"(1.) The obligation of society to identify and register as early as possible all feeble-minded children. All students of social problems will concede that feeble-mindedness is one of the fundamental causes of our numerous social ills. It is a prolific source of poverty, destitution, all kinds of crimes against property and person, social immorality, illegitimacy, and of prolific and degenerate progeny."There are few problems in present-day constructive social economics which are more important than the development of a State-wide and a nation-wide policy for the compulsory official identification and registration of feeble-minded children, particularly all those who come from homes where the conditions are not such as to guarantee continuous supervision and support."(2.) The proper educational care and training of feeble-minded children. The adequate discharge of this obligation involves segregating the feeble-minded in special classes as soon as they can be indubitably diagnosed and providing for them the type of training which will maximally develop those powers and aptitudes which they possess and which will maximally equip them for earning their livelihood."(3.) Provision for continuous oversight and supervision over the feeble-minded."
"(1.) The obligation of society to identify and register as early as possible all feeble-minded children. All students of social problems will concede that feeble-mindedness is one of the fundamental causes of our numerous social ills. It is a prolific source of poverty, destitution, all kinds of crimes against property and person, social immorality, illegitimacy, and of prolific and degenerate progeny.
"There are few problems in present-day constructive social economics which are more important than the development of a State-wide and a nation-wide policy for the compulsory official identification and registration of feeble-minded children, particularly all those who come from homes where the conditions are not such as to guarantee continuous supervision and support.
"(2.) The proper educational care and training of feeble-minded children. The adequate discharge of this obligation involves segregating the feeble-minded in special classes as soon as they can be indubitably diagnosed and providing for them the type of training which will maximally develop those powers and aptitudes which they possess and which will maximally equip them for earning their livelihood.
"(3.) Provision for continuous oversight and supervision over the feeble-minded."
It is clear that if we wish to reduce the number of mentally defective and socially inadequate individuals we must not only consider measures for preventing as far as possible the transmission of hereditary defect, but must also provide for the youth of the country an environment and training calculated to encourage the development of its best powers. There is no doubt that unfavourable home conditions and unsuitable educational methods conspire to keep many children from realizing their full capabilities. This is especially true of the backward and feeble-minded. It is, moreover, wasteful and ineffective to force on children of poor mental receptivity and potentialities an educational curriculum devised for those of normal mentality, since the subnormal impede the general progress in an ordinary class, and in it they soon form a discouraged minority which learns to accept failure unquestioningly. Untrained to perform the simple work which is within their power and in the achievement of which they might earn self-respect and happiness, they feel themselves to be aliens, and may cease to regard the laws of society in which they have no sense of membership. In such cases the community which might have benefited from their work had their potentialities been properly developed is burdened by their maintenance, and, further, if they are not law-abiding, has also the expense of segregating them in reformatories and gaols. Hence it is clearly the duty of the State to adapt the educational curriculum to the requirements of various groups of children.
The child who has been handicapped by illness and lack of opportunity, the child who is inherently dull and backward, must be distinguished from the child with nervous instability or definite mental defect. Wherever possible, the training suitable for various improvable types of children should be arranged in connection with the ordinary public schools. But the curriculum must be modified to suit the need of the individual and should be directed with the object of making him a useful member of society. By this means these pupils are not deprived of that association with their normal fellows which is of such value as a preparation for their after-life in the community.
For children whose homes are unsuitable or too remote from centres, who require more continuous supervision, or who tend to become delinquent, special residential schools will be necessary. These schools would also be used for those whose capabilities cannot be assessed without extended expert observation for a considerable period.
The special school is to be regarded as a training-centre for such feeble-minded children as are expected as a result of the training received there to be fitted to take a place in the community and to perform useful work under adequate supervision. There is a danger of filling the special schools with children whose poor mental endowment renders them incapable of receiving benefit at all commensurate with the energy and expense devoted to them. Such children are subjects for custodial institutions.
