nerican Social Work in e Twentieth Century DWARD T. DEVINE and LILIAN BRANDT i^«vfa D cents THE FRONTIER PRESS lOO WEST TWENTY-FIRST STREET NEW YORK Printed in the United States of America KOENIG-MOAK PRINTING COMPANY NEWYORK American Social Work in the Twentieth Century By EDWARD T. DEVINE and LILIAN BRANDT Expanded by permission from an article contributed by the authors to the Encyclopaedia Britannica NEW YORK THE FRONTIER PRESS 1921 • • • • * • • • , • • • • • «• • • CONTENTS Page I. INTRODUCTION ' i-^ II. AT THE BEGINNING OF THE CENTURY - - - 3-16 Public relief -- 3 Private philanthropy ____------- 6 The treatment of crinminals ---------- 8 State supervision ------------- 12 Beginnings of preventive philanthropy ------ 13 Discussion of problems ----------- 14 III. DEVELOPMENTS IN THE TWENTIETH CEN- TURY 17-48 Dominant ideas ------------- 18 The new social movements ---------- 19 Research and surveys ----------- 22 Reaction on relief and correction _-- 24 Study of methods ------------- 27 Training schools ------------- 28 Formulation of standards ---------- 30 Coordination and "programs" --------- 32 Financial federations and community trusts - - - - 33 Increased reliance on government ------- 37 Changes in vocabulary ----------- 40 Confusion and duplication - - 42 The war and social work ---------- 44 IV. PRACTICAL ADVANCE: 1900-1920 49-62 General relief ------- -- 49 Child welfare -------------- 51 Care of the sick and promotion of health ----- 53 Treatment of crime ------------ 56 Improvement of conditions -- 58 Present needs -------------- 6i Copyright, 1921 by The Frontier Press INTRODUCTION In the United States of America "social work" has come Into use In recent years as a comprehensive term, Including charity and philanthropy, public relief, punishment and reformation, and all other conscious efforts, whether by the state or on private Initiative, to provide for the dependent, the sick, and the criminal, to diminish the amount of poverty, dis- ease, and crime, and to Improve general living and working conditions. The twentieth century has seen an extraordinary development In this field. The number of persons interested — whether as volunteers, serving on boards and committees, or as contributors of finan- cial support, or as salaried employees, making this their daily occupation — has multiplied manyfold. The amount of money appropriated from taxes, an- nual contributions for the current work of privately supported organizations, and endowments by men and women of wealth, have increased enormously. New forms of social work have come into existence, some of which have had a marked Influence in Eng- land and other foreign countries. The older forms have improved their methods, as well as extended their scope. Principles have been formulated; standards have been set up; training courses have ^\^%j f>0%j ■J J *A!\^ERICAN SOCIAL WORK been established; general instruction has been intro- duced into the colleges and universities, and even to some extent into the secondary schools; a technical literature has been produced; intelligent discussion of social problems in the popular periodicals and the daily press has become common. Along with this rapid expansion, a unifying process has been going on, of which the very term ''social work" is at once an evidence and a result. Before 1900 there was no such collective name. In the early years of the twentieth century, however, as individuals engaged in the various forms of pub- lic relief and private charity, in penal and custodial institutions, and in social reform, became more and more conscious of their common interests, and as new undertakings came into existence which were of an obvious kinship, though they could not prop- erly be described as either charity or correction, "social work" came Into use to meet the need for a comprehensive term. While It Is still used with con- siderable latitude — extended by some to Include almost anything which contributes to the social wel- fare; by others reserved for voluntary charitable work done In the most approved way — It has grad- ually acquired a fairly definite content, and is now current In the sense we have indicated.* *For a fuller discussion of the scope and nature of social work and its distinguishing characteristics in America as compared with corresponding activities in other countries see Social Work, by Edward T. Devine, Chapters I-V, published by the Macmillan Company, New York. II AT THE BEGINNING OF THE CENTURY Although the laws in American states do not unl- formly recognize what in England is called the ''right to relief," there has always been nevertheless a tacit assumption that any kind of misfortune which threatens life or physical well-being should be provided for; and that if relatives, friends, or vol- untary agencies do not make such provision, the state must, or at least should, do so in some way. PUBLIC RELIEF In colonial days this assumption was met by such expedients as naturally suggested themselves to prac- tical, hard-working men, engaged in building a new country; at first by providing for each case indi- vidually, by special action of the town or county officials; later by a system of out-door relief, by ap- prenticeship and indenture for orphan children, by hiring out dependents with any degree of working capacity to the highest bidder and turning over the infirm and helpless to the lowest bidder. The abuses which developed both in out-door relief and in the contract and lease system led, in the early part of the nineteenth century, to the establishment of almshouses by town or county authorities AMERICAN SOCIAL WORK throughout the older states, to serve as a general asylum for all classes of dependents and defectives and also for some classes of delinquents. By the end of the nineteenth century a great variety of public institutions and agencies had been differentiated from the almshouse. Public opinion by this time had generally recognized that the alms- house was not a suitable place for tramps, vagrants, and disorderly persons; for children; for the insane, feeble-minded, epileptic, blind, and deaf; for con- finement cases, cases of acute illness and contagious disease; but that all these classes should be provided for in specialized institutions, leaving in the alms- house, whicTi thus becomes itself a specialized insti- tution, only the aged infirm and chronically disabled who are in need of public support. These theoretical conclusions, however, were by no means completely in any state, or uniformly throughout the country, embodied in practice. In many of the newer states, with no correctional insti- tutions except jails and state prison, the courts still habitually committed certain minor offenders to the almshouses. Although sentiment against subjecting children to the influences of almshouse life had crystallized early and unmistakably, there were seventeen states which in 1900 still maintained their dependent children in almshouses. Probably the greatest progress toward specialized care had been made in the case of the insane, but in most of the states these institutions were still inadequate and IN THE TWENTIETH CENTURY consequently over-crowded, while in many a certain number of insane public charges were still to be found in the county poorhouses or even in the jails; and the horsewhip was still advocated by some of their official guardians as the most efficacious means for quieting the violent. State schools for blind and deaf children had been quite generally established, but there was practically no provision for the in- struction of persons who became blind or deaf or otherwise disabled in adult life. There were only 26 public institutions for the feeble-minded in the country, and special provision for epileptics was rare. Even In so advanced a state as New York there were about as many "idiots," feeble-minded, and epileptic in the almshouse as in the special insti- tutions for their care. There were still many large cities and towns which had no general public hos- pital; confinement cases were very generally ad- mitted to the almshouses, in default of any other place for their reception; and as there was almost no public provision for the care of consumptives, and little under private auspices, they were found in large numbers in the almshouse population. Ex- cept in certain cities, out-door, relief was very gen- erally given by local public officials throughout the country^ in the form of groceries, fuel, clothing, and sometimes in money. This, and the undifferentiated almshouse, were still the public provision available for the majority of dependents. AMERICAN SOCIAL WORK PRIVATE PHILANTHROPY Parallel with the public agencies were many which had been established, and were conducted, under church auspices, or by Incorporated societies or less formal associations of private Individuals. Division between public and private responsibility has not been determined by a priori reasoning. It has developed pragmatically. The state, holding the position of ultimate responsibility, has been obliged to make provision for such classes as have not Inspired private charities, for the residual ele- ment In all classes, and for those who need control or restraint of some kind as well as maintenance. Public provision has been most successful for those who can be cared for advantageously In groups, be- cause they need education or professional treatment which can best be organized In an Institution; and for those whose condition warrants temporary or permanent removal from their homes, either In their own Interest or for the sake of others. It has, how- ever, by no means been limited In this way, and while there has been much discussion of the prin- ciples which should determine the division of work between public and private agencies, there is even yet no generally accepted theory. The institutions under private auspices which ex- isted in 1900 were chiefly orphan asylums, hospitals, and homes for the aged. Most churches gave charitable assistance on occasion to their own mem- IN THE TWENTIETH CENTURY bers, and the larger ones had a Ladles' Aid Society or a St. Vincent de Paul Society or some other more or less formally organized machinery for the pur- pose. In the cities there were "bread lines" and "soup kitchens" and temporary shelters for the homeless. In many places there were non-sectarian general relief societies, such as the New York Asso- ciation for Improving the Condition of the Poor, dating from the forties; and In about a hundred cities. Including practically all the larger ones, there was a Charity Organization Society or Associated Charities or United Charities, modelled — perhaps too slavishly for American needs — after the London Charity Organization Society or one of the early American copies of that English society. There were also many societies for assisting cer- tain classes of the needy In their own homes — widows, for example, or members of a particular nationality — some of which dated back nearly a cen- tury; or for giving some particular kind of help, such as legal aid. There were i6i societies for the protection of children from cruelty and neglect, either as their sole object or In addition to the pro- tection of animals; and a considerable number of societies performing one or more of the functions of the pioneer Children's Aid Society of New York — to find homes In families for homeless children, to conduct lodiilng-houses and reading-rooms for newsboys, and in other ways to promote the welfare of city "waifs." "Fresh-air societies" existed