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Citizenship and Learning Disabled People: The Mental Health Charity MIND’s 1970s Campaign in Historical Context

Abstract

Current policy and practice directed towards people with learning disabilities originates in the deinstitutionalisation processes, civil rights concerns and integrationist philosophies of the 1970s and 1980s. However, historians know little about the specific contexts within which these were mobilised. Although it is rarely acknowledged in the secondary literature, MIND was prominent in campaigning for rights-based services for learning disabled people during this time. This article sets MIND’s campaign within the wider historical context of the organisation’s origins as a main institution of the inter-war mental hygiene movement. The article begins by outlining the mental hygiene movement’s original conceptualisation of ‘mental deficiency’ as the antithesis of the self-sustaining and responsible individuals that it considered the basis of citizenship and mental health. It then traces how this equation became unravelled, in part by the altered conditions under the post-war Welfare State, in part by the mental hygiene movement’s own theorising. The final section describes the reconceptualisation of citizenship that eventually emerged with the collapse of the mental hygiene movement and the emergence of MIND. It shows that representations of MIND’s rights-based campaigning (which have, in any case, focused on mental illness) as individualist, and fundamentally opposed to medicine and psychiatry, are inaccurate. In fact, MIND sought a comprehensive community-based service, integrated with the general health and welfare services and oriented around a reconstruction of learning disabled people’s citizenship rights.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Email address for correspondence: Jonathon.toms@ntlworld.com
Footnotes
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I thank the Wellcome Trust for providing the grant that enabled me to research and write this article (Grant no. 206056/Z/17/Z). I also thank the three anonymous reviewers for their criticisms, insights and suggested amendments.

Footnotes
References
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1. For example, John Welshman and Jan Walmsley (eds), Community Care in Perspective: Care, Control and Citizenship (Basingstoke: Palgrave MacMillan, 2006); David Race, ‘The historical context’, in David Race (ed.), Learning Disability; A Social Approach (London: Routledge, 2002).

2. Nikolas Rose, ‘Unreasonable Rights: Mental Illness and the Limits of the Law’, Journal of Law and Society, 12, 2 (1985), 199–218; Nikolas Rose, ‘Law, rights and psychiatry’, in Nikolas Rose and Peter Miller, The Power of Psychiatry (Cambridge: Polity Press, 1986), 177–213; Kathleen Jones, Asylums and After: A Revised History of the Mental Health Services: From the Early 18th Century to the 1990s (London: The Athlone Press, 1993).

3. Sedgwick Peter, Psychopolitics, ch. 7 (London: Pluto Press, 1982); Rose, op. cit. (note 2).

4. For an overview, see Katja Guenther and Volker Hess (editorial), ‘Soul Catchers: The Material Culture of the Mind Sciences’, Medical History, 60, 3 (2016), 301–7.

5. Alexandra Bacopoulos-Viau and Aude Fauvel (editorial), ‘The Patient’s Turn: Roy Porter and Psychiatry’s Tales, Thirty Years On’, Medical History60, 1 (2016), 1–18; Sarah Chaney, “‘No ‘Sane’ Person Would Have Any Idea”: Patients’ Involvement in Late Nineteenth-century Psychiatry’, idem, 37–53; Hazel Morrison, ‘Constructing Patient Stories: “Dynamic” Case Notes and Clinical Encounters at Glasgow’s Gartnavel Mental Hospital, 1921–32’, idem, 67–86.

6. The mental hygiene movement began in the United States in the first decade of the twentieth century. On this history, see, for example, Johannes Pols, “‘Beyond the Clinical Frontiers”: The American Mental Hygiene Movement, 1910–1945’, in Volker Roelcke, Paul Weindling and Louise Westwood (eds), International Relations in Psychiatry: Britain, Germany and the United States to World War Two (Rochester: University of Rochester Press, 2010), 111–33.

7. It was originally called the Central Association for the Care of Mental Defectives, changing its title to CAMW in 1922.

8. Mathew Thomson, The Problem of Mental Deficiency: Eugenics, Democracy, and Social Policy in Britain, c. 1870–1959 (Oxford: Clarendon Press, 1998), 217.

9. For a recent example, David Stack, ‘A Moment of Madness’, Total Politics, 43, 2012.

10. Thomson, op. cit. (note 8).

11. Thomson, op. cit. (note 8), 46–7. That the Act’s extension of ‘mental deficiency’ to include people considered ‘feebleminded’ did have a significant class basis was, in fact, emphasised by Josiah Wedgewood, one of the few parliamentarians to strongly resist its implementation.

