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A Scandinavian Visitor Looks At U.S. Institutions

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

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"to believe you are born with bad luck though you are merely born" -- Erik Lindegren, from "The Man Without A Way" (Mannen utan Vag), 1942. (1)

(1) Erik Lindegren, who died in 1968, was a major Swedish poet of the 20th century and a close personal friend of the author (Eds.).


Foreign visitors to the United States are likely to be impressed by the seemingly inexhaustible resources and wealth of America. Thus, a visitor who works in the field of mental retardation in another country would be inclined to expect that public institutions for the retarded are planned, constructed, and operated with the same thoroughness and lavish disregard for cost that appear evident in the planning, construction and operation of other facilities such as expressways, motels, hotels, skyscrapers. A visitor with such expectations is in for a rude shock.


In the last 2 years, I have visited a number of public institutions in several states, and on each occasion I have reacted with disbelief and bewilderment to what I saw. I found it difficult to understand how a society which is built on such noble principles, and which has the resources to make these principles a reality, can and will tolerate the dehumanization of a large number of its citizens in a fashion somewhat remindful of Nazi concentration camps.


Since my first visit to the United States I have seen the book by Burton Blatt and Fred Kaplan (Christmas in Purgatory. Rockleigh, New Jersey: Allyn & Bacon, 1967) in which the conditions I have alluded to above were described and pictorially shown. Actually, I can add relatively little to this description except to say that my observations are similar to those of Blatt and Kaplan. I must, however, take exception to the use of the word "Purgatory," and not merely because I observed worse things than those depicted by the hidden and horrified camera at work in that too-little-known book. Once upon heathen times, there was an image of the god Moloch, an iron sculpture of a man, hollow, and made to be heated as a furnace. In the outstretched arms of this horrifying image of iron and fire, children were placed to be sacrificed for shallow reasons. Upon signals of the officiating witchdoctors and priest, the agonizing and sorrowful screams of the parents were solemnly and respectably drenched by the sound of trumpets and kettledrums. The image was placed deep down in a little valley 200 yards below what later was called Mount Zion. This place was named the Valley of Hinnom -- thus giving the name to Gehenna, and later in slightly more enlightened times, to Hell.


Below, I will briefly sketch some of my observations. Upon entering a certain building of Institution No. 1 in the North-Central state M, personnel could be seen supervising, through a glass wall, a huge L-shaped dayroom, each wing of which was about 20 yards long and 10 yards wide. The bottom of the windows of this room was at eye-level for an adult. On the large terrazzo floor were a few wooden tables and benches and a couple of metal carrousels. In this dayroom no toys were to be seen. Some of the children had their heads lying across the tables; others huddled on the floor along the walls, or in the darkest corners if they could. This was the only dayroom for the severely retarded residents of this building. The adjoining room was their bedroom, with 87 beds in endless lines. About 10 children were lying in bed, some with excrement in their hands and mouth. Only one person was working with the children, and she was a mentally retarded girl about 16 years of age. The majority of the children spent only a few hours each day outside the building for recreation or for training purposes.


In the special hospital unit for low-functioning children with medical complications, I found several children tied to their beds, with plastic nose-feeding tubes constantly fastened to their noses and hanging over the high bars of their cribs.


In another and new building at Institution No. 1, moderately retarded girls of ages 10 to 16 were housed. Most of these girls apparently attended a training program, but 40 of them slept in the same bedroom, and the huge dayroom was equipped with only a few benches and a TV set. This created a deadening atmosphere for the girls upon their return from classes or recreation.


Another building at Institution No. 1 consisted of two large day-rooms, one dining hall, and a large single dormitory with 104 beds for severely and profoundly retarded adult men; large unsheltered toilets, without doors, opened directly into the dayrooms; the dayrooms, also without doors, opened into the bedroom. Since many residents were incontinent, a huge ventilation system had been installed on high legs at one end of the dormitory to eliminate most of the odors. At the side of the dormitory were isolation cells for residents engaging in destructive and disturbed behavior. Each cell was equipped with a toilet and a wooden chair. On the floor of one cell, a naked man was squeezing his own excrement. I was informed that the number of attendants on this ward for 104 men was a maximum of three, and often only one. The number of chairs was not sufficient for the number of residents, and most of the men who were not sitting were walking aimlessly around, some naked, some half-dressed in very simple clothes. Few residents of this building leave the building or its fenced-in outdoor exercise areas.

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