Toms Jonathan
Med Hist. 2017 Oct;61(4):481-499. doi: 10.1017/mdh.2017.55.
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.
当前针对学习障碍者的政策与实践源于20世纪70年代和80年代的非机构化进程、对公民权利的关注以及融合主义理念。然而,历史学家对这些理念得以运用的具体背景知之甚少。尽管二手文献中很少提及,但在这一时期,“心智”组织在为学习障碍者争取基于权利的服务的运动中表现突出。本文将“心智”组织的运动置于该组织作为两次世界大战期间精神卫生运动主要机构起源的更广泛历史背景中。文章开篇概述了精神卫生运动最初将“智力缺陷”概念化为自我维持和有责任感的个体的对立面,而这些个体被视为公民身份和心理健康的基础。接着追溯了这种等式是如何被打破的,部分原因是战后福利国家条件的改变,部分原因是精神卫生运动自身的理论化。最后一部分描述了随着精神卫生运动的崩溃和“心智”组织的出现最终产生的公民身份的重新概念化。它表明,将“心智”组织基于权利的运动(无论如何,这些运动主要关注精神疾病)描述为个人主义的,并且从根本上反对医学和精神病学,这种说法是不准确的。事实上,“心智”组织寻求一种全面的基于社区的服务,与一般健康和福利服务相结合,并围绕学习障碍者公民权利的重建展开。