The Care and Control of the Feeble Minded

The Care and Control of the Feeble MindedThe Care and Control of the Feeble MindedThe Care and Control of the Feeble MindedThe Care and Control of the Feeble MindedThe Care and Control of the Feeble MindedThe Care and Control of the Feeble Minded

WAKEFIELD UNION

SPEECH BY MR W. MOORHOUSE Chairman of the Wakefield Board of Guardians

On the

General Question of the Care and Control of the Feeble Minded

( Delivered at a Meeting of the Finance and General Purposes Committee on the 1st Feb 1911)

He said –

This is one of the most urgent and most difficult of the many social problems confronting us today.

It is, however, satisfactory to find that most earnest efforts are being made to grapple with it, and to realize that the elimination of degenerate stock is the way to preserve a high standard of racial vigour.

On January 1st 1909, there were under care in England and Wales 128,787 Certified Insane, an increase of 2,703 on the previous year, and of these 91.1 per cent were pauper patients.

Separate from Certified Insane, the estimated number of Mentally Defectives was 149,628. Of this number it was estimated that 65,509 were in need of proper provision, and of the 65,509 there were 6,990 in Workhouses and 4,700 on Out-Relief.

Those are very sad statistics. We as Guardians know that the imbeciles are not an inviting class. They are often disagreeable in manners or appearance and not too clean in habits. Yet they have strong claims upon us for better care and treatment. They are helpless.

Their poverty is not always their own fault. They are prisoners without being offenders, and must stay whether they like it or not. This is the terrible lot we have to deal with.

 It was in 1904 that a Royal Commission was appointed to consider “the existing methods of dealing with Idiots and Epileptics and with Imbeciles and Feeble-Minded not certified under the Lunacy Laws.”

Two years later the reference to the Commission was extended authorising them “to enquire into the expediency of amending the present system or adopting some other system for the Care of Lunatics and Mental Defectives.”

After considering their report I have come to the conclusion that the lot of the Feeble-Minded has been very carefully and exhaustively dealt with by the investigators who formed the Commission, and they have fully placed the lamentable truths of the case before the public.

 The Commissioners say:-

“Of the gravity of the present state of things, there is no doubt. There are numbers of mentally defective persons whose training is neglected, over whom no sufficient control is exercised, and whose wayward and irresponsible lives are productive of crime and misery, of much injury and mischief to themselves and others, and of much continuous expenditure, wasteful to the community and to individual families.”

Now lay minds like ours may better understand this somewhat difficult problem if we just consider how the Commissioners classify the Mentally Defective.

They disallow the name of “Lunatic” and “Asylum” and classify the mentally defective as follows:-

Persons of unsound mind (who require care and control).

Persons mentally infirm (who are incapable of managing their own affairs)

Idiots. Defective in mind from birth.

Imbeciles. (Capable of guarding themselves against common physical dangers, but incapable of earning their own living).

Feeble-Minded. (Persons who may be capable of earning their own living under favourable conditions, but are incapable of competing with others or managing themselves).

 Moral Imbeciles. (Persons who display some Mental Defect with vicious or criminal propensities on which punishment is no deterrent).

Epileptics.

Inebriates.  All of these three are considered Mentally Defective.

Deaf, Dumb and Blind.

 As to the commissioner’s recommendations, their main aim is to show the necessity of Continuous Control of the Mentally Defective.

They propose to establish a central authority called “The Board of Control” composed of salaried Commissioners (Medical Men and Barristers).

England and Wales is to be divided into eight districts.

The work is to be locally administered by County Councils and County Borough Councils who are to form a Statutory Committee for the Care of the Mentally Defective of every type.

The cost is to be borne by the County Councils and County Borough Councils, aided by new grants from the Exchequer.

Receiving homes to be provided for the Reception, Observation and Temporary Treatment of cases of Mental Defects.

Three methods of control are recommended.

Certification – Oversight – Detention.

Notification to Local Committees devolves upon Public Medical Officers, and there is to be supervision and registration of all homes where Mentally Defectives are maintained.

And then the Commissioners say:-

“The new authority for the care of mentally defective should form no part of the Poor Law System of the country”

At present our Insane are mainly controlled by the Lunacy Commissioners and it is therefore of importance to know their views of the Royal Commissioner’s Recommendations.

They say- “We practically approve their recommendations, but we express our unanimous opinion that the Lunacy Commission, or the Board of Control, should be left in its present independent position, and not relegated to a department either of the Home Office or the Local Government Board.”

Now let us see what view we find in the Majority Report of the Royal Commission on the Poor Laws.

“The feeble minded should be dealt with in accordance with the recommendations of the Royal Commission on the subject. There should be detention and reformative treatment and single lapse cases of unmarried mothers should be dealt with in institutions apart from the Workhouse, preferably in charitable institutions, but if these are not available, the public assistance authority 9that is the new name for guardians) should institute homes of their own”. That means they condemn the present institutional treatment by guardians, but recommend the re-establishment by the Public Assistance Authority, showing beyond all doubt that institutional treatment as at present provided by the Guardians is absolutely necessary.

And the view contained in the Minority Report is like unto it.

“We concur in the view of the Commission that all grades of the Mentally Defective (including the Feeble-Minded, the Epileptics, the Inebriates, the Imbeciles, the Lunatics and the Idiots) should at all ages be wholly withdrawn from the charge of the Poor Law Authorities, as well as from the Educational Authorities, and that their entire responsibility for their discovery, certification and appropriate treatment should be entrusted to the County Councils and County Borough Councils.”

Let us now consider what has been done in this matter locally.

