Appalachia's Children: The Challenge of Mental Health

This thoughtful, compassionate book makes a major contribution to our understanding of the Southern Appalachian child—his mental disorders and his adaptive strengths. Drawing upon his extensive fieldwork as a clinical child psychiatrist in Eastern Kentucky, Dr. Looff suggests means by which these children can be helped to bridge the gap between their subculture and the mainstream of American life today.

The children described in this book, the author points out, are in a real sense not "all children." Since no child grows up in a vacuum, the children of Eastern Kentucky cannot be understood apart from the historical, geographic, and socioeconomic characteristics of the area in which they grow. Knowledge of the children requires some knowledge of the lives of parent, teachers, and the many others upon whom they are dependent. That is to say, mental disorder—or mental health—is embedded in a social matrix. Dr. Looff therefore examines the milieu of these Southern Appalachian children, their future as adults, and how they can achieve their potential—whether in their native or an urban setting. In viewing the children within their own cultural framework, Dr. Looff shows how they develop toward mental health or psychopathology, suggesting supportive techniques that build upon the strengths inherent in each child. These strengths, he suggests, rise out of the same culture that burdens the child with handicaps.

Dr. Looff's position is one of guarded optimism, based on the successes of the techniques he has used and observed in seven years of work in Appalachian field clinics. Although he details instances of mental disorder in children, and instances of failure in family functioning, he notes at the same time family strengths and sees these strengths as sources of hope.

Although this book is based on fieldwork techniques within a specific area and culture, it is paradigmatically suggestive of wider application. Dr. Looff demonstrates effectively and clearly the profound need for increased concern about what is happening to the rising generation—the children of Eastern Kentucky, the children of the Southern Appalachian region, and the children of the rural south.