The Manor Institution, Epsom: Some Comments on its First Two Years
By the Medical Superintendent. —————————–The Manor Institution (1,003 beds) commenced to function as one for the care of mental defectives on January 3rd, 1922, and this article is an attempt to describe some of our methods following a suggestion that this institution has been run on somewhat different lines to most others of its kind.
It should be stated at the outset that we have no children of the very lowest grade, except in the school, which circumstance accounts for our being able to claim that 100 per cent, of the patients are employed usefully. It has been our ambition to extend to the boys and girls as much freedom as possible with a view to culturing them to live as near as can be the lives of normal individuals. Some of the features that appear to strike visitors are that children, or adults, go about unattended, that there are open doors and gates, no walls, etc., or other obstacles to running away, and the association and meeting of the sexes is as occuis in the outer world.
This, I suppose, is all true to a certain extent, and of necessity increases the responsibility of the staff, and requires a detailed knowledge of the individual characteristics and careful organisation. In some cases the meeting of the sexesr occurs as the result of structural arrangements, but in others it is intentionally allowed, e.g., the object of a workshop containing both sexes is that boys who are unable to fend for themselves, i.e., the paralysed and simpletons, etc., who are apt to get bullied and knocked about are found to be mothered, well cared for, and encouraged to work in girls’ workshops; at the weekly dance which has now become the most popular form of entertainment, boys and girls not only dance but are allowed to sit and talk together if so disposed, as opposed to the old institution idea of the two sexes sitting on opposite sides of the hall. With a well placed staff there can be no risks, and the behaviour is most orderly. This arrangement adds greatly to the enjoyment, and without doubt has done much to encourage interest in personal appearance?even many of the most slovenly being observed to take infinite pains in this respect?and a normal regard for respectable behaviour in the presence of the opposite sex. At present smaller boys are being trained with a hope that they will one day take their place in the orchestra which, for the time being, only consists of staff. It is now really excellent and, without doubt, forms one of the most useful adjuncts we possess, for to miss a dance is a great punishment.
I have repeatedly heard the Manor spoken of as an open institution, but this statement requires some qualification. All our male wards for boys over school age are open, there being no locked doors and the patients come and go to work as they please or can enter the gardens or recreation grounds at will. A smaller number of boys has to be dealt with differently, and will be described later under the headings of the “S.S.” and “O.K.” The girls on the other hand, with the exception of the Girl Guides, numbering approximately 100, also to be described later, are kept under rather closer supervision.
The chief difficulties found in running an institution on these lines are the facilities to abscond, the endeavours of the boys to converse with the girls, and many minor other delinquencies; but these worries to my mind, have been more than repaid by the general happiness and contentment of our population and its educational advantages. Our difficulties were doubtless very considerable at the start, and in my opinion such a system is impossible without submitting one’s flock to what might be described as some intensive form of living that is:?they must be at work, play, or sleep, which permits of no time for getting into mischief. Numerous industries and occupations exist for all; out of work hours similar pains are taken in organising games of all kinds, gymnasium, swimming, expeditionary parties, voluntary educational classes for those over school age, etc. It was found quite early that our week ends, with work shut down, were troublesome times, and the Manor Committee wisely decided to permit Sunday games out of church hours, which has made all imaginable difference in behaviour. Different members of the staff are detailed daily to see that footballs, cricket equipment, etc., are plentifully in use and matches started, it being found very essential to be able to hold somebody always responsible for these necessaries.
In my opinion it is also of the utmost importance that there should be some definite and systematised method for classifying children according to marks received for behaviour and work done?due regard being paid to their mentality ?whereby some disciplinary measures can be taken, if necessary, by the removal of privileges, etc. The establishment of the guide and similar movements not only works to this end but is responsible for much pleasure and useful training. I will now, in more detail, describe some of these organisations.
GUIDES. —–I should say at the outset that without a competent enthusiastic and altruistic officer, no good, in my opinion, will result, and needless to state nothing is obtained by simply dressing a child in uniform. We had our first Girls enrolled at the Manor three months after opening, since when the movement has steadily developed and is now represented by a large company (known as the 4th Epsom) embracing Rangers, Guides, and Brownies. Naturally at the outset we were confronted with many problems, difficulties and failures, to obviate which we have organised what is now a somewhat complicated but successful and very flourishing system which can be briefly described as follows:
The Guides live in a separate villa known as Guide Lodge. Guide Lodge is ruled by two bodies?The Court of Honour and the Council of the Lodge.
