Extra-Institutional Care of Mental Defectives in New York State, U.S.A
- Author:
Susan W. Hoagland.
Member, Board of Managers, Rome State School, N.Y. Field Agent, New York
State Commission for Mental Defectives. —————————————No State should consider itself either humane, or efficient from a business point of view, which continues to support in idleness any of its dependents (not excluding those physically or mentally handicapped), who might, under proper training and supervision, become at least partially self-supporting. But as a rule it is not until an intolerable weight of taxes drives a state into new methods of conservation, or when some big-hearted genius undertakes to relieve conditions which he or she vicariously feels to be intolerable, that the partial powers of handicapped dependents are ever fully developed.
Fortunately for the feebleminded all over the world, both these conditions have prevailed during the last decade in N.Y. State, USA The demands of educational authorities who, finally roused to the importance of dealing adequately with mental defectives in the public schools, set up a standard of a’’ speical ungraded class” for every 10 children three years retarded in school work; of social workers who, appalled by the many social evils resulting from the full liberty allowed feebleminded persons in the community after school age, were pressing both parents and judges toward the committment of all mental defectives to proper State institutions; and the irritation of the State Institutions, which, already full to overflowing, were rebelling at the apparently never ending procession of new patients pressed upon them,?forced the State legislature into creating a permanent Commission of three persons to consider New York State’s mental deficiency problem as a whole and return recommendations.
The first and most pressing demand confronting this commission was for the provision of at least “20�000 more beds for the feebleminded”! and it was in their search for means of doing this stupendous task in post war time that their attention became focussed upon the original experiments in extra-institutional care for mental defectives then being carried on by the Rome State School, Rome, N.Y. This school is the State’s largest institution for mental defectives, of which Dr Charles Bernstein has been the devoted and very active superintendent for over 20 years.
Close personal observation and sympathetic interest in the 6�000 “children” coming under his care during that time, had brought Dr Bernstein to the conclusion that a certain proportion of them were failing to fulfil even their partial possibilities of usefulness in the world, mainly because they lacked relatives, or friends able and willing to supplement their pathetic inability to compete in the open market with normal human beings at the job of earning a living. Years before the State commission began its work, Dr Bernstein had decided that every patient in his school had an inalienable human right to as much normal life in the community as he was capable of using with safety to himself and the public, and had dedicated himself not only to the securing of this right for them, but also to protecting them in their enjoyment of it, or in any suffering brought upon them in the process of securing it. ‘ ‘How many of us”, he demanded of his apprehensive assistants, “even those above average intelligence, would have made good in life without parents, relatives, or friends to stand back of our repeated failures and start us up, over and over again ? even 70 times seven ?’’
COLONIES FOR BOYS* ——————Renting a hundred acre farm near the school, Dr Bernstein began his experiments by placing there 20 boys who had been already trained and found trusty in the main school, under the supervision of a capable, trained farmer and his wife to live in the farmhouse and carry on the work of the farm. At the end of the first year, including the sums earned by the boys in spare hours at helping the surrounding farmers, this first experiment surprised even its founder by paying for itself. In other words these 20 boys had become not only self-supporting, but had led vastly happier, more human lives in simple natural surroundings than in the vastly more expensive crowded institution with its highly polished floors and necessarily formal routine. They had also improved in self-respect, in their physical carriage, and in some instances one to two grades in intelligence. They had also been of immense help to the farmers of the region, who were at the time desperate for helpers.
The success of this colony led to repeated duplications of it, until to-day the Rome State School is running 16 such farm colonies for boys, and three other colonies of different types. One of the latter is placed under a suitable man and wife, in an ordinary town house in a good neighbourhood, in Rome, from which the boys go out to day’s work as lawn tenders, furnace tenders, elevator boys, bundle boys, etc. During the late war these boys handled all the freight at Rome’s main railroad station. This group also supports itself.
Another group of low-grade boys, including several imbeciles, was placed near the lately acquired Rome Country Club grounds and did excellent service at clearing the ground of stones and brush, work for which at that time it was impossible to get ordinary labour.
A third group of boys among whom were some of the most serious disciplinary problems of the school, was taken to the heart of the Adirondack mountains far from any possibility of harming themselves or others. Here they planted trees for the State forestry conservation commission, and happily secured for themselves a better record for living trees at the end of the season than the State’s hired labourers of the year before. Their pride and delight in the open life of the mountain camp, was good to witness, and healthy fatigue following each day’s strenuous labour reduced disciplinary problems to a minimum.
These colonies for boys proved so successful that no opposition to them now remains, and there seems therefore no reason for not increasing their number indefinitely, provided they are carried on under competent supervision. 360 “Rome boys” are now supporting themselves in this normal happy way, thus freeing as many beds in the main school for more socially dangerous cases.