Institutional care is necessary for mentally defective persons whose helplessness or anti-social traits would render them either the victims of the unscrupulous or a menace to society. Such individuals should be segregated in farm and industrial colonies, so that not only is the community freed from the responsibility of their presence, but they themselves are afforded opportunity of leading much happier and more useful lives, and of becoming, to some extent, self-supporting.
All feeble-minded children within the community, whether in special classes, or on parole from an institution for the feeble-minded, or over school age, should be carefully supervised.
It is clear that the problem of making provision for the feeble-minded and mentally abnormal in the community is first to be encountered in the schools, though there must be considered also a much smaller number of such low mental capacity that they have never sought admission there.
In deciding the place of the feeble-minded in the community factors other than the degree of mental defect have to be considered. Many feeble-minded individuals are capable of performing useful work, and provided they have no anti-social traits and can receive adequate care outside their permanent inclusion in an institution is undesirable, not only from consideration of their own well-being, but also from a social and economic standpoint. Many feeble-minded individuals are so dependent upon routine that having once been trained in the regular performance of simple duties they find difficulty in breaking their methodical programme. In this way their lack of initiative is really protective, as it tends to keep them steadfastly at their labours.
In the case of all feeble-minded persons living outside institutions, whether with relatives or otherwise, the State should, in the interest of both such feeble-minded individuals and of society, have the ultimate right of supervision.
The magnitude of the task to be undertaken cannot be estimated unless we have some indication of how numerous are those for whom special measures must be adopted. The information given below must not be too literally interpreted, but will serve to throw some light upon existing conditions in New Zealand.
In the absence of a complete system of notification, which the Committee consider is urgently necessary, any estimate as to the number of feeble-minded to be dealt with must be largely a matter of conjecture.
From the annual report of the Education Department, however, interesting information is available showing the ages of the pupils in the several classes of the primary schools. The following table is considered worthy of reprinting in this report, for from the figures it supplies some idea may be formed of the number of backward and feeble-minded children attending primary schools. Children of extremely low-grade mentality do not attend school as a rule, while feeble-minded children higher in the scale, discouraged by the unsuitable course of instruction and lack of sympathetic treatment, tend to leave school early. Hence the number of feeble-minded children in any community must be considerably larger than the school records indicate.
The following table shows the ages of pupils in the several classes of the primary schools. The numbers between the heavy horizontal lines represent those that, beginning school under six years of age spend an average of two years in the preparatory classes and one year in each of the standards. The numbers above the upper heavy lines have progressed at a greater rate than that indicated, and those below the lower lines have either begun school later or have progressed more slowly.
The most arresting feature in the table (p. 13) is the large number of children in classes lower than should be expected at their age. Thus the preparatory classes had 12,693 pupils over the age of eight years. This number is certainly a considerable reduction on the total for the previous year, but it still represents no less than 18 per cent. of the total roll of those classes. Particular attention is being directed to the problem of retardation, and in some of the larger centres special classes for retardates have been established.
It will also be seen that the actual number of children retarded three years or more, including the preparatory classes and up to Standard III—beyond which the higher grades of the feeble-minded do not progress as a rule—is 4,917 out of a total of 212,709 children attending school, or a trifle over 2 per cent. In some countries three years' retardation is regarded asprimâ facieevidence of mental deficiency. Probably New Zealand has much the same proportion of mental defectives as other countries. This is stated by Goddard to be between 2 and 3 per cent. of the population.
A recent survey made by the Education Department of the children attending the primary schools in a typical area disclosed the fact that out of a total school population of 16,499 no fewer than 950 pupils, constituting 5.7 per cent. of the total school enrolment, are retarded two years or more. Some of these may be classed as dull normal; some may be suffering from remediable physical defects; others may be merely the victims of unfavourable circumstances, while others again may be what Burt calls "late bloomers"—i.e., cases of slow development. Many of them, however, will ultimately prove to be mental defectives. Deficiency sometimes does not reveal itself definitely until the pre-adolescent period or early adolescence.
