285

THE TASMANIAN MENTAL
DEFICIENCY ACT.

By

H. TASMAN LOVELL, M.A., Ph.D., Associate-Professor of Psychology, University of Sydney.

IN at least one of its recent enactments the State of Tasmania has shown itself more advanced than the other States of the Commonwealth. We urge geological and other surveys of an economic and most necessary kind to be sure, but we do not seem to have awakened to the great necessity of a mental survey of our people. This omission is doubtless due to the fact that only comparatively recently has the instrument required for such a survey been brought by the science of psychology to that point of accuracy where it can be reasonably relied upon for diagnosis. Whatever may be said of mental tests, they can now, in the hands of capable clinical psychologists, provide a quite adequate mathematical index of the intelligence of each individual examined. The index is quite adequate for the classification of individuals into the broad groups of "very superior," "superior," "normal," "borderline,' "feeble-minded," "imbecile," and "idiot." Such a classification will serve all purposes required by any State which admits that mental deficiency has a social incidence, acknowledges its responsibility for the care and treatment of the feeble-minded, and is prepared to undertake practical measures. Persons, rated as sub-normal after a careful psychological examination, become a problem to be met and solved by State activity. Especially true is this of the low-grade moron, the imbecile, and the idiot. Much of a State's activity has been wasted hitherto upon legislation which has assumed the existence of a sense of responsibility which does not and could not exist in a certain percentage of its citizens. There is required a different kind of treatment from that which assumes the sense of responsibility to be present. In short, it is with this percentage not so much a moral problem as a scientific one, dealing with definite causes which, through the progress in the study of psychology and mental hygiene, have now come under a measure of control. In New South Wales we are woefully unenlightened and woefully behind, both in the knowledge of these causes and in the application of that knowledge to practice. The welfare of a people demands that very lowgrade mentality should not be perpetuated, nor is that welfare subserved when those who are feeble-minded are allowed to

reproduce their kind while those of higher grade intelligence restrict the number of their offspring. The country's welfare also requires that the opportunities offered to persons of lowgrade intelligence for the commission of anti-social acts should be reduced to a minimum. Sentimentality should prevent no State from accepting this responsibility to posterity. Finally, appropriate treatment will render mentally deficient persons healthier and happier, and will provide the kind of education most suited to their case.

But it is first necessary to determine what persons are feeble-minded and to what extent they are so. It is this progressive purpose which the State of Tasmania has conceived and which it is energetically carrying out.

In 1920 there was presented to the Parliament of Tasmania and passed "The Mental Deficiency Act." This Act is based mainly upon the English Act. Further, during the year 1921, Dr. E. Morris Miller, Lecturer on Psychology in the University of Tasmania, with the concurrence of the Chief Secretary, visited the United States and Canada to inquire about the measures taken there to deal with mental deficiency. There now exists in Tasmania a highly effective statute, proclaimd on March 15th, 1922, and administered by a Mental Deficiency Board under the chairmanship of Dr. E. S. Morris, Director of Public Health. The other members of the Board are Dr. E. Morris Miller as Director of the Psychological Clinic; Dr. E. R. A. MacDonnell, Medical Superintendent of the Mental Diseases Hospital, New Norfolk, Mr. J. A. Johnson, M.A., Principal of the Teachers' College, and Mr. R. H. Crawford, Secretary for Education and Chief Inspector. The secretary to the Board is Mr. E. J. Tudor of the Public Health Department. Thus the constitution of the Board shows the embodiment of the principle that the problem is a complex one requiring the co-operation of medical, psychological and pedagogical experts for its solution.

The first Report of the Board, giving an official account of its activities for the year 1922-23 has now been published, and excellent work it appears to be doing.

The Board first proceeded "to ascertain and register those persons in the State who are defectives." Its policy is "early diagnosis and ascertainment of cases at school age. It hopes that "within the space of three years the schools' population of the State will have been surveyed. At the same time the Clinic is commencing a survey of institutions and homes where defective children and adults are likely to be found."

The Board states that "a residential training school for certain classes of defective children is indispensable." There are defective children capable of improvement by specialised education "who are legally excluded from the ordinary schools and others who . . . are quite unsuitable for the ordinary school classes. These require special instruction and treatment in a residential training school or institution. When such defectives, after receiving their training in an institution or training school, pass beyond the school age at 16 years, or even at 18 years, they are severally examined, and, according as they are socially efficient or inefficient, are released into the community under suitable supervision, placed under guardianship, or transferred among the adults of some institution or colony with which the school is connected."

"As it is not financially possible to provide training schools for the whole of a State's defective population, Education Departments usually establish special classes or schools for limited numbers. In these classes special instruction and training (similar to that in the training schools) are given." This instruction is "varied according to the individual child's mentality... The whole trend of the instruction is towards helping the child to do and make things within his 'capacity to achieve'... to correct remediable physical defects; to form habits of cleanliness and neatness; to be industrious; and to respond readily to the social requirements of his simplified environment; in other words, to be at home with those about him, useful, and contented with his lot."

Appended to the Board's Report is a lengthy and interesting one from the Director of the Psychological Clinic to the Chairman of the Board.

