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THE MENTAL DEFECTIVE
THE MENTAL DEFECTIVE.—UNIVERSITY OF LONDON : THE NEW HOME
21
They have come to the conclusion, some of the basal arguments advanced that however, in favour of this policy have but little foundation. Procreation by mental defective persons is found to be " not excessive," relative to the average increase of population, and there is said to be ground for believing that " the average number of children who reach adolescence in families where one of the parents is feeble-minded does not significantly exceed that for the community as a. whole." In deciding upon its attitude to sterilisation the Committee confesses that unanimity was found impossible ; it was also impressed by the lack of sufficient knowledge, both of heredity in general and the heredity of mental defect in particular. Hence it is not surprising that the Committee has steered a middle course and is content to record its general view that sterilisation might be an appropriate and desirable procedure -with adequate safeguards-in a small proportion of mental defectives in respect of whom the chief social danger is propagation. Only in one respect is the Committee more dogmatic, when it states that sterilisation, even if widely applied to mental defectives, would cause no appreciable difference in their number for many generations. This opinion appears on the surface to be somewhat inconsistent with its cautious policy, but it is in line with biological knowledge in that it recognises that carriers play a large part in the propagation of mutations. The committee lately appointed by the Board of Control will have the responsibility of further investigation into this question. The B.M.A. Committee rightly emphasises the necessity for clinical teaching on mental defect, both for medical students and in post-graduate schools. By their training practitioners are seldom equipped for the diagnosis of any grade above the. imbecile, and when one considers how much material is possessed by local authorities, both of education and of mental deficiency, in the larger areas where there are medical schools, there seems to be no excuse for this ignorance. This is a point which might perhaps have had more prominence in the report.
courage.
THE LANCET. LONDON:SATURDAY, JULY 2, 1932
THE MENTAL DEFECTIVE on mental defect is now The becoming apparent. report1 just issued by a committee of the British Medical Association strengthens the impression left by the Wood report that the perspective has greatly changed since the Royal Commission -of. -1904-1908, and it shows several ways in which the angle of approach has altered. First of all, the tendency to regard the
A
CHANGE
of outlook
defective as a person separated by a gulf from normal humanity has been replaced by the conception that " there is a continuous curve of variability in mental power and social capacity and behaviour from the idiot to the normal person." In the second place the pioneers of this movement were possessed by the idea that mental defect was at the root of a very large proportion of our problems of poverty and crime ; indeed, it was the antisocial possibilities of the defective that occupied the centre of the picture. The B.M.A. Committee, on the other hand, asserts that " antisocial conduct is not an essential characteristic and : is not necessarily even a common characteristic of mentally defective persons," and that " there are - large numbers of - feeble-minded persons whose behaviour in the community is no more repre: hensible, either socially or sexually, than that of persons who are not classed as mentally defective." The growth of child guidance and other movements: for the psychological treatment of delinquents is further evidence of the realisation that delinquency and mental defect are not necessarily associated. Yet a third change is reflected in treatment. In the earlier years permanent custodial care was regarded as the one and only satisfactory solution, being designed to protect the defective from himself, to protect the community from him, and lastly to prevent the propagation of his defect. It is obviously impracticable, in view of numbers, that such a policy should be applied to all defectives, but in addition experience has shown, both in America and England, that a certain proportion can be successfully trained for ordinary life and can be allowed to rejoin the community under adequate supervision. It is therefore not so much segregation that is demanded now as socialisation " ; though it remains to be seen whether the Committee is right in thinking that this goal can be reached by the great majority. The Committee’s findings on sterilisation will ,
.
