The purpose of this study is to examine the dynamics between professional knowledge and the power to construct social realities. The focus is on the institutions which contributed to mental hygiene as a protocol for public policies directed toward children. The social history of the child in the twentieth century is juxtaposed with shifts in the configurations of private and public institutions in a sociology of mental illness. The mental hygiene movement created one of the twentieth century's major paradigms. Mental hygiene was conceptualized as the development of a science of promoting mental health and preventing mental illness. The' working premise of the movement was that early life experiences determined adult competence and constituted the root cause of major social problems from crime and dependency to labour unrest and war. The National Committee for Mental Hygiene was established in the United States in 1909 and a second National Committee was established in Canada in 1918. Mental hygienists developed an ideology of child oriented prevention in public health, welfare and educational policies which legitimated public intervention into the private spheres of family relations and child rearing. The idea of mental hygiene was based on a medical model and as such it was part of the new psychiatry and public health movements of the Progressive Era. As a paradigm mental hygiene fostered the identification of children according to scientific standards. Mental hygiene contributed to the transformation of juvenile delinquency into a psychiatry of maladjustment in childhood. As a positivistic approach to public health, mental hygiene research elaborated criteria to determine age related stages of normal psychological and biological progress. Mental hygiene was a product of professional researchers and policy makers. The knowledge base of mental hygiene grew with the expansion of higher education in the United States especially in regard to scientific medicine. The medical model was subsequently applied to research in the behavioural and social sciences. Scientific philanthropy provided funds for research, professional education, and the distribution of knowledge. The accumulation of monetary resources by nineteenth century entrepreneurial capitalists, who applied these funds to further the growth of scientific models, were a sustaining factor in twentieth century mental hygiene. The agents of power described as part of the mental hygiene movement include: 1) the National Committees for Mental Hygiene in the United States and Canada; and, 2) general purpose foundations in Rockefeller related philanthropy and the Commonwealth Fund. By mid-century, the federal, state/provincial and local governments of the United States and Canada had assumed major aspects of the former role of the National Committees and philanthropy in mental health advocacy. The theoretical foundation of mental hygiene evolved in conjunction with the development of the scientific method as applied to preventive medicine, especially in fields related to psychiatry. Mental hygiene was a primary carrier of the medical model into applied disciplines in the social and health sciences. The professionalization of education, social welfare and psychology, as imbued with mental hygiene, translated technological change into revised concepts of public and private spheres in relationship to family and child life. The medicalization of human differences limited the potential for radical revisions in social organization. It justified unequal access to political and economic power on the basis of psychological and biological characteristics. The mental hygiene paradigm served to maintain established social configurations in the face of social change. The function of justifying inequalities was especially important in the United States but less so in Canada for reasons of the timing of nation-building, national history, character, and culture. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

This mixed-methods research study was conducted for the purpose of examining school-based occupational therapists' child psychosocial knowledge and attitudes, along with how therapists developed this knowledge and attitudes. Using a phenomenological qualitative approach, the study addressed the following broad research question: What meaning do school-based occupational therapists give to their experience in developing child psychosocial knowledge? Using a quantitative approach, a survey instrument was used to answer the following questions: (a) What level of child psychosocial knowledge and attitudes do school-based occupational therapists possess? (b) How do the following variables impact child psychosocial knowledge and attitudes: (1) level of education, (2) academic course content, (3) participation in mental health fieldwork, (4) application of psychosocial knowledge in non-mental health fieldwork, (5) professional practice experiences, and ( 6) continuing education experiences. Snowball sampling was used to select 11 school-based occupational therapists for the phenomenological portion of the design. Data were analyzed using Giorgi and Giorgi's (2008) method of phenomenological analysis. Random sampling was used to select 1,000 school-based therapists who were mailed the Occupational Therapy Child Mental Health Questionnaire based upon The Teacher Mental Health Opinion Inventory (Morris, 2002). The response was N = 630. Data were analyzed using descriptive statistics and analysis of association. Using the mixed-methods triangulation convergence model, where both quantitative and qualitative data were collected at the same time and the results converged during interpretation by comparing and contrasting them, the following conclusions were made: (a) school-based occupational therapists possess and use child psychosocial knowledge: however. they do not believe it is sufficient; (b) school-based occupational therapists have a difficult time articulating psychosocial knowledge; however. through case descriptions they are able to give many examples of psychosocial knowledge they use in practice; (c) school-based occupational therapists believe that holistic, occupation-based, and client-centered practice, along with additional psychosocial intervention strategics, help them maintain a positive attitude toward children with emotional disturbance; (d) school-based occupational therapists experience tension when attempting to apply their holistic, occupation-based, and client-centered practice in an environment that is typically focused on students changing to meet the environmental demands; (e) due to the constraints of the educational system and the IEP, school-based occupational therapists practice holistically by incorporating psychosocial knowledge in a hidden fashion; (f) school-based occupational therapists believe that mental health fieldwork and rich experiences with individuals who have mental illness is important to developing a comfort level with people who have mental illness; (g) school-based occupational therapists do not readily connect the learning from adult mental health fieldwork that they apply in their school-based practices.