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“In the past people with learning disabilities have been perceived as objects of fascination and fear, resulting in them being both worshipped and, or vilified” (Atherton H, 2003). Within the historical timeline of learning disabilities in society, individuals went from cared for with in their community, to various forms of institutionalization and again to community care (Atherton H, 2003). This essay will gain understanding into the range of treatment and evaluate the effects these had on the lives of individuals with learning disabilities.
Preceding the Industrial Revolution, individuals with learning disabilities were supported within their communities by their families. However, when the Industrial Revolution (approximately 1760 onwards) began, there was a great need by society for skilled labor, a skill of which individuals with learning disabilities were deemed incapable of providing. In 1995 David Race proposed that “the measurement of people by their ability to cope with the new technological and commercial processes” deemed individuals with learning disabilities to lack the intelligence needed in order to profit to society, thus introducing the Poor Law Amendment Act 1834. This Act responded to the situation arisen from the Revolution, leading to the segregation of individuals with learning disabilities into workhouses. However, this Act did not extend as far as Scotland, but only within England, Wales and Parts of Ireland.
It wasn’t until eleven years later that the Scottish Government produced the 1845 Scottish Poor Law Act. The Scottish Act covered the elderly, ill, and disabled, providing them with poor relief. There are contrast within the Scottish and English Act’s. One, is that within England, Wales and parts of Ireland, workhouses were run by Parishes as order by the Government, whereas within Scotland, it was voluntary to run Poorhouses (the title used within Scotland for workhouses). Another being, within the Scottish Act, individuals deemed ‘able-bodied’ were exempt as they were seen to be still able to carry out work related tasks. (Higginbotham P, 2018). However, although the Scottish Act states the disabled, it meant that the physically disabled receive relief, and does not specify for individuals with cognitive disabilities.
Twelve years after the 1845 Scottish Poor Law Act and the 1845 Lunacy Act within England, came the Lunacy (Scotland) Act 1857. With the Lunacy (Scotland) Act 1857, came the establishment of the Scottish Lunacy Board (SLB). Both the Act and the SLB brought about the rise in Asylums within Scotland. The Act determined the system to be for individuals deemed to be an idiot, lunatic or insane. However, there was no clear distinction between whether an individual had a learning disability or a mental illness, both fell under the lunatic category of the Act. (Greenland C, 1958). At this point in time, there was no admissions policy with what deemed an individual suitable to be sectioned and institutionalized (Greenland C, 1958). Thus, bringing about the 1886 lunacy Act.
The 1886 Lunacy Act made a very clear distinction between the definition of a lunatic on one hand, and idiot’s and imbeciles on the other. The educational needs of individuals were involved also. However, when evaluating the definition ‘educational needs’ of individuals within the context of the Act, it did not mean within educational curriculum area’s, but more on how one should behave within society, in other words, training to ‘fit in’ to their community. (Barber C, 2012).
Individuals with learning disabilities were deemed with the inability to ‘fit in’ due to being feared by society and the moral panic that came also. The fear and panic arose from the fear of reproduction between individuals with learning disabilities. Society feared that with reproduction of individuals with learning disabilities would bring more, and then society “…would be over run and crumble” (Jarrett S, 2014). However, this fear was because of the little medical understanding. This fear then brought about the eugenics of the United Kingdom, “the science of improving the inherited stock, not only by judicious matings, but by all other influences” (Galton D, 1998). If individuals are locked away and segregated from the wider society and each other there would be no reproducing between them, thusly ‘extermination’ (Takayabayashi A, 2017). However, even with this fear and panic, mental illness and learning disabilities were still being confused. Even within the Amended 1890 Lunacy Act.
The 1890 Lunacy Act brought about the dominance of psychiatry and psychology within Asylums. Although there was no clear distinction between learning disabilities and mental illness within the Act itself, the intelligence quotient (IQ) was used in order to test whether an individual had a learning disability (Takayabayashi A, 2017). “A classification of mild, moderate, severe and profound has been used to describe the degree of learning disability…less that 20…profound…20-34…severe…35-49…moderate…50-70…mild learning disability” (Lowth M, 2016). However with Dr Mary Lowth (2016) stating the IQ degrees of learning disabilities, she also goes on to state “However, this classification is only partially adequate, as the degree of intellectual impairment provides very little information about the person’s social, educational and personal needs”, Lowth is describing that the IQ test only measures a person’s ability within an educational curriculum, meaning during this time, an individual’s intelligence is not measured within their social ability or personal abilities (Webb J & Whitaker S, 2012). The IQ test was the role of the Psychologist within the institutions, “Psychologists are uniquely qualified to administer a variety of psychological tests. Psychological tests are designed to measure variables such as intelligence or the presence and extent of disorders…” (Miller A, 2018). This shows that there was the dominance of the Medical Model, this model involves society paying their attention to the diagnoses of an individual rather than the personality of the individual (ombudsman, N.D) beginning within society. With the dominance of the medical model, and medical professions such as psychiatrists and psychologist, also came the alienation of individuals with learning disabilities. ‘Alienism’ was the term used to describe the further segregation of individuals with learning disabilities. This term was used as its definition is the study of something deemed not normal. (Merriam-Webster, 2018). The increase in medical professions and the great use of the term ‘alienism’ brought about the mass increase in asylums and institutions being open for ‘idiots, imbeciles, lunatics, and the feeble-minded’. (Brigham L, et al, 2000).