Of the total number on the school registers 266, or 1.6 per cent., are retarded three years or more. It is interesting to note from information supplied by Mr. N. R. McKenzie, Inspector of Schools, that this is exactly the percentage of defectives discovered in the schools of a section of the city of Toronto as the result of a psychological survey. It also corresponds with the number in the Vancouver city schools, where nineteen special classes are operating with a school population of 19,000—i.e., one class per 1,000 pupils.
For the purpose of this report a preliminary survey from information supplied by social workers, school-teachers, police, Hospital Boards, &c., has been made by the Education Department of what may be regarded as the obviously feeble-minded and epileptic cases known to exist outside institutions in the Dominion.
The following figures show the number of such cases reported, but these figures are incomplete—the actual number must be greater:—
Table showing Ages of Pupils in the several Classes of the Primary Schools.
In many parts of America and in some European countries the problem of the mentally backward and feeble-minded child receives close attention. The juvenile delinquent is also carefully studied. For children who fail to make good in school, or who are guilty of frequent misdemeanours, a system of intelligence testing and psychological analysis is carried out. A study is also made of family history and environmental influences. Children who are "maladjusted to their environment" are kept under survey with a view to finding what is the difficulty and how it can be overcome. To quote from the "Mental Hygiene Bulletin," published by the National Committee for Mental Hygiene for the United States of America: "Children showing definite problems are selected for more intensive study and treatment. The grossly mentally handicapped child, who is likely to become a social problem if not properly dealt with in childhood; the psychopathic and mentally maladjusted child, who later in life may develop mental disease; the child manifesting conduct disorders which may be the beginning of a delinquent or criminal career; the retarded child; the epileptic; the child with speech-defect or with some physical disability; the child with gross personality difficulties; the exceptionally brilliant child—all present problems that demand attention during the child's school life. Such children are given a thorough physical examination, a careful psychiatric study, and an individual psychological examination, including a variety of psychological tests, not only to determine the child's intelligence rating, but, in so far as possible, his special abilities and disabilities. A social study is made of the child's home, school, and other environments to determine what factors may have unfavourably influenced the development of the child, and what forces may be utilized in securing the child's adjustments. The results of all these studies are given to the school authorities with recommendations relative to the needed adjustments."
In New Zealand there is need of increased facilities for the study of the individual child, and the services of psychological experts should be available in order to group children according to their mental equipment and special requirements. Only those fully qualified to estimate accurately all the evidence available are fitted to decide the destiny of children.
Herein lies the danger of relying exclusively upon the use of mental tests.
Mental testsare of definite value in enabling the observer to arrive at a conclusion regarding the general mental development of the subject, or to investigate some particular psychological function. A too exclusive dependence upon the result of the application of these tests, especially by a layman, would invariably lead to error. A comprehensive survey is necessary, taking into consideration such factors as family history, environment, physical condition, behaviour, temperament, &c. The observation, possibly for a considerable period of time, of an expert psychiatrist or psychologist may be necessary in order to arrive at an accurate estimate of the mental ability of the subject.
In this regard we quote from Tredgold, "Mental Deficiency": "There are, however, very many exceptions, particularly when we are dealing with the milder grades of deficiency, so that if serial tests are depended upon for the diagnosis of these cases they may be, and often are, very fallacious. I may say here that although it would, of course, be extremely valuable if we could devise tests which would accurately measure mental capacity, particularly that capacity and those qualities which are needed for social adaptation and maintenance, we have not yet succeeded in doing so. The mental factors which may be involved in this capacity for social adaptation, and which render the individual in need of care, supervision, or control, are many and varied, and there is even some danger that too much reliance upon serial tests may distract from the adequate investigation of these qualities and defects and lead to totally erroneous conclusions."