COLONIES FOR GIRLS. ——————To initiate this policy for feebleminded girls was quite a different matter, and demanded a far more daring courage, the popular belief being that feebleminded girls are a greater danger to the community, as well as in far greater danger from the community than are feebleminded boys. For even one feebleminded girl to become pregnant, whether married or unmarried, as a result of any experiment on the part of the State, would be enough, said the extreme eugenists and the overanxious social workers, to condemn the whole scheme.
But in spite of the thousand and one objections successively placed in his way. Dr Bernstein proceeded with his experiment of “Working Girls’ Colonies” for feebleminded girls. Renting an ordinary house in a good neighbourhood in Rome, a small city lying about two miles from the main school, he placed there 20 trained, trusty girls under a capable matron, well known for her work at the school and imbued with the high purpose of the experiment. A social worker was also attached to this colony, who not only carefully selected places for the girls to work at domestic service, but also collected their wages and adjusted difficulties arising from this new venture.
The charge made for the girls’ services was small at first in order to emphasize the educational feature of the experiment rather than its financial value, and also because some inducement had to be made to encourage employers to undertake what was then regarded as more or less missionary work. Some slight neighbourhood opposition to the colony showed itself during the first month or two, but as domestic servants were scarce in Rome, practically all the neighbours soon availed themselves of this new source of help and the opposition quickly faded, especially as the State School was known to be both able and desirous of keeping up exceptionally well any property under its care.
Life at the colony house was a delight to the girls in comparison with life in a big formal institution. Many privileges of individual dress, amusement, and possessions could be allowed them that were impossible in the larger group, especially after all the girls were steadily earning. They were allowed to start savings accounts, and to help choose and purchase not only their own clothing, but also attractive furnishings for the colony house, which was now their home. Games, dolls, and a victrola were soon added, as well as several pet animals, to which the 76 studies in mental inefficiency.
girls were endlessly devoted. Taffy pulls, sewing bees, dances in front of a big open fire were frequent occurrences, and once a week the matron took a group to the ‘ ‘movies,’’ as girls were never allowed out after dark alone. But for the most part all of them were healthily tired at the end of each day’s work, which seemep to include sufficient varied experiences to amuse and satisfy the majority of them. The Domestic Service Colony soon made its own way, the preference of both employers and matrons being for the girls of lower grades of intelligence. High grade imbeciles did very well, as they were never placed in positions of responsibility, but only where they could be hands and feet for some kindly housewife, who did her own work. But there remained a group of the quicker, brighter, more restless girls to be provided for and since their type is often so emotionally unstable as to make it seem unwise to trust them on the street alone (as the domestic service girls were safely allowed to do), a new type of colony was established for them in a small factory town about 20�miles from the school. Twentyfour such girls were placed in a big attractive house with a good yard, under the care of two matrons, one of whom ran the home, while the other went with the girls to the factory, taking a job as forewoman there in order to adjust the girls’ difficulties on the spot, immediately, to keep them steady, and see them home again.
This scheme provided just the stimulus needed to satisfy this set of girls, especially as they were soon earning all the way from $8 to $15 a week at piece work. This was much more than the duller more plodding domestic workers could earn, so that this group could afford more attractive home furnishings and personal wearing apparel. They even bought a second hand automobile in which the matron took them long rides on Sundays and evenings, through the beautiful surrounding country. They also rented a large attractive cottage at the nearby lake for the two weeks of their summer “lay-off” from the factory. They asked for and were granted a feebleminded baby from the main institution, for a pet, and took excellent care of him with the matron’s help. They lavished pretty clothes and too many toys upon him out of the part of their earnings allowed them for spending money, and were very careful to be absolutely quiet when he was asleep which was a blessing to the often overstrained nerves of the matrons.
To-day Rome State School is supervising 12 of these working girls’ colonies, one of them daringly situated in the heart of the third largest city in the State; and another, of coloured girls, in a small town of which the centre is a boys’ college, and over which the president of the college keeps a close supervision, as it represents the only source of domestic service for the college professors’ wives. These colonies are now caring for about 321 girls, the population changing more or less constantly in response to the needs of the colonies and also of the girls, some being returned to the main school temporarily for hospital or disciplinary care and training, or permanently as unsuitable for colony life. In time some of the girls proved so trustworthy and so suited to the homes into which they gradually settled down, that they were allowed to sleep at their places of employment, but they were still required to use the colony house as an amusement centre for their days off, and as their home when employers were away for any reason ? Last year these colony girls (domestic and mill colonies together) earned about ?62�000.