to V- AMERICAN SOCIAL WORK provide outings of a day or longer in the country or at the seashore for city children. "Visiting nurs- ing associations" had demonstrated the value of such service, and forty or fifty had been organized, with an aggregate force of not more than 140 nurses in the entire country. In the larger cities and indus- trial centers day nurseries had been established for the convenience of wage-earning mothers and to reduce the number of children who were candidates for a place in an institution. THE TREATMENT OF CRIMINALS In the treatment of criminals America had made several notable contributions in the nineteenth cen- tury. The reformatory system for adult first of- fenders, developed at Elmira, New York (opened In 1876), by Z. R. Brockway, out of various ele- ments of treatment which had been tried separately in scattered places, had commended Itself to penol- ogists, and reformatories for men sixteen to thirty years of age constituted a part of the correctional system of ten or more states. Reformatories for women existed in only three. The indeterminate sentence, though the idea may not have originated In the United States, was first embodied in law in Michigan in 1867, and received its Impetus from the development of the reformatory system, of which It formed an essential feature. By 1900 It was in use in commitments to reformatories In eight or ten states, to penitentiaries in two, and was al- IN THE TWENTIETH CENTURY lowed by law in several others. Parole — conditional release before expiration of sentence — was per- mitted by law in about half the states. Reformatory schools for juvenile delinquents, which had naturally come into existence much earlier than reformatories for adults, were to be found by 1900 in four-fifths of the states — more of them for boys than for girls, even in proportion to their numbers as delinquents. Juvenile courts were just at the beginning of their development. The pioneer law had been passed in Illinois in 1899, and the first separate court for children opened in Chicago in July of that year. Probation also was only beginning to receive atten- tion. Growing out of the privilege of the court to suspend sentence after conviction, it had been in practice in connection with adult offenders through- out Massachusetts for twenty years, and was estab- lished by statute in New Jersey in 1899, but had not spread farther. As applied to children, it had not yet been tried. Probation, indeterminate sentence, reformatory institutions, special courts for children, and even specialized treatment for women and children of- fenders, were still, however, in the position of novelties, and affected relatively few individuals. Fixed sentences, determined by the nature of the offence, without reference to the needs of the of- fender, were the rule ; and they were served for the most part under conditions dictated by the theory of retribution rather than reformation as the object 10 AMERICAN SOCIAL WORK of punishment. For the greater part of the coun- try, and for the great mass of law-breakers, there was no provision other than the county jail and the state prison or penitentiary. After the long dispute which had been w^aged through the middle of the nineteenth century over the relative merits of the "Pennsylvania" or "separate" plan of prison and the "Auburn" or "congregate" plan, the latter, in which the men worked together during the day and were locked up in cells at night, had become the pre- vailing type. The theory of isolation was kept only in the Eastern Penitentiary in Philadelphia, where it had originated, and even there it was little more than a tradition, since as a matter of fact there were usually at least two men in each cell. The principal departure from this prevailing type, aside from the few reformatory institutions, was in the southern states, where it was not uncommon for the state and county prisoners to be "leased" to private employers in gangs — a practice which led to the gravest abuses. Almost no attention had anywhere been paid to diet or other physical or mental needs of prisoners. As the characteristic charitable institution of America is the town or county almshouse, so the characteristic correctional institution — east and west, north and south — was then, as it is still, the county jail or town "lock-up." Intended originally and primarily as a place of detention for prisoners awaiting trial, it was also very generally used, IN THE TWENTIETH CENTURY 11 except in the large cities, as the institution to which minor offenders were consigned by the courts for punishment, and sometimes even as an asylum for the insane. Generally small, with the most rudi- mentary sanitation, frequently "fire-traps," they are described by a committee of the National Confer- ence of Charities and Correction in 1900 as "foul dens, infested with vermin, reeking with dirt and filth." Professional criminals and innocent persons awaiting trial, prostitutes, boys and girls arrested for a trivial first offence, were "herded together" in idleness, dirt, and bad air. De Tocqueville had called them the worst prisons he had ever seen, and throughout the nineteenth century they had been denounced as "schools of crime" and "breeding- places for disease," until such expressions as appear in quotation marks in this paragraph have come to be associated with them, but the committee men- tioned above was obliged to record in 1900 that "tradition, custom, and the slow progress made in American jurisprudence, have left our common jails but little in advance of the petty places of incarcera- tion known to our forefathers of the past century." Private charity in the field of correction had con- cerned itself chiefly with establishing reform schools for juvenile delinquents; "Houses of the Good Shepherd," "Magdalen Homes," and "Florence Crittenton Homes" for "fallen" girls and women; and prisoners' aid societies for helping discharged prisoners to find work and re-establish themselves in 12 AMERICAN SOCIAL WORK society, official assistance at this point being limited to a suit of civilian clothes, transportation home, and a little money for immediate expenses. The National Prison Association, organized in 1870, had made distinguished contributions, in its annual meetings, to penological theory, and had done much to advance the adoption of practical reforms, such as the indeterminate sentence and the reformatory system. STATE SUPERVISION To ensure a certain standard in the conduct of public charitable and correctional institutions, state boards or commissions had been established in over half the states. These were of two main types: (i) advisory boards, with authority to inspect, re- port, and make recommendations, relying for their influence chiefly on the power of publicity; and (2) boards of control, with full executive powers and executive responsibility, replacing the boards of managers of the several institutions. The former type was considerably in the majority. In two or three of the older states the general supervisory board had been broken up into two or three spe- cialized bodies — one for the charitable agencies, one for the prisons, and one for the institutions for the insane; and there was a disposition on the part of experts to favor such specialization in supervision. IN THE TWENTIETH CENTURY 13 BEGINNINGS OF PREVENTIVE PHILANTHROPY Of "preventive philanthropy" or "constructive social work" there was very little by the end of the nineteenth century. There had never been lacking, to be sure, individuals who saw beyond the imme- diate distress or delinquency or degradation of the individual to the social conditions which were active causes of their trouble; and it is altogether probable that those who were helping the poor and providing for homeless children twenty years ago were quite as sincere as social workers of to-day in their desire to do it in such a way as to make them self-support- ing and self-sufficient members of society rather than pauperized dependents for life. But the conscious emphasis on "rehabilitation" and the educational "movements" for the improvement of social and in- dustrial conditions were almost wholly in the future. Interest in providing public baths and play- grounds and small parks in congested districts had been growing for several years. There were "stamp saving societies" and other devices for en- couraging "thrift" among the poor. The New York Tenement House Committee had begun work in 1899, and was laying the foundations of the housing movement in its twentieth century aspect. The Provident Loan Society had been established in New York, and was competing successfully with pawnbrokers of the exploiting type. The Consum- ers League had exposed the horrors of sweat-shop 14 AMERICAN SOCIAL WORK work, and through its assault on the conscience of the consuming public was preparing the way for a general concern about Industrial conditions. But the conspicuous educational social agency at this period was the settlement. In the fourteen years since Stanton Colt had established the Neighbor- hood Guild on the lower East Side of New York City, the number of settlements had increased to over one hundred. They had many forceful per- sonalities among their leaders and were attracting the enthusiasm of young college graduates and con- tributing a great deal to an understanding of the lives of the poor, of the conditions under which they lived, and of the relation of those conditions to pov- erty and disease and crime. DISCUSSION OF PROBLEMS For a quarter of a century the National Confer- ence of Charities and Correction, with its annual meetings, had served as a medium through which the social workers of the country exchanged experi- ences, discussed their problems, and extended their acquaintance; and its volumes of proceedings had grown to a substantial body of reference material. Twenty states or more had organized state confer- ences. A weekly journal, Charities, was published by the Charity Organization Society of New York. Courses In "practical sociology" or "charities and corrections" were gaining a foothold in several col- leges. Among social workers themselves, especially IN THE TWENTIETH CENTURY IS those connected with the charity organization socie- ties, there had been for eight or ten years a desire for training courses which should give a preparation for such work. In 1898 the first of these training courses had been undertaken by the Charity Organi- zation Society of New York, in a six weeks' "Sum- mer School in Philanthropic Work." Among the questions in which the social workers of the country were taking a lively interest at the opening of the twentieth century were the following : The "spoils system" as affecting appointments to positions in public charitable and correctional insti- tutions; more generally, the importance of having capable and specially equipped men and women in charge of all work, public and private, for the poor and the sick and the delinquent; and, by consequence, the need for training courses to prepare for such work; The evils of the county jail and village "lock-up," with a demand for the very abolition of these insti- tutions; how to provide work for prisoners without subjecting them to exploitation and without arousing objections from organized labor; State care vs. local care (by the county or town) for the Insane; advantages of the "colony plan," with simple architecture, for Institutions for the insane, feeble-minded, and epileptic, In place of the palatial or monastic structures which had