Introduction

The Section of Social and Transcultural Psychiatry at McGill University—the first of its kind in the academic landscape—was created in 1955 and was one of the major research teams in the postwar period to produce knowledge at the intersection of cross-cultural psychiatry and epidemiology. In the 1950s and 1960s, before the creation of the Department of Epidemiology at McGill in 1964, the team led by the psychiatrist Eric Wittkower (1899–1983) had already embarked on a series of surveys about major mental disorders like schizophrenia and depression. The early surveys differed from asylum statistics and the global programs developed by the WHO. They were based on local comparative Canadian studies and on a large network of correspondents created by means of the first transcultural psychiatry international newsletter and later journal, Transcultural Research in Mental Health Problems. Thanks to this visibility, the group at McGill played a central role in the organization of panels to present its survey results at the World Congress of Psychiatry in Zurich (1957) and in Montreal (1961).

In this chapter, I will explore the types of questionnaires used at McGill in cross-cultural psychiatry. Next, I will turn to the evolution of the surveys after the arrival at McGill of the psychiatrist and epidemiologist Brian Murphy (H.B.M. Murphy, 1915–87) in 1959, and I will focus on the standardization of techniques. Finally, I will describe their use in various cultural environments in Canada, including in Canadian rural communities in the 1960s, partly inspired by the work of Alexander H. Leighton (1908–2007), then at Cornell University, principal investigator of another Canadian epidemiological investigation, the Stirling County Study in Nova Scotia. McGill's approach emphasizes the importance of interdisciplinarity in the early history of psychiatric epidemiology. Furthermore, it illustrates how schizophrenia, perceived at the same time as a universal category and as a category whose prevalence is affected by sociocultural factors, was a boundary object between psychiatrists and social scientists in the postwar years.

The Foundation of the McGill University's Transcultural Psychiatry Unit in 1955

In 1955, the first university unit in transcultural psychiatry (today, called the Division of Social and Transcultural Psychiatry) was established by the psychiatrist Eric Wittkower and the anthropologist Jacob Fried. Born in Berlin to a Jewish family and originally trained as a specialist in internal medicine, Wittkower left Germany in 1933 as a consequence of its new Anti-Jewish Laws.

Taiwan has been pivotal in the development of international psychiatric epidemiology not only because of its pioneering work in the comprehensiveness of mental disorder surveys but also due to its advanced survey methods. Its lauded island-wide survey conducted in the early post–World War II period and the follow-up studies, collectively known as the “Formosan model,” are important pioneering works among developing countries in the Asia-Pacific region. In one of my previous works, I demonstrated that in the 1950s and 1960s, collaboration between international and Taiwanese psychiatrists in the field was critical in shaping the World Health Organization's (WHO) international social psychiatry projects. This might provide a non-Western exam ple of a crucial post–World War II venture in psychiatry. However, it might also overemphasize the importance of Taiwan on the world map. In fact, such advances have a much more complex historical background. In this chapter, I examine studies conducted by psychiatrists working for Taihoku Imperial University (1928–1945), arguing that tropical governance under Japanese colonialism was the most significant factor in the development of psychiatric epidemiology in East Asia and that the psychiatric research methodology developed during the colonial period (1895–1945) laid the foundations for postwar international collaborative works on psychiatric epidemiology. The combination of statistics and field observational surveys developed for the purpose of Japanese colonial expansion and the opportunities for Taiwanese doctors to participate in international academic activities were cornerstones of the postwar global decolonization that accompanied developments in psychiatric epidemiology.

The Genealogy of Modern Psychiatry in Colonial Taiwan

Modern psychiatry was introduced in Taiwan in various stages during the Japanese colonial period (1895–1945), serving colonial governance in various ways. Psychiatric knowledge or, more broadly, knowledge of the psychiatric sciences was introduced to the tropical island as part of the colonizers’ plan to conduct social and cultural surveys in line with the “biological principles” of colonial planning. These principles were proposed by Gotō Shimpei (後藤新平), the first Minsei Chôkan [chief civil administrator], in 1898, three years after Taiwan became a Japanese colony. His vision was instrumental in creating the infrastructure for Japan to govern Taiwan by applying a range of administrative methods to govern the complex, but wayward, society earlier ineptly controlled by the Chinese Qing rule (1683–1895).

In 1917, as World War I was at its height, the gothic novelist Arthur Machen attempted to describe the growing sense of fear and unease that haunted the United Kingdom. He depicted a rootless and invisible emotion, a nameless terror, that moved silently across the land leaving a trail of destruction in its wake. Frightened horses, suicidal farmers, and paralyzed children mapped out the emotion's itinerary across the kingdom. Machen's tale of a transformative horror was rooted in a tradition of gothic literature that had been reinvigorated in the late nineteenth century. However, its central device of an epidemic of fear and its disease-like transmission across the population drew upon different sources: the scientific literature on the pathology of collective emotions that served as a precursor for psychiatric epidemiology in Victorian and Edwardian Britain. Even without its supernatural overtones, this tale seems curiously remote from contemporary psychiatric epidemiology. The distance between the epidemics of feeling described in those early writings and the organization of contemporary practice is striking. Although there was a large literature on the relationship between mental disease and poverty, there is little attempt to map the movements of affect or read transformations of emotion as an index of social or historical change. Instead such epidemics of feeling were read through the psychological concept of suggestion— as a form of primitive and unconscious communication—anchored in the evolutionary frameworks of crowd psychology and the herd instinct.

By the end of World War II this epidemiological understanding of fear had been transformed. Insecurity, terror, and anxiety were no longer seen as capricious forces but instead understood as environmental conditions that could be defeated through political interventions and social planning. Fear was tamed. It moved from being a fickle and fantastic force to become instead an object of political calculation. Indeed in the wake of the war, it would provide the grounds for a new program of social and material reconstruction. As this chapter will partly show, the architects of the welfare state in the 1940s and 1950s saw their task as the engineering of a society in which individuals would be freed from the pathological anxieties of financial insecurity, unemployment, and homelessness. Aneurin Bevan, widely seen as the architect of Britain's National Health Service, complained that modern lives were wrecked by anxiety.