By Hamish Tristram

The mental health system has been criticised for its objectives and the institutions through which it seeks to achieve them.

Levin Hospital and Training School has a number of alarming features. I believe that the defects of this hospital are not lack of finances but its institutional nature and lack of expert advice and adequate research.

We need mental hospitals. Perhaps a child cannot be kept at home because of the stress this causes within the family. Often it is economically impossible for the parents to obtain, or undertake the training of a mentally defective child. In smaller centres, full facilities cannot be provided.

However the system is misdirected. I attribute this, initially, to poor counselling of parents and a mistaken attitude to these children.

Often the institution cannot provide the elemental training and social adjustment that a normal home does. The individual care a child receives at home is incomparably superior. At Levin, short-stay patients, from good homes are usually recognised by their greater personal security, easier attitude toward adults, and greater alertness.

To place a young child in an institution is to deprive him or her of the extra stimulation a mentally defective child needs. Inevitably the child suffers.

Play Centres

To encourage parents to keep these children at home, more emphasis should be placed on local play centres for mentally defective children. Instruction should be provided in training methods which parents could administer at home. Short-stay hospitals for children from smaller centres would enable ability assessment, and give the family a break. This principle could be extended to week-day boarding schools for older children.

Above all, the community must lose its fear and repugnance for the mentally defective child. This would tree parents from fears that keeping the children will alarm visitors, friends, neighbours and affect the other children.

Parents of any class and intellectual level may have a mentally defective child.

In this sense the mentally defective child is a child of the whole community, and should be accepted as such. In most instances these children are not only harmless, but good-natured and possessing as individual a character as normal children.

Occupational centres are a notable advance in enabling training within the community, but need more funds. Provision should be made for new techniques and work material to be introduced by highly-trained consultative staff from the main centres.

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Those who work in these occupational centres can feel like pioneers, guided more by instinct and ingenuity than is necessary. This also applies to Government training programmes. The administrators must be temperamentally suited. Skilled advice and good materials must be readily available. The "do-it-yourself" New Zealand approach places too great a burden on staff.

Frustration dogs this work. The slow pace of the children seems to infect the institutions. Programmes stagnate, old methods become inbuilt. Too often apathy goes disguised as patience. Progress is slow in any case; what use are new methods?

This seems the difficulty of large New Zealand institutions. The enthusiastic and imaginative people one does find in the system require the cunning of foxes and the patience of Job to establish anything new.

Smaller

Smaller institutions, where only the trainable or educable child is kept, in the core or control of training, rather than medical staff, would be preferable.

Policy decisions should be in the hands of education experts.

A hospital atmosphere should be avoided. Private institutions tend to approximate more closely to this ideal. Cameron House at Levin has little of the hospital atmosphere about it. So it may be surmised that the need is recognised, but thwarted.

In its present form the institution is very unsatisfactory.

The moves of the Intellectually Handicapped Children's Society and the Steiner movement spring, I believe, from a dissatisfaction with the inadequacies of the system.

However I feel that in some ways students who criticise the mental health system, damage their cause. Descriptions, tinged with Gothic horror, of mental hospitals, give a distorted picture.

Change is essential, but in some functional aspects places such as Levin are satisfactory. The staff, especially the male nurses, have at their best, an admirable attitude. This is more so the more mature the staff member. Often the younger staff are inept because, I think, they are unfamiliar with the behaviour of children. It would be wise to place an age restriction on the necessary staff and to encourage married men and women making a career of this work. This calls for enlightened administration and enhanced status of staff.

Generally, the good humour and dedication of those who work with the mentally defective child under difficult conditions is admirable. The treatment may be rough and ready but is rarely cruel.

There is however an alraming tendency among some sections of the staff, as in the general community, to forget that each mentally defective child is an individual. This is apparent in the dressing of the children and the lack of care for their personal appearance. This neglect is one of the worst institutional features.

Poor Planning

While much poor planning is evident at Levin, the villas are generally in good repair, clean and airy. As is often the case with government construction, inadequacies seem to stem from those who must work in the buildings. Small rooms, poor ventilation, inadequate plumbing, waste space and the 'prefab' obsession are among the features which mar even the newer buildings.

On way of showing concern for these children is to visit the hospitals for social or games. Children in institutions love to meet and talk with new people. Their attention can be overwhelming, even alarming, but is a release for their natural affections. Taking a child for an outing with the family or a group to a beach or farm, will often provide mutual enjoyment. These children are starved for stimulation and react to it readily.

Those who are interested in such work should beware of the word "rewarding". Progress is slow. Often it will be tempestuous and infuriating, and very often plain boring.

But in each child there is potential, however small, some personality, however warped. To release this, to provide affection and interest, and receive it in return, is satisfying.

This work is more interesting if the attitude of the institution is progressive and experimental. The work, is not depressing, because, if children are left untrained they regress. Providing stimulation to these children is worthwhile, The alternatives are tragic. We must not return to those days when humanity, however defective, was left to vent its frustration and boredom in institutions hidden from the world. It is to the credit of those who initiated New Zealand's post-war training programmes that much of this has been obviated.

It is now time to remove the care and training of the mentally defective child as much as possible from an institutional environment.

Constant research for, and application of new techniques and educational aids in a freer, more specifically educational environment, is imperative.