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Introductory remarks by Dr. Gunnar Dybwad, Director, Mental Retardation Project, International Union for Child Welfare, at the opening session of the International Working Conference on Architectural Planning in Mental Retardation -- Copenhagen, April 4-6, 1966

It is with profound appreciation that I wish to welcome you all, because by your willingness (and for many of you the willingness of the organizations with which you are associated) to attend this Conference, you have brought into realization a plan I have been thinking about for many years, to bring together an international group of architects. And this is a good moment for me to express my sincerest thanks to my architect friends in many countries who have greatly stimulated my thinking.

Over the past 25 years, I have visited more than 500 institutions in the field of health, welfare, education, and delinquency, and at various times I have had institutional assignments, so that I became well acquainted with them from the inside, but it was not until a few years ago when I first saw some new institutions for the mentally retarded in the Scandinavian countries, and in particular Lillemosegaard (which we all shall visit on Wednesday morning) that I was suddenly struck with the tremendous contribution architects can make in our field. When I have chosen as the title of my few remarks this morning "Architecture's Mission in the Field of Mental Retardation," I have done so to indicate that I include architects among the professional groups that can make a primary contribution to the field of mental retardation.

As I am sure Dr. Grunewald will amply document in his presentation this morning, the last 10 to 15 years have brought about a revolution in the field of mental retardation which has affected the basic attitudes towards the mentally retarded and their families, not just on the part of the persons working in the field, but on the part of the general public as well. The problem, as always, has been to translate a shift in ideas into the reality of actual programs, and it is in this regard that the architects have been in a position to demonstrate in concrete form (an expression which certainly is here most appropriate) how such concepts as individualized treatment or integrity of the individual can be brought to life.

From the psychological laboratories have come to us in recent years some challenging new findings about the possibilities of sense training, even with the most severely retarded. It is the architect who can make a unique contribution by creating a physical environment that by its very existence leads the severely retarded individual to a development of sense for space and for color.

Auditory stimulation should also be mentioned here, good auditory stimulation as compared with the deafening, nerve wracking bedlam of noises which existed in the large old day rooms with their tiled walls.

One of those new thoughts developed during the past fifteen years is that the mentally retarded are not a species set apart, but are human beings like you and I, human beings with a handicap to be sure, but entitled within the limitations of their handicap to live like other human beings. As a result, we have developed the concept of A D L, Activities of Daily Living, as the focal point of the day to day rehabilitation and training of the mentally retarded. Training in "activities of daily living" sounded like a mockery in the old traditional institution where the interplay between the sterile daily routines and the sterile physical surroundings created a pattern of existence which again last week at an international symposium in Dublin, Ireland, was described by a psychiatrist as a process of "de-humanization". While, of course, the architect is in no position to control the activities of the institution or treatment center once it is built, he can create a physical setting which at the very least creates a natural setting for individualized treatment and normal patterns of living, and complicates a reversal to old institutional routines.

Perhaps I should clarify my comments with a more specific exemplification. Even in those few institutions already in existence where gifted architects did have an opportunity to design the kind of facility I have tried to describe, I have usually found two remnants from the past, the toilets and the facilities for washing and bathing, where the architectural lay out was such as to favor the old impersonal institutional routines, discouraging personal self-sufficiency on the part of the residents. Thus, I am eagerly waiting to see an institution where the architectural design even of these rooms facilitates and encourages a training in normal patterns of daily living.

I hope it does not strike you as unseemly that in this formal opening session of an International Conference I am discussing such lowly subjects as toilets and washrooms. However, if I did hear any grumbling among our participants yesterday, it was grumbling about just these things -- only the persons who grumbled did not think about mentally retarded residents, they thought about their own feelings about the great importance of privacy and convenience in such usually unmentioned routines of daily living!

As one who has been accustomed to work with institutions serving three or four thousand and more patients, I am fully -- indeed painfully -- aware of the tremendous problems which face us in accomplishing the needed readjustments.

One of the members of the Conference mentioned to me last night how necessities brought on by an extremely sparsely populated area forced his office to design a small modest living unit for no more than seven retarded individuals -- and these seven constitute the entire institutional population.

As I listened to him, I wondered whether it would not be these small units (and of course they do not have to be quite that small) which can help us to return institutional living to something which bears greater resemblance with common human existence, and provide us with basic patterns of group living which can be adapted in larger institutions.

I realize, of course, how much in some of the countries here represented the regimented routines in our regimented buildings go back to regimentation from a distant bureaucracy that clings to out dated concepts, bases its judgements on outdated information, and prevents the use of modern building concepts and materials.

Having spent a good part of my professional life as a State bureaucrat, who had to formulate and enforce rules and regulations, I am well aware of the tremendous force of inertia one can here encounter. Therefore, I hope this Conference will not neglect to discuss international aspects of the effects of State rules and regulations pertaining to construction, fire prevention, etc., for buildings for residential use or for day care or instructional purposes.

This would appear to be an area where international exchange of information would be particularly important, because certainly for once we should not hear the objection "but things are different in our country -- we have a different culture" because fire resistancy should be a more objective, generally applicable criterion.

Certainly, I do not want to press this aspect as a matter of priority in our discussion, but neither should we lose sight of it, as it unfortunately happens all too often.

Altogether, I do hope that this first international exchange on architectural planning in mental retardation will be followed by some international action. It is for this reason that I am most appreciative of the presence here of several international organizations. Usually on occasions like this one can expect a friendly greeting by wire -- but today we have with us the Presidents of the two voluntary international organizations working in this field, the International Association for the Scientific Study of Mental Deficiency and the International League of Societies for the Mentally Handicapped. We certainly hope that they will feel stimulated to seek further contacts with the International Union of Architects which has sent here an official observer, but which is of course represented also by many of the architects who are participating in this meeting.

Some of you may wonder why we have no one from the United Nations agencies here with us. So do I. We sent invitations both to the European and to the main office of the World Health Organization, but they could not arrange to be represented. This is doubly regrettable since during a symposium called a few years ago by the European Office of the World Health Organization the question of architectural planning for buildings serving emotionally ill, maladjusted, and mentally retarded children was pointed up as a particularly pressing need.

However, I am sure that the International Organizations here represented will -- on the basis of the findings of this Conference, persuade the various UN agencies that within their broad interests in the fields of health, education welfare and rehabilitation, the challenge to architecture in the field of mental retardation should find a place.