Cental
SUBNORMALITY AND INDUSTRIAL WORK* by
Chief Clinical Officer, Mental Health Authority, Victoria, Australia
flit A
1
ara
ai?^ well-integrated
pro-
industrial opportunities in any society despends su?normal ^eve^ economic and c^echnni?n>
for
the
"itieeds 'for
S(Ji
^the
mrVe
There development. t?81'calenough social organisation 0 ?e
Cnnorrna! People to be accepted in
)jdustrv I^rnunitYt^len
Placement into in^ast staSe in the
Perati1S Pis alfl ?.0u^
? coherent programme, involve such things as ^urserva8nOS'S' suPPort to parents,
"early
training
Dt'?nal fend hostel
C6'
centres,
voca-
s^terec^ workshops
Iterated n?rma?l0St ^evei?ping
nations, subtolerated in rural small towns. But with the industrialisation and c?^Dul education, the subnormal PerSon ?0ry ee?mes a problem, both to his see society* ^ is difficult to People
'areas
are
'introd-.Tr ^^ilv be
how^-10 mis evolutionary
av
.,
8r.ammP triai or ?a^ P?rt in
Alan Stoller
or
^anisation
ased
0n
n
Swif
p?Per delivered
priorities
Subnormal" is defined here as those below the I.Q. of 70-75. Those with I.Qs. above this level should usually profit from ordinary education, and go on to work in open employment, even if performing only simple jobs. The "Educable Group" (I.Q. 50-70) should also be able to attain a high level of success in their jobs. Collmann and Llewlyn have determined the outcome for this group in England and demonstrated 66% complete success, with only 10% completely unemployable; the latter being predominantly so because of physical and temperamental handicaps. The "trainable group" (I.Q. 30-50) are unlikely to become occupationally independent, but a good number can work in sheltered workshops, whilst living in hostels or at home.
Mentally subnormal people from
and wealth to supin a newly growing
Switzerland, August
educational
to those who are normal.
the last two groups may be prevented from attaining occupational status because of physical, emotional and social handicaps, but prompt and adequate diagnosis early in life, remedial treat-
can
^ow an integrated proevolved without indus-
___?esides, rne,
process
community, obviously go "Mentally
at the 17th Annual Meeting of the World Federation for Mental Health, 1964.
71
physical disabilities and continual attention to emotional and social development will reduce the number of
or open industry. Whilstfc! subnormal person is lim>0 both in his capacities and rate of ing, original estimates of his p?'ft tialities have been revised recent years (O'Connor and Hern% 1962). With learning broken down1 simple elements, skills can be le'ir and retained as well as by normal sons, and carried over into other Success has been achieved by rev1^
sheltered
ment of
mentally
unemployables.
upward^
International definitions and standards need to be worked out and programmes in different countries compared. In some communities there may be more socio-cultural subnormality; in others, less opportunity for casefinding and a lack of integration between health and social services. In others, again, the problem may remain submerged, because the values of the community encourage feelings of shame or guilt.
SIZE OF PROBLEM In Victoria, Australia,
over
ta|
methods, playing d Dimitri, 1963). %iSerils ^Ue of many non-institutionalso rehabi?
Persons' n^itateH S1i A u ,rou?h training schemes. or industrial e\uit ^e?ered workshop an institution or Within ^ trafninS community and attached to
'!
?
centre. It may be
vl^Da
an
entirely
induspart of 'Vial te -eWorkshop, secti?n in factory, or, an
e
3lnallvS ma^ multi-purpose r-entr f!t 'Seopf rl ere typesnee^?f tohandicapped investigate '^hiclf f;o ^P.e ?f unit is most appropriate or a
a
a
a
t
a
^VaParticular and eng
?.es
v
Vopiearious
environment, and the
disadvantages of mixhandicapped
lyPes
'fully.- nC0Untry has,
jhe
as
yet, provided
a
?rated programme to supply ferities required, ran?e and ere are often divisions of ent s nn?ental responsibilities for differ.?f the subnormal populaU?n e also an important need rfor c with employers and unions, and with voluntary which may also be runj
'gover
th6
eYL10ns
spend it himself (with some superDaily records of work output should be charted; and regular assessment made of productivity, work quality, reaction to supervision, relavision.