There is no doubt, however, that in the hands of competent observers properly applied tests afford information of great value in assessing mental and moral capacity, but the observer must be competent.
The Education Act, 1914, contains provision (see section 127) for the establishment of special schools for the education and training of afflicted children (deaf, blind, feeble-minded, and epileptic) between the ages of six and twenty-one years, with provision in the case of inmates of special schools for extension of the period of detention where it is considered necessary in the public interest. For the purposes of this Act,—
"'Feeble-minded child' means a child who, not being an idiot or imbecile or otherwise a proper person to be sent to an institution under the control of the Mental Hospitals Department, and not being merely backward, is by reason of mental or physical defect incapable of receiving proper benefit from instruction in an ordinary school, but is not incapable by reason of such defect of receiving benefit from instruction in a special school."
"'Epileptic child' means an epileptic child who is unfit by reason of severe or frequent epilepsy to attend an ordinary school, but is not idiot or imbecile or otherwise a proper person to be sent to an institution under the control of the Mental Hospitals Department."
Section 127: "(2.) It shall be the duty of the parent of any ... feeble-minded or epileptic child to provide efficient and suitable education for such child."
"(3.) If the parent of such child fails to provide such education for such child, or is deemed by the Minister to be unable to provide such education, the Minister may direct that such child be sent to such special school or other institution for the education of feeble-minded or epileptic children as he thinks fit."
Section 129: "Every parent, teacher of a school (either public or private), constable, or officer of a charitable or kindred institution who is aware of the place of residence (either temporary or permanent) of a blind, deaf, feeble-minded, or epileptic child, and the householder in whose house any such child resides, shall send notification of the fact to the Minister, giving name, age, and address of the child; and if any such person neglects or fails to comply with this provision, such person shall on conviction thereof be liable to a fine not exceeding one pound, or in the case of a second or subsequent offence, whether relating to the same or another child, not exceeding five pounds."
Section 56: "Every public school shall be organized and conducted in accordance with regulations (a copy of which shall be conspicuously put up in the school): Provided that the Minister may, on the application of the Board, sanction the establishment of special classes for backward children—that is, children who, through physical infirmity, absence from school, or otherwise, are below the average standard of education reached by other children of the same age."
The Mental Defectives Act, 1911, divides mentally defective persons into six classes, as under:—
"'Mentally defective person' means a person who, owing to his mental condition requires oversight, care, or control for his own good or in the public interest, and who, according to the nature of his mental defect, and to the degree of care, oversight, or control deemed to be necessary, is included in one of the following classes:—
"Class I:Persons of unsound mind—that is, persons who, owing to disorder of the mind, are incapable of managing themselves or their affairs."Class II:Persons mentally infirm—that is, persons who, through mental infirmity arising from age or decay of their faculties, are incapable of managing themselves or their affairs."Class III:Idiots—that is, persons so deficient in mind from birth or from an early age that they are unable to guard themselves against common physical dangers, and therefore require oversight, care, or control required to be exercised in the case of young children."Class IV:Imbeciles—that is, persons who, though capable of guarding themselves against common physical dangers, are incapable, or if of school age will presumably, when older, be incapable, of earning their own living by reason of mental deficiency existing from birth or from an early age."Class V:Feeble-minded—that is, persons who may be capable of earning a living under favourable circumstances, but are incapable from mental deficiency existing from birth or from an early age of competing on equal terms with their normal fellows, or of managing themselves and their affairs with ordinary prudence."Class VI:Epileptics—that is, persons suffering from epilepsy."
"Class I:Persons of unsound mind—that is, persons who, owing to disorder of the mind, are incapable of managing themselves or their affairs.
"Class II:Persons mentally infirm—that is, persons who, through mental infirmity arising from age or decay of their faculties, are incapable of managing themselves or their affairs.
"Class III:Idiots—that is, persons so deficient in mind from birth or from an early age that they are unable to guard themselves against common physical dangers, and therefore require oversight, care, or control required to be exercised in the case of young children.