12. Jones Greta, Social Hygiene in Twentieth-Century Britain (London: Croom Helm, 1986), 2728.

13. Stewart John, Child Guidance in Britain 1918–1955: The Dangerous Age of Childhood (London: Pickering and Chatto, 2013).

14. See, for instance, Ruth Darwin, ‘The proper care of defectives outside institutions’, in Central Association for Mental Welfare, Report of a Conference on Mental Welfare Held in the Central Hall, Westminster, London, SW on Thursday and Friday, December the 2nd and 3rd, 1926 (London: CAMW, 1926), 23–35: 23–4.

15. Evelyn Fox, ‘The Mentally Defective and the Community’, Studies in Mental Inefficiency, 4, 4 (1923), 71–9. Wellcome Trust Archives and Manuscripts, Mind Archives: SA/MIN/B/80/57a.

16. Jan Walmsley, Dorothy Atkinson and Sheena Rolph, ‘Community care and mental deficiency 1913–1945’, in Peter Bartlett and David Wright (eds), Outside the Walls of the Asylum: The History of Care in the Community 1750–2000 (London: The Athlone Press, 1999), 181–203.

17. Clive Unsworth, The Politics of Mental Health Legislation (Oxford: Clarendon Press, 1987), 51–2.

18. Thomson, op. cit. (note 8), 293.

19. For a fuller discussion of the NCCL’s campaign, the input of psychologists and NAMH’s response, see Jonathan Toms, Mental Hygiene and Psychiatry in Modern Britain (London: Palgrave MacMillan, 2013), 120–5: 130–4.

20. Ibid.

21. John Hall, ‘Mental Deficiency – Changing the Outlook’, The Psychologist, 21, 11 (2008), 1006–7; Race, op. cit. (note 1).

22. Lilly Mark, The National Council for Civil Liberties: The First Fifty Years (London: MacMillan, 1984), 7879.

23. Gunzburg H.C., ‘The Colony and the High-Grade Mental Defective’, Mental Health, 9, 4 (1950), 8792. SA/MIN/B/80/27/10.

24. Clarke A.D.B. and Clarke A.M., ‘A Rehabilitation Scheme for Certified Mental Defectives’, Mental Health, 14, 1 (1954), 410. SA/MIN/B/80/27/14.

25. Rolph Sheena, Reclaiming the Past: The Role of Local Mencap Societies in the Development of Community Care in East Anglia (Milton Keynes: Open University, 2002).

26. Long Vicky, ‘Work is therapy? The function of employment in British psychiatric care after 1959’, in Ernst Waltraud (ed.), Work, Psychiatry and Society, c. 1750–2015 (Manchester: Manchester University Press, 2016), 334350.

27. Stainton Tim, ‘Equal citizens? The discourse of liberty and rights in the history of learning disability’, in Brigham Lindsay, Atkinson Dorothy, Jackson Mark, Rolph Sheena and Walmsley Jan (eds), Crossing Boundaries: Change and Continuity in the History of Learning Disability (Kidderminster: BILD, 2000), 87102: 97.

28. Tizard J., ‘The Mental Deficiency Services Today and Tomorrow’, Mental Health, 15, 3 (1956), 8592: (quote on p. 89). SA/MIN/B/80/27/16.

29. Unsworth, op. cit. (note 17), 255–6.

30. Royal Commission on the Law Relating to Mental Illness and Mental Deficiency 1954–1957, Report (London: HMSO, 1957), Cmnd.169, para. 601.

31. See, for example, NAMH Annual Report 1963–4. SA/MIN/B/80/7/2.

32. For example, A.D.B. Clarke, Recent Advances in the Study of Mental Deficiency (London: NAMH, 1966). SA/MIN/B/74a.

33. Gunzburg H.C., Junior Training Centres: An Outline of the Principles and Practices of Social Education and Training of the Mentally Subnormal Child (London: NAMH, 1963) [reprinted 1966], 10.

34. Tizard Jack, Community Services for the Mentally Handicapped (London: Oxford University Press, 1964), 101.

35. Raynes Norma V. and King Roy D., ‘Residential care for the mentally retarded’ [1967], in D.M. Boswell and J.M. Wingrove (eds), The Handicapped Person in the Community (London: Tavistock and Oxford University Press, 1974), 299–306: 299.

