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The Origin And Nature Of Our Institutional Models

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

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A 1964 prospectus, written by the staff of an institution, contained the following instructions to an architect regarding the design of a new residence building for adult and young adult "trainable" retardates: "All interior wall surfaces shall be of a smooth material, and without wall projections other than those specifically stated. All thermostats should be protected with a guard to avoid tampering. Window areas shall be kept consistent with patient needs. Excessive window areas are not desirable. Consideration should be given to using shatterproof glass in patient areas. Door louvers in patient areas should be made of a steel material to withstand patient abuse. Mechanical and electrical equipment and controls throughout the building shall either be tamperproof or located outside the patient areas. Maximum water temperatures for bath and lavatories must be automatically controlled to eliminate the possibility of scalding. Switches in large patient areas shall be located on the outside of the rooms. A cubicle measuring 24" x 12" x 12" should be provided for each patient." While such instructions are not conclusive evidence that the instructors held a "subhuman" view of retardates, such instructions certainly appear to be consistent with such a view.

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It cannot be emphasized too strongly that the alleviation of dehumanizing and other undesirable management practices is ultimately more a matter of attitude, rather than of money as widely claimed. There have always been residential facilities that provided exemplary service at very low cost. Usually, such facilities were small, privately operated, and affiliated with religious organizations. On the other hand, one can point to public institutions in this country where even generous funding and high staff-to-resident ratios have failed to change old practices. Eight attendants can look at 75 residents from behind an unbreakable glass shield as easily as one attendant can, and I have known an institution where this was the sanctioned pattern.

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The Retardate as a Menace. Unknown events or objects, if alien enough, tend to arouse negative feelings in both man and beast. Man's history consists mostly of his persecution of fellow men who were different in features, skin pigmentation, size, shape, language, customs, dress, etc., and it is apparent that man has been apt to see evil in deviance. It is not surprising that one role perception prominent in the history of the field is that of the retardate as a menace. The retardate might be perceived as being a menace individually because of alleged propensities toward various crimes against persons and property; or he might be perceived as a social menace because of alleged contribution to social disorganization and genetic decline.

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The residential care model derived from the menace perception has much in common with the subhuman model. Certain features, such as segregation from the community, as well as segregation of the sexes, are likely to be accentuated. Since the menace model may ascribe a certain willfulness and evil intent to the retardate (in marked contrast to the medical model), an element of vindictiveness and persecution may enter into his management, and some of the protective features of the subhuman model may be omitted. Otherwise, residential features of both models have much in common.

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The history of the menace model in the United States will be reviewed later in this essay.

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The Retardate as an Object of Pity. One residential model is based upon the image of the retardate as an object of pity. Persons possessed of such an image will often hold one or more correlated views:

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1. The retardate is seen as "suffering;" from his condition, and there is emphasis on alleviation of this suffering.

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2. Although the retardate may be seen as "suffering," he may also be believed to be unaware of his deviance.

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3. The retardate is seen as "an eternal child" who "never grows."

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4. Being held blameless for his condition, the retardate is seen as not accountable for his behavior.

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5. The retardate is viewed with a "there but for the grace of God go I" attitude.

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In residential care, the "pity image" will tend to be expressed in a paternalistic environment (1) which shelters the resident against injury and risk and (2) which will make few demands for growth, development, and personal responsibility. Both these features may imply infantilization and lack of risks and environmental demands such as stairs, sharp edges, hot water, hot heaters, and electric outlets, as discussed previously.

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The pity model has some features in common with the disease and subhuman models. However, there are important differentiating features. The pity model strives to bestow "happiness" upon the retardate, usually by means of emphasis on programs of fun, religious nurture, and activity for its own sake. This, in turn, is likely to result in allocation of generous space and facilities for music, arts, crafts, parties, picnics, and worship (e.g., a chapel on the grounds).

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