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T H E O R Y A N D
P R A C T I C E O F
M E N TA L H Y G I E N E -
E N D S E M E S T E R
TA S K S 2 0 2 1
S U B J E C T C O D E : ( E N M N R E K 2 1 0 1 -
2 0 2 0 2 1 2 - N K - E N M N R E K 2 1 0 1 )
S U B M I T T E D T O
P R O F E S S O R H O R V Á T H A N N A M Á R I A
S U B M I T T E D B Y M A Q S O O D M A R I A M
( G Y O D 8 T )
C O N T E N T S
Introduction to Health, Mental Health and Mental
Hygiene
History of Mental Hygiene
Modern Mental Hygiene
Goals, Functions and Roles of Mental Hygiene
Role of Mental Hygiene in Disorders and Situations-
Burnout and Addiction
Conclusions from a Future Recreation Professional
I N T R O D U C T I O N T O H E A LT H
• “A state of complete
physical, mental and social
well-being and not merely
the absence of disease or
infirmity” (WHO, 1948)
M E N TA L
H E A LT H
A N D
H Y G I E N E
According to the World Health Organization
(WHO), mental health is “a state of well-being in
which the individual realizes his or her own
abilities, can cope with the normal stresses of
life, can work productively and fruitfully, and is
able to make a contribution to his or her
community” (WHO, 2004)
Mental Hygiene is defined as “a science dealing
with the preservation and promotion of mental
health as well as prevention and treatment of
mental illness or abnormalities..” (Beers, 1909)
M E N TA L H Y G I E N E C O N T I N U E D . . .
• Mental Health
• Mental Hygiene
• Mental Wellness
• Mental status has two possibilities either health or disorder/illness.
Are terms used to describe
the absence of mental
illness.
H I S T O RY O F M E N TA L H Y G I E N E
• History of mental hygiene movement started in 1908 with the work of C.W. Beers
who is an author of a very famous book called, "A Mind That Found Itself".
• Beers was born in Connecticut and graduated from Yale University in 1897. After
graduation he first took up a business career and spent three years in various
business offices. During this period a nervousness from which he had suffered for
some time became exaggerated, and in 1900 he attempted suicide by jumping
from a third storey window of his home. He was taken to a hospital suffering from
minor bodily injuries. From these he soon recovered, but he spent the next few
years of his life in various hospitals for the insane. While in these institutions he
was repeatedly shocked at the treatment accorded to various patients, and he
decided to investigate the situation as thoroughly as possible. With this idea in
mind, he contrived to behave so badly that he was sent from ward to ward and
experienced the most drastic treatment that was then accorded to the insane. He
soon became convinced of the necessity of reforming these institutions. This idea
became almost an obsession, and he spent much of his time in the formulation of
plans. After recovering from his mental illness, he then proceeded to carry out his
plan for a mental hygiene movement which would eventually encircle the globe.
B E E R S ' D R E A M O F A W O R L D - W I D E
M O V E M E N T F O R M E N T A L H Y G I E N E H A S
B E E N F U L F I L L E D
1908
The first Committee for Mental Hygiene was
organized in Connecticut in 1908.
1909
American National Committee in 1909 was
then established
1918
The Canadian National Committee for Mental
Hygiene was organized in 1918 by the late
Dr. C. K. Clarke and by Dr. C. M. Hincks.
1922
In 1922 an International Committee for
Mental Hygiene was organized as a sort of
clearing house for information collected by
the various national committees of countries
across Europe and South America.
M O D E R N
M E N TA L
H Y G I E N E
• The concept of modern mental hygiene intends to state that
education about mental health and wellness should be
advocated even in the absence of mental health disorders.
Modern mental hygienists are primarily interested in the
everyday problems of the everyday man, or woman. They
dig deeper into the immediate life cycles to understand the
end-results Also they are more and more impressed with
the life problems that never reach acute stages, that under
ordinary circumstances never reach the psychiatrist, or the
mental hospital or clinic. "They feel that there is more need
for a teacher than a physician, an adviser than a judge, a
friend than an executioner or jailer. "
• Modern mental hygiene focuses on positive aspects of
every person's life and it makes them capable of fulfilling
their wishes.