36. Kushlick Albert, ‘The need for residential care’, in Shennan V. (ed.), Subnormality in the 70s: Action for the Retarded (London: NCMHC and WFMH, 1972), 1326. A.D.B. Clarke and B. Tizard (eds), Child Development and Social Policy: The Life and Work of Jack Tizard (Leicester: BPS, 1983), 4.

37. Pilkington T.L., ‘Hospital Services for the Mentally Subnormal’, The Lancet, 282 (1963), 1279 (originally published as Vol. 2, issue 7320); T.L. Pilkington, speech, in NAMH, The Heart of the Matter: Report of the Annual Conference, 1966 (London: NAMH, 1966), 50–7. SA/MIN/B/80/43/4.

38. NAMH, Annual Report 1965–6, 5; Council of Management Minutes, paper on ‘National Trends and The Mental Health Services’ 21 November 1967. SA/MIN/A/3/1.

39. NAMH, Annual Report 1967–8, 18. SA/MIN/B/80/7/2.

40. Robb Barbara (ed.), Sans Everything: A Case to Answer (London: Thomas Nelson & Sons Ltd, 1967).

41. A White Paper, Better Services for the Mentally Handicapped, was published in 1971, under the Conservative Government. Hospital population was to be reduced considerably but hospitals were not intended to be emptied and closed.

42. Morris Pauline, Put Away: A Sociological Study of Institutions for the Retarded (London: Routledge, 1969).

43. Rix Brian, All About Us: The Story of People with a Learning Disability and Mencap (London: Mencap, 2006). The Declaration’s seven Articles are reprinted in S. Mattingly (ed.), Rehabilitation Today (London: Update Books, 1977), 175. It was adopted virtually unchanged by the United Nations General Assembly in December 1971. However, there remained ambiguity in its provisions regarding the extent of community integration.

44. NAMH, Annual Report 1968–9, 8; Council of Management, 23 June 1967. SA/MIN/A/3/1.

45. NAMH, Annual Report 1969–70, 5. SA/MIN/B/80/7/2.

46. Ibid., 5.

47. Ibid., 4. SA/MIN/B/80/7/2.

48. Ibid., 4.

49. Ibid., 8. SA/MIN/B/80/7/2; C.H. Rolph, Believe What You Like: What Happened between the Scientologists and the National Association for Mental Health (London: Deustch, 1973); NAMH, op. cit. (note 45). SA/MIN/B/80/7/2; Council of Management Minutes throughout 1967–1972. SA/MIN/A/3/1.

50. NAMH, MIND Manifesto, republished in MIND and Mental Health, 1 (1971), 3–6: 4. SA/MIN/B/80/27/28.

51. Marshall T.H., Citizenship and Social Class and Other Essays (Cambridge: Cambridge University Press, 1950).

52. Goriely Tamara, ‘Making the welfare state work: changing conceptions of legal remedies within the British welfare state’, in Regan Francis, Paterson Alan and Goriely Tamara (eds), The Transformation of Legal Aid: Comparative and Historical Studies (Oxford: Oxford University Press, 1999), 89112.

53. Byles Anthea and Morris Pauline, Unmet Need: The Case of the Neighbourhood Law Centre (Routledge: London, 1977), 14.

54. Regan et al. op. cit. (note 52), 1.

55. Rose Hilary, ‘Up Against the Welfare State: The Claimant Unions’, Socialist Register, 10 (1973), 179203.

56. Maria Mayer-Kelly and Michael D. Kandiah (eds), ‘The Poor Get Poorer Under Labour: the Validity and Effects of CPAG’s Campaign in 1970’, ICBH Witness Seminar Programme, seminar held 18 October 2000, (Institute of Contemporary British History, 2003, http://www.icbh.ac.uk/icbh/witness/cpag/, accessed 13 April 2016).

57. Dyson Brian, Liberty in Britain, 1934–1994: A Diamond Jubilee History of the National Council of Civil Liberties (London: Civil Liberties Trust, 1994), 43.