prevailed; Subsidies from the public treasury to private charities, especially hospitals and orphan asylums; "Abuse" of medical charities, by which was meant the use of hospitals and dispensaries by persons able to pay for treatment; 16 AMERICAN SOCIAL WORK Conditions for success in "placing-out" dependent children; advantages of country life and the "cottage plan" in institutions for children; Relative advantages of advisory state boards and boards of control; of a single supervisory board for all state institutions and of specialized boards; The "scope" and "purpose" and methods of "organized charity," and its "relation" to all the older forms of philanthropy ; Haw to secure and keep and train "friendly visitors" and use them to the best advantage; Whether a charity organization society should have a relief fund or should merely investigate cases of distress and obtain relief for them from appropriate sources when it w^as needed. Among the new topics which were gaining a place in their discussions were tenement house reform, the social aspects of tuberculosis, physical defects of school children, backward children, juvenile courts and other specialized courts, probation. Ill DEVELOPMENTS IN THE TWENTIETH CENTURY On these foundations rest the expansion and the developments which have taken place since 1900. There is no sharp dividing line between the old and the new in social work, any more than there is in any other department of human activity; nor is the new something essentially different from the old. Rather it has developed naturally and gradually out of it. The ideas which underlie modern theories of social work have been expressed here and there through past centuries; the germs of modern meth- ods may be found in isolated agencies long before the close of the nineteenth century. What has really happened is that ideas formerly held by indi- viduals have become general; that methods repre- sented by sporadic agencies have become character- istic; that there has been a shift in the emphasis placed on the various causes of misery; that scien- tific progress has made possible both a better under- standing of social problems and more effective meas- ures; that the scope of social work has expanded; that, partly as a result of these changes, interest in social problems and in social work has extended to a considerable part of the population. 18 AMERICAN SOCIAL WORK DOMINANT IDEAS One of the ideas which became dominant among social workers early in the present century was that ''prevention is Ketter than relief." A second, in the picturesque phrase of Jacob A. Riis, was that "a man cannot live like a pig and act and vote like a man." Both these ideas grew out of the experiences of men and women who were engaged in work for the relief or the reformation of individuals or who were living among the poor in social settlements. They could not fail to see that there were widows and orphans to be supported because men had died prematurely of preventable disease or industrial ac- cidents; that back of the superficial shiftlessness and intemperance and inefficiency and criminality of those whom they were trying to help were such things as bad housing, congestion of population, child labor, over-work, inadequate pay, absence of opportunities for play — all of which were producing dependents and criminals faster than the public and private agencies could take care of them; and that it was the part of prudence and economy, as well as of humanity, to look below the surface and to take appropriate action. Economists supplemented these observations of the social workers and confirmed their convictions by pointing to the material resources and prosperity of America, and suggesting that there was no excuse for want and misery. The characteristic American \ IN THE TWENTIETH CENTURY 19 attitude of impatience towards poverty, which had been responsible for relative indifference to social problems in earlier days, was translated into an en- thusiasm for ^'prevention," and the vision was built up of a nation in which there should be no prevent- able poverty or preventable disease or preventable crime. "Maladjustment," ''exploitation," "social justice," "underlying causes," "adverse social con- ditions," became conspicuous words in the vocabu- lary of social work. "A decent standard of living" and consideration of what constitutes "a living wage" displaced discussions of the "dangers of pau- perization" and distinctions between "worthy" and "unworthy" poor. Thus interest shifted from the personal to the environmental causes of poverty and crime; from "defects of character" as causes to their significance as symptoms; from moral elements in family life to the economic and physical as their determinants; from a distrust of liberal relief to a conception of the pauperizing influence of poverty itself. THE NEW SOCIAL MOVEMENTS Out of these ideas naturally developed the "or- ganized social movements" which are characteristic of contemporary American philanthropy. While they have worked out a technique strikingly similar to that used by the early abolitionists, temperance reformers, and advocates of "woman's rights," they owe no conscious debt to those great reform move- 20 AMERICAN SOCIAL WORK merits of the nineteenth century, but are the result of fresh consideration of particular evils. In the past twenty years one destructive social force after another h^as been singled out for special study and attack by appropriate methods, and the aggregate of resulting effort and interest constitutes in each case a "movement." There has been considerable variety among them in strength and vitality, and one or two promising beginnings (for diminishing con- gestion of population, for instance) were dissipated after a year or two, or absorbed into one of the others; but there is a long list of those which have made an impression on the thought and the action of the present generation. Conspicuous among them, for one reason or another, are the movements for the prevention of tuberculosis, cardiac disease, blindness, venereal disease, infant mortality, for the control of cancer, to abolish extortionate charges for loans secured by salaries and pawnable property, to promote wholesome recreation, to diminish child labor, to improve the health of children, to further industrial education, to advance the interests of the Negro, to reform the criminal law and criminal pro- cedure, to prevent insanity and promote mental health, to improve housing conditions, to improve and standardize labor legislation. Each of these movements is represented by a national organization — some of them by several, promoting different aspects of the general purpose — and in most cases a large number of local societies IN THE TWENTIETH CENTURY 21 or committees also exist, more or less closely af- filiated with the national body. The central feature of their work is educational propaganda, based on the study of relevant facts. Whether the purpose is to secure legislation or the enforcement of laws, to provide needed institutions, to stimulate action by public administrative bodies, or simply to spread information which individuals should have for their personal guidance, the fundamental necessity is to "educate the public." Millions of dollars have been spent to this end in the last two decades, and remarkable ingenuity has been used in devising ef- fective methods. Simple "literature," presenting clearly the essential facts (about the nature of tuber- culosis, for example, and the precautions which should be taken), printed in alluring style and trans- lated into many languages; photographs, lantern slides, posters, motion pictures, standardized ex- hibits arranged to tell the whole story to any one who walks through the room; monologues by clowns, plays, "canned" lectures to use on the phono- graph; "Christmas seals;" a press service supplying material to newspapers all over the country; "clean- up weeks" and "fire prevention weeks;" a "tubercu- losis day" or a "child labor day" in the churches and in the schools, with ready-made lectures to be used on the occasion; lectures and motion pictures at county fairs; travelling exhibits, in vans and motor cars, touring the countryside, — are some of the methods which have been utilized. 22 AMERICAN SOCIAL WORK RESEARCH AND SURVEYS Another Inevitable result of the lively interest in ''prevention" and in "underlying causes" was to stimulate research into social conditions. The new organizations which have just been mentioned were obliged to begin operations by "collecting data/* before they could "push a program" or "educate the public." Charity organization societies, settlements, and others among the older philanthropic agencies, began to delve into their records, or into their hitherto unrecorded experiences, for knowledge about social conditions and the nature of poverty. University professors turned their students into the fascinating field of "first-hand investigations." Sev- eral heavily endowed "Foundations" were estab- lished — notably the Russell Sage, the Rockefeller, and the Carnegie, and a little later, the Common- wealth Fund — with research as one, if not the pri- mary object. For about a decade, beginning about 1902-04, literally innumerable studies were made in the causes of poverty and crime, the "social aspects" of tuberculosis and other preventable diseases, the relation of mental defect and unsanitary housing and child labor and congestion of population to de- pendence and delinquency, the standard of living of workingmen's families (how, as a matter of fact, they lived at different income levels, and how much income was necessary to secure what was agreed to be a normal standard), the conditions under which IN THE TWENTIETH CENTURY 23 men and women and children worked, and similar questions. Fragmentary studies in one factor after another inspired a desire for something more comprehensive, and in 1907 the "Pittsburgh Survey" was under- taken by the committee in charge of the publication then known as Charities and the Commons (now the Survey)^ with financial support from the Russell Sage Foundation, and with co-operation from many of the social and sanitary movements of the country and from citizens and organizations of Pittsburgh. It was an attempt to get, and then to present, a bird's-eye view of the conditions affecting the wage- earning population of an industrial center. These studies, published later in six volumes, had imme- diate practical results in Pittsburgh itself. They have had a wider influence — because of the dramatic prominence assumed in them by industrial accidents, the twelve-hour day and the seven-day week — in im- pressing on America the evils of over-work and of the out-worn theory of employers' liability. They also established the "social survey" as a method of research. There have been only one or two equally ambitious — notably one of Springfield, Illinois, con- ducted by the Russell Sage Foundation's Depart- ment of Surveys and Exhibits — but surveys of the educational system, of the social agencies, of the facilities for recreation, of provision for the care of the sick, of agencies for child welfare, etc., etc., have been made under various auspices in many cities and 24 AMERICAN SOCIAL WORK States; and although this method has at times been absurdly applied, it has done a great deal to estab- lish the sound principle that plans for improvement should be based solidly on an understanding of the actual conditions and factors in the situation, REACTION ON RELIEF AND CORRECTION