G O A L S O F
M E N TA L
H Y G I E N E
Realization of Potentialities
Happiness
Harmonious Development
Effective Existence
F U N C T I O N S
O F M E N TA L
H Y G I E N E
Training: The first function of mental hygiene is to train mental
health personnel who can understand people's psychological
problems and can help them to meet their needs.
Prevention: The second most important function of mental
hygiene is to prevent mental health problems by developing
such programmes which may evaluate and reduce mental
health disorders in the population .
Cure of mental disorders: The third function is to develop
programmes for those who are suffering from mental health
disorders. They need counselling or psychotherapy as a
treatment.
Preservation: One function of mental hygiene is to maintain
and preserve mental health through education programmes.
R O L E O F
M E N TA L
H Y G I E N E
Adjustments at Home
Adjustments to School
Adjustments to Society
Adjustment to Work
Adjustment to Self
R O L E O F M E N TA L
H Y G I E N E I N D I F F E R E N T
D I S O R D E R S A N D
S I T U AT I O N S
B U R N O U T
• Burnout is a state of emotional, physical, and mental
exhaustion caused by excessive and prolonged stress.
It occurs when the person feel overwhelmed,
emotionally drained, and is unable to meet constant
demands. As the stress continues, they begin to lose
the interest and motivation that led them to take on a
certain role in the first place.
S I G N S A N D
S Y M P T O M S
O F
B U R N O U T
Physical Signs &
Symptoms
Emotional Signs &
Symptoms
Behavioural Signs &
Symptoms
• Feeling tired and
drained most of the
time.
• Lowered immunity,
frequent illnesses.
• Frequent
headaches or
muscle pain.
• Change in appetite
or sleep habits.
• Sense of failure
and self-doubt.
• Feeling helpless,
trapped, and
defeated.
• Detachment,
feeling alone in
the world.
• Loss of
motivation.
• Increasingly
cynical and
negative outlook.
• Decreased
satisfaction and
sense of
accomplishment.
• Withdrawing from
responsibilities.
• Isolating yourself
from others.
• Procrastinating,
taking longer to get
things done.
• Using food, drugs,
or alcohol to cope.
• Taking out your
frustrations on
others.
• Skipping work or
coming in late and
leaving early.
S T R E S S V S
B U R N O U T
• Burnout may be the result of unrelenting stress, but
it is not the same as too much stress. Stress, by
and large, involves too much: too many pressures
that demand too much of the person physically and
mentally. However, stressed people can still
imagine that if they can just get everything under
control, they will feel better.
Stress Burnout
Characterized by over-
engagement.
Characterized by
disengagement.
Emotions are overreactive. Emotions are blunted.
Produces urgency and
hyperactivity.
Produces helplessness
and hopelessness.
Loss of energy. Loss of motivation, ideals,
and hope.
Leads to anxiety disorders. Leads to detachment and
depression.
Primary damage is physical. Primary damage is
emotional.
May kill you prematurely. May make life seem not
worth living.
C A U S E S O F
B U R N O U T
Work-Related Causes
of Burnout
Lifestyle Causes of
Burnout
Personality Traits Contributing
to Burnout
• Feeling like you
have little or no
control over your
work.
• Lack of recognition
or reward for good
work.
• Unclear or overly
demanding job
expectations.
• Doing work that is
monotonous or
unchallenging.
• Working in a
chaotic or high-
pressure
environment.
• Working too
much, without
enough time for
socializing or
relaxing.
• Lack of close,
supportive
relationships.
• Taking on too
many
responsibilities,
without enough
help from others.
• Not getting
enough sleep.
• Perfectionistic tendencies;
nothing is ever good enough.
• Pessimistic view of yourself
and the world.
• The need to be in control;
reluctance to delegate to
others.
• High- achieving personality.
P R E V E N T I N G A N D T R E A T I N G B U R N O U T
B Y M E N T A L H Y G I E N E P R A C T I C E
• Learn how to reduce stress in the moment.
• Manage troublesome thoughts and feelings.
• Motivate oneself to take the steps that can relieve stress and
burnout.
• Improve relationships at work and home.
• Rediscover joy and meaning that make work and life worthwhile.
• Increase overall health and happiness.
