Mental Deficiency as a Community Problem

(Printed by kind permission of the London Association for Mental Welfare.) I feel that it is necessary at the outset to explain why most of my remarks this afternoon refer to the more general and theoretical aspects of my subject. We had hoped that Part III of the Report of the Joint Committee on Mental Deficiency would have been published by this time. In this part of the Report the Committee deal fairly thoroughly with the subject of mental deficiency as a community problem, but, as this is not yet published, it is obviously impossible for me to discuss the specific recommendations of the Committee this afternoon; and therefore I shall confine my remarks to the more academic and theoretical features of my subject. We shall deal more especially with the problem of the care of the mentally defective living in the general community. In doing so, we do not forget the importance of the other form of care, namely, the institutional care of defect-ives. The cleavage between these two forms of care has been too marked in the past. This has been due to the fact that most of the institutional cases have required permanent care. Owing to the scarcity of accommodation, only the lower grade cases and the more urgent of the feeble-minded have been admitted to our institutions. As the accommodation increases a much larger proportion of higher grade cases will be admitted and a certain proportion of these will, after a few years' training, return to the general community. Dr. Douglas Turner has expressed this most aptly when he said?" Institutions in the past have been stagnant pools?in the future they will be running lakes." It will thus become one of the chief aims of our institutions to give defectives the type of training that will best fit them to take their place in the ordinary industrial and social world; and the success with which we shall be able to care for the mentally defective thus rehabilitated will depend largely upon the early training they receive in the institutions. The first question we have to decide is the magnitude of the problem of the community care. There are about 300,000 mental defectives in England and Wales. It is estimated that about 120,000 require institutional care of some kind and about 200,000 remain in the general community. Of these, 84,000 are children of school age and are …