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Society, as a whole, has been somewhat insensitive to the plight
of the mentally ill and retarded, indifferent to the treatment they
receive and most reluctant to afford them the resources, financial
and manpower, for their needs. For instance, in hospital schools
for the mentally handicapped, nearly 75% of all teaching staff,
dedicated but unqualified, are operating equipment for the
physical needs of their pupils which, charitably, can only be
termed fair. Of a total of approximately 9,000 mentally subnormal
children in hospital, current statistics suggest that some
25% are receiving no education whilst a further 20% are taught
only in the wards. Persistence with such methods merely condemns
patients to a permanent institutional life and, seemingly,
perpetuates a system denounced several years ago when the
government recommended the gradual phasing out of our large
mental hospitals. Custodial care is effete—its continuance in a substantial
number of cases has proved to be detrimental to the
patients and it is well-known that our worst catatonics are to
be found in our ill-equipped, overcrowded, understaffed and outdated
asylums. Even allowing for the country's recent economic
troubles, nationally, the paucity of local authority non-medical
residential or day-care provision is lamentable. Segregation is
dehumanising and, since all societies must eventually provide for
their handicapped members, initial planning with such groups in
mind will prove a more logical and economical approach than the
establishment of separate facilities in the future. Diagnosis of a
child's physical and psychological status should be early; it should
also involve disciplines other than medical; it should not label a
child for all time and his/her abilities as well as disabilities
should be suitably stressed. With regard to the latter, family
counselling is indispensable to enable parents to participate in
developing their child's full potential and so reduce the necessity
for future formal care and, moves to integrate the mentally handicapped
into the normal education system are to be applauded.
Paradoxically, after a century or more of treatment by isolation,
modern psychiatry is reverting to the age-old method of
dealing with mental illness, namely, in the patient's own home
and environment and it is here that the local authority services
will have their greatest impact. It was in this vein that, during
the current year, plans for the development of services for the
mentally handicapped were outlined in the Government's Command
Paper "Better Services for the Mentally Handicapped"
indicating the range of services which should be made available.
For the first time ever, local authorities have been given targets
in respect of residential homes, schools and adult training centres
and, similarly, Hospital Boards have been set limits to the