• Exercise
• Healthy Diet ( eat less of sugars and more of Omega- 3 rich diet to
boost mood, avoid nicotine, alcohol or caffeine)
A D D I C T I O N
• “Addiction is defined as a chronic, relapsing brain
disease that is characterized by compulsive drug
seeking and use, despite harmful consequences.
It is considered a brain disease because drugs
change the brain—they change its structure and
how it works. These brain changes can be long-
lasting, and can lead to the harmful behaviors
seen in people who abuse drugs.” (NIDA)
A L C O H O L I S M
A N D D R U G
A D D I C T I O N
Alcoholic means a person whose persistent
and excessive indulgence in alcoholic liquor is
causing or is likely to cause serious injury to
his health or is a source of harm, suffering, or
serious annoyance to others or renders him
incapable of properly managing himself or his
affairs.
Drug addicts: addiction to intoxicating,
stimulating, narcotic, or sedative drugs is
causing or is likely to cause serious injury to
his health or is a source of harm, suffering, or
serious annoyance to others or renders him
incapable of properly managing himself or his
affairs. (Parliament Counsel Office, 2008)
A D D I C T I O N
B E H AV I O U R S
• 1. Frustration and internal pain, that leads to anxiety and a demand for
relief of these symptoms
• 2. Fantasizing about using alcohol and drugs or behaviours to relieve
the uncomfortable symptoms
• 3. Obsessing about using drugs and alcohol and how his or her life will
be after the use of substances
• 4. Engaging in the addictive activity, such as using substances in
order to gain relief (acting-out)
• 5. Losing control over the behaviour (substance use)
• 6. Developing a feeling of remorse, guilt, and shame, that lead to
feelings of dissatisfaction
• 7. Making a promise or resolve to oneself to stop the behaviour or
substance use
• 8. After a period of time, the pain returns, and the addict will again
begin to experience the fantasies of using substances (Recovery
Connection,2005-2012)
A L C O H O L I S M
A N D H E A L T H
Alcoholism is a major health problem and
ranks with cancer and heart disease as a
threat to health. The alarming rates at which
drug addiction is on the rise make it a
massive threat in its own right.
Use of alcohol and drugs is one of the leading
causes of death and injury among teenagers
and young adults Around one in three adults
drink at levels that put them at risk of
developing a number of related health
conditions, including alcoholism and liver
disease (Lehmann,2012)
P H Y S I C A L
C O N S E Q U E N C E S
O F A D D I C T I O N S
• It impairs memory and thinking ability, ranging from one-
time "blackouts," in which the person cannot remember
a night of hard drinking, to permanent brain damage and
dementia (confusion and memory loss).
• It raises the risk of cancers of the lip, mouth, neck,
oesophagus, stomach, pancreas, and breast
• In men, it can cause impotence (inability to have an
erection). In women, it can cause infertility (inability to
have a baby). (Human Diseases and Conditions,2012)
R O L E O F M E N TA L H Y G I E N E I N
A D D I C T I O N R E C O V E R Y
I M P L E M E N T I N G
1 2 -
S T E P P R O G R A M
• Self Help Groups
• Open group
• Closed meetings
• Participation meetings
• Step meetings Big Book Meetings
M E N T A L H Y G I E N E
F O R A F U T U R E
R E C R E A T I O N
S P E C I A L I S T
• With past experience of serving as a physical
therapist and a teacher for the visually impaired,
there is a dire need to work on the mental health of
clients along-with physical health for optimum
performance and better prognosis. I am primarily
interested in providing therapeutic recreation in
future to different populations such as cerebral
palsy or autistic individuals because research
advocates that therapeutic recreation is beneficial
for people with physical disorders and it can boost
mental health along-with physical health.
R E F E R E N C E S
• Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007). No health without
mental health. The lancet, 370(9590), 859-877.
• Lemkau, P. V. (1949). Mental hygiene in public health.
• Meyer, A. (1918). The mental hygiene movement. Canadian Medical Association Journal, 8(7), 632.
• Blatz∗, W. E. (1936). Modern Mental Hygiene. Religious Education, 31(3), 189-191.
• Weber, A., & Jaekel-Reinhard, A. (2000). Burnout syndrome: a disease of modern societies?. Occupational
medicine, 50(7), 512-517.
