Correspondence to the Editor
STUDIES IN MENTAL INEFFICIENCY. 65 Correspondence. the; Editor.
Sir,
In your last number you published an interesting article by Dr F. Douglas Turner, on ” Institutions for Defectives.” 1 hope tha if I venture to criticize it on one main point I shall not be thought to be unappreciativ e o the value of much in it.
This point is Dr Turner’s plea foi the large institution. Indeed, the word “large hardly seems to me adequate: an institution for two or three hundred patients would seem to most people large, and Dr Turner, w 11 e thinking that ” the tendency will be to have institutions containing a thousand or twe ve hundred patients,” would personally prefer ?ne with ” not more than six 01 seven hundred,” because he thinks ” this is the largest number a superintendent can keep in actual touch with, and it is important he should have a personal interest in all his Patients.”
I sincerely trust he is wrong about the tendency favouring mammoth institutions. I had thought that the mammoth institution was deservedly falling out of favour and coming to be recognized as a mistake of Victorian social organization. Certainly this is the feeling of very many whose experience gives them even’- right to judge. Some of us have hoped for a new temper of social philanthropy which should take into account much in the way of homeliness and humanity which cannot well be tabulated in statistics: something that has seemed to us to belong rather to the small home, with its intimacies, than to the large institution, with its necessary abundance ?f routine.
Ihit what I am concerned to point out especially here is that other authorities, for instance, Professor G. Elliot Smith, M.D., and T. H. Pear, B.Sc., in their little work, Shell Shock, disagree markedly with his opinion that a superintendent can take a personal interest in each of six or seven hundred Patients,
If it is urged that Dr Turner is thinking, not of medical attendance, but of personal interest, I venture to state categorically that he is wrong in supposing that an average superintendent can keep in actual touch with and take a personal interest, really worthy of the name, in even rive hundred patients?that it is only quite an exceptional person who can take a continued daily personal interest in more than three or four hundred persons. (I have heard that similar considerations have led public authorities in providing for children to favour small homes: and what applies to normal children applies with more force still to great numbers of the mentally defective.) What Dr Turner says about classification in a large Institution is, of course, obviously true. The larger the number to be classified, the easier to divide them up so as to secure about the same degree of defect in each class. But the advantage has its reverse side. The more you classify, obviously the less you individualize. In the mammoth institution it will be inevitable that interest centres rather on the class than the individual. In smaller homes there will still be classification: this is inevitable. But there will be something which is better than classification, viz., individualism. The only intelligent object of classification, after all, is to adapt treatment to capacity and requirements. The danger of classification,?the danger which besets every large institution, our public schools, for instance,?is that while grouping people together on the grounds of their similarities in one point or another, it is apt to lead to their receiving identical treatment in all respects, to overlook their essential differences as individuals.
Dr Turner considers it inconceivable that county authorities will set up a system of small homes. The points he presses against such a system amount in effect to the single objection that ” the expense will be prohibitive.” I urge most strongly in reply to this objection that it will be short-sighted indeed to let the consideration of the immediate expense in pounds, shillings and pence i volved weigh with us in considering the treatment of this question. Where the salving of human material, the raising the standard of human possibilities, is concerned, money is well spent, and the best will be the cheapest in the long run.
I am, etc., A. H. Baverstock, Rector of Hinton Martel, Wimbourne.
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