Leading into the 20th century, the ‘care’ of individuals with learning disabilities were marked by the Royal Commission on the Care and Control of the Feeble Minded 1908, otherwise know as the Radnor Report. (Barber C, 2012). The report investigated the ‘causes’ of ‘mental defectives’ and concluded that mental deficiencies were inherited. From this conclusion, it was agreed that ‘mental defectives’ were to be segregated from society. (Barber C, 2012). Asylums and institutions were now ‘home’ to individuals with learning disabilities and was to be for many years in the historical time line.
Institutions were used to segregate and hide individuals whom were deemed, and diagnosed to be imbeciles, feeble-minded and idiots. (Barber C, 2012). Between the publication of Radnor Report and 1948 many individuals with learning disabilities were admitted into institutions as it was deemed to be in the best interest of the individuals.
David Barron (2000), whom has a mild learning disability, describes his life of growing up within an institution. Barron (2000) describes the hospital as “spotless and clean…windows had bars on everyone… doors were locked”, these descriptive wordings show that although the institution was hygienic, it was a form of imprisonment to those ‘living’ there. The bars on windows, and locked doors were used as a constant reminder to patients that there was no link to the outside society, and that they were forgotten. “you were not allowed to mix with the opposite sex. It was against the law throughout England, Scotland, Ireland and Wales…that was the ruling and the law of institutions at that time” (Barron D, 2000). Barron is describing the eugenics within institutions. It describes the fear of reproduction and increase in population of individuals whom were ‘mentally defective’. Then came the Mental Deficiency Act 1913.
The Mental Deficiency Act 1913 did not abolish nor attempt to abolish institutions and individuals were still being classified as imbecile, idiot, or feeble-minded. This piece of legislation was then amended in 1927. The Mental Deficiency Amendment Act 1927, although labels were still the same, “allowed for mental deficiency resulting from illness or accident – previously it had to have been there from birth” (The Open University, 2018). This meant that individuals who were once deemed ‘normal’ by society, whom were then in an accident causing brain or cognitive damage, were then classed as either an imbecile, idiot, or feeble minded. (The Open University, 2018).
With societies continuing want to decrease and eliminate individuals with learning disabilities, The Brock Report of 1934 allowed the sterilization of female individuals if it were necessarily deemed therapeutic. This is the height of eugenics within the United Kingdom, and was deemed the ultimate way to strengthen society with the extermination of individuals with learning disabilities. (Darwin L, 1834).
However, not a lot changed quickly for individuals with learning disabilities within institutions when the National health service (NHS) 1946 came. Institutions were renamed hospitals but were still predominantly dominated by the medical model. There were still strict routines, psychology, psychiatry and medication. (Barber C, 2012).
The life of Patricia Collen within Normansfield institution describes the negative impact the NHS had on the support and care for individuals with learning disabilities. Leading up to the purchase of Normansfield, it was a private fee-paid institution for wealthier families. However after World War 2, clothing and supplies were rationed and the building went into distress. Then in 1951 the NHS took over, and transitioned it into a hospital. Patricia’s life went from being individualised, to regulated and systematic. All patients wore the same clothing. Routines were installed which left Patricia sitting in the same spot for many hours and only moving to be fed and be put to bed. (Cadbury H & Whitmore M, 2010). This shows that even with the creation of the NHS, were still not being treated as human beings and continuing to be segregated from society. However, change did come for individuals with learning disabilities.
Between the years of 1944 and 1959, the Education Act 1944 came to light which deemed children with learning disabilities as uneducable and two years later in 1946 came the National Association of Parents of Backwards Children (now known as Mencap) was founded to support the ‘uneducable’ children. (The Open University, 2018). Then came the Act that first mentioned care in the community.
The Mental Health Act 1959 was the first act to mention community care, however funding was so little due to the still strong belief in the medical model and segregation. However, it did bring about the difference in sectioning, to either be a voluntary decision, or by the state if deemed a danger. However, the term mental defect was still being strongly used, and was still used as a term to further alienate individuals with learning disabilities. Change was fast enclosing institutions.
Between the years of 1959 and 1980 came the crumble of institutionalisation and the rise in community care. Irving Goffman in 1961 covertly researched into life within an institution and the horrendous living environments that individuals were subject to. “An inmate who shows defiance receives immediate punishment, which increases until he openly ‘cries uncle’ and humbles himself” (Goffman I, 1961). This shows the physical abuses that patients were subject to throughout their treatment. This insight showed that institutionalisation was not in the best interest of individuals with learning disabilities, but the worst. (Goffman I, 1961). During the same years came Normalisation, “Making available to all mentally retarded people patterns of life and conditions of everyday living that are as close as possible to the regular circumstances and ways of life in society” (Söder, M, 2006, p.193). The concept of normalisation was that all individuals, whether learning disabled or not should have the right to access everything, such as homes in the community, jobs in the communities, and day to day life activities. (Söder, M, 2006, p.193). Change had began for individuals with learning disabilities.
Institution began to be abolished and individuals were moved into care in the community. Care companies were set up for home care, person centred planning took dominance over control and choice was a large part of day to day living for individuals. The Social Model, “The social model of disability says that disability is caused by the way society is organized…” (Disability Nottinghamshire, 2018), was now in dominance.
In conclusion, for almost two hundred years the labels received by individuals with learning disabilities have varied between positive and negative, thus affecting the type of care they receive and the quality (Atherton H, 2003, p.43). Individuals were misdiagnosed as idiots, or imbeciles just for being different, their lives were belittled due to the difference between ‘them’ and society. And were medicated and ‘trained’ to fit into society, however, it was society whom should have been trained to accept individuals with learning disabilities.
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