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THE UNDEVELOPED RESOURCE AT THE EDGE OF CHANGE (1)

Gunnar Dybwad (2)

Your theme for today is "The Undeveloped Resource at the Edge of Change". If you listened with care this morning, you found that undeveloped or not, this resource has an edge that is quite sharp and may cause some pain and, indeed, there may even be a little bit of blood.

Essentially we are here to talk about change and how much of it came and why more did not come. Throughout the United States one can observe isolated examples of very excellent specialized programs for the mentally retarded which have been in existence for many years and yet, not only in the neighboring states, but very often in the very same state, they have not been adopted or adapted by others.

A large number of professional workers representing many disciplines have written reports on outstanding services for the mentally retarded in other countries, and have furnished elaborate documentation through the printed word, through photographs and slides. Numerous committees and commissions -- and certainly you had no dearth of them in California -- have reported on needs. As a matter of fact, I still refer back to some of the earlier reports from the California Legislative Committees which were far advanced, with sweeping recommendations for improvements. President Kennedy's campaign to combat mental retardation was, of course, of particular significance. President Johnson's Committee on Mental Retardation, in its report in 1967 and again in 1968 was no less critical and no less adamant that sweeping changes had to be made than had been President Kennedy's original panel in 1962. Yet with all of this, progress has been amazingly slow.

Now I think it might be good if we stopped talking for a little while this noon as to what you ought to have, and try to find out why it is that you are not getting it. What are the obstacles to change? An overall national problem, brought out this morning, is the way in which society at large, communities, and also certain societal institutions still perceive the retarded as a deviant person. I think we have a long way to go before we can effectively change these attitudes. Every once in a while we get some very grim reminders such as the Atlantic Monthly article, you will recall from earlier this year, which advocated euthanasia for all children born with mongolism. Every once in a while you get a glimpse at the depth of such feelings that still exist and which we conveniently try to overlook because we have a tendency to overlook the unpleasantness. Certainly, this kind of role perception, as the sociologist would say of the mentally retarded as a deviant person or, as that article suggested, a non-person, is change inhibiting.

Another inhibiting factor is the sheer extent and size and monetary value and, last but not least, the economic utility for certain communities of the current physical plants, facilities and services of the large institutions for the mentally retarded. They tend to block, or at least effectively delay, action towards change. This is again an unpleasant topic. We do not like to suggest that people make money by building institutions, all sorts of people, all sorts of money, money which is not made when funds are used to hire needed staff. Thus, certainly the momentum of the current service pattern centering on large institutions is another effective inhibiting source for change.

Looking at this problem from a broad or nationwide prospectus, one can characterize the present development of mental retardation services in the United States somewhat as follows: Although there has been widespread advocacy for increased emphasis on non-residential services, the need for residential services is perpetuated and reinforced by the placing of a low fiscal priority on non-residential services and of a high fiscal priority on maintenance and, in many states, still on construction of residential facilities. The result is a shortage of non-residential services, which, of course, in turn, leads to an accentuation of the urgency for the creation of additional residential services, which are storing up an ever larger number of individuals since those ready to return to the community cannot be released, cannot return because of the inadequacy of funds for non-residential service. Here is a real vicious circle all through the country, representing, I repeat, the momentum of the current service pattern. System maintenance is what this is called by the sociologists, who have become more and more fascinated with this phenomenon.

But then, of course, we have some other inhibiting factors toward change. Different groups have investments in different services and certainly there are several professional groups who have a very substantial investment in the present institutional system. They are concerned with their job status, job security, job opportunities and this is a definite inhibiting factor. About that there can be no doubt, because enough public documents have been released by the particular professional organizations to make quite sure they will neither lose their jobs nor their influence.