The Court of Honour is responsible for the discipline and general government of the company and its affairs. It consists of the Captain of the Company and her two Lieutenants (members of the staff); Brown Owl, who also acts as Secretary and Treasurer, the company leader and patrol leaders (all girls). The Captain or her Lieutenants presides at all meetings of the Court of Honour.
The Council of the Lodge, consisting of staff, i.e., the Captain and the Charge Nurses, is responsible for the discipline and general management of the lodge as a place of residence, the former only visiting there. One of the chief objects of its formation was that nurses who were performing duties as such should be kept cognisant of what was being done by the Guides, in the early days the nurses claimed that certain things were done without their knowledge, a state of affairs which led to many troubles. By the present arrangement the Court of Honour and Council of the Lodge have to report to and work in conjunction with one another.
Girls who are regarded as being likely subjects to submit to the discipline and possessing the requisite capabilities for being trained in Guide procedures, are invited to visit for one week in order to acquire elementary knowledge of the work and of the training to which they would have to submit. At the end of this time, if still considered suitable and still willing, they are invited to live wit t e Guides for one month during which time they are considered to be on probation. At the end of this month, if deemed expedient, they are placed on probation for a further month and then, if the reports of the Patrol Leader and other officers of the Court of Honour are satisfactory, they are finally accepted, proceed to tram and be enrolled in accordance with Guide Law. The Manor authorities neither claim nor wish for any jurisdiction with regard to Guide proceedings. The Lodge has its own book of constitution, containing regulations, from which no departuie may be made, and embodied in which are sufficient elements to ensure that nothing affecting the administration of the institution can take place without the necessary sanction of the Medical Superintendent, a book being kept whereby he, by signature, approves or refuses requests presented to him.
Guides take part in the industries of the institution the same as the rest ot the children and can obtain badges as the result of attaining proficiency when examined by Guiders or people connected with the movement from the outside world.
Apart from this work and the ordinary company training, they are responsible for the manual work and upkeep of their home, i.e., the Guide Lodge. This work is performed weekly by different patrols under the supervision of the Patrol Leader, and in the event of not being satisfactory, the Court of Honour deals with the matter. The Court of Honour can expel any girl from their company and she is then sent back into the institution, so that it has much disciplinary power.
The privileges of becoming a guide are pretty extensive, e. g., she is on’parole, going about unattended in the institution or grounds, certain areas being placed out of bounds. They are required to be indoors by a certain hour, that is when the flag is “struck,” the time depending upon the season of the year. As a company they attend rallies connected with Guides in the County and occasionally other functions; they arc permitted to attend outside churches, and outing parties are organised for them. Last summer a number of them were allowed to go away for two weeks to live under canvas with their Captain. During the summer months tents are erected in which they sleep out in the grounds if they so wish.
The Lodge may issue invitations to friends and gives dances or entertainments on occasions, providing their own refreshments, etc., from Lodge funds, the list of Visitors’ names being first submitted to the Medical Superintendent for approval. It is from members of the Guides that girls, so far, have been permitted to go into local domestic service, both daily and on licence, part of the arrangement being that they shall, once or twice a week, return to the institution and continue with guide instruction.
The life of a guide is a very full one, as the officers devote very much time, after duty hours, to the amusement and training generally, so that our girls are now regarded by the neighbouring guides as being of quite a high standard. To my mind it is very encouraging to find that members of the nursing staff are beginning to go into the ranks for training. The company has recently eommenccd to publish its own monthly magazine.
“BROWNIES.” ———-The Brownies are in charge of Brown Owl?one of the Senior Guide girls? and her Tawny Owl (a member of the staff), by whom they are regularly trained pending enrolment as Guides when age permits.
SCOUTS. ——-The Scouts (5th Epsom Troop) have developed on somewhat different lines to those described above in reference to Guides, chiefly because there has been no isolated building sufficiently large for residential quarters. A Scouts’ Headquarters has however been established in a building well apart from the main institution and owing to the wise hospitality extended by the Manor Committee in approving of neighbouring Scouts visiting, much has been learnt by our boys both on the Recreation field in the form of football, cricket, athletic sports, etc., as well as at Headquarters where lectures and Scout training in all its branches proceeds regularly under experienced Scout masters of local troops in addition to our own. In my mind no doubt exists as to the beneficial effect that has accrued from our association with the outside world through the medium of visiting scouts.
As in the case of guides, scouts can claim many privileges; they are providep with a pass that permits of being out on parole for stated hours, and, following a letter previously addressed to the parents, may, on occasions, proceed home for the day unaccompanied. As a troop they attend local jamborees in the neighbourhood, take part in outside church parades, and on one occasion, when His Majesty the King was visiting Epsom, three of our boys took their place with nine other scouts to form a Body Guard. One of our boys has been, in the presence of other troops, awarded the certificate and Gilt Cross from the Chief Scout for displaying presence of mind in rescuing a child from a perilous position.