The impulse to the educational movements and to research, as has been indicated, originated in the older forms of social work, and many beginnings are to be traced more particularly to the New York Charity Organization Society. Within a few years ( 1 897-1905) this society enlarged its activities by establishing a Tenement House Committee, a Com- mittee on the Prevention of Tuberculosis (which in its first year or two formulated the program and initiated the methods which have been followed by local associations generally in this and other educa- tional movements, and promoted by the National Tuberculosis Association after its creation in 1904), a Committee on Criminal Courts, a school for the training of social workers, and a weekly journal for the interchange of information and discussion in the field of philanthropy ( The Survey, originally Chari- ties, with which were later united The Chicago Com- mons, Jewish Charity, The Charities Review, and Lend-a-Hand). Other societies created similar committees, or undertook some other kind of educa- tional work as an adjunct to their original function. The charity organization movement, in short, IN THE TWENTIETH CENTURY 25 "Americanized" itself, ceased to look at poverty through the spectacles of a particular class move- ment in England, and began to deal with it in a more courageous spirit, by methods more harmonious with American resources and American traditions. All these new activities, in turn, had a reflex in- fluence on the older forms of social work. As the idea of prevention took hold, and as the significance of child labor, unsanitary living conditions, over- work, ill health, and other social problems, came to be realized, those who were engaged in the relief of the poor, whether in public or in private agencies, found their task growing more and more complex. There were many more considerations to take into account; there was much more to do for each family; and it required a great deal more money to do the minimum that they could be satis- fied to do. In particular they found themselves logically obliged by their new knowledge to examine into the health of each member of the family, to see that physical defects in children were corrected, that the family diet was suitable and suflicient, that the home was decently sanitary, that incipient phy- sical and mental troubles were properly treated; to make it possible for children to stay in school at least as long as the law required, and preferably beyond that age, for mothers and fathers who were ill to have adequate medical treatment and con- valescent care; and to supplement the income, if necessary, sufliciently to secure these essential con- 26 AMERICAN SOCIAL WORK ditions, though of course without permitting any development of "the pauper spirit." Other forms of social work were impelled to broaden their scope in different ways. Hospitals and dispensaries came to see the connection of their institutions with the homes of their patients, and "hospital social service" was devised. Provision for the insane, for the tuberculous, for delinquent children and adults, was extended in both direc- tions — to watch over them after discharge, and to reach them at an earlier stage of their difficulties. Prevention of infant mortality led back to pre- natal care and instruction of mothers. In general, interest was stimulated in the begin- ning of poverty, disease, and crime, in the less spectacular of their manifestations, and in the less obtrusive social problems: conditions which might later lead to a '^housing problem" where none is as yet discernible; the so-called "minor offenses," as being of greater social significance than felonies; the incipient stages of physical and mental disease; and above all, the early stages of the individual life as the most remunerative object of social effort. The individual acquired a new importance : as a human being with a continuous life and with a place in the evolution of the race; not merely an object of charity or discipline for the moment, but with a past holding the explanation of the present, and with a future to be influenced by the present; and not an isolated individual, but a unit in a family, IN THE TWENTIETH CENTURY 27 a community, a nation, contributing to their char- acter, as well as the focus of all the social forces they represent. The possibilities of the individual when released from the oppression of adverse con- ditions were realized with fresh vividness. "Re- habilitation" became the conscious goal in philan- thropy and correction. A desire positively to in- crease comfort and welfare and joy grafted itself on the enthusiasm for preventing unnecessary mis- ery, and by the end of the first decade of the century it could be said, as Jane Addams did say in her presidential address at the National Conference in 19 10, that ''the negative policy of relieving des- titution, or even the more generous one of pre- venting it, is giving way to the positive idea of raising life to its highest level." STUDY OF METHODS Under the influence of these various ideas, social workers began to study their own work more closely. They became suspicious of boasts that 95 per cent, say, of the patients were "cured," or that 85 per cent of the inmates of a reformatory were "re- formed," or that 90 per cent of the children placed out "did well;" and they began to take more in- terest in the other five or fifteen or ten per cent. They tried to find out more exactly and more con- cretely the results of their work as they stood after a lapse of five or ten years; and when they did this 28 AMERICAN SOCIAL WORK they were forced to recognize the necessity for "follow-up work," as It has come to be called, de- scriptively if inelegantly. They began to analyze their own methods, and to try to appraise them from their effects on the lives of the individuals concerned. They turned their attention to the clerical and mechanical aspects of their work, and ^'efficiency" became as popular among them as with business men. They isolated special classes of cases for consideration of their special needs — wid- ows with small children, deserted wives, adoles- cents, unmarried mothers, Italians, Russians, Poles, families in which there is a case of tuberculosis, and so on. They discussed what information case records of various kinds should contain, and how it should be entered; how records should be filed; what circumstances should be taken into account in selecting homes for children; how to go about mak- ing a "diagnosis" of a famlly^s situation, or an in- vestigation of any social problem; how to prepare an exhibit; what to put in an annual report, and how to print it and illustrate it; how to raise money; how to make a "survey;" and before long they were talking consciously about the "technique" of social work, arguing for it as a new "profession," and demanding certain qualifications in those who would enter it. TRAINING SCHOOLS Training schools for social workers were both an IN THE TWENTIETH CENTURY 29 expression of this interest in methods and in turn a stimulus to it. The Summer School of Philanthropy, begun in 1898 by the Charity Organization Society of New York, was expanded in 1903-04 into a course running through the academic year, to which a little later a second year was added, providing a two-year course of special training for graduate students and persons who had had the equivalent of a college course, with instruction which included both study of principles and practice in doing social work under supervision, and which was recognized by Columbia University as of graduate standard. Within a few years similar schools, affiliated more or less closely with educational institutions, but, like the New York school, owing their existence to social workers, were established in Boston, Chicago, St. Louis, Philadelphia, and Richmond, while in- struction on the same general plan was introduced in a considerable number of colleges and univer- sities. By 1920 such training was offered by most of; the leading educational institutions of the country, either as graduate or under-graduate work in the departments of the social sciences. The tendency is towards making such training a recognized ele- ment in the graduate departments of universities. No new independent schools have been established for a decade or more, and one of the most im- portant of them (the Chicago School of Civics and Philanthropy) was discontinued in 1920 on the 30 AMERICAN SOCIAL WORK creation of a Graduate School of Social Service Administration in the University of Chicago. Whether or not social work has become a **pro- fession" is a question of mere academic interest, and open to dispute ; but it has at any rate become a recognized occupation, engaging large numbers of men and women, requiring relatively high equipment in the way of education and personal qualifications, and offering salaries which compare favorably with those available in the teaching profession, in the ministry, or indeed in any occupation to which per- sons with the interests and the preparation of social workers would naturally be attracted and for which they would be qualified. FORMULATION OF STANDARDS From their study of methods social workers were led to formulate standards, and this has been done with special success in matters of legislation. The Uniform Child Labor Law, prepared by the Commissioners on Uniform State Laws of the American Bar Association and adopted by the National Child Labor Committee, and the essential features of a Workmen's Compensation Law as advocated by the American Association for Labor Legislation, are conspicuous examples, to the in- fluence of which the statute books of most of the states by this time bear witness. Societies engaged in similar work have formed national organizations which, through their field agents, their correspon- IN THE TWENTIETH CENTURY 31 dence with local branches, their district and national conferences, have promoted uniformity of methods in their several fields. Standard specifications for the construction of sanatoria, standardized exhibits, and various other examples of this tendency, might be mentioned; but aside from those which are purely legislative, the standards which have had the great- est influence are those formulated by the White House Conference on the Care of Dependent Children, held by invitation of President Roosevelt January 25-26, 1909, and by the Conference on Child Welfare Standards, held under the auspices of the federal Children's Bureau ten years later. The unanimous recommendations of the White House Conference, which consisted of 216 men and women, representing "every state In the Union, every form of child-helping work, and every phase of religious belief," were adopted as a quasi creed or constitution by the child welfare workers of the country. The Children's Bureau Conference, held in 19 19, at the close of the "Children's Year," had a far wider scope. It considered the essentials to child welfare from every conceivable point of view; and drew up minimum standards for children enter* ing employment; for the protection of the health of children and mothers (before birth, in infancy, at "pre-school age" and school age, and through adolescence) ; for the protection of "children in need of special care," under which Is Included not only the care of all who formerly were known as 32 AMERICAN SOCIAL WORK dependent, defective, and delinquent, but also ex- tended provision for the welfare of all children in the way of recreation and attention to their "men- tal