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I have recently visited some brand new buildings in State schools for the mentally retarded. Each time I have been shocked at the lack of imagination displayed in the design, at the gross neglect of features facilitating supervision of the residents, at the continued insistence on mass housing as against smaller groups which would make possible a more individual approach, and finally at the lack of color.

While we continue to build so-called "cottages" housing from 50 to 100 people and more, the Scandinavian countries think of housing units from 12 to 15 residents. While we are considering a dormitory housing not more than 24 to 32 patients a major advance, over there they have "dormitories" with 5 to 7 children; and even those divided by half-high partitions providing some degree of privacy.

I made an interesting observation recently: It came to me during my recent trip when in some State institution employees quickly slammed the door in my face because a few children were there in a bathroom in the nude. Both in Norway and Denmark, I found some of the more severly retarded happily playing outdoors in the nude with charming young attendants sitting nearby, and nobody rushed to cover up these children, when visitors came. But if you look at the housing afforded these children, you see a strange contradiction to this conduct: In Norway and Denmark everything possible is done to individualize the housing facilities and accommodation for these children, to give them places where they can store a bit of their property, to make them feel there is somewhere a corner that belongs to them, to bring color into their life. In many American institutions however, while they go to great length to cover the nudeness of the bodies of these children, their life as such is denuded of much that is human, of much that distinguishes the human being, by virtue of his individuality from the life of other beings.

Thus in countries where there is less to work with, financially and materially more is being accomplished simply by imaginative planning and careful consideration of the needs of the individual human being.

I was greatly interested to see that one of our most progressive states recently conducted several extremely detailed time studies of the actual life on the ward as reflected in the activities of the ward personnel. This is a most encouraging development because surely from this type of specific information we will gain valuable guidance as to the fashioning not only of future programs, but future buildings. There is only one caution and a very important one: we cannot be content merely to improve present procedures; we must realize that we have to inject those ingredients of good care which at the present time are so sadly lacking.

Again let me remind you of what I told you briefly at last year's convention concerning the problem: under the leadership of the National Probation and Parole Association our juvenile detention homes have developed interesting and useful architectural patterns which vary sharply from the traditional buildings. There is no reason why we should not insist that similar imagination should be shown in the building programs for the mental retardation housing of the future.

For my final comments in this admittedly inadequate and partial summary of institutional planning for the future, let me refer to a different type of personnel problem that I covered earlier, namely the role of the volunteer and of the parent.

I am aware of the great resistance many of our superintendents have had and still show toward effective utilization of volunteers. It is my firm conviction that the institution of the future will make far more use of volunteers, not just in play and recreation activities, but also by assisting in ward service (as they have done for a number of years now in many of our general hospitals). Volunteering for service has become part and parcel of the American way of doing things, and I am happy to say that we already have among our institutions today some excellent examples of how institutional programs can be enhanced by utilizing volunteer manpower.

Furthermore, I predict that among the volunteers, we shall find in those days to come, parents of retarded children. And here again of course we already have seen some outstanding examples, particularly in the crisis during the 1957 epidemic of Asiatic Flu. Certainly the institution of the future will welcome the parents as a partner and not restrict them from visiting, from correspondence, and from the freest possible access to the institution's facilities.

In this regard I am reminded of the parallel shift in the attitude of the general hospital toward the visiting parent: here, too, parents were seen as the enemy, the disturbers of peace and routine, and yet in our most progressive hospitals, we now allow parents free and unlimited visiting privileges and even the privilege of sleeping overnight in the bed next to their child. This is no more a revolution than what we are aiming at in our institutions.