|trade?"0P?ration Wanning ls^ons' gover Altered
workshops
through
subsidies. If there !adeqi,n7lentcentral and regional
are
(?rdi
tions with other workers and work attitudes. This type of facility is most suitable for the "educable" person. The majority of "trainable" people, however, would not be able to adjust to such an environment, and would be more suited to a workshop in which they would be expected to work a day of about 9.30 a.m. to 4 p.m. Holidays would be longer, tasks would be simpler, and although a factory atmosphere would still be maintained, time would be necessary for further occupational, social and academic training. Continuing efforts would be needed to develop further academic and social skills, even beyond the age of 25. Status and social approval would be important motivating factors here, together with tangible money rewards, which increase with improvement in work
no co-
bodies, there could be ex^ensiv ?Ver^aPPing services, and many !!subno6 Pers?ns betwerrna^ en the various
^
tered
a
might be caught agencies involved,
Serninar in Australia
VVorkshops (Forsythe,
ls
on
shel-
1963) it
ressed that the major needs for
theSe
Were ma^a ?ernent.money, work and good It was also necessary to creat of eth.a 8?od public image. A code Was needed to avoid the Utider of industry and other shejtJilting All contracts were facilities. t? ^eed?n a strictly business basis; Scru 0Us attention was to be paid to qualjt y; h? delivery dates were to be .
,
ploitat^6
The J00,
quired
Ployer
Wa$
?
'
anc* there was to be no ex?f the handicapped person. manager himself was remake the contacts with emvariety of levels of skills
esirable,
and
a
capacity.
In both these kind of centres, social and recreational facilities should be
series of regular
available. 73
Social skills, like work skills, are lost without practice. Workshops should be within the community, have their own identity, be within or near to an industrial area, and should cover a sufficient population to provide an adequate intake to the centre. The trend towards maintaining the subnormal person within the community is a healthy one, but cannot be developed without sufficient early training facilities, hostels and sheltered workshops, as well as the means of integrating these with already existing services. Institutionalisation is a costly process, and each person who can be maintained in relatively cheaper hostel accommodation, and who can also add something to the common wealth, means a considerable saving to the community. (An estimate that this could involve at least one per 1,000 of the population indicates how much this might represent to the public purse.) The developing pattern of community care must be seen as complementary to institutional care, and not replacing it. But as time goes on, it is hoped that less and less institutional
aA
will be required for those the I.Q. of 30. Education of the bringing with it the involvement industry and trade unions, is promote that change of values will lead to the fulfilment of a s
SUBNORMALITY AND INDUSTRIAL WORK* by
Chief Clinical Officer, Mental Health Authority, Victoria, Australia
flit A
1
ara
ai?^ well-integrated
pro-
industrial opportunities in any society despends su?normal ^eve^ economic and c^echnni?n>
for
the
"itieeds 'for
S(Ji
^the
mrVe
There development. t?81'calenough social organisation 0 ?e
Cnnorrna! People to be accepted in
)jdustrv I^rnunitYt^len
Placement into in^ast staSe in the
Perati1S Pis alfl ?.0u^
? coherent programme, involve such things as ^urserva8nOS'S' suPPort to parents,
"early
training
Dt'?nal fend hostel
C6'
centres,
voca-
s^terec^ workshops
Iterated n?rma?l0St ^evei?ping
nations, subtolerated in rural small towns. But with the industrialisation and c?^Dul education, the subnormal PerSon ?0ry ee?mes a problem, both to his see society* ^ is difficult to People
'areas
are
'introd-.Tr ^^ilv be
how^-10 mis evolutionary
av
.,
8r.ammP triai or ?a^ P?rt in
Alan Stoller
or
^anisation
ased
0n
n
Swif
p?Per delivered
priorities
Subnormal" is defined here as those below the I.Q. of 70-75. Those with I.Qs. above this level should usually profit from ordinary education, and go on to work in open employment, even if performing only simple jobs. The "Educable Group" (I.Q. 50-70) should also be able to attain a high level of success in their jobs. Collmann and Llewlyn have determined the outcome for this group in England and demonstrated 66% complete success, with only 10% completely unemployable; the latter being predominantly so because of physical and temperamental handicaps. The "trainable group" (I.Q. 30-50) are unlikely to become occupationally independent, but a good number can work in sheltered workshops, whilst living in hostels or at home.
Mentally subnormal people from
and wealth to supin a newly growing
Switzerland, August
educational
to those who are normal.
the last two groups may be prevented from attaining occupational status because of physical, emotional and social handicaps, but prompt and adequate diagnosis early in life, remedial treat-
can
^ow an integrated proevolved without indus-
___?esides, rne,
process
community, obviously go "Mentally
at the 17th Annual Meeting of the World Federation for Mental Health, 1964.