• Vaníčková, R. (2021). Psychology of health and mental hygiene: Psychosocial risks, consequences, and
possibilities of work stress prevention. Problems and Perspectives in Management, (1).
• West, R., & Brown, J. (2013). Theory of addiction.
• Krupinski, J., & Stoller, A. (1969). Incidence and prevalence of alcoholism as presenting to the Mental Hygiene
Department, Victoria. Australian and New Zealand Journal of Psychiatry, 3(3), 159-169.
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Mental Hygiene an Overview

  • 1. T H E O R Y A N D P R A C T I C E O F M E N TA L H Y G I E N E - E N D S E M E S T E R TA S K S 2 0 2 1 S U B J E C T C O D E : ( E N M N R E K 2 1 0 1 - 2 0 2 0 2 1 2 - N K - E N M N R E K 2 1 0 1 ) S U B M I T T E D T O P R O F E S S O R H O R V Á T H A N N A M Á R I A S U B M I T T E D B Y M A Q S O O D M A R I A M ( G Y O D 8 T )
  • 2. C O N T E N T S Introduction to Health, Mental Health and Mental Hygiene History of Mental Hygiene Modern Mental Hygiene Goals, Functions and Roles of Mental Hygiene Role of Mental Hygiene in Disorders and Situations- Burnout and Addiction Conclusions from a Future Recreation Professional
  • 3. I N T R O D U C T I O N T O H E A LT H • “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1948)
  • 4. M E N TA L H E A LT H A N D H Y G I E N E According to the World Health Organization (WHO), mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (WHO, 2004) Mental Hygiene is defined as “a science dealing with the preservation and promotion of mental health as well as prevention and treatment of mental illness or abnormalities..” (Beers, 1909)
  • 5. M E N TA L H Y G I E N E C O N T I N U E D . . . • Mental Health • Mental Hygiene • Mental Wellness • Mental status has two possibilities either health or disorder/illness. Are terms used to describe the absence of mental illness.
  • 6. H I S T O RY O F M E N TA L H Y G I E N E • History of mental hygiene movement started in 1908 with the work of C.W. Beers who is an author of a very famous book called, "A Mind That Found Itself". • Beers was born in Connecticut and graduated from Yale University in 1897. After graduation he first took up a business career and spent three years in various business offices. During this period a nervousness from which he had suffered for some time became exaggerated, and in 1900 he attempted suicide by jumping from a third storey window of his home. He was taken to a hospital suffering from minor bodily injuries. From these he soon recovered, but he spent the next few years of his life in various hospitals for the insane. While in these institutions he was repeatedly shocked at the treatment accorded to various patients, and he decided to investigate the situation as thoroughly as possible. With this idea in mind, he contrived to behave so badly that he was sent from ward to ward and experienced the most drastic treatment that was then accorded to the insane. He soon became convinced of the necessity of reforming these institutions. This idea became almost an obsession, and he spent much of his time in the formulation of plans. After recovering from his mental illness, he then proceeded to carry out his plan for a mental hygiene movement which would eventually encircle the globe.
  • 7. B E E R S ' D R E A M O F A W O R L D - W I D E M O V E M E N T F O R M E N T A L H Y G I E N E H A S B E E N F U L F I L L E D 1908 The first Committee for Mental Hygiene was organized in Connecticut in 1908. 1909 American National Committee in 1909 was then established 1918 The Canadian National Committee for Mental Hygiene was organized in 1918 by the late Dr. C. K. Clarke and by Dr. C. M. Hincks. 1922 In 1922 an International Committee for Mental Hygiene was organized as a sort of clearing house for information collected by the various national committees of countries across Europe and South America.
  • 8. M O D E R N M E N TA L H Y G I E N E • The concept of modern mental hygiene intends to state that education about mental health and wellness should be advocated even in the absence of mental health disorders. Modern mental hygienists are primarily interested in the everyday problems of the everyday man, or woman. They dig deeper into the immediate life cycles to understand the end-results Also they are more and more impressed with the life problems that never reach acute stages, that under ordinary circumstances never reach the psychiatrist, or the mental hospital or clinic. "They feel that there is more need for a teacher than a physician, an adviser than a judge, a friend than an executioner or jailer. " • Modern mental hygiene focuses on positive aspects of every person's life and it makes them capable of fulfilling their wishes.
