THE NEED OF PERSONALITY STUDY IN THE CASE AND TRAINING OF MENTAL DEFECTIVES


There is hardly time to bring to your attention all of the mental defects of this group, but in order to point out better the kind of training and care they require, I should like to mention a few of the outstanding characteristics which are of such vital importance as to require most careful consideration.


In a brief discussion of the need of personality study in the care and training of mental defectives there will be little opportunity to do more than to mention briefly a few statistics showing the number of children in the school at Mansfield and awaiting admission, the estimated prevalence of feeble-mindedness within the state and elsewhere, point out some of the outstanding characteristics of mental defect, show you by means of stereoptican pictures how we are training the children at the Mansfield State Training School and Hospital, especially the higher grade types, so as to enable all who receive such training to live more useful and happy lives whether they remain in the institution, or improve sufficiently to return to community life.

At the present time we have at Mansfield 684 children, ranging in age from 4 to 76 years (we call them all children regardless of age, for mentally they still remain children no matter how old they may be in years). Of the 684 in the school, 104 are epileptics, and these, with a few exceptions, are mentally deficient as well as epileptic. Mentally the children are classified as 438 in the idiot and imbecile groups and 246 in the highest grade, or moron, group.

With the opening of the new buildings now nearly ready for occupancy, about 200 more children can be accommodated, bringing the total enrollment to 864, including sixty who are on parole either in their own homes or in a place of employment. But the admission to Mansfield of 200 additional children will not solve the problem for all who are now known to need institutional care for there will remain more than 300 for whom no early provision seems possible. Furthermore, even under the present unsystematic method of registration with our social service department, the known number of the feeble- minded who are in need of institutional care is steadily increasing.

From the result of various and somewhat widely distributed surveys, it is estimated that 2 per cent. of all school children throughout the country are feeble-minded. A recent survey in Massachusetts shows that in that state there are more than 60,000 known mental defectives with only about 4000 cared for in institutions such as Mansfield. On the basis of the surveys which have been made in other states it has been estimated that there are from 16,000 to 18,000 mental defectives in Connecticut, and that one-fourth of this number should have institutional care and training. However, it is well to bear in mind that this estimate of the total number of the feeble-minded refers chiefly to the higher grade types more particularly, the morons, for in comparison to the number of morons, there are relatively few of the helpless, deformed, low-grade idiots and imbeciles, for whom so little can be done except to see to it that they receive good care and are treated kindly.

Therefore, the real problem is with the higher grade imbeciles and the morons. Fortunately it has been found that the majority of these higher grade defectives have good homes, benefit from association with their normal brothers and sisters, can be educated and trained to a certain degree in the special classes in the public schools, never seriously misbehave and that in so far as their behaviour is concerned, they successfully become assimilated into community social life. Thus with the present concept as to the cause of mental defect cutting the number of cases probably due to heredity nearly in half, this assimilation into the natural social life of the community furnishes a brighter outlook for a more satisfactory solution of the problem than formerly was thought possible.

On the other hand, far too many of the higher grade class fail to benefit by the education and training which is open to them in the public schools, develop bad personality traits, indulge in antisocial behaviour and lacking the capacity and will for normal achievement, easily drift into pauperism, prostitution and crime. It is for this troublesome class that institutional segregation and training is very essential.

Some of these children are sent to the institutional school because of unsuitable home conditions and not because they have become a community problem, but in considering what we are trying to do at Mansfield, please remember that the great majority of the higher grade class who are trainable to some useful purpose, do not come to us until for one reason or another, they have become troublesome, and that they do not come to us as a rule during that period of their life when children are most susceptible to the right kind of influence and example. For this reason in our effort to train them to make the most of such capabilities as they possess, we not only have to overcome the handicap due to the lack of adequate training, but we have to deal also with the added burden of firmly rooted bad personality and behaviour traits which are difficult to eradicate or even to modify.

