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Christmas In Purgatory: A Photographic Essay On Mental Retardation

Creator: Burton Blatt and Fred Kaplan (authors)
Date: 1974
Source: Available at selected libraries
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The American people have the right to know. In spite of what we wish to know, in spite of the pain that knowing may bring to us, we have the right to be informed about any serious conditions that affect our people. There is a maturity that comes to a people when it no longer needs the protection of ignorance. Only children, with their fantasies, or sick adults, with theirs, believe that ignoring a problem can make it go away.

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Our recommendations derive from many sources: our experiences prior to this study, what we observed during the study, the reactions of many astute individuals to this study, and the advice of students and colleagues. The core of our proposal was originally presented by Sarason and Gladwin a number of years ago in Sarason's book, Psychological Problems in Mental Deficiency, published by Harper and Bow in 1959:

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It is disappointing but true that the quality of research being done in our institutions is poor. The psychological personnel are for the most part geographically, financially, and socially apart from their professional brethren. The disinterest of behavior science departments (psychology, anthropology, sociology, psychiatry) in the area of subnormal functioning makes the solution of the problem most difficult. We must frankly state that we do not have any bright ideas of how to begin to go about remedying the situation. On the assumption that this particular problem will not change markedly in the forseeable future, it might be profitable to consider a program which would allow the institutional worker to go for extended periods to certain centers where there is an active research and training program -- a center where he can possibly learn new skills and content which he could apply to research in his own setting. This suggestion, however, presupposes that there will be several research centers which can offer this kind of opportunity. An increment in skill and knowledge sufficient to justify this kind of effort can probably not be attained in a one- or two-week workshop, but should rather be viewed as requiring at least a half-year or year training course (p. 651).

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Can one any longer ignore the needed relationship between the state institution for the mentally retarded and the state university? In addition to the emergency need for at least doubling per capita expenditures in state institutions and for reducing the sizes of institutional populations wherever and however possible, our study of this problem leads to an additional set of recommendations that may contribute to an improvement of institutional programs and facilities:

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1. In each state, a board of institutional visitors should be appointed by the governor or other constituted authority. This board would be responsible for reporting directly to the highest state officials. Appointments to this board should be made regardless of political party affiliation and these appointments should be contingent on both knowledge of the broad field of human welfare and demonstrated dedicated public service. Members of this board of visitors would not be, concurrently, members of any particular institution's staff or board of trustees.

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2. Within each state institution for the mentally retarded, each department (e.g. medical, psychological, educational, nursing, cottage life) should have a board of advisors. This board of advisors, through periodic visits and consultations, would know the institution and its problems intimately and, thus, be in positions to advise and assist in the resolution of difficulties. In essence, the advisory board would be organized for direct consultation and assistance to the institutional staff. As this board would not be responsible for rating institutional personnel or recommending their salary increments or promotions, it is possible that members of this board would become involved with the most pressing and severe problems of the institution -- without "endangering" the positions of the staff that trusts them. In this way, it would be possible for problems currently secreted from the outside world to be given the exposure and ventilation needed for satisfactory solutions to them.

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3. In each state, a state university should be given responsibility and resources to provide comprehensive in-service training and consultation for all institutional employees, from the chief administrative officer to the attendant recruit.

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4. In each state, one state institution for the mentally retarded should be designated as a center for the in-service training of all personnel to be employed for state service in institutions and clinics for the mentally retarded. As a condition for employment as institutional superintendent, psychologist, teacher, nurse, or attendant the candidate would have to spend a specified period of time at the training center. His preparation program would range from a few weeks to one calendar year, depending upon his background and experiences and the nature of the position he intends to assume. During this training program, the candidate would be involved in clinical experiences that relate directly to his future employment, would participate in seminars, colloquia, and other instructional experiences designed to prepare him for the sensitive and demanding activities of work with the mentally retarded. At the end of the candidate's training program, the director of this facility and his staff would rate the candidate and recommend him, or not recommend him, for employment. To the degree that this program is workable with currently employed staff, every inducement and encouragement should be provided to permit them to complete this preparation.

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