Many mentally defective girls wear out their environment more quickly than normal persons, so that the possibility of transferring them repeatedly to different types of colonies, in different places, under different types of matrons, is a valuable asset in their care. One girl, though a good worker, flatly refused to go two days in succession to the same place for work, but is to-day working quite steadily and happily by being sent to a different place of work each day in the week, the Monday place being considered quite satisfacory a week from the Monday before.
RESULTS. ——–After 14 years of experience with the colonies for boys, and eight years with those for girls, Rome State School has to-day over 1�000 of its patients outside the walls of its main institution (over one third of its population). It has put this colony method of care for certain types of the feebleminded far beyond the experimental stage. From its results Dr Bernstein judges that fully 40% of the feebleminded may be handled in this comparatively simple and much less expensive way, earning at least two thirds of their own keep as a group.
These experiments have not only demonstrated the humaneness of the scheme by brightening and delighting hundreds of handicapped human beings, but has also shown itself a valuable aid to discipline in the main school, because of the new hope and desire to improve that it instils into the children remaining there. It has also raised the grade of intelligence, the appearance and behaviour of mauy individuals sharing its life.
More than this, it has led many parents and also many judges to be willing to allow borderline cases of mental defect to remain for life under competent supervision who must otherwise have fallen into misery and disgrace, because the public would not be willing to commit such cases to an institution for life, to sit around the walls of their wards doing nothing. It has educated many communities into a more sympathetic understanding of these handicapped human lives and consequently into a more willing payment of taxes sufficient to give such children proper care. It has also shed welcome light on the problems of many socially insufficient individuals. The Superintendent of one factory employing our girls reports that they compare very favourably with the so-called normal girls in his factory, many of whom would in his opinion be safer and happier under our colony system of care. It is the writer’s belief that many domestic servants are of this very class and in pathetic need of the same type of friendly human supervision of their leisure hours.
During Rome’s eight years of experience with “Working Girls Colonies” 860 girls have passed through this test for partial freedom and to-day 360 of that number still remain in the colonies.
There have been nine pregnancies incidental to attempted escapes during the initiation of the system; but it should be noted that, although the chances for escape are naturally greater than in the main school, there have been proportionately fewer runaways from our colonies than from our main school. It should also be considered that these casualties took place among a group of girls whom we should probably not have been able to hold at all under any other system. For parents and judges are very unwilling, and justly so, to “put away” for life, in a state institution either boys or girls who appear able to enjoy life and earn at least a part of their own support.
Had the financial success of this experiment proved less astonishing, Dr Bernstein would still claim that the human benefits it confers upon the individuals thus partially liberated would fully justify the state in continuing and extending it, even though it necessitated greater expense than intra institutional care. For the State as foster parent or guardian must meet the whole of its human responsibility, which surely includes far more than simply food, clothing and shelter.
During the Great War many opportunities of earning wages were open to the feebleminded which would not be theirs in normal times. But even though they have been obliged to relinquish certain of their jobs to more efficient labourers, the demonstration has been made, once for all, of what they can do under training and supervision; so that never again can the world shut its eyes to the shame and cruelty of allowing even these partially efficient persons to remain idle from lack of public interest.
OBJECTIONS. ———–Such a bold proposal as even a partial liberation of any group or type of mental defectives was sure to meet opposition. The first note of protest came from the extreme eugenists who insisted that the public mind would by this system be unduly diverted from the great necessity of making impossible, by the absolute segregation of all feebleminded persons, the reproduction of mental defects. In vain Dr Bernstein reminded these persons that the absolute segregation of all feebleminded persons, rich and poor, was an impossible Utopia; first because of lack of public sympathy with the proposal, and again on account of the over whelming expense of carrying it out. He also stated it as his belief that half the working population of the world would fall below the extreme eugenist’s standard of normal mentality and suggested that since we could not to-day secure total segregation of all mental defectives, we had better train and supervise as carefully as possible those who could with some degree of safety be given a partial liberty, thus saving the beds already available in public institutions for the more socially dangerous cases.
Certain types of social workers who had become almost rabid over the need of banishing from society every kind and grade of mental defect, violently opposed the possibility of even limited liberty for any individual that he or she had laboured so hard to “put away” for life, and declared that the state had no right to countenance any system which opened the way to possible escape and marriage of even one feebleminded inmate solemnly committed to its care.