It is not difficult for anyone to recognize idiots and low grade imbeciles and to appreciate little we can do for them, but it is not easy for the casual observer to detect the higher grade defectives, and especially those close to, and within the borderline group. Physically, many of this class have few, if any, physical defects to distinguish them from their normal brothers and sisters, while mentally there is no positive dividing line which brings them out sharply into contrast with the normal, one group so merging into the other that often only a trained observer can detect the mental defects and understand the reason back of their failure at home, in school, at work and in society.

There is hardly time to bring to your attention all of the mental defects of this group, but in order to point out better the kind of training and care they require, I should like to mention a few of the outstanding characteristics which are of such vital importance as to require most careful consideration.

As a class, even the higher grade defective are sadly deficient in reasoning power and judgment. Their power of attention is poor and no matter what they undertake to do, it is difficult for them to hold themselves to sufficiently close application to make sure of successful accomplishment. They are stubborn, untruthful and deceptive. They have weak wills and to a marked degree, lack the power of self-denial and self-control. Their sex instincts are highly developed and following the path of least resistance, they are easily influenced for the wrong.

They possess little ethical sense and not appreciating responsibility, give little thought to the consequences of their behaviour. In fact, when left to their own direction, their whole life is characterized mainly by child- like superficiality, and is sadly lacking in ability of accomplishment and in depth of character and purpose. Therefore, since these children are creatures of habit rather than of lessons learned, we must carefully study the personality traits of each individual and direct the training toward the development of those habits which will enable them to live their lives in the best way for themselves and for society.

We must recognize in applying this training that a mentally defective person remains a child in mind and character, that it is useless to try to teach him intellectually more than he is able to assimilate and that it is better to place a greater emphasis upon some kind of unskilled labor in which by constant repetition of performance he can become serviceable and happy. Habits of industry and profitable accomplishment tend to improve his personality traits, to increase his self-respect, to create confidence and make him more amenable to the requirements of social life. Appeals to his artistic sense help to broaden his vision and stabilize his ethics. For instance, John can be taught attention, concentration, cooperation, respect for the rights of others and self-control more effectually in a ball game, specialize dance or dramatic play than in the class room or potato field.

Besides, when satisfactorily completed these feats not only give a helpful sense of accomplishment and amusement to those less fortunate. We find that with this class of children precepts without practice are of small avail and that the preparation for a dramatic entertainment brings various emotions to the front and teaches numerous lessons which are unconsciously applied. But it is not necessary to go into further detail, for you will observe in the pictures which I am presenting the variety of ways by which we endeavor to inculcate the much-needed lessons for socializing these children.

While many mental defectives who require institutional care can be trained to do a great deal worthwhile work with their hands and are able to get along very well in the restricted social environment only by the along very well in the mind that all this is accomplished only by the patient, sympathetic supervision of the officers, teachers and other employees, who know just how to direct the activities of such children and wisely assist them in quickly adjusting their many difficulties. However, there are very few under institutional care who would be able to get along satisfactorily without the same understanding supervision, for when away from the kind of help which they at all times so urgently need, the characteristics which I they at all times so urgently need, the characteristics which I have mentioned, together with the discouragement which follows their failure to compete successfully with their normal fellows, lead them to depravity and delinquency.

To meet this need we are building a social service department which will ensure to those children who can be rehabilitated in the community, that measure of continued intelligent supervision and guidance which they require, and in less than three years time this department, with offices at the capitol in Hartford, has proved itself to be a vital adjunct to the work at Mansfield. During this time in addition to supervising an average of more than fifty children home on parole and visiting many other homes to see if the home conditions were suitable for parole privileges, the social service department has investigated 582 applications for admission; obtained a complete social service history in each case and arranged for the admission of many urgent cases.

In a number of instances this work has made possible a satisfactory disposition of the case elsewhere so that admission to Mansfield would not be necessary. The social service department is now at the point in its development when we expect it can greatly broaden the scope of its activities and by means of the permanent supervision which this department will give, we believe that an ever increasing number of boys and girls who have undergone training at Mansfield, will either return to their homes or be able to establish themselves satisfactorily elsewhere in some form of remunerative employment which will enable them to become at least partially self-supporting, and help them to lead respectable lives.

Henry B. Ballou