In November 1985, a conference was held in the Wakefield Town Hall, between the Asylums Committee and representatives of various Boards of Guardians in the West Riding, nearly all of the unions were represented. Two members represented this board on that occasion.

This is what the Commissioners in Lunacy then said:-

“There are at present in the asylums numbers of patients who might well be discharged if the Committee were satisfied that such patients would be suitably provided for in Workhouses. Harmless and chronic patients would be better and happier at the Workhouse (assuming always a proper staff and accommodation were provided) and further a considerable economy might be effected by this method of treatment.”

 The matter remained in abeyance until October 1905, when the asylums committee again circularized all Boards of Guardians in the West Riding, asking for certain information and enquiring whether the guardians would be prepared to take the harmless cases if some portion of the four shillings paid to Guardians out of the Exchequer Contribution Account for patients in Asylums was allowed to them towards the maintenance of such cases.

Nothing more was done on the matter. But to me the above proposal of the Asylum Committee that Guardians should take over these cases is very, very strange reading when compared with the report of the Executive Committee of the County Councils Association of last week in which they are now asking a Parliament to Reform the Poor Laws, and recommend “That all grades of the mentally defective persons (whether idiots, imbeciles, weak minded or epileptics) should all be removed out of the Poor Law and dealt with by the same Authority as Lunatics on the grounds of economy.”

In June of last year the Yorkshire Ladies’ Council of Education summoned a meeting in the Wakefield Town Hall, under the Presidency of the Lord Bishop of Wakefield, and at that meeting it was decided to convene a Public Conference. The conference was held in Leeds last November, and this board sent representatives – Mrs Reader, Mr Kendall, and Mr Spink – and it is the report of that conference we are now met to consider.

The object of the Yorkshire Association, which was then formed, was:-

To arouse and educate public opinion with a view to secure provision for the permanent Care and Welfare of the Feeble Minded. (A most desirable object).

To press for Legislation on the lines of the recommendations of the Royal Commission.

To aid in the formation of a Farm Colony, and this work to be undertaken by the Yorkshire Association.

Personally I think it is most desirable to arouse public opinion for the better treatment of the Imbecile Poor.

For the public are grossly neglectful of the mentally deficient in their midst, and they dispose of an unpleasant situation by simply ignoring it.

Whether the Guardians should press for legislation on the lines of the Royal Commissioners recommendations is a matter for our deepest consideration. If this farm colony scheme is carried out it will require considerable funds, and if we support it we shall have to make substantial contributions towards it.

Personally, I am not usually whole hearted in support of Authorities Semi Voluntary and Semi Public.

And if a farm colony is established I am convinced that only a small proportion of those in Workhouses could be transferred there, for we must remember that there are probably 1,000 imbeciles in the Workhouses in the West Riding.

Yet I regard it as a most laudable effort and much on the lines of the Royal Albert Institution, which has accomplished so beneficial a work.

Now what are the views of Guardians on this social problem from our own experience. What are our recommendations to be and how does the question affect us in this union?

The number of certified imbeciles in this workhouse is 46, and the number of weak-minded un-certified, 22, their average age is about 43 years, and their cost, 2000 pounds a year. In addition there are about 30 what we may call slightly Feeble-Minded, simply through old age or disease.

Now I want this position to be clearly understood that if a Farm Colony is established and we associated this union with it not more than perhaps 5 per cent. Of our cases should be taken there, (such for instance as the lad of 18 who was before the House Committee last Wednesday, and who should have some proper training), because the bulk of our cases are too old for a farm colony.

But what of the 90 and 5 per cent? Is it advisable to retain these in Workhouses?

I answer: It is.

If the name Workhouse is changed.

If separate and altogether distinct accommodation is provided for them (such as we are at present building for our females).

If there be an adequate staff of attendants.

If the four shillings grant be allowed for these as in the case for pauper lunatics, and

If further powers of detention in certain cases is granted.

Don’t let us get it into our heads that all feeble minded persons should be placed in Institutions. I don’t gather the Royal Commission even suggest that, for many of them can with the greatest advantage, be left under private care and the Guardianship of Relatives and Friends.”

Don’t forget our cases are under medical care and supervised by a Commissioner in Lunacy whose last report was very favourable so far as our treatment goes.

And the last opinion I can give you on the treatment of imbeciles in our workhouses is that of the Lunacy Commission for 1909.

“We visited 237 workhouses and saw 14,706 patients out of a total of 18,396 for England and Wales. It is impossible not to be struck with the happiness and contentment that prevails amongst the inmates. This is probably due to the fact that patients remain more or less in their own neighbourhood in which they were born, and in surroundings they are accustomed to, and are visited by their friends, and retain their individuality to a large extent than in the crowded Asylum.”

So I have come to the conclusion that the chronic cases should remain under the care of the Guardians, who take such a personal interest in them, and that the younger cases which come under their control should be transferred to some institution formed by a combination of unions, or failing this, to one on the lines as recommended at the conference of the Yorkshire Association, where they may be trained to useful lives, and their expenses paid by the guardians.

If the chronic cases remain under the care of the guardians there must be an adequate staff, and I am of opinion that for our male infirm wards, one male and one female attendant is not sufficient.

As briefly as possible I have tried to give you my views on a very difficult subject.

I have tried to outline (so that we may better understand this position):_

The general question showing its urgency.

The recommendations of the Royal Commission.

The views of the Lunacy Commissioners on those recommendations.

The opinions of the Majority.

The opinions of the Minority.

What has been done locally in conference with asylums committee since 1895.

The object of the Yorkshire association for the better care of the feeble-minded, and

What should be the practical action taken by such boards of guardians as our own.

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