hygiene." COORDINATION AND "PROGRAMS'* Out of their study of social problems as such, and out of their scrutiny of their own work, social workers developed a new sense of the inter-relations of social agencies. As affecting case-work, this showed in an increased appreciation of the idea of "registration," which had been one of the cardinal principles of the charity organization movement. Under the new name of "confidential exchange" or "social service exchange," and sometimes under new and Independent auspices, it has been possible to establish in the leading cities a central record of the families known to the various social agencies, so that each society may learn which of the other agencies are or have been interested in any parti- cular family, and may consult with them, to the advantage of all concerned — especially the family. Furthermore, social workers began to think of particular agencies and particular methods as ele- ments In the community's equipment, to consider what place each one should occupy, what its ap- propriate function was, and what was needed to supplement it. In other words, they began to make "programs :" for a comprehensive campaign against tuberculosis; for a charity organization society in IN THE TWENTIETH CENTURY 33 a small town; for an adequate system of care for the insane; for state legislation on behalf of child- ren — "children's codes," as they are called, pre- senting a harmonized and comprehensive plan of desirable laws; and so on. The national associa- tions in the different educational movements not only outlined in a general way the elements in the "campaign" against the particular evil of their con- cern, but also suggested concrete programs for lo- cal organizations. "Councils of social agencies" have been organized in some cities to promote mutual understanding and the development of a community program, while the "financial federa- tions" which have been developed for joint raising of funds have, as an incident to their main purpose, perhaps been the strongest influence of all in this direction. Since the war it has become distressingly obvious that there is need for coordinating the ap- peals and the work of the national agencies also. FINANCIAL FEDERATIONS AND COMMUNITY TRUSTS The financial federations demand more than passing mention, for they bid fair to establish them- selves as an integral feature of social work in Amer- ica, and to have an important influence on its future character and its future status in the social economy of the country. Before the end of the nineteenth century "bureaus of advice and information" had been created by the charity organization societies 34 AMERICAN SOCIAL WORK in several of the large cities, as a service especially, although not as a rule exclusively, to their own mem- bers, supplying them on request with information about any organization or individual from whom they received an appeal for a contribution. In other cities, beginning with Cleveland about 1900, the chamber of commerce had established a "charity endorsement committee," which made up a list of aproved agencies for the convenience of its mem- bers, who, with their families, constituted a large part of "the giving public." As social agencies multiplied, and as they devel- oped their appealing powers, the competition they plied for attention became so intense that neither of these earlier devices was sufficient assistance to contributors. And so, a few years before the war, there arose here and there a protest against the harassing competitive methods of the local charities, which led to the idea of "financial federation:" viz, that all the agencies In a community which depended on voluntary contributions for their support should form an association, agree on a joint budget for the next year, throw into a common pool their contri- butors' lists and other information about sources of income, present their united needs to the public In a single campaign, and share in the results in pro- portion to their budgets. Jewish charities were the first to do this successfully, but by 19 17 there were general federations in several cities, some of them with several years of experience behind them. s« IN THE TWENTIETH CENTURY 35 When the war brought demands from a host of new and old organizations, in sums that had never before even been imagined, a hot-house develop- ment of the fundamental idea in federations was forced. "War chests" were set up in some 300 cities by the summer of 19 18, to raise the money asked for by the American Red Cross, the Y.M.C. A., the Y.W.C.A., the War Camp Community Ser- vice, and other "war work" agencies, and in some places the local charities also were included in the Chest. The general satisfaction felt with the ex- periment led a number of the cities to convert their War Chests into "Peace Chests" or "Community Funds," and there are now (1921) at least thirty important cities in the country in which the social agencies have adopted this method of raising their funds in association. It has been demonstrated conclusively that a great deal more money is secured than by separate competitive appeals; that a much larger proportion of the population contribute (20-30 per cent instead of an estimated 2-10 per cent) ; that less expense is involved and less annovance to contributors. There has been, and is still, though it is diminishing, considerable opposition to financial federations on the part of some social workers: part of it due to mere short-sighted jealousy for the prestige of a particular organization; part of it to a serious ap- prehension that some subtle control of the policies 36 AMERICAN SOCIAL WORK of the social agencies would be exercised by the financiers and business men who initiated and pro- moted the plan for their joint financing. These apprehensions, as a matter of fact, have not been realized in the cities where federations have had a fair trial. Indeed, the strongest argument in favor of them lies In the patent fact that they not only, through joint budget-making, joint study of com- munity needs, joint planning for community welfare, tend to dissipate the narrow institutionalism of indi- vidual agencies, but that they also increase the fund of intelligent interest in the social work of the com- munity, and provide a channel through which the public may register its judgments of the social agencies more effectively than heretofore and thus share more effectively in their development.* Community trusts, such as the Cleveland Foun- dation and the Boston Permanent Charity — to safe- guard bequests and gifts, and to ensure that not a "dead hand" but a living intelligence shall deter- mine how they shall be applied to the changing needs of the community — are another manifestation of a healthy concern on the part of donors for the way in which their gifts shall be used. Within a few years such trusts have been established in over thirty cities. *Four articles on Welfare Federations, by Edward T. Devine, were published in the Survey, May 14, May 28, June 18, and July 16, 1921. A full discussion of giving, from the contributor's point of view, may be found in Hoiv Much Shall I Give? by Lilian Brandt, published by The Frontier Press, New York. IN THE TWENTIETH CENTURY Zl A Uniform Trust for Public Uses, suitable for adoption by any trust company, has been devised by Daniel S. Remsen, of New York, as a standardized formula for the creation of any charitable trust. Large sums have been assigned to the care of the existing community trusts in wills already drawn, and the movement may have a profound influence on the social work of the near future, and is there- fore deserving of the most careful study. INCREASED RELIANCE ON GOVERNMENT Throughout this period — even before the war — there has been a noticeable tendency away from the old American individualism and distrust of govern- ment. Supervision over private social work has been extended, and there has been a tendency to- wards some degree of public control. Recourse has been had to legislation to establish minimum standards of housing, of working conditions, even of wages, to protect women and children in industry, and to accomplish other objects for the promotion of the social welfare; and such legislation has been increasingly sustained by the courts. The great cost of adequate provision for the sick and adequate education of the well to prevent the spread of disease, together with the growing recognition that to be adequate such measures must reach all citizens, have made it inevitable that they should be undertaken largely by public authorities. Boards of Health have extended their control over 38 AMERICAN SOCIAL WORK infectious diseases, as public opinion, formed by the new understanding of the social significance of such diseases, has given them support. They have es- tablished sanatoria and all sorts of clinics, published and distributed tons of information, and maintained corps of nurses and physicians to visit the poor in their homes and give them verbal instruction. Pub- lic schools have added physicians and nurses and psychiatrists and dentists and "visiting teachers" to their staff, have offered evening classes and vacation schools and public lectures and opened their build- ings for "community centers," as well as lent a hospitable ear to the clamor for admitting into the curriculum this new subject or that, each urged as vitally important to the future citizenry of the coun- try. Three-fourths of the states have established bureaus of "child welfare" or "child hygiene" in one of their departments. There has even been a spectacular extension of public out-door relief, which had fallen into dis- repute during the nineteenth century, and was dwindling rather than increasing. Partly as a result of the new conviction that children were better off with their mothers than in institutions or even in foster homes, partly from a sudden appreciation of the service performed to the state in the bearing of children and a determination that the state should recognize this service, most of the states of the Union within a very few years (beginning with Mis- souri in 191 1 ) made special provision for payments IN THE TWENTIETH CENTURY 39 from the public treasury, under the pseudonym of ^'widows' pensions" or "mothers' allowances," ^'mothers' aid," "funds to parents," or even "mothers' compensation," to women who were good mothers and who without this assistance might be obliged to place their children in Institutions. Reliance on the state has gone so far as to de- mand assistance in promoting social welfare from the federal government, within the elastic limits allowed by the Constitution. Its taxing power has been invoked to discourage the employment of child- ren In factories, mines, and quarries, In order to extend some measure of protection to the children in the more backward states. Financial aid for vo- cational education, and (by a measure passed since the war) for the re-education of Industrial cripples, has been granted by the federal government to the states In proportion to their population and their own appropriations for the purpose; and for several years similar assistance on the same principles has been urged to stimulate provision for maternity care, particularly In the rural districts. The Department of Agriculture has done "social work" on a sub- stantial scale In rural districts. "Labor" has been taken out of the Department of Commerce and Labor and erected Into a separate department, with corresponding Increase In Importance. A Children's Bureau, placed