"Class IV:Imbeciles—that is, persons who, though capable of guarding themselves against common physical dangers, are incapable, or if of school age will presumably, when older, be incapable, of earning their own living by reason of mental deficiency existing from birth or from an early age.
"Class V:Feeble-minded—that is, persons who may be capable of earning a living under favourable circumstances, but are incapable from mental deficiency existing from birth or from an early age of competing on equal terms with their normal fellows, or of managing themselves and their affairs with ordinary prudence.
"Class VI:Epileptics—that is, persons suffering from epilepsy."
This is similar to the classification in the English Mental Deficiency Act, which also includes the following definition:—
"'Moral imbeciles'—that is, persons who from an early age display permanent mental defect, coupled with strong criminal or vicious propensities, on which punishment has little or no deterrent effect."
"'Moral imbeciles'—that is, persons who from an early age display permanent mental defect, coupled with strong criminal or vicious propensities, on which punishment has little or no deterrent effect."
In the opinion of the Committee it is very important that a similar definition should be included in any amendment of the New Zealand Act.
A Magistrate may order the committal to an institution of any person coming within these definitions if he is satisfied that such person is mentally defective and two medical men give a certificate to that effect. Persons coming under the description in Classes I, II, III, or IV are committed to the mental hospitals, but there seems to be considerable reluctance both on the part of medical practitioners to certify and of Magistrates to commit to a mental hospital epileptics and those described as "feeble-minded." Evidence was given before the Committee to the effect that there would not be the same disinclination to send these classes of patients to a special institution such as a farm colony or an industrial colony.
Apart from the residential special schools, special classes have been established in connection with public schools in each of the large centres of population throughout the Dominion with promising results.
The Committee visited the special classes in one of the centres, and were impressed with the sympathetic attitude of the teachers towards their scholars and the happy appearance of the children, who seemed to be keenly interested and busy over their appointed tasks.
There is as yet no special provision in New Zealand for the education of epileptic children. Fortunately, the number of these is apparently small, but, as in many cases it is undesirable for them to attend the ordinary classes of the elementary schools, the question of arranging for their tuition otherwise requires earnest consideration.
Following on legislative authority contained in the Education Act already referred to, provision for feeble-minded children, within the meaning of the Act, was made by establishing the special school at Otekaike, near Oamaru, with accommodation for 195 boys, and some years later a similar institution was opened at Richmond, near Nelson, with provision for about eighty girls.
These institutions contain two separate divisions, providing for—(1) The training of children of school age, and (2) the instruction of young persons over school age in handicraft and farm-work.
Both institutions have modern and well-equipped day schools with trained women teachers, and at Otekaike the industrial division is provided with workshops and instructors in trades and handicrafts.
The children are housed in modern and well-appointed cottage homes, each with accommodation for thirty-five, and are supervised by selected women attendants.
The Committee visited and inspected both Otekaike and Richmond, and were very favourably impressed with the healthy environment and careful management of these institutions, and with the humane and sympathetic methods adopted for the purpose of making the best of imperfect human material.
At both places physical exercises, musical drill, and organized games form an important part of the training, and the teachers deserve commendation for the efficiency of the pupils in these respects and their general appearance of physical fitness.
Moral training and training in habits of personal cleanliness and prompt obedience form an important part of the curriculum, and the effects are noticeable in the quick movements and alert attitude of the inmates. The girls at Richmond receive training in domestic work, needlework, knitting, darning, &c., according to their ability.
The children are taught various kinds of handiwork, and by grouping them according to mental capacity they are given a school course modified to suit the individual. In the industrial division at Otekaike, baskets, sea-grass furniture, and all kinds of wickerware and coir mats are well made, and are readily sold. Bootmaking and repairing for the institution are also carried out by certain of the inmates under a practical man. Attached to Otekaike there is an area of land where farming, gardening, and fruitgrowing absorb most of the labour of the older inmates.