’
UNIVERSITY OF LONDON: THE NEW HOME A
phase of an arduous undertaking has; definitely commenced, for, according to a statement, emanating from Lord ATHLONE, Chancellor of the University of London, and made in unison with the principal officers of the University, a splendid scheme has been embarked upon for the erection of a central building to house corporate’ activities. For years throughout the columns of FINAL
now
the press, and reflected in these pages, a discussion went on as to where this centre was to be placed, and whence the money for its construction Rival claims were put forward, was to be drawn. sometimes with deliberation and sometimes at the naturally attract much attention, and in some instance of romance, for the acquisition of Holland quarters its members may be accused of lack of House, Ken Wood, the Foundling Hospital, and Report of Mental Deficiency Committee. Appointed by even Somerset House, while certain obvious claimsthe Council of the B.M.A. in 1930 (Chairman: Prof. R. J. A. for remaining at South Kensington were forcibly Berry ; hon. secretary: Dr. R. G. Gordon). Brit. Med. Jour. Suppl., June 25th, p. 322. put forward. There were urged, sometimes from, "
1
21
They have come to the conclusion, some of the basal arguments advanced that however, in favour of this policy have but little foundation. Procreation by mental defective persons is found to be " not excessive," relative to the average increase of population, and there is said to be ground for believing that " the average number of children who reach adolescence in families where one of the parents is feeble-minded does not significantly exceed that for the community as a. whole." In deciding upon its attitude to sterilisation the Committee confesses that unanimity was found impossible ; it was also impressed by the lack of sufficient knowledge, both of heredity in general and the heredity of mental defect in particular. Hence it is not surprising that the Committee has steered a middle course and is content to record its general view that sterilisation might be an appropriate and desirable procedure -with adequate safeguards-in a small proportion of mental defectives in respect of whom the chief social danger is propagation. Only in one respect is the Committee more dogmatic, when it states that sterilisation, even if widely applied to mental defectives, would cause no appreciable difference in their number for many generations. This opinion appears on the surface to be somewhat inconsistent with its cautious policy, but it is in line with biological knowledge in that it recognises that carriers play a large part in the propagation of mutations. The committee lately appointed by the Board of Control will have the responsibility of further investigation into this question. The B.M.A. Committee rightly emphasises the necessity for clinical teaching on mental defect, both for medical students and in post-graduate schools. By their training practitioners are seldom equipped for the diagnosis of any grade above the. imbecile, and when one considers how much material is possessed by local authorities, both of education and of mental deficiency, in the larger areas where there are medical schools, there seems to be no excuse for this ignorance. This is a point which might perhaps have had more prominence in the report.
courage.
THE LANCET. LONDON:SATURDAY, JULY 2, 1932
THE MENTAL DEFECTIVE on mental defect is now The becoming apparent. report1 just issued by a committee of the British Medical Association strengthens the impression left by the Wood report that the perspective has greatly changed since the Royal Commission -of. -1904-1908, and it shows several ways in which the angle of approach has altered. First of all, the tendency to regard the
A
CHANGE
of outlook
defective as a person separated by a gulf from normal humanity has been replaced by the conception that " there is a continuous curve of variability in mental power and social capacity and behaviour from the idiot to the normal person." In the second place the pioneers of this movement were possessed by the idea that mental defect was at the root of a very large proportion of our problems of poverty and crime ; indeed, it was the antisocial possibilities of the defective that occupied the centre of the picture. The B.M.A. Committee, on the other hand, asserts that " antisocial conduct is not an essential characteristic and : is not necessarily even a common characteristic of mentally defective persons," and that " there are - large numbers of - feeble-minded persons whose behaviour in the community is no more repre: hensible, either socially or sexually, than that of persons who are not classed as mentally defective." The growth of child guidance and other movements: for the psychological treatment of delinquents is further evidence of the realisation that delinquency and mental defect are not necessarily associated. Yet a third change is reflected in treatment. In the earlier years permanent custodial care was regarded as the one and only satisfactory solution, being designed to protect the defective from himself, to protect the community from him, and lastly to prevent the propagation of his defect. It is obviously impracticable, in view of numbers, that such a policy should be applied to all defectives, but in addition experience has shown, both in America and England, that a certain proportion can be successfully trained for ordinary life and can be allowed to rejoin the community under adequate supervision. It is therefore not so much segregation that is demanded now as socialisation " ; though it remains to be seen whether the Committee is right in thinking that this goal can be reached by the great majority. The Committee’s findings on sterilisation will ,
.
’
UNIVERSITY OF LONDON: THE NEW HOME A
phase of an arduous undertaking has; definitely commenced, for, according to a statement, emanating from Lord ATHLONE, Chancellor of the University of London, and made in unison with the principal officers of the University, a splendid scheme has been embarked upon for the erection of a central building to house corporate’ activities. For years throughout the columns of FINAL
now
the press, and reflected in these pages, a discussion went on as to where this centre was to be placed, and whence the money for its construction Rival claims were put forward, was to be drawn. sometimes with deliberation and sometimes at the naturally attract much attention, and in some instance of romance, for the acquisition of Holland quarters its members may be accused of lack of House, Ken Wood, the Foundling Hospital, and Report of Mental Deficiency Committee. Appointed by even Somerset House, while certain obvious claimsthe Council of the B.M.A. in 1930 (Chairman: Prof. R. J. A. for remaining at South Kensington were forcibly Berry ; hon. secretary: Dr. R. G. Gordon). Brit. Med. Jour. Suppl., June 25th, p. 322. put forward. There were urged, sometimes from, "
1