  • 9. G O A L S O F M E N TA L H Y G I E N E Realization of Potentialities Happiness Harmonious Development Effective Existence
  • 10. F U N C T I O N S O F M E N TA L H Y G I E N E Training: The first function of mental hygiene is to train mental health personnel who can understand people's psychological problems and can help them to meet their needs. Prevention: The second most important function of mental hygiene is to prevent mental health problems by developing such programmes which may evaluate and reduce mental health disorders in the population . Cure of mental disorders: The third function is to develop programmes for those who are suffering from mental health disorders. They need counselling or psychotherapy as a treatment. Preservation: One function of mental hygiene is to maintain and preserve mental health through education programmes.
  • 11. R O L E O F M E N TA L H Y G I E N E Adjustments at Home Adjustments to School Adjustments to Society Adjustment to Work Adjustment to Self
  • 12. R O L E O F M E N TA L H Y G I E N E I N D I F F E R E N T D I S O R D E R S A N D S I T U AT I O N S
  • 13. B U R N O U T • Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when the person feel overwhelmed, emotionally drained, and is unable to meet constant demands. As the stress continues, they begin to lose the interest and motivation that led them to take on a certain role in the first place.
  • 14. S I G N S A N D S Y M P T O M S O F B U R N O U T Physical Signs & Symptoms Emotional Signs & Symptoms Behavioural Signs & Symptoms • Feeling tired and drained most of the time. • Lowered immunity, frequent illnesses. • Frequent headaches or muscle pain. • Change in appetite or sleep habits. • Sense of failure and self-doubt. • Feeling helpless, trapped, and defeated. • Detachment, feeling alone in the world. • Loss of motivation. • Increasingly cynical and negative outlook. • Decreased satisfaction and sense of accomplishment. • Withdrawing from responsibilities. • Isolating yourself from others. • Procrastinating, taking longer to get things done. • Using food, drugs, or alcohol to cope. • Taking out your frustrations on others. • Skipping work or coming in late and leaving early.
  • 15. S T R E S S V S B U R N O U T • Burnout may be the result of unrelenting stress, but it is not the same as too much stress. Stress, by and large, involves too much: too many pressures that demand too much of the person physically and mentally. However, stressed people can still imagine that if they can just get everything under control, they will feel better. Stress Burnout Characterized by over- engagement. Characterized by disengagement. Emotions are overreactive. Emotions are blunted. Produces urgency and hyperactivity. Produces helplessness and hopelessness. Loss of energy. Loss of motivation, ideals, and hope. Leads to anxiety disorders. Leads to detachment and depression. Primary damage is physical. Primary damage is emotional. May kill you prematurely. May make life seem not worth living.
  • 16. C A U S E S O F B U R N O U T Work-Related Causes of Burnout Lifestyle Causes of Burnout Personality Traits Contributing to Burnout • Feeling like you have little or no control over your work. • Lack of recognition or reward for good work. • Unclear or overly demanding job expectations. • Doing work that is monotonous or unchallenging. • Working in a chaotic or high- pressure environment. • Working too much, without enough time for socializing or relaxing. • Lack of close, supportive relationships. • Taking on too many responsibilities, without enough help from others. • Not getting enough sleep. • Perfectionistic tendencies; nothing is ever good enough. • Pessimistic view of yourself and the world. • The need to be in control; reluctance to delegate to others. • High- achieving personality.