At Head Quarters various social entertainments, supper parties with local scouts from time to time take place, and in the event of a Scouts dance being held in the town some of our boys are permitted to attend. In the summer they are allowed to sleep under canvas in the park and if attended by a member of the staff, i.e., the Scout Master, to camp beyond the limits of the institution grounds, coming in daily for their usual work. As with the guides a boy has to go through certain preliminary stages, lasting two months, before he can be enrolled, with a view to passing his tenderfoot. Scouts are also left to organise their own affairs, as far as possible without any interference from the Manor authorities, except that any requests of a nature affecting the administration of the institution aie submitted in a book to the Medical Superintendent for his approval.
“CUBS.” —–The Cubs at this institution are under the command of the Girl Guides Captain, a procedure permitted of by the Association. They form a delightfu little company and can provide a most amusing and entertaining programme. It was with considerable pride that we saw our Cub Tug o’ War team win the final pull last autumn at a general meeting where some seven or eight troops of various towns were represented.
SYSTEM OF REWARDS. —————-It goes without saying that any institution of this nature must have some means at hand for controlling the discipline of its boys and girls, more especially is this the case where so much freedom and opportunities of getting into mischief exist.
Confinement to bed, and, on the very rarest occasions, a simplified diet, is our last resort.
The main method of control consists in classification and the allowing of many rewards and privileges, which can be removed, and so act as a deterrent. Both sexes over school age are divided into four classes, each class carrying with it certain rewards and privileges. A misconduct report is written out by the staff on every occasion of offence and the culprit is brought before the Medical Officer the following morning, and he, after consideration of the facts, intimates why the boy or girl is being reduced in class. Once a month the medical staff discusses those placed in the lowest classes and decides whether promotion can be allowed. This decision is arrived at by reviewing the marks allotted for the past four weeks. Each workshop or place of employment is provided with a book in which the supervisor inserts, when necessary, a bad mark for unpunctuality, misbehaviour, laziness, etc. These bad marks deducted from the possible maximum ?f good marks represent those earned at industries. In addition the wards reward Jttarks for work done and interest taken in the upkeep of their place of lesidencc. The Medical Staff also have a column where they are empowered up to a certain limit to give marks, taking into consideration the mentality and general behaviour of the child. The sum total of all these methods represents a percentage of possible marks that could be earned, and since each class demands a certain percentage, the grading into classes is worked out automatically. The books are made up daily and appear weekly in the Medical Superintendent’s office for initialling. Besides the marks in columns placed opposite each child’s name, a further insertion is made stating the nature of and the quantity of work finished at any given industry.
The rewards and privileges consist of such things as tobacco, sweets, ribbon, crochet cotton, etc., attending dances and entertainments, the town Cinema, leave from the institution with friends, half-holidays, etc.
“S.S.” AND “O.K.” BOYS. ———————As stated earlier, the male side, that is, boys over 16 years of age numbering 273, reside in open wards by which is meant that doors are unlocked and the boys come and go to work or enter the recreation grounds or gardens as they please. Needless to say we soon discovered that some were found to abuse these privileges and could not be dealt with on freedom lines. These particular boys are now satisfactory controlled by classing into two groups which are popularly known here as the S.S. and O.K.
The S.S. (or Special Supervision) boys represent the habitual absconders and the incorrigibles who house break, get into our Tuck shops, thieve on every possible occasion, and can conform to no regulations of any kind whatsoever. They live in a room by themselves and never go unattended anywhere, and are taken to sleep at night in an observation dormitory. They are still employed in the various industrial shops but have to be taken to and fro in charge of the instructor with whom they work, who calls for and returns with them again to the S.S. Room. Such boys can, behaviour and work being satisfactory, still enjoy most other privileges such as entertainments, dances, football, tobacco, etc. In many ways some of our most popular and delightfully sporting boys exist as the rogues to be found in S.S.
The O.K. boys, partly so called because they are the observation boys living in “K” Ward embrace a somewhat different type. These are boys who are always out of bounds without permission, go down to the town, ‘bird nesting’ in neighbouring orchards, attend local race meetings, fairs, etc., but inevitably return to the institution after having enjoyed a good day’s outing. Such boys are allowed to go and return from work unaccompanied and enjoy all privileges, save that they are marked individuals in the ward and their failing to return immediately from shops would be observed. They are not allowed to leave the ward or its gardens until shop hours. In other words their time is always fully accounted for and we know that they are within bounds. As with the S.S. Boys they can still take part in a football match, etc., but are not given any opportunity by the staff of wandering away.