almost by chance in the Depart- ment of Labor, was created in 191 2, at the instance of the social workers of the country, who are also 40 AMERICAN SOCIAL WORK generally in sympathy with the current demands of the physicians for a Department of Health and of the teachers for a Department of Education, each with a secretary occupying a seat in the President's Cabinet. CHANGES IN VOCABULARY In the vocabulary of social work, euphemisms have been substituted very generally for older ex- pressions which had come, either justly or through some unfortunate misunderstanding, to have un- pleasant associations. "Mothers' allowances" is one example. Against the word "charity" in particular there has been a veritable revolt: by some because they think that the idea itself is unworthy of a gen- eration which has envisaged "social justice;" by others because of the "stigma" attaching to the word, which prevented the poor from availing them- selves of the help of the organizations existing for their benefit, or introduced an element of hardship with the help if they were not so prevented. The combination "charity organization" was considered especially obnoxious. Early misinterpretations and criticisms of the charity organization societies had been louder than all explanations and refutations, and. had firmly established in the popular mind the idea that "organized charity" was synonomous with "red tape," investigation merely for the sake of making a record, absence of human sympathy, un- willingness to give any help but "advice," and that IN THE TWENTIETH CENTURY 41 of a distasteful nature, and so on. It was argued, moreover, that chanty organization societies had so expanded their activities and so modified some of their original functions that their name was no longer descriptive. A number of them, accordingly, and of the Associated Charities, shook off their discredited titles and chose to call themselves "Social Service Bureaus," "Social Welfare Leagues," "Family Wel- fare Associations," or something of the sort, while new societies took such names at the time of their organization. Many of these societies refer to their erstwhile "cases" as "clients." City Departments of Charities became "Departments of Public Wel- fare." The national association which was formed in 19 1 1 to foster the charity organization movement now calls itself the American Association for Or- ganizing Family Social Work, and it publishes a directory of what it calls "family social work soci- eties" — a verbal combination which may avoid of- fending the susceptibilities of the initiated, but which has a curious sound. In the latest edition of this directory (March 192 1) a little over a third of the 300-odd societies appear under the new style names, which incorporate "welfare," "service," "commun- ity," "pubHc," "social," "family," in a great variety of combinations; while less than two-thirds still use a name Including "charity," "relief," "aid," or some other indication that they exist for the purpose of giving assistance to those who need help. "Asso- ciated Charities" Is still, however, far in the lead, 42 AMERICAN SOCIAL WORK with over a hundred adherents, some of which, moreover, have been organized within the last three or four years, and this suggests that there may yet be a reaction against this tendency in nomenclature. For somewhat different reasons "reformatories** for boys and girls have become in some cases "in- dustrial schools;" "Magdalen Homes" and homes for "fallen" women have dropped the suggestive qualifying word; "idiot" has almost disappeared from use; insane "asylums" have become "hospi- tals;" the "almshouse" or "poorhouse" has become the "count}^ infirmary" or the "city home for the aged." The movement for "social hygiene" has operated from the beginning (about 1905) under this discreetly inoffensive name. CONFUSION AND DUPLICATION What with the broadening scope of individual agencies — adding to their original functions one new one after another to which they find themselves attracted — and the tendency to use names of a pleasant sound and vast implications, which rather express the aspirations of the organization than describe concretely what it undertakes to do, out- lines have become extraordinarily blurred, not merely in appearance but in reality. It would puzzle even the average well-informed contemporary American to say whether a given "public welfare bureau" or "social welfare board" is part of the city administration or a private society; to know that IN THE TWENTIETH CENTURY 43 a ^'community service organization" is affiliated with the American Association for Organizing Family Social Work, not with Community Service (Incor- porated). The National Tuberculosis Association is "headquarters for the Modern Health Crusade." There exist contemporaneously an "American Child Hygiene Association," a "Child Health Organiza- tion," and a "National Child Welfare Association," while the National Child Labor Committee, despite a name which seems to indicate a tangible and limited task, advertises its scope as including also "education; delinquency; health; recreation; child- ren's codes." A list has been compiled of sixty national organizations which deal with one aspect or another of child welfare, and the number concerned with health and with "Americanization" must be nearly as formidable. This confusion and duplication among national organizations is reproduced in the localities to which their influence extends. There is, in short, among the educational social agencies, a situation very similar to that which existed among the relief societies in the 70's and 8o's, and which led to the movement for the organi- zation of charity. The National Information Bureau is now attempting to apply to national organizations the principles of the endorsement bureaus of the local chambers of commerce, and has undertaken an inquiry into the functioning of the national agen- cies in selected cities which should be very useful. Several gestures toward coordination have been 44 AMERICAN SOCIAL WORK made by the national agencies themselves: a ^'National Public Health Council," for example, has been formed, and similar movements are on foot in other fields. Whether these efforts will result in a genuine coordination (which would involve a limita- tion of function on the part of many organizations) or will merely add to the confusion by creating new national bodies charged with "coordinating" the others, remains to be seen. THE WAR AND SOCIAL WORK The first effect of the war on social work in Amer- ica, while the United States was still neutral, was to strengthen and improve it. Sympathy for the sufferings in Europe quickened sensitiveness to social problems at home. The whole world became a laboratory of social work. A little later the ap- peals of the Commission for the Relief of Belgium, of the Y.M.C.A., for its work among the prisoners of war, of the Red Cross for its hospitals in France and its Typhus Commission in Poland, tended to drown those of the familiar every-day agencies at home, and many of them had greater difficulties than in many a day to carry on their accustomed ac- tivities. This was not an unmixed evil, for it com- pelled scrutiny of plans within each organization, to determine what could be spared with least dis- advantage, or how more work could be done with a diminished staff and less money. It would be too much to say that the decisions were always wise, IN THE TWENTIETH CENTURY 45 or even that they were always based on judicious deliberation, but the general effect, as it is when an individual's income is reduced, was to force a more or less conscious review of expenditures and to con- centrate attention on the essentials. When the United States entered the war, in April, 19 17, social work leaped into unprecedented prom- inence. Many of the wonted social problems were intensified and some new ones created, especially by the operation of the draft and the establishment of training camps; while a new demand for persons with experience in human problems sprang up in government departments and war industries. A fer- vor developed for "service," especially for service to our soldiers and sailors at home and abroad and to the civilian sufferers in the countries of our al- lies. The Red Cross organized its Home Service Sections to minister to the families of men in ser- vice, its Bureau of Refugees and Relief in France and other activities on behalf of the civilian popu- lations in European countries. With official encour- agement, especially from Secretary Baker, the seven "morale-making agencies," as they were called — the Y.M.C.A., Y.W.C.A.. Knights of Columbus, Jewish Welfare Board, Salvation Army, American Library Association, War Camp Community Ser- vice — adapting themselves to the situation or created for the purpose, and "coordinated" to some extent by the two "Fosdick Commissions" in the Army and in the Navy, undertook to occupy the leisure of the 46 AMERICAN SOCIAL WORK soldiers and sailors, in training at home or on duty abroad, and to turn it from a liability into an asset. They provided physical, social, and spiritual com- forts, mental diversion, games and entertainment, and "surrounded the camps with hospitality," acting on the principle which social workers had been urg- ing for twenty years or more — that wholesome recreation is a preventive of vice, a promoter of efficiency, and a sound social investment. The federal government, through the system it adopted of allotments and allowances to the families of men in service, compensation for death and dis- ability, re-education of the disabled, and "war risk insurance;" through the Housing Corporation, the Federal Employment Service, the Division of Vene- real Disease in the Public Health Service, the thrift campaign of the Treasury Department, the educa- tional work of the Food Administration, and other undertakings, plunged into social work on a gigantic scale, accessory to the war. Much of it, unfortunately, though wisely conceived, was so badly executed that it is a national disgrace, but customary indifference to logic in such matters has permitted it to establish a conception of "Uncle Sam as social worker" and to strengthen the demand that the federal government should make more substantial direct contributions to social welfare. The established forms of social work fared badly under the competition of these new activities. Financial support was difficult to secure, and — what IN THE TWENTIETH CENTURY 47 was more serious — many agencies saw their per- sonnel sadly depleted by the superior appeal of "war work." Young people without experience were fre- quently the only ones available for positions of re- sponsibility, and the poor and the sick had to take the consequences. On the other hand, many cap- able men and women who would not otherwise have been attracted to social work, have entered it as a permanent occupation by way of this avenue of ap- proach; and many thousands more, who have re- turned to their former occupations or their former leisure, have had experiences which cannot fail to be of advantage to social work because of the interest they will keep and the knowledge they have acquired. Aside from this increase in the popularity of so- cial work and in the general understanding of social problems, the conspicuous effect of the war on social work in America has been to hasten the process of nationalization which had been going on for half a century. This has shown itself not only in the dis- position to expect more active