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Action Implications, U.S.A. Today

From: Changing Patterns in Residential Services for the Mentally Retarded
Creator: Gunnar Dybwad (author)
Date: January 10, 1969
Publisher: President's Committee on Mental Retardation, Washington, D.C.
Source: Available at selected libraries

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Wolfensberger's chapter on the origin and nature of our institutional models has provided us with a careful documentation of a historical development which has led to this sorry state of affairs. To find the answers as to the reasons for its continuance despite all the protestations of recent years, one would have to look to the social scientist and his helpful interpretation of the nature of bureacratic -sic- processes and of system maintenance. The question as to how to bring about change has been dealt with in a preceding section of this chapter; in this section, the emphasis will be on what needs to be changed in regard to certain aspects of the location and design of residential facilities.

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Human Management Versus System Management

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To put it briefly, the traditional and unfortunately still prevailing method of designing and constructing residential facilities for the mentally retarded was predicated on and guided by system management. The new program to which this book is dedicated is based on human management. The traditional institution reflected a mass approach; the residential center of the future must be based on the needs of individual human beings.

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The thought behind the traditional design was the need to create accommodations for diagnostic categories in quantity; in the new residences, services will begin with a human being, and rather than to create an environment to accommodate and maintain the level of functioning of his "category," we will need to provide an environment allowing for and indeed stimulating growth and development. Knowledge how such growth and change takes place thus becomes the key point of departure not only for the architectural design of rooms, buildings, and complexes of buildings but also for the crucial matter of site location and the perennial problem of the size of a facility. Once the architect has accepted the overriding principle of normalization and the associated concepts of integration, dispersal, specialization, and continuity as they relate to a residential human management service, he will have a tangible frame of reference within which he can design and properly locate living space that will enhance rather than hinder growth and change on the part of mentally retarded individuals (Dybwad, 1968).

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Site Selection

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Much has been written in criticism of the location of institutions for the mentally retarded. What needs to be kept in mind is that these selections were preordained to failure because of the way the task was defined: to find a very large tract of land on which to place a large institution (usually with the thought of further expansion) at a reasonable land cost. Frequently, this prescription led to the acquisition of land nobody else wanted, thus affording the real estate speculator with political connections a handsome profit, or a town badly in need of a supporting "industry" would find it a good investment to provide such land free of charge. As far as the residents were concerned, they appeared only as a quantity, as a figure of 1,000, 1,500, or 2,500; there was no thought, indeed there was no possibility of thinking of them as individuals belonging to a family, or any thought of that family's geographic relationship to the institution harboring their son or daughter.

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Normalization impinges on site selection in several significant ways reflecting the concepts of integration, and also of specialization and dispersal. Integration implies maintaining and indeed developing not just the sense of belonging but the closest possible physical proximity between the mentally retarded and the family. This implies visits from the family to the center, and visits of the mentally retarded individual to his home. But there is another dimension to integration; the principle of normalization not only refers to the life the mentally retarded leads in the institution and his contacts with the family but also bears upon his contacts with society, usually in the context of a community. This implies that the residential center not only should be within reasonable distance of the home of the mentally retarded but should have a definite ongoing relationship with the community, a relationship that has meaning not just to the center as a social institution, not just to a staff, but also to the residents themselves.

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The concept of dispersal adds to the process of site selection another dimension in the literal sense of this term. It seeks to limit the center to a sensible size in terms of human interaction, interaction of the resident with his fellow resident, interaction of the resident with the staff, interaction of the director of the center with both the staff and the resident, and finally also interaction of the center as a whole with the surrounding community. From the factors here enumerated, it will be obvious that there can be no set figure indicative of satisfactory dispersal. Much will depend on the kind of resident the center is serving, and much will depend on the interactional capacity of the surrounding community.

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