The S.S. and O.K. boys represent approximately one seventh of our adult males, the remaining six sevenths being free agents. From time to time a boy is discharged, on trial, from S.S. or O.K., or again if O.K. means fail S.S. is resorted to. It is a regrettable fact that an S.S. boy’s word of honour, in many instances, is often found to count for Nil, not lasting more than an hour or two.
A very encouraging fact is that in spite of the freedom and liberty permitted here only two cases are on record of delinquencies occurring in the neighbourhood, attributable to the institution. In the one a boy ran away and stole some reins as he left the town, and in the other a boy broke bounds and was caught with his arm through a shop window taking cigarettes. If such cases are so rare, under supervision, surely no reasonable community should expect or demand the segregation of all certified mental defectives under prison-like regulations; such action is a gross injustice and cruelty to the many. It is regrettable that the word ‘ ‘mental’’ has to be associated with our wards, a description which seems to always call for ridicule or fear at the hands of the ignorant who seem to adopt this attitude towards any suffering with a diseased mind. This view on the part of the public and the lay mind is such that it is difficult to experiment with freedom, yet I look forward to the time when somebody will be able to show that it is possible, in a large institution with mental defectives under proper supervision to allow considerable parole, possibly amounting to thousands of instances a year.
FINAL REMARKS. ————-I think it will be realised from the above that we are rightly spoken of as being a fairly open institution with much freedom enjoyed by the elder children. Its advantages to my mind are extensive. It promotes happiness and gives one a far greater insight into the characteristics and behaviour of individuals. This latter knowledge is of considerable importance when consideration is being given to the possibility of recommending a discharge or permitting of employment in the world either on licence or as a daily employee, a procedure which is being encouraged here.
Happiness, I suppose all authorities will agree, is of paramount importance apart from anything else, if good work is to be obtained, so also is anything which increases the knowledge of the individual peculiarities and traits of our charges. Faulty conduct in many cases results from faulty environment, bad examples, and no moral training generally, prior to admission. The primitive instincts in many defectives no matter whether sexual, of acquisition, or of what nature, have never been schooled to inhibition, and yet many are unquestionably capable of improvement in behaviour and conduct. For these reasons I encourage the mixing of the sexes. By placing an inseparable barrier between them no inhibition of instincts is called for and nothing in this direction is accomplished; let them see normal individuals conducting themselves (for the one hope of the mental defective to my mind is his power of imitation) and let them be put to the test, under supervision, where no harm can come, until they themselves learn by experience what should, hafcl they been more fortunate, have been taught to them by their parents and others in healthy surroundings. Unquestionably to run an institution on such lines is a great responsibility and anxiety to the higher officials, moie especially so with the majority of staff untrained or with fixed notions. In the past we have all had to be greatly influenced by the opinion of the public who, in ignorance, have been responsible for much cruelty and still are. Let us extend hospitality and help to them on every possible occasion, making friends, and by so doing win over their sympathies and increase their knowledge. We have also been influenced by fear of failure, and still, I suppose, must be, } et I believe controlling authorities are all for advance in treatment on human lines and would willingly play their part in upholding any administrator who, with this object in view, found himself being severely criticised.
Most of our difficulties arising under the present regime do so in my opinion, not because the system is at fault, but from conditions over which we have no control; money is short and accounts for the majority; staff has to be limited and structural defects and requirements cannot always be dealt with. Our residents have been uninstitutionalised and are only gradually becoming so; experience goes to show that it is only a matter of time and organisation in which normal brains generally outwit the abnormal.
In our first few months troublesome incidents were continuous; two hay ricks, in different situations on the farm, were fired one afternoon, thatched shelters were burnt, false fire alarms were numerous, work strikes organised, and a door which had been placed in a corridor and taken exception to, knocked down by a trolley filled and pushed with boys, etc. However I am glad to say this is past history, and though our incorrigible and unstable type of admissions have greatly been added to since, this state of affairs no longer exists, though the same freedom is permitted. Absconders were naturally pretty numerous, but we have, comparatively speaking, few now, and these, in many instances, result from the relatives’ connivance followed by concealment of their child. This, I regret to say, is still a difficult problem, since although proceedings in court can be and have been taken against the offenders, this is a most undersirable practice, leading to publicity of malicious statements and lies in local papers on the part of the defendants.
This article has been written by request. I do not pose as an authority on the care and control of the mentally defective, but merely relate one’s experiences, and, imbued with ideas born of an affection for the mentally afflicted, I strive at the Manor, Epsom, for advancement, trusting it to be in the right direction.
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.