Enthusiasm and goodwill may be indispensable to the success of health education. They are not enough. Systematic and intelligent planning is also needed. This means that we should: a) find out what the health workers consider as the main local health problems, b) explore community feelings on the subject, c) establish the objectives of the health education programme on the basis of these findings, d) determine evaluation procedures to be followed, and e) choose the best methods after careful pretesting.

Well, listening and discussing over yesterday and today, nobody said it would be easy. Any doubts we may have had about the range and complexity of primary prevention should by now be laid to rest. Not only do we have to face an elusive definition of mental health itself that is so ephemeral it often seems impossible of operational translation, but mental health is so affected by such a tremendous range of life experience and environment that the logical conclusion for practice would seem to be an intervention in all phases of life and in all activities to improve the human condition. Of course, this is not peculiar to mental health. It is true of health generally. At the same time, we have been shown rather specific preventive methods, physical and psychosocial-some of proven merit-some with distinct promise. We have, I believe, been amply persuaded, from the keynote address onwards, that we have little justification for waiting for definitive research before we act. The issue then is not really whether we should be doing something, but what we should be doing. Well, what we should be doing, is one question. To what extent we can do it, is quite another. With our seriously limited resources and the powerful, centripetal pull of overwhelming clinical case loads of those in more dire need, we must seriously ask what specific forms of primary preventive intervention we may select for our own settings that will do the most demonstrable good with the greatest economy of resources and time. So why not leave things as they are, disperse our conference and go back to the essential task of making the initial action decisions? As if things were not complicated enough, why do we have now to add the vague, almost miasmic area of social and cultural perspectives which may make us feel better-or more likely, worse-but which are unlikely to offer much of real practical value? Are we now to be regaled with bland, self-evident generalities, or perhaps just touch the rim of new, arcane insights that will serve only to confuse the whole issue? At first blush, the social and cultural perspectives of primary prevention may seem an unlikely area of relevance for everyday realities, practicalities, and decision-making-and may seem even more so, following the scientific elegance and relative precision of the preceding presentations of this morning.

There is probably no time in the history of a profession when it is inappropriate to examine its foundations and directions: no profession can afford to lapse into a protective ritualism that limits its vision of its place in the broader scheme of things and of its potential for growth. If conservative, unimaginative performance is a common feature of everyday professional operations, perhaps this is to some extent excusable because of the many pressures toward conformity and the need to keep accepted procedures going; this is however, an egregious fault in a university in which the future professional is being prepared for his role and where some degree of intellectual turmoil and the constant creative widening of frontiers is precisely what distinguishes a university school from a technical training school. Troupin,13 in a survey of schools of public health in 1960-1961, stated that “Practically every school mentioned that its curriculum is under study and evaluation. . . .” This is as it should be. This paper is a description of the kind of self-examination presently being (and, hopefully continuously in the future to be) conducted by one institution in attempting to design its program of professional preparation of the health education specialist. Such an attempt, taking place in a university, is subject to pressure from two opposing points of view. On the one hand, those who have worked in universities know that there is often an assumed dichotomy between academic and professional education with derogatory implications for the latter. This dichotomy is based upon the aristotelian claim that any education concerned with useful knowledge is illiberal; that the fact of being applied or useful marks studies of a lower intellectual level “merely because its students are acquiring a special form of expertness for which they expect to be paid.”ll