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The Normalization Principle And Its Human Management Implications

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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Section 16 contains a summary of the tasks of the Boards for provisions:

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Section 16: "The Board for the provisions and services for the mentally retarded shall:

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work towards the attainment of the provisions needed by the mentally retarded residing within the county council community;

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plan and coordinate the activities of the county council community according to the law, and work towards the satisfactory development of law;

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administrate the facilities for the retarded which are under their management and other activities for them which are managed by the county council community, if not otherwise governed according to the second, third, and fourth paragraph of Section 6;

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take charge of the local supervision of other facilities for the retarded according to the more detailed instructions given by the King;

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bring before the county councils those proposals which concern provisions for the retarded as they are found to be needed."

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This "energy section" of the law aims at actively engaging the Board for provisions and services for the benefit of all retarded in need of the provisions ensured to them by this law. A prerequisite for this is the dissemination of information, and active cooperation with child care centers, agencies working with the mental hygiene of children and youths, district physicians, district nurses, children's hospitals and child clinics, Swedish parents' association for the retarded, etc. The Boards for provisions shall also be responsible for the development of services in a satisfactory manner, as, for instance, the supply and training of personnel, and the application of new methods and practices in the training of the retarded and their integration into the community.

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The old painful system of registration is eliminated; the new procedure will be to register at the residential institution or special hospital of residence or in the school attended. In the rest of the cases, only the Boards for provisions will only keep a record of all known mentally retarded and will there make a notice of the different kinds of provisions supplied in each special case.

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While the Swedish law offers a basis for the creation of decentralized, differentiated, specialized smaller institutions, hostels, and boarding homes for the retarded, some conditions still exist in Sweden that are not consistent with the normalization principle. For example, there are still about half a dozen institutions for more than 400 persons, the largest having as many as 740 residents. These institutions, as well as some in the 200-400 range, are institutions for heterogeneous age groups from early childhood to senescence, and two of them still even have special schools on the grounds. (All the other 25 special boarding schools have independent locations.)

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More than half of the mentally retarded living in institutions in Sweden do so in facilities built after 1954, when a special law on mental retardation services was enacted. These newer institutions usually provide single and double bedrooms, and occasionally 4-bed rooms. Most of the older institutions have been modernized and rearranged according to modern standards. However, there still are a few deplorable regional institutions in Sweden where the retarded have to live as many as 10 to a room, with large, inadequate dayrooms which serve as many as 25 or 30 persons. These institutions are satisfying neither to the retarded nor to the Swedish parents -- nor, for that matter, to the authorities.

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There are also institutions which, even with modern communications, remain isolated from the mainstream of community life. One of the main conclusions of the previously mentioned Stockholm Symposium was "that facilities for retarded persons should not be situated in remote or secluded areas, which preclude the essential contact between them and the community and which would prevent their complete integration in society."

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With regard to residential accommodations, the following conclusion was reached: "The Symposium recommends that each country should determine and proclaim the desirable standards of accommodation for mentally retarded persons having regard to the following considerations:

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1. that the structure of each facility planned should take into account the special needs of mentally retarded persons;

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2. that facilities should not be sited in isolation, nor planned in such a manner that the mentally retarded persons for whom they are intended, would be deprived of normal contacts with the community;

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3. that while there are differences of opinion as to the optimum size of multi-purpose complexes, such as residential centers which incorporate education, training and treatment functions, there is general agreement:

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a. that it is much more difficult to fulfill the rehabilitation programme in all its aspects in a big institution than in a relatively smaller one;

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b. that the living, dining and recreational units of such complexes should be small, with living accommodation for numbers not exceeding some 15 to 20 persons;

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