"The functions of the Clinic as prescribed by the Act are the diagnosis of mental deficiency, the classification of mentally defective and other children, the instruction of teachers of special and other classes, and the study of mental deficiency, and for any other purpose appertaining thereto."

Of the functions of a psychological clinic the Director says, among other things:

"The main function of a psychological clinic is to examine the cases of exceptional children referred to it for the purposes of diagnosis, prognosis, and advice as to pedagogical training and treatment. These exceptional children comprise those who deviate from the normal, positively and negatively, are retarded in schoolwork, mentally dull and backward; who manifest abnormal or aberrant trends, resent reasonable discipline, show undue signs of obduracy or stubborness, misbehave as psychopaths, delinquents, truants or inferiors, reveal marked instability and want of control during puberty and adolescence; in fact, who are in any way maladjusted to the ordinary conditions of life

whether in the home. school, or community. In short, the clinic is concerned with the mental hygiene of childhood.

"Any person, school, court, department of State, child welfare, or other social or philanthropic agency dealing with the problems of child life may refer cases to the Clinic for the report and advice.

"The examination is distinctively individual. The child is mentally and physically examined, and inquiry is made to ascertain the relevant hereditary and environmental factors. In the light of the findings differential treatment is determined. Advice is given as to home care, school training, vocation, or placement in a suitable environment. In appropriate cases diagnosis may be deferred, and the child placed under observation or given special opportunity for restoration to normality if possible, or at least for betterment of mental functioning. Where remediable physical handicaps are discovered, such as malnutrition, adenoids, goitre, nervousness, eye and ear defects, &c., the cases are referred to the proper quarter for suitable treatment and reexaminations are made when information is to hand from the physician that the physical deficiencies have been made good, or that no further improvement is likely.

"Another important function of the Clinic is the classification of mentally-deviating children."

con

"The Clinic, as its years of service increase, will amass a siderable amount of data concerning metal development, intelligence scales, and other means of mental measurement, percentages of children represented in the various classes, methods of examination, arrangements for selecting and discovering children for examination, means of making necessary inquiries, collection of statistics and their tabulation, and so on."

"In view of the importance of individual psychology, especially in reference to the mental hygiene of childhood, the cases referred to the clinic will afford exceptional means for clinical demonstrations in the teaching of psychology, and it is hoped that these facilities will be eventually availed of by the Departments of Psychology and Education in the University. The concrete presentation of individual reactions to definite situations is an indispensable method of psychological instruction, and enables the student, and particularly the teachers, to individualise the child and understand many of the prime factors underlying his deviations. Reference to the Psychological Clinics visited by me in the United States will show how closely associated they are with the departments of psychology and education in the Universities, and in most cases the professor in charge of the department assumes the directorship of the Clinic. It is, indeed, his psychological laboratory, where he is able to study the living individual, both in ordinary life and under the limitations imposed by laboratory practice."

"Finally, it is desirable to make clear that the Psychological Clinic, as distinct from what is usually known as a Psychiatric Clinic, is mainly psycho-educational in function; it is concerned chiefly with children, deviating from mental normality, either positively or negatively. The only adults it is likely to have referred to it are clearly cases of mental deficiency. On the other hand, the Psychiatric or Psychopathic Clinic deals with mental and nervous disorders, and is almost wholly concerned with adults. The functions of the Psychiatric Clinic or Psychopathic Hospital are the examination, diagnosis, and early treatment of incipient cases of mental illness, as well as a

limited number of a more serious and urgent nature which may ultimately reach a final destination in the mental hospitals."

There follows then a detailed account of the heads under which examinations are made, of the way in which the teacher, the medical examiner, and the Director of the Clinic collaborate, of the manner in which selection is made of school children for examination. The results of the year's work are represented in a series of interesting tables. On the question of the proportion of mental defectives to the total population the report says:

"The number of defectives in a community is not easily gauged, and the figures given by different authorities vary considerably. During the year we have surveyed a State primary school population of some 7300, giving the percentage of ascertained feeble-minded children in State schools as 0.75 per cent. This school population is mainly urban, and includes a few country districts. According to the later figures, coming from less-crowded and more prosperous areas, the percentage will probably fall below what is here stated. By the end of the incoming year's work we shall be in a position to gauge the percentage of feeble-minded grade more accurately. We shall endeavour at that time to ascertain the numbers of children attending non-State schools and the numbers below school age, so as to determine the total percentage of mental defectives of all grades among the child population of the State. We would expect that it will be somewhat below 0.5 per cent. These estimates are in keeping with conservative opinion in other countries, which is more and more gaining general acceptance.'

It is not possible to reproduce here the detailed results as set out in the tables; but we can congratulate the State of Tasmania, its Mental Deficiency Board, and the Director of the Psychological Clinic upon a good year's work. It may be interesting to add that while the State of New South Wales has so far done nothing, yet a psychological clinic has been conducted this year at the Sydney University, by Dr. A. H. Martin, Lecturer in Psychology. It worked in conjunction with the Psychiatric Clinic, and gave excellent opportunity for the training of advanced students in psychology.