71
physical disabilities and continual attention to emotional and social development will reduce the number of
or open industry. Whilstfc! subnormal person is lim>0 both in his capacities and rate of ing, original estimates of his p?'ft tialities have been revised recent years (O'Connor and Hern% 1962). With learning broken down1 simple elements, skills can be le'ir and retained as well as by normal sons, and carried over into other Success has been achieved by rev1^
sheltered
ment of
mentally
unemployables.
upward^
International definitions and standards need to be worked out and programmes in different countries compared. In some communities there may be more socio-cultural subnormality; in others, less opportunity for casefinding and a lack of integration between health and social services. In others, again, the problem may remain submerged, because the values of the community encourage feelings of shame or guilt.
SIZE OF PROBLEM In Victoria, Australia,
over
ta|
methods, playing d Dimitri, 1963). %iSerils ^Ue of many non-institutionalso rehabi?
Persons' n^itateH S1i A u ,rou?h training schemes. or industrial e\uit ^e?ered workshop an institution or Within ^ trafninS community and attached to
'!
?
centre. It may be
vl^Da
an
entirely
induspart of 'Vial te -eWorkshop, secti?n in factory, or, an
e
3lnallvS ma^ multi-purpose r-entr f!t 'Seopf rl ere typesnee^?f tohandicapped investigate '^hiclf f;o ^P.e ?f unit is most appropriate or a
a
a
a
t
a
^VaParticular and eng
?.es
v
Vopiearious
environment, and the
disadvantages of mixhandicapped
lyPes
'fully.- nC0Untry has,
jhe
as
yet, provided
a
?rated programme to supply ferities required, ran?e and ere are often divisions of ent s nn?ental responsibilities for differ.?f the subnormal populaU?n e also an important need rfor c with employers and unions, and with voluntary which may also be runj
'gover
th6
eYL10ns
spend it himself (with some superDaily records of work output should be charted; and regular assessment made of productivity, work quality, reaction to supervision, relavision.
|trade?"0P?ration Wanning ls^ons' gover Altered
workshops
through
subsidies. If there !adeqi,n7lentcentral and regional
are
(?rdi
tions with other workers and work attitudes. This type of facility is most suitable for the "educable" person. The majority of "trainable" people, however, would not be able to adjust to such an environment, and would be more suited to a workshop in which they would be expected to work a day of about 9.30 a.m. to 4 p.m. Holidays would be longer, tasks would be simpler, and although a factory atmosphere would still be maintained, time would be necessary for further occupational, social and academic training. Continuing efforts would be needed to develop further academic and social skills, even beyond the age of 25. Status and social approval would be important motivating factors here, together with tangible money rewards, which increase with improvement in work
no co-
bodies, there could be ex^ensiv ?Ver^aPPing services, and many !!subno6 Pers?ns betwerrna^ en the various
^
tered
a
might be caught agencies involved,
Serninar in Australia
VVorkshops (Forsythe,
ls
on
shel-
1963) it
ressed that the major needs for
theSe
Were ma^a ?ernent.money, work and good It was also necessary to creat of eth.a 8?od public image. A code Was needed to avoid the Utider of industry and other shejtJilting All contracts were facilities. t? ^eed?n a strictly business basis; Scru 0Us attention was to be paid to qualjt y; h? delivery dates were to be .
,
ploitat^6
The J00,
quired
Ployer
Wa$
?
'
anc* there was to be no ex?f the handicapped person. manager himself was remake the contacts with emvariety of levels of skills
esirable,
and
a
capacity.
In both these kind of centres, social and recreational facilities should be
series of regular
available. 73
Social skills, like work skills, are lost without practice. Workshops should be within the community, have their own identity, be within or near to an industrial area, and should cover a sufficient population to provide an adequate intake to the centre. The trend towards maintaining the subnormal person within the community is a healthy one, but cannot be developed without sufficient early training facilities, hostels and sheltered workshops, as well as the means of integrating these with already existing services. Institutionalisation is a costly process, and each person who can be maintained in relatively cheaper hostel accommodation, and who can also add something to the common wealth, means a considerable saving to the community. (An estimate that this could involve at least one per 1,000 of the population indicates how much this might represent to the public purse.) The developing pattern of community care must be seen as complementary to institutional care, and not replacing it. But as time goes on, it is hoped that less and less institutional
aA
will be required for those the I.Q. of 30. Education of the bringing with it the involvement industry and trade unions, is promote that change of values will lead to the fulfilment of a s