At Richmond the area of land available for cultivation is limited, but even so it occurred to the Committee that something more might possibly be done in the direction of providing congenial and profitable work for the older girls, as, for instance, the growing of flowers for sale in the Wellington markets.
At Otekaike, after training, the best types of the older inmates are placed out, usually with farmers in the district, and for the most part are leading useful lives under the supervision of the local Juvenile Probation Officers of the Education Department.
The matter of placing out girls from the school at Richmond is obviously one of much greater difficulty.
At both Otekaike and Richmond there is a growing group of custodial cases, due to the fact that in many instances the parents or guardians are either unable to provide proper protective measures for the children if released, or are unsuitable in other ways to have the control of them. On the other hand, there is reluctance on the part of medical practitioners to certify such cases for a mental hospital. It is very desirable, of course, that the special schools should be used as trying-out places for children whose mental equipment is questionable, but where after a reasonable trial it is evident that merely custodial care is required there should be some simple method of passing them on to farm colonies or suitable custodial homes.
As a matter of fact, the school at Richmond has its full complement of pupils, and as many cases have now to be refused admission it is urgently necessary that other provision should be made, especially for the older girls needing custodial care.
Mention should also be made of a visit paid by the Committee to the industrial school at Caversham, which deals with girls and young women who have failed to make good when placed out under supervision in the community. There is a small clothing-factory attached to the institution, which provides useful employment for certain of the better-type girls. It is stated that, even under present conditions, which are not altogether satisfactory, the majority of the Caversham girls benefit from the training they receive to such an extent that they can be trusted to earn their living in the community under supervision.
The Committee, however, are of opinion that the buildings and site are most unsuitable for such an institution. Little level space is available for recreation purposes, the property is overlooked at the back, and the location and general plan of the buildings are such that the utmost vigilance has to be exercised. For the inmates belonging to the reformatory section it is considered that such an institution should be situated in the country with sufficient suitable land to permit of gardening and farming on a small scale. This would afford healthful occupation for the inmates and contribute towards their support. Such an institution should be so situated as to be readily accessible from all parts of the Dominion.
In the matter of the admission of young offenders over sixteen years of age to the Caversham Industrial School, and also to the Boys' Training-farm at Weraroa, the Committee found that in these cases the Courts have no authority to commit direct, but must first sentence the young person to imprisonment and then recommend transfer to an industrial school. Such a system is not only cumbersome, but is fundamentally wrong, and should be remedied as soon as possible. The Courts should have discretionary powers to commit any young offender under eighteen years of age direct to an industrial school.
At Caversham there is a small proportion of the inmates who should be transferred to a Borstal institution. This refers to the so-called "over-sexed" girl, and the girl with strong anti-social proclivities, who should be confined to an institution where there is provision for segregation and treatment of refractory cases. In many instances these young women should be kept under control for a considerable period. Many are hopelessly immoral, and in the interests of society should not be allowed their liberty.
That section of the Caversham institution comprising children committed to the care of the State on account of destitution or unsuitable conditions in their homes would be better provided for in a separate receiving home. This would be in accord with the practice obtaining in all the other centres.
The Education Department deals with all children committed to the care of the State for causes varying from destitution to delinquency. The procedure is for the police to charge the children and for the Magistrate to commit them to the nearest receiving home, where they are kept under observation, trained in proper habits, and so forth, and as soon as possible, if they exhibit no anti-social traits,placed out in selected foster-homes. The Department holds the view, shared by leading authorities, that home life, however humble, provided the foster-parents are suitable people, is better than institution life for the majority of the children who are cast on the State for sustenance and protection. The supervision of these cases, and the selection of employment for them when they become old enough, are carried out by the nurses, Managers of receiving homes, and Juvenile Probation Officers of the Education Department. Several of these officers gave valuable evidence in the course of this inquiry. These officials not only look after the welfare of the children brought under State control, but also carry out a great deal of preventive work in the way of advising parents and supervising children, who by their timely and kindly intervention are saved from coming within the scope of the law.
