Intellectual Disability

In the nineteenth century, there was an increasing interest in, and concern for, people with intellectual disabilities. Methods of distinguishing between mental illness and intellectual disability and the development of classification systems for levels of disability were attracting interest in Europe and the United States of America before the Western Australian colony was formed. Institutions began to develop which, as the century progressed, moved from a model of residential educational care into a model of custodial care. There were a number of factors affecting this shift in attitude. Growing populations made the prevalence of intellectual disability more visible, and a repressive moral and sexual climate found people with uninhibited behaviours confronting, uncivilised, 'animal like' and more prone to sin. There was a public demand that these people 'be controlled'. Also, when attempts to educate people with intellectual disabilities failed, or did not progress quickly enough, it was seen not as a failure of education methods or time invested, but as a lack of humanity within the people with intellectual disabilities ('the idiots are not so human after all', Megahey, p.24). These views were gaining ground at a time in the second half of the nineteeth century when institutionalisation flourished - factories, hospitals, civil service and private bureaucracies all grew as marks of progress in a civilised society.

In Western Australia, the 'care' of children with intellectual disabilities was almost entirely custodial until the second half of the twentieth century. In 1913, the Inspector for Public Charities had noted that there was no adequate provision for children who were mentally defective. In the 1920s, eugenics had stimulated some interest in treating and training children with intellectual disabilities, advocating policies of segregation and sterilisation. The eugenics movement promoted the Mental Deficiency Bill 1929 but this failed due to a lack of parliamentary support for sterilisation and the expenditure on separate facilities. Parliament did, however, continue to support the segregation of children, adolescents and adults with intellectual disabilities in hospitals for the 'insane'. In this, it was not out of step with public opinion, though there were people in the community who were concerned about the plight of children left in these institutions. Dr Roberta Jull, who had 'given years of study to the question of mental deficiency', was reported to have said in 1924 that Western Australia 'lagged behind the other States':

Pathetic cases had come under her notice in Western Australia of the helpless position of these children sent from homes or institutions to sink or swim and very often sink into a condition of hopeless suffering. In the community, The Salvation Army was doing something at Seaforth for the deficient boys, but nothing was being done for the girls. Only recently a mother with a girl of this type asked her if there was a place to which the child could be sent after the death of her parents, and she had been forced to reply that there was not. The West Australian, 26 September 1924, p.10

In 1936 a three-year-old boy was murdered by his father. The boy had been diagnosed as 'mentally deficient, incurable and subject to fits'. The father, who shot his son three times, said he had no choice but to take this action as the boy was getting bigger, the fits were more frequent and there was 'no one to care for him'. When the case came before the courts 45,596 people petitioned for a lighter sentence. The death sentence was commuted to life imprisonment with hard labour, but the boy's father was unconditionally released after serving 3 years and 17 days of that sentence.

A pre-World War II plan to transfer mental defectives to a farm in Wokalup that had been purchased by the Government from the Ugly Men's Society had been put on hold during the war. Part of that interrupted plan was to transfer residents of Whitby Falls to Wokalup, and use Whitby Falls as a youth detention centre.

In 1949, a member of the Mental Welfare Committee at the Claremont Mental Hospital, F. Huelin, suggested that with appropriate facilities and education the 70 children at Claremont could enjoy more productive lives. The Minister for Health, Mrs Cardell-Oliver, disagreed, stating that ninety percent of the children were of the lowest grade and, essentially, incurable. Post-war housing, in the government's opinion, was a much more pressing issue. An expose in the Sunday Times newspaper in February 1950 showed that small boys were housed with men of all ages.

Until the second half of the twentieth century, the landscape for children with intellectual disabilities was bleak. In 1952, however, a movement started that would change things forever - the Slow Learning Children's Group: 'the intervention of parents in search of better futures for their children remains one of the most important interventions in the twentieth century history of intellectual disability in Western Australia' (Gillgren, p.77). In 1988 Les Walter, State President of the Slow Learning Children's Group (the Group), wrote about life in 1950s Perth:

My earliest recollections of life as a parent of a child with an intellectual disability was the great many barriers we needed to overcome as families. Many in society saw such parenthood as socially unacceptable. In many instances we were ostracised in public places, our children were stared at and rejected and schoolchildren were most unkind…Schools made no provision for our children and there were no opportunities for them in employment, in recreation and sport or in residential. Claremont Mental Hospital was about the only option. There was little knowledge about intellectual disability or about ways and means of providing services in this field. There seemed to be a real dearth of professional people ready to tackle the social issues confronting people with intellectual disabilities and their families.

