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The Role Of Public And Voluntary Services In Prevention And Treatment

Creator: Gunnar Dybwad (author)
Date: April 9, 1963
Source: Friends of the Samuel Gridley Howe Library and the Dybwad Family

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-*Presented at the meeting of the Citizen's Committee on the Children's Bureau's 50th Birthday, Washington, D. C. April 9, 1963.-

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-**Executive Director, National Association for Retarded Children.-

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The three presentations which we have just heard have brought to you in several dimensions some of the high points of the findings of the President's Panel on Mental Retardation. There is no doubt that this report constitutes a major, if not the most important, "bench mark" in the history of mental retardation in this country and I dare say the world; but we cannot afford to contemplate, in leisurely adoration, this great achievement; -- five and one-half million retarded and their families are waiting for the benefits we can derive from the work of the President's Panel. They challenge us into tangible action and it is my task here this morning to discuss some of the ways in which we must implement the Panel's recommendations and to point up some of the obstacles we will encounter in the process.

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In doing so, I shall not so much refer to the Panel Report itself but rather to the products which bear testimony to the National Administration's intention to give this matter highest priority so far as federal action is concerned, namely the decisive message which the President sent to Congress on February 5th on the subject matters of mental retardation and mental illness, and the various bills which have since been introduced into Congress at the behest of the Administration to carry out specific steps set forth in the President's message.

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Faced with so comprehensive a program as is contained in the Panel's report and the President's message, it is difficult to single out any one point as more important than all the others. Yet the more I have conferred with officials of public and private agencies, and with the leaders of associations for retarded children across the country, the more I become convinced that the keystone for the development of an adequate action program is effective, coordinated planning on the state level. More specifically, I refer to the coordinated planning that must be done by the state agencies responsible for the various programs envisioned by the Panel and the President's report.

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In doing so, I by no means belittle the role that is now played and increasingly will have to be played by private agencies and by the more than 1,000 associations for retarded children that have come into existence during the past decade. Nor do I mean to imply that state programming will be more important than programming in the local community. There is indeed growing agreement that in the long run services to the mentally retarded must be planned and given in the local community whenever it is at all possible. The problem is how we will get to that point.

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The most formidable stumbling block rests in the past which by and large identified services to the mentally retarded with institutional services and, with few exceptions, had these rendered by state agencies. There were available, to be sure, in many States educational services for the mentally retarded but they were provided only for the upper levels and even for those only on a sporadic basis. More important yet than the actual availability was the public's image of the situation: the retarded or defective child or adult belonged in an institution.

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Time does not permit me to elaborate on this in the present context, but I am sure many of you are aware of instances in the most recent past when state health departments have disclaimed any concern with the physical well being of the retarded because they consider retardation a mental health problem exclusively and thus fully the responsibility of the mental health authorities. Similarly, you know of education authorities who saw services to the retarded, instructional or otherwise, as outside the sphere of the educator, a task for the welfare authorities.

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The significant point is that in the past the mentally retarded, as soon as he was recognized as such, was a "displaced person," displaced from the community literally whenever possible, and figuratively otherwise -- there were no services for him or his family, and no end to the rejection he suffered. It was "up to the State" to take care of him, and Albert Deutsch has left with us a vivid picture to what extent the state's role was seen as a custodial or police function.

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Of course there were some outstanding exceptions to this state of affairs but we are concerned here with broad national trends, trends which are still all too recognizeable to this present day. (For instance for those of you who feel that my reference to police function is an overstatement, let me raise the question how one would explain otherwise that right now there are still numerous States which in allowing a parent to remove his child from a state institution for the retarded for a week's vacation specifically forbid the parent to spend part of this time with his child outside the state's borders. How else could one interpret such nonsensical restrictions upon a responsible citizen and taxpayer whose child is disabled but neither delinquent nor, in his parent's care, a danger to others or himself. And one could go on enumerating many other infringements of the civil rights of the retarded and his parents by the state agencies providing institutional care.) It stands to reason that in the presence of such rigidity and restrictiveness, much of which is by no means the result of administrative whim but is laid down by statutory mandate, great difficulties will be encountered as we try to move into the dynamic free exchange between community and institutional programs, between local and state services which the Panel report foresees.

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