58. NAMH, Annual Report, 1971–2, 12. SA/MIN/B/80/7/3.

59. Williams Paul, ‘The Roots of a True Campaigning Movement’, Community Living, 26, 3 (2013), 17.

60. NAMH Council of Management, 18 June 1971. SA/MIN/A/3/2.

61. This was reprinted in NAMH, MIND and Mental Health, Summer (1972), 14–17. SA/MIN/B/80/27/29.

62. Appleby M., ‘The Hospital as a Power House of Care’, Apex, 1, 1 (1973), 21.

63. Shearer Ann, ‘Wanted: Political Leadership not ‘Generalised Goodwill’’, Apex, 1, 1 (1973), 20.

64. Reported in Mary Manning, ‘Do Staff Really Need Qualifications?’, Community Care1 October 1975, 7.

65. Barham Peter, ‘From the asylum to the community: the mental patient in post-war Britain’, in Gijswijt-Hofstra Marijke and Porter Roy (eds), Cultures of Psychiatry and Mental Health Care in Post-War Britain and the Netherlands (Amsterdam: Clio Medica, 1998), 221240: 229.

66. NAMH, op. cit. (note 58), 7. SA/MIN/B/80/7/3.

67. Council of Management Minutes, 23 November 1973. SA/MIN/A/3/3.

68. Jones, Asylums, op. cit. (note 2), 203; Anthony Clare, ‘Can The Law Reform Psychiatry?’ MIND OUT, 48 (1981), 17; Rose, ‘Unreasonable Rights’, op. cit. (note 2); Sedgwick, op. cit. (note 3), ch. 7.

69. Gostin Larry O., A Human Condition: The Mental Health Act from 1959 to 1975, Observations, Analysis and Proposals for Reform (London: Mind, 1975).

70. Unsworth, op. cit. (note 17), 342–3.

71. Gostin, op. cit. (note 69), 15.

72. For example, Co-ordination or Chaos? The Rundown of the Psychiatric Hospitals (London: MIND, 1974); MIND’s Evidence to the Committee of Enquiry into Special Education (London: MIND, 1975); MIND, The Mental Handicap Component in Social Work Training (London: MIND, 1977).

73. MIND, ‘MIND’s Evidence to the Peggy Jay Committee of Enquiry into the Care of the Mentally Handicapped’ (March 1976), 1. SA/MIN/B/80/10.

74. MIND, Services for Mentally Handicapped People: MIND’s Evidence to the Royal Commission on the National Health Service (London: MIND, 1977).

75. Ibid., 18.

76. For example, Editorial, ‘The Issues of Mental Handicap’, MIND OUT, 28 (1978), 2; Alison Wertheimer, ‘Researching into Mental Handicap’, MIND OUT, 40 (1980), 16–18: 17.

77. Editorial, ‘The Issues of Mental Handicap’, ibid., 2.

78. MIND, MIND’s Further Evidence to the Royal Commission on the NHS (London: MIND, 1979), 10 (emphasis in original).

79. MIND, Services, op. cit. (note 74), 27.

80. MIND, Services, op. cit. (note 74), 4.

81. MIND, Services, op. cit. (note 74), 28: 29.

82. MIND, Services, op. cit. (note 74), 27; 36.

83. MIND, Services, op. cit. (note 74), v: vi.

84. MIND, Services, op. cit. (note 74), 29: 14.

85. Indeed, this continued to leave people vulnerable to exploitation; see, for example, Granada TV’s 1978 World in Actionwhich exposed the exploitation of learning disabled people in adult training centres: https://www.youtube.com/watch?v=MgfjUh2j2Mo (accessed 22 June 16).

86. Rawnsley Kenneth, ‘Psychiatry in Jeopardy’, British Journal of Psychiatry, 145 (1984), 573578: 577.

87. In other words, that people will not need tailored support or specialist services. Alan Heaton-Ward, Left Behind: A Study of Mental Handicap (London: Routledge, 1978), 78–80.

88. Report of the Committee of Enquiry into Mental Handicap Nursing and Care (Jay Committee) HMSO 1979 Cmnd 7468; MIND, MIND’s Response to Jay, (1979), 20.

89. Valuing People: A New Strategy for Learning Disability for the 21st Century, Cm 5086 (London: Department of Health, 2001).

90. Welshman and Walmsley (eds), Community Care, op. cit. (note 1), 223.

I thank the Wellcome Trust for providing the grant that enabled me to research and write this article (Grant no. 206056/Z/17/Z). I also thank the three anonymous reviewers for their criticisms, insights and suggested amendments.

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