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A Metropolitan Area In Denmark: Copenhagen

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

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As a model I have chosen the service system in the area of Copenhagen, which forms a regional unit of the Danish National Service for the Mentally Retarded. Before describing this regional system, I will discuss the larger background of services in Denmark.

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Brief History of the Development of Service Systems in Denmark

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Denmark covers some 43,000 square kilometers (16,538 square miles) and has a population of 4.8 million. Copenhagen, the capital of Denmark, lies on Zealand, the largest of the Danish islands (7,543 square kilometers; 2,901 square miles) and has just over one million inhabitants. Denmark has a highly developed communication system and a relatively even distribution of social, medical, and educational services within easy reach of the citizens.

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In 1855 and 1865, the first two institutions for the mentally retarded were established by private organizations. Between 1890 and 1922, social security programs initiated earlier were supplemented with more general social insurance acts of parliament, covering old-age benefits, health insurance, industrial injuries, disability insurance, relief, and unemployment. The costs of these programs are divided between the national government, the local authorities, and the citizens as members of the insurance system. Social security schemes are to a large degree financed through general taxation.

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The National Assistance Act of 1933 defined institutional care, treatment, education, foster-home care, etc. as the responsibility of the Danish Government. By this social reform legislation social programs of the 19th and early 20th century were consolidated. This act was reaffirmed and updated by the passage of the National Assistance Act in 1961, and supplemented by special acts on the deaf, the blind, and the mentally retarded (the latter in 1959). All those not covered under the provisions of any of the acts are eligible for services under the Rehabilitation Act of 1960.

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In 1937 an act to combat sickness and mortality among infants in their first year was passed as the first of a series of laws concerned with preventive medicine. A Maternity Welfare Act, in force since 1945, provides for free regular examinations of all expectant mothers by a doctor and a midwife, and the health of children is regularly checked in their homes by visiting public health nurses. In 1946 an act was passed which provides for nine free preventive medical examinations of infants from birth to their seventh year. At this age, health control is taken over, under the act of 1946, by the school physician attached to each school, who carries out regular examinations. Any departure from normal development is brought to the attention of the family physician, who provides for the required treatment. Preventive work is also the responsibility of the general practitioner, who plays a very important role, although municipal clinics have been set up for this work in Copenhagen and some of the larger provincial cities. Everyone may freely choose where he wishes to be examined.

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Social research, including studies of the conditions of handicapped persons, is carried out by the Danish National Institute of Social Research.

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A commission (the Social Reform Commission) appointed by the government in 1964 has been charged with preparing and reporting on a total reform of the organizational, administrative, and financial structure of the Danish social security system.

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The Obligations of the Danish Service System to the Mentally Retarded as Defined in the Act of 1959

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The act concerning the care of mentally retarded and other handicapped persons grants the mentally retarded civil rights in nearly all respects. With this act, (1) the Mental Retardation Service (2) has been established as a semi-independent organization under the jurisdiction of the Ministry of Social Affairs.


(1) A copy of the 1959 act is found in the Appendix.

(2) The reader should keep in mind that there are two "Services:" the National Health Service, and the Danish Service for the Mentally Retarded.

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The service system or the mentally retarded is divided into 12 regions as will be seen from the attached sketch, each region being administered from a center. However, a single superregional training program for care personnel is operated in Copenhagen, as described in the appendix.

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The entire organization is governed by a board of directors, acting in concert with the regional centers. The board of directors consists of eight members appointed by the Minister of Social Affairs. One members is to be a representative of the National Health Service, one is to represent the Ministry of Education, and one is to be a representative of the countrywide association of parents for the retarded. The remaining five members are persons who must be expected to have insight and interest in the Mental Retardation Service. This composition is characteristic of the multidisciplinary feature of the Service. The members are appointed for 4 years -- a period that corresponds to the electoral period of local councils. The board is chaired by the Director of the Service, who is appointed by the King.

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