participation by the federal government, but in a new consciousness of the national character of the fundamental problems of education, health, and an adequate income; in a new prominence accorded to certain elements of the national life which have hitherto been comparatively neglected, such as the rural population, the Negro, the foreign-born; in a new realization that the nation is no stronger than its weakest spot, and that our boasted democracy is only factitious as long as cer- 48 AMERICAN SOCIAL WORK tain great sections of the population are allowed to labor under serious removable handicaps. Topics in which interest has been intensified are education, recreation, physical efficiency, venereal disease, men- tal defect, "community organization," re-training of cripples and other handicapped adults. In general, the effect of the war has been to con- firm the principles of social work and to commend them to a larger public. In the treatment of crim- inals, however, it has been the reverse. For the moment, at least, it seems that much of the progress painfully made in the course of the nineteenth cen- tury has been brushed away. The military and poli- tical attitude toward the conquered enemy is seen in a reversion to the principles of vengeance and re- tribution in dealing with civilian law breakers. There has been an actual increase in certain forms of crime, especially violence and banditry, and in- dignation over the "crime wave" has temporarily overcome that concern for the individual offender which had been slowly growing under the teachings of penologists. A reaction has taken place in favor of the death penalty and of severe and even brutal sentences. The substitution in 192 1 of lethal gas for hanging or shooting as the method of executing the death penalty in the state of Nevada was no doubt actuated by the belief that it is more humane, but one of the arguments presented on behalf of this greater humanity was that it would abate the sentiment against the death penalty. IV PRACTICAL ADVANCE: 1900-1920 In these twenty years of the twentieth century, as always in human history, Ideas have far outstripped practice, and in social work the gap between gen- erally accepted theories and actual provision is as wide as it was In 1900. Both ideals and practice have made great strides in advance, and they are still far apart. By way of summary — what differ- ence have the twenty years made to the individuals whose welfare is at stake ? GENERAL RELIEF The fundamental task of helping those who are in some sort of economic difficlulty is done more thor- oughly. A larger proportion of those who need assistance receive It; a larger proportion receive a kind and amount adapted to their needs; individual and family situations which are likely to produce de- pendence later are more frequently recognized and more frequently corrected. Just how much pro- gress these comparatives measure, however, it would be difficult to estimate. There are now over three hundred "family social work societies," as com- pared with one hundred at the beginning of the century. The Home Service Sections of the Red Cross, which have been continued in some small 50 AMERICAN SOCIAL WORK towns and rural communities since the close of the war, supply for those places something correspond- ing to the general relief society or "family society" in the cities. Public relief has been extended by the all but universal provision of "mothers' allowances," though they are generally inadequate in amount and inadequately or incompletely supervised. An organized system for assuring prompt relief in any community visited by a disaster — fire, flood, earth- quake, forest fire, cyclone, explosion, tidal wave — has existed since 1906 under the auspices of the Red Cross. In theory "rehabilitation" is accepted as the ob- ject of the social agencies which have to do with children or with family groups or individuals capable ultimately of self-support, including the public de- partments which administer out-door relief; and each year brings a clearer understanding of what this theory involves. Available resources for, re<:- reation and education, for physical and mental examination and treatment, are utilized more fully. Money is spent much more freely, especially to en- sure adequate food, sanitary homes, the recovery or preservation of health, to keep families together, and to keep children in school. In public institu- tions diet has improved, even under the shrinkage in the purchasing power of appropriations, and in gen- eral the physical conditions are better. Here and there the almshouse has been transformed in accord- ance with the theories of the nineteenth century, IN THE TWENTIETH CENTURY 51 and through the continued growth of specialized In- stitutions its population Is gradually decreasing and by this process of attrition it is losing Its place of preeminence among the social agencies of the coun- try. It is still, however, much the same institution that it was twenty years ago, and it still affects far too many individuals to justify the indifference which is still its portion. In other respects, too, there has been little advance in provision for those who reach old age without resources and without relatives who can take care of them : accommodations In private homes for the aged have not increased substantially; the plan of placing them In families has nowhere had much attention; and thus far there has not been much sentiment in any state in favor of old age pensions, nor much evidence brought forward that they are needed. CHILD WELFARE * Children (the other class of "natural depend- ents"), in their character as the most responsive subjects for both "preventive" and "constructive" efforts, have acquired a new and scientific interest, which, combined with their undiminished appeal to the affections and sympathies, has made this indeed "the century of the child." The case of the child who must be supported wholly or In part by others than his parents or near relatives has improved more than that of the aged. There are more chances than there were twenty years ago that arrangements will 52 AMERICAN SOCIAL WORK be made for him to stay with his own mother or that he will be placed in some other family where he will at least have the experiences and training of family life; if the latter, that the home will be chosen with reference to his particular requirements of mind, body, and temperament, and that in case of a mistake it will be discovered before his future is seriously jeopardized. If he goes to an institu- tion, it is more likely to be one in which he is re- garded as an individual, and in which the life is organized for the benefit of the children rather than primarily for ease and economy of administration. The capital invested in old-style congregate institu- tions and the initial cost of replacing them by a plant on the cottage plan retards the tendency in this direction. Few institutions of the old type have been constructed in recent years, and some old insti- tutions have moved out from the city into a colony of small buildings of home-like architecture, permit- ting better classification of the children and a more nearly normal life; but the process of displacement is slow, the nineteenth century city institution still predominates, and the character of the life which can be organized in an institution is largely deter- mined by its architecture. While in the best institu- tions and the best placing-out agencies physical and mental examinations are given to the children and more careful attention is paid to the correction of defects than in the average family, such skilled pro- fessional care is still the exception, not the rule. IN THE TWENTIETH CENTURY 53 CARE OF THE SICK AND PROMOTION OF HEALTH It Is in provision for the cure and prevention of di sease and fo r the promotion of health "Ctetrtfe^ twenty years have seen the most marked adv^ahce. Ill health as a cause of Individual inefficiency and poverty and even crime ; good health as the founda- tion of Individual welfare and happiness; prevent- able disease as one of the greatest and least excus- able social evils; physical efficiency as a national ideal, — these Ideas, with their limitless possibilities of application, elaboration, and sub-division, have created a large proportion of our current social work, and materially modified most of the rest. General hospital accommodations and dispensary service have increased at a rapid rate, considering the investment required. Although there Is not yet suitable provision for more than twenty per cent of the tuberculous who are in need of Institutional care, still nearly all of the 60,000 beds In the 689 sanatoria and special hospitals, day camps and pre- ventorla (January i, 192 1) have been provided since 1900. This Is true also of most of the con- valescent homes, the many specialized clinics — pre- natal, "baby," dental, venereal disease, psychiatric, etc. — the medical examination of school children, the nursing service of schools and health depart- m.ents. The level of knowledge about tuberculosis and other preventable diseases and about personal hygiene has rlseii perceptibly. A new type of agency 54 AMERICAN SOCIAL WORK is now coming into prominence — "health centers" and "well baby clinics," for example — which is di- rected towards the preservation and improvement of the health of those who are well. Provision for the treatment of mental disease has also continued to increase, until in 1920 there were 232,680 patients in institutions; and the tend- ency already well established in the nineteenth cen- tury towards public care, and that by the state rather than by local units, has progressed until in all but eight of the states all insane who are public charges are found in state hospitals (i.e., none in almshouses or other county or city institutions). In twelve states now there are psychiatric hospitals, psychia- tric wards in general hospitals, detention hospitals, or other provision for the temporary care of mental cases. The corollary, however, is that in 36 states there is no such provision for temporary care and observation, and in these twelve only a fraction of the population is thus served. The hospitals in most states are sadly over-crowded. Notwithstanding this pressure, the Scotch plan of boarding out selected cases of certain types, which has long been followed with success and satisfaction in Massachu- setts, has not been adopted elsewhere. National prohibition, however, has substantially reduced the number of admissions to the alcoholic wards, and it may be that this influence will enable the states with- in the next few years to match accommodations to applications. A few institutions undertake to keep IN THE TWENTIETH CENTURY 55 watch over patients discharged as cured or Im- proved, and a few private organizations supplement the work of the public Institutions In this way and also try to avert the development of Insanity In In- cipient or suspected cases which are brought to their attention. In New York a state system of clinics has been organized under the joint auspices of the state hospitals, the state Department of Health, and the Committee on Mental Hygiene. In gen- eral, however, the prevention of mental disease and the promotion of mental health are still novelties. For mental defectives provision has Increased rapidly as compared with what there was at the beginning of the century, but very slowly as com- pared with the need. There were about 40,000 feeble-minded In Institutions In 1920, which