  • 17. P R E V E N T I N G A N D T R E A T I N G B U R N O U T B Y M E N T A L H Y G I E N E P R A C T I C E • Learn how to reduce stress in the moment. • Manage troublesome thoughts and feelings. • Motivate oneself to take the steps that can relieve stress and burnout. • Improve relationships at work and home. • Rediscover joy and meaning that make work and life worthwhile. • Increase overall health and happiness. • Exercise • Healthy Diet ( eat less of sugars and more of Omega- 3 rich diet to boost mood, avoid nicotine, alcohol or caffeine)
  • 18. A D D I C T I O N • “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long- lasting, and can lead to the harmful behaviors seen in people who abuse drugs.” (NIDA)
  • 19. A L C O H O L I S M A N D D R U G A D D I C T I O N Alcoholic means a person whose persistent and excessive indulgence in alcoholic liquor is causing or is likely to cause serious injury to his health or is a source of harm, suffering, or serious annoyance to others or renders him incapable of properly managing himself or his affairs. Drug addicts: addiction to intoxicating, stimulating, narcotic, or sedative drugs is causing or is likely to cause serious injury to his health or is a source of harm, suffering, or serious annoyance to others or renders him incapable of properly managing himself or his affairs. (Parliament Counsel Office, 2008)
  • 20. A D D I C T I O N B E H AV I O U R S • 1. Frustration and internal pain, that leads to anxiety and a demand for relief of these symptoms • 2. Fantasizing about using alcohol and drugs or behaviours to relieve the uncomfortable symptoms • 3. Obsessing about using drugs and alcohol and how his or her life will be after the use of substances • 4. Engaging in the addictive activity, such as using substances in order to gain relief (acting-out) • 5. Losing control over the behaviour (substance use) • 6. Developing a feeling of remorse, guilt, and shame, that lead to feelings of dissatisfaction • 7. Making a promise or resolve to oneself to stop the behaviour or substance use • 8. After a period of time, the pain returns, and the addict will again begin to experience the fantasies of using substances (Recovery Connection,2005-2012)
  • 21. A L C O H O L I S M A N D H E A L T H Alcoholism is a major health problem and ranks with cancer and heart disease as a threat to health. The alarming rates at which drug addiction is on the rise make it a massive threat in its own right. Use of alcohol and drugs is one of the leading causes of death and injury among teenagers and young adults Around one in three adults drink at levels that put them at risk of developing a number of related health conditions, including alcoholism and liver disease (Lehmann,2012)
  • 22. P H Y S I C A L C O N S E Q U E N C E S O F A D D I C T I O N S • It impairs memory and thinking ability, ranging from one- time "blackouts," in which the person cannot remember a night of hard drinking, to permanent brain damage and dementia (confusion and memory loss). • It raises the risk of cancers of the lip, mouth, neck, oesophagus, stomach, pancreas, and breast • In men, it can cause impotence (inability to have an erection). In women, it can cause infertility (inability to have a baby). (Human Diseases and Conditions,2012)
  • 23. R O L E O F M E N TA L H Y G I E N E I N A D D I C T I O N R E C O V E R Y
  • 24. I M P L E M E N T I N G 1 2 - S T E P P R O G R A M • Self Help Groups • Open group • Closed meetings • Participation meetings • Step meetings Big Book Meetings
  • 25. M E N T A L H Y G I E N E F O R A F U T U R E R E C R E A T I O N S P E C I A L I S T • With past experience of serving as a physical therapist and a teacher for the visually impaired, there is a dire need to work on the mental health of clients along-with physical health for optimum performance and better prognosis. I am primarily interested in providing therapeutic recreation in future to different populations such as cerebral palsy or autistic individuals because research advocates that therapeutic recreation is beneficial for people with physical disorders and it can boost mental health along-with physical health.
  • 26. R E F E R E N C E S • Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007). No health without mental health. The lancet, 370(9590), 859-877. • Lemkau, P. V. (1949). Mental hygiene in public health. • Meyer, A. (1918). The mental hygiene movement. Canadian Medical Association Journal, 8(7), 632. • Blatz∗, W. E. (1936). Modern Mental Hygiene. Religious Education, 31(3), 189-191. • Weber, A., & Jaekel-Reinhard, A. (2000). Burnout syndrome: a disease of modern societies?. Occupational medicine, 50(7), 512-517. • Vaníčková, R. (2021). Psychology of health and mental hygiene: Psychosocial risks, consequences, and possibilities of work stress prevention. Problems and Perspectives in Management, (1). • West, R., & Brown, J. (2013). Theory of addiction. • Krupinski, J., & Stoller, A. (1969). Incidence and prevalence of alcoholism as presenting to the Mental Hygiene Department, Victoria. Australian and New Zealand Journal of Psychiatry, 3(3), 159-169. Click to add text