychiatric services in the armed forces.
Third revolution: Community mental health
By the 1950s, Canada was becoming increasingly receptive to the community mental health movement, which places emphasis on community services and care for mental health care consumers as opposed to institutional placement. Beginning in 1955 and completed in 1963, CMHA led a Canadian study, entitled “More for the Mind.” It contained 57 recommendations concerning mental health care in Canada, including proposed upgrading of institutional care, interdisciplinary service delivery and decentralization of mental health services, and increased emphasis on prevention. Before Hincks’s death in 1964, he stated, “All we need is leadership by people who recognize the fact that we are in the oxcart stage of development. In Amsterdam, they haven’t built a mental hospital in years because their mental health workers are working in the community, where they should be working and where the real job’s to be done.”
Fourth revolution: Tertiary prevention
Dr. Hincks was an advocate of what is commonly called tertiary prevention, where appropriate and adequate services are available to prevent relapses and foster rehabilitation and the return to normative community living for the 20 to 30 percent of our fellow human beings who will experience some type of mental disorder during their lifetimes.
Hincks was also responsive to the need for early identification and intervention for those at risk, as a way of preventing disorder, and to the need for services for children in unusual and devastating circumstances – all areas of prevention at a secondary level.
A concluding note
As Steve Lurie, Executive Director, CMHA Metro Toronto Branch, pointed out in the 1980s in his paper, “More for the Mind: Have We Got Less?”, there is no doubt that mental health services in Canada have improved since the days of Clarence Hincks. There is greater availability, but it is not clear that we are dealing with mental disorders or mental health matters more effectively. With regards to prevention at all levels, services to children, the elderly, ethnic populations and a more responsive system, much remains to be done.