To these Dr Bernstein emphasized the already overcrowded condition of the state institutions; the fact that these institutions were schools and not prisons; the ignorance and apathy of the general public toward building sufficient institutions to care for even the most socially dangerous types of feebleminded persons; and also the unwillingness of parents and judges to “put away” for life in state institutions any child who seemed able to earn at least part of its support. Both of these groups then demanded sterilization as a prelude to a system of testing for freedom of feebleminded persons. Dr Bernstein reminded them that this doubtful procedure was again unlikely to be agreed to by the general public, and that proper supervision should be able largely to eliminate the danger feared; also that without this drastic practice we should be able to secure and hold a far greater number of feebleminded persons under strict supervision than we could hope to do were sterilization known to be a part of the state’s policy.
The Labour Unions fearing that the feebleminded would be used to replace normal labour, made certain demands that were recognized as just, and a promise was given them that our ‘ ‘children’’ would never be allowed to work for lower wages than others were paid on the same job, also that in case of strike we would at once remove them until the dispute at issue was settled, since we recognized that they would not be able to take part in the affair intelligently and the State as such could never take part in any industrial struggle.
Other interested onlookers objected that the colony system would draw public attention to, and therefore label unfavourably the girls living in the colony houses; that every loafer within miles of the houses would be drawn to annoy its inmates, while girls placed directly in private homes at service and supervised there would naturally sink out of sight and thus avoid unfavourable publicity.
This unpleasant thing has happened several times to our colony houses, but has been promptly met by the matrons, and the offenders sent to jail for the offence, which cleared the atmosphere of this particular trouble for a long time thereafter. The same thing happens in the case of the girls placed directly in private homes at service, and there it is much more difficult to discover and punish, because the employer desires no such publicity, and often hides the facts, fearing that the girl will be removed from their home because of them. Another objection is that the state is exploiting these helpless “children” by taking their earnings from them for their own support. This seems hardly a tenable position, since experience has shown that in almost every case the child has not been able to direct his or her life alone, and without our supervision, which the state is paying for, they would soon drift into the courts and prisons, or maternity wards of city hospitals.
The State Commission for Mental Defectives soon understood, and has for the last three years intelligently backed up this hard won success of Dr Bernstein’s organizing genius. Due to its recommendations the state legislature last year voted to support and extend the colony system as widely and rapidly as feasible. The Commission also instituted the employing of Field Agents to supervise mental defectives in the community, since they realize that only a small proportion of the total number to be cared for ever reach a state institution. They now consider their first and strongest drive must be toward securing proper mental examinations of, and adequate schooling for all mentally defective children; second, the supervision of all feebleminded persons in the community throughout life, leaving state institutions as the last resort when other types of supervision have failed. Five Field Agents have already been appointed whose duties are to assist in the parole work of the state institutions, and to arrange for the admission to state institutions of suitable cases; to supervise mental defectives in their own homes, and in industrial placement as far as possible; but especially to do the mental testing and social work connected with the free mental clinics which the commission is placing within easy reach of towns or rural communities where such opportunities are not readily available. Twenty-six of these clinics have already been established, held bi-weekly, tri-weekly, or monthly as needed.
Calls for new clinics are constantly coming in, as they become better understood and appreciated by public schools, courts, medical men and social workers.
We recognize that England is far ahead of us in the community supervision of the feebleminded in their homes, and also in industry, but our state-wide clinics and our colony system providing as it docs for gradual steps toward further liberty, as earned, we believe to be New York’s contribution to the solution of this subject. Already congratulations and inquiries as to details of the colony system are pouring in from all over the world.
PRIVATE EFFORT. ————-One of New York’s largest private reform schools, for girls from 16 to 21, has sold its enormous congregate building and is trying out a new plan of boarding homes for different types of offenders, from which the girls go out to work by the day, iising’the!home:’as’?their’centre^forrsupervision8and7guardianship, thus reflecting the influence of our colony^systemTorrthevfeebleminded girls. The writer believes that a comparison of the two groups’of girls would show less difference than is suspected in the types of mentality.
The Jewish Big Sisters of New York City, finding that their problem girls were almost always girls of subnormal intelligence, and that no trade school for girls would bother with such problems, have pushed intelligently for the establishment of a special trade school for such girls, and to their credit be it said that such a school for 100 of these girls is to be opened in New York City this Fall by the Board of Education. They also found that the ordinary employment agency would not bother with these problem cases, and they have opened a “Vocational Adjustment Bureau for Girls” which deals only with girls having an IQ below average intelilgence, and already they have over 100 employers working with them intelligently to place their girls at jobs suited to their mental abilities.
May I take this occasion to thank all of the English workers in this field from whom I received so many courtesies during my stay in London earlier in this year. I shall endeavour to help their ideas and experience bear fruit for the feebleminded of our country. If any of these workers should visit America, I hope they will surely get in touch with the New York State Commission for Mental Defectives at 105, East 22nd Street, N.Y. City, and with Dr Charles Bernstein at Home State School, Rome, N.Y.
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