On my supervisors’
retirement about a year ago I was left with a large box of books, some of which
long out of print and still others, with almost faded pencil lines marking
sections that must have had some relevance to his work all those years ago. One
of these was the 1971 Hansels and Gretels, Studies of Children in Institutions
for the Mentally Retarded, by Dorothea & Benjamin Braginsky (New York:
Holt, Rinehart and Winston). I finally got around to reading this book in the
last week, more so out of interest for its historical context.
The book, as expected, is
peppered with language that many of my younger colleagues would hardly believe
is possible – I’m of course referring to clinical labels and accepted
terminology of the time. Consider; for example “…as a psychologist in a large
state school and colony,…”, “classified as high-grade mental defectives…”, “…I
prepared myself through library research and clinical conferences to look for
moronic behaviour…”.
Chapter 5, titled “Retardates
and Their Keepers: Conflict of Interests” particularly caught my curiosity.
Here the authors begin the chapter with an acknowledgment of an assumed covert
ideological conflict between the retardates and the institutional staff. I
think they were correct in seeing this to be crucial in interpretations
concerning retardate behaviour. The authors’ show insight when are expounding questions
such as “what is the nature of their affliction, who are they, how should they
be treated, what are their needs, and why are they incarcerated,..” etc.
In order to ascertain the attitudes that the training school staff maintain about mental retardation, its treatment and prognosis, and the institution, the Braginskys provide the results of a 100-item adaptation of the Retardation Attitude Test (RAT). What's really fascinating here isn't so much the variance between "Upper Staff" and "Lower staff" attitudes, which by the way is in itself interesting, but the kind items in the RAT. For example, item 15 "Although Retardates may seem all right when they have left here, they shout not be allowed to marry." Something incidentally about 30% of both upper and lower staff agreed with.
As well as my interest in
this book’s historical throwback – I had also read the more current paper by Dianne
E. Green (et al) New Zealand Attitudes to Mental Health (New Zealand Journal Of
Psychology, 1987, 16, 37-41) that also dealt with stereotyped attitudes towards
the mentally ill. I’d wondered if attitudes have indeed changed and if so by
how much.
The researchers examined
propositions about stereotyped attitudes towards the mentally ill based on
responses of a group of New Zealand university students and the results
compared with those if similar New Zealand studies carried out by the authors
some three and six years previously, and with a U.S.A study carried out nine
years previously.
In a historical sense, the
authors talk of a contemporary shift in the care and treatment for the mentally
ill and that has been away from institutional care and towards greater
involvement of the community. Also, an acknowledgment of proposals introduced
by various countries for the community to be more deeply involved in the care
and treatment of the mentally ill, for a diversity of fresh therapeutic
treatment and management styles with different types of institution to be
initiated, and for the adoption of safeguards to prevent the oppressive control
of patients.
In order to throw some
light on the validity of these assumptions the present authors examined
attitudes of one section of New Zealand community (in this case university
students) with a rationale that, subject to social and situational pressures,
attitudes are generally a precursor to behaviour, and that attitudes to the
mentally ill might indicate the readiness with which people could be expected
to respond personally to the specific demands for community mental health care.
Three propositions were
examined; two of which are described below.
Proposition one:
That people attach a
stigma to the mentally ill, was confirmed. Ratings of the three relevant
concepts (a) “mental patient”, “insane people”, and (c) “ex-mental patient”
were examined. When it came to the
concept of “mental patient” the stereotype had a highly negative rating without
bothering you with the statistical reliability. Interestingly, this did not
differ significantly from the 1981 negative stereotype.
Proposition one:
That the public holds
moderately favourable attitudes toward mental health professional was tested
via 2 concepts (a) “psychiatrist” and (b) “doctor”. The rating for this mental
health professional was moderately positive as it was in 1981. However, the
rating for the concept “doctor” was much more positive than for the
psychiatrist, as it was in 1981, 1978, and 1971.
The authors conclude that social attitudes towards the
mentally ill need to be changed before community-oriented mental health carte
policies can have much hope of long-term success.