was twice as many as In 19 10, but not more than six per cent of the estimated total number In the country. There are still fourteen states which have no sep- arate Institution for such patients. While there has been considerable discussion of plans for registering mental defectives and assuring some sort of com- petent guardianship to those who do not require Institutional care, such plans have not been put into operation. In the conduct of the Institutions the tendency Is towards making them less custodial In their atmosphere, more medical and educational, less like a poorhouse, more like a combination of hospital and school, but — as It has been quaintly ob- served — many states are "as yet unaware of the 56 AMERICAN SOCIAL WORK change." Special classes for backward children are now maintained in over a hundred cities, but the aggregate enrollment of over 20,000 represents only a small portion of the children who would benefit by such observation and attention, even in these citites. TREATMENT OF CRIME In connection with crime the greatest advance has been made in the case of juvenile delinquents in cities, who are now treated rather like neglected children than like criminals. Nearly three-fourths of them now come before courts intended especially for children's cases, the best of which have facilities for thorough physical and mental examinations and social investigation, and judges who have become expert in this work. All the states except Wyoming had by 19 19 made some provision for the use of probation for juvenile offenders, and about half the juvenile courts have a probation service in opera- tion. Country and village children are as yet hardly touched by these new methods. The proportion of juvenile delinquents sent to institutions is smaller than it was twenty years ago, and some of these institutions have become excellent schools. They have made more progress than those for dependent children in transforming their plants and their methods to correspond with current theories of what they should be, but there are still far too many chil- dren living in vile conditions in Houses of Refuge which are virtually prisons. IN THE TWENTIETH CENTURY 57 The Interests of adult criminals have advanced still less. It is more generally admitted that every correctional institution should be a "reformatory," and more of them are than formerly, but this idea is not yet common among wardens and prison of- ficials. There is increased attention to physical con- ditions and needs, better ventilation, im.proved sanitation, more physical exercise, and in the re- formatories some use is made of psychological tests and some attention paid to the correction of physi- cal defects. The value of elementary instruction and of productive occupation is more generally real- ized in the state prisons, and the reformatories pro- vide also vocational training. The old perplexity of how to prevent prison labor from competing with free labor has ceased to be a practical prob- lem, with the general acquiescence of organized labor in the "state use" system. Contract labor, however, is still found In many state prisons, and there has been little or no progress in making the work of the man In prison contribute to the support of his family at home. Iron discipline Is still the* rule, and there has been little improvement in diet. The convict lease system in the south has almost dis- appeared. A few county jails have been remodelled and a few others have been replaced by farm colonies. The use of probation for adult offenders has increased, though less rapidly than for juvenile delinquents. 58 AMERICAN SOCIAL WORK Private enterprise in these twenty years has con- cerned itself chiefly with furthering the movement for juvenile courts and probation; promoting spe- cialized provision for women offenders, including policewomen and separate detention houses; devel- oping protective work, especially for girls; securing the establishment of night courts and special courts for cases involving family desertion and other domestic relations; and in a few places, in intermit- tent efforts to secure a rational treatment of beof- gars, drunkards, and other misdemeanants. Interest at present seems to center around protective work for young offenders; the need of separating the feeble-minded from those of normal mental powers in reformatories and of distinguishing between them throughout the correctional system; the possibilities of educational work with negligent and cruel parents as a substitute for prosecution; problems of court organization and procedure, including the proposal for merging juvenile courts and the so-called domes- tic relations courts into "family courts." The reac- tion to a medieval attitude towards crime and criminals which has been noticeable in public opinion since the close of the war does not seem to be shared by social workers. IMPROVEMENT OF CONDITIONS While it would be out of the question to review in this place the progress which has been made dur- ing the twentieth century in the general standard of IN THE TWENTIETH CENTURY 59 living and the conditions under which the mass of Americans live and work, still so large a part of the social work of these twenty years has been con- sciously directed towards this object that it would be equally impossible to close without a reference to it. The contribution of organized social work cannot be definitively disentangled from that of or- ganized labor or the press or the medical profession or university teachers or any of the other forces which have been influential in bringing about these improvements, but it is patent to any student of the period that it has been an important factor. The educational social movements, through their re- search, their programs, their publicity, and their propaganda, have to a large extent enlisted the in- terest of the other factors, determined which ques- tions should have precedence, how they should be presented to the public, what policies should be pushed, and in other ways have influenced the direc- tion which progress should take. The twentieth century has seen two of the great reform movements of the nineteenth — for woman suffrage and for national prohibition — culminate in amendments to the federal constitution, as did their quondam contemporary, the movement for the abo- lition of slavery, half a century earlier. The movements which have developed since 1900 have different objectives. The recreation movement has put play into the American standard of living and has revised the values attached to leisure time 60 AMERICAN SOCIAL WORK from childhood to old age. The movement for the prevention of tuberculosis, with Its off-spring and associates, have produced a noticeable revolution in the public understanding of health and disease, and in provision for the promotion of the one and the cure and prevention of the other. Other move- ments have been formulating standards and getting them crystallized In state laws and city ordinances. Standards of housing have been very generally established, prescribing a minimum of sanitation, ventilation, safety, and decency. Thus far housing reform has accomplished next to nothing In reducing over-crowding; and It has made little contribution of a positive nature in the situation created by the decrease in building operations, begun during the years of the war and continued since by the pro- hibitive cost of materials and labor — the result in part of conspiracies among producers and dealers which have recently been exposed by legislative in- vestigations. But the standards of construction, although gravely threatened by the shortage in ac- commodations and the consequent demand for hous- ing of any kind, if only It be shelter, have for the most part been maintained, and that through the activity of the organized Interest in good housing, which has been able to oppose successfully the or- ganized Interest on the other side. Remarkable progress has been made in the pres- ent century in labor legislation — notably the substi- tution in all but six states of a system of workmen's • • • « « • a « IN THE TWENTIETH CENTU!Rnr " *.•..»>... 61 compensation for death or Injury from industrial \ accident in place of the employers' liability pro- \ cedure which was generally In force as late as 1911 ; the protection of working women; the provision for fixing a minimum wage in certain low-paid occupa- tions with reference to the cost of living; and the protection of children by gradually pushing up the minimum age for leaving school and going to work until it has reached fourteen in most states and six- teen in several. This progress is largely the product of the movements for the improvement of industrial conditions, as represented in such organizations as the American Association for Labor Legislation, the National Child Labor Committee, the National Consumers League. And when the temptation came, under the pressure of production for purposes of war, to relax these hard-won standards, it was because of the educational work of these and kin- dred organizations during the preceding fifteen or twenty years, and because they were at hand to In- terpret the experiences of European states and to warn of the dangers, that America had the wisdom to resist the temptation. PRESENT NEEDS From this review it is obvious that social work is in its gawky adolescent stage. It has been growing fast, and some of its members and organs have not kept pace with others. In particular: (i) The humanitarian aspect of social work has been overshadowed by the twentieth century enthusiasm 62 AMERICAN SOCIAL WORK r^ior prevention; provision for the aged, the incur- able, the feeble-minded, and others who do not in their proper persons offer favorable material for rehabilitation, but who need kindly care, has not increased and improved as it should, or as might have been expected. (2) The multiplication of agencies, and the tre- mendous expansion of some of them, have resulted in a vast amount of expensive administrative ma- chinery for connecting headquarters with local units and one organization with another, without a corresponding gain in practical co-operation and in tangible benefits to the poor and needy. The urgent need of social work just at this time, if it is to reach a well-proportioned maturity, is that it should "survey" itself with the same scientific eye that It has been turning on adverse conditions; ap- praising Its accomplishments with reference to the total number of human beings concerned rather than by exceptional cases of brilliant success; measuring progress by the methods generally In use rather than by the degree of acquiescence In formulated prin- ciples or the extent to which Its own jargon has been adopted, and above all, with the whole complex sys- tem of social work In mind, not one specialized field, much less the Interests of one particular organiza- tion; and that It should then enlist the Interest of a wider public, seeking the assistance of all elements of the population In determining policies, until the promotion of the social welfare shall be no longer the affair merely of a small "professional" group, but of every citizen in the democracy. How Much Shall I Give ? By LILIAN BRANDT With an introductory note by Frank A. Fetter Examines current practice, motives, and ideals with respect to benevolent giving, reviews their historical backgrounds, and suggests an answer for American citizens of to-day 1 53 -f- XIV pages; three diagrams Price ?2.oo ■^1 s THE FRONTIER PRESS lOO WEST TWENTY-FIRST STREET, NEW YORK