Was it any wonder that families decided that they would band together and undertake the task themselves?...we in Western Australia were not alone in this and throughout the world after World War II parent organisations sprang into being all seeking something better… (Les Walter, State President, Slow Learning Children's Group, in Hunt, 1989 p.7).

However, many children were not reached by the progressive efforts of the Group. When Dr Guy Hamilton began as Senior Medical Officer at the Claremont Mental Hospital in 1962, he saw children suffering in appalling conditions. Notwithstanding the good publicity that the Group was generating, the WA public remained alternately fearful of and disinterested in children with intellectual disabilities. In 1964, a father was found guilty of the willful murder of his four year old intellectually disabled son. The child had been diagnosed as 'backward' at the University of Western Australia's psychology clinic and was referred to Princess Margaret Hospital for assessment. The assessment confirmed that the boy would not be able to go to a normal school and might have to be drugged to make him controllable. The father was sentenced to life imprisonment, which was commuted to 10 years. He was released in four years, with significant public sympathy for the plight in which he found himself.

Up to the mid-1960s, the formative influences in public sector out-of-home care for people with intellectual disabilities in Western Australia were:

economics, bogus science in the form of eugenics, the continued failure of the authorities to recognise the differences between mental illness and intellectual disability, and the medicalisation of residential care (Gillgren, p.87).

The 1960s forward were characterised by the 'new discourses of deinstitutionalisation and normalisation' whereby social role valorisation, education and training replaced custodial care and medicalisation. The 1964 appointment of Dr Guy Hamilton as Superintendent of the newly-established Mental Deficiency Division of Mental Health Services was a critical factor in this movement. Hamilton enjoyed a lot of support from the Slow Learning Children's Group for his normalisation policies, which included establishing hostels that it was hoped would give children with intellectual disabilities the stimulation, care, attention and stability of 'a good normal home' (Stella, p.97).

Normalisation was a term used in the 1970s to describe a policy whereby people with disabilities would be provided with services and support to enable them to live a life 'as close as possible to the norms and patterns of the mainstream of society'. The normalisation policies of the 1970s in Western Australia were followed in the 1980s by social role valorisation. The effect of normalisation policies was to introduce community-based hostels, recreation and employment opportunities.

Social role valorisation has been an important concept in modern models of care for children with intellectual disability in Western Australia. Social role valorisation seeks to 'support processes which enable devalued people to attain and keep valued social roles' (as a friend, or student, for example) and 'avoid negative roles (such as patient or client). These roles are lived out in the community, and people are not segregated into institutions.

In 1968 the Minister for Health established a Ministerial Committee to plan for the delivery, through government and voluntary agencies, of 'a comprehensive service for all ages and grades of retarded persons, including those with severe physical handicaps' (Ellis, p.157). Membership of the Committee included:

• Director of Mental Health Services (chairman)
• Professor of Child Health, University of Western Australia
• Medical Superintendent, Princess Margaret Hospital for Children
• Superintendent, Mental Deficiency Division of Mental Health Services
• Director of Special Services, Education Department

Input was also received from the Slow Learning Chidren's Group and the Mentally Incurable Children's Association.

The plan recommended that the Government supervise the financial needs and methods required for treatment, placement and accommodation of people with intellectual disabilities, the provision of education and training; the development of appropriate staffing for centres and institutions; and the siting and suitability of buildings for such facilities. Amongst the new services it recommended were segregated activity centres, sheltered workshops, the expansion of Irrabeena and Pytron, increased services to country areas, and the creation of a special ward at Princess Margaret Hospital for those requiring specialised services. Hostels were also to be provided to raise the number of places available from 167 to 700 (Stella, p.99).

Local councils often objected to hostels being situated in residential streets, but over time a network of hostels was developed. Because children were admitted to Claremont 'for life' before the 1960s, there were many who were adults by the time they were transferred to hostels. A number of hostels were established by the government between 1968 and 1984 to implement the normalisation policy. Prior to leaving Claremont, people were assessed by Irrabeena to determine the best placement. The model aimed to enable people to progress to 'higher skill' hostels and/or to independent living in flats. Hostel residents went out to work in sheltered workshops, or to school.

The initial concept for hostels was to keep them small (up to 16 beds) but as demand grew, so did waiting lists. By 1978, there were 17 government-run hostels with 350 residents in Western Australia, mostly in the metropolitan area.

By the 1980s, a Community Residential Support Service had been established to help people with intellectual disabilities live independently. Social trainers supported people to develop interpersonal relationships, social skills and 'compensatory mechanisms' (knowing how to get help when needed).