Several witnesses before the Committee pointed out the need for the establishment of special Courts for children and juveniles.
The Committee recommend that such provision be made, and also that clinics be established providing for the physical and psychological examination of all children coming under the jurisdiction of these Courts. The fuller knowledge thus acquired would be extremely valuable to the authorities dealing with the children.
Many countries have recognized this need and have established properly constituted Courts for dealing with children and juveniles as apart and distinct from Police Courts.
In this connection it is surprising to find that New Zealand is lagging behind in that in the laws relating to the punishment of crime hardly any distinction in procedure is made between the child and the adult. It is true, of course, that a practice has grown up whereby children are dealt with in the Police Courts at a time apart from the hearing of adult cases, but the procedure of the Criminal Court has been retained—i.e., the young delinquent is charged with an offence, is required to plead, and if found guilty is liable to conviction. In the majority of such cases the charges are for minor offences and are dealt with summarily, but a child charged with an indictable offence and remanded to the Supreme Court for trial or sentence may in the interim be detained in prison.
By arrangement between the Departments concerned most of the cases of children and juveniles are investigated by the Juvenile Probation Officer of the Education Department prior to the hearing, but these officers have no legal standing in any Court, and are not even empowered to bring a destitute child before a Magistrate for committal to the care of the State. This function must be carried out by a police constable.
The Children's Court, as it is constituted in other countries, is a Court of equity, and its principal function is to consider all children brought before it as cases requiring protection and care. It is the business of the Court, by means of careful investigation in each case of conduct, school history, family history, and mental condition, to ascertain, if possible, the reason for misconduct, and either to eliminate or modify the causes, or to remove the child from the environment that has contributed to its present condition.
The presiding Magistrates are usually selected on account of their experience with children and knowledge of child psychology. In some of the Courts in America women are selected for these positions.
It is common knowledge that lack of mental balance, retardation, and physical defect are responsible for much juvenile delinquency, and it is therefore essential that if the children appearing before the Courts are to be dealt with in a scientific manner there should be provision on the lines recommended above.
It seems to the Committee that the Dominion has now come to the parting of the ways in this matter, and unless the multiplication of the feeble-minded is to be allowed to go on in an ever-increasing ratio, with consequences dreadful to contemplate, the problem must be dealt with on broader lines, and in a more comprehensive fashion.
In the first place, a comprehensive system of notification is essential so that a register as complete as possible may be made of the cases to be dealt with.
The English Commission for Inquiring into the Care and Control of the Feeble-minded, whose report appeared as far back as 1908, laid down the basic principles of a sound policy in dealing with this question. Their first principle was that persons who cannot take a part in the struggle for life owing to mental defect should be afforded by the State such protection as may be suited to their needs. Their next principle was that the mental condition of these persons, and neither their poverty nor their crime, is the real ground of their claim for help from the State. Their third principle was that if the mentally defective are to be properly considered and protected as such it is necessary to ascertain who they are and where they are.
This, of course, is the object of the system of registration to which we have referred.
Lastly, the English Commission held that the protection of the mentally defective person, whatever form it takes, should be continued as long as it is necessary for his good.
These principles appear to us to be quite sound, and we have no hesitation in adopting them.
In regard to the method of compiling the register, some excellent suggestions were made by Dr. Theodore Grant Gray, Medical Superintendent of the Nelson Mental Hospital. He proposed, first, that a Government Department or sub-department should be created to deal with all feeble-minded and mentally defective persons living outside institutions. It would deal not only with the feeble-minded, but it would act the part of a Government "after-care association," in that it would keep in touch with all persons discharged from mental hospitals. One of its duties would be to keep a register of all feeble-minded, epileptic, and mentally defective persons living outside institutional care. Dr. Gray further