Volume 1

Report of the Committee of Enquiry into Mental Handicap Nursing and Care.

  • Great Britain. Committee of Enquiry into Mental Handicap Nursing and Care.
Date:
1979
Catalogue details

Licence: Open Government Licence

Credit: Report of the Committee of Enquiry into Mental Handicap Nursing and Care. Source: Wellcome Collection.

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    authorities; some mildly mentally handicapped people may be using general social services and may not be identified as mentally handicapped. It is not enough to know how many people are mentally handicapped, we also needed to know something about the degree of handicap. Here we come up against the problem of definition. Mild mental handicap covers a wide range of people from the borderline with severe handicap to the borderline with those whose intelligence is below normal but for whom this does not present a problem. For practical purposes an Intelligence Quotient of 50 is commonly taken as the broad dividing line between mild and severe mental handicap and the IQ range 50-70 is usually used to classify people with mild mental handicap. But such divisions take no account of emotional development, social competence, and environmental and educational influences which affect the functioning of any individual. 10. Even when the figures have been collected the problem of interpret- ation remains. It is not possible to say that a certain type of handicap always requires a certain type of service, so that planning and forecasting must be matters of judgement. Ideas about the care needs of mentally handicapped people are constantly changing — in recent years particularly, as residential care staff have begun to discover the hidden potential of their clients — but today’s buildings, reflecting yesterday’s theories, will limit and define the scope of tomorrow’s services. It is therefore particularly important to be flexible and open-minded about ways in which care can be provided and about the extent of the need for different types of care. At present it is generally agreed that some severely handicapped people will require lifelong residential care but there are differences of view across the spectrum of mental handicap in relation to the variety of residential, day and domiciliary services which could or should be provided. In these circumstances it is difficult to estimate the demand for these services and therefore also the staffing required to run them. In the absence of any other figures we have had to use the planning figures set out in the 1971 White Paper which gave projections of numbers of adults and chil- dren requiring various types of residential care, hospital treatment, education and day services over the next 15-20 years. But even these figures were tentative and will need to be adjusted in the light of experience. All these constraints mean that the statistics quoted in the following paragraphs have to be interpreted with caution. Futhermore it is likely that preventive measures will reduce the number of children born with mental handicap in future years. The lack of firm figures is not however as damaging to planning as it may appear. In Chapter 4 we explain that a large increase in staffing is necessary and authorities can therefore continue to plan to increase both services and staffing in the foreseeable future without any fear of over provision. | 11. The White Paper, published in 1971, estimated that there may be about 120,000 severely mentally handicapped people in England and Wales, of whom about 50,000 are children. Case register studies over the past 15 years have suggested prevalence rates for severe mental handicap among children varying between 2.95 and 5.81 per thousand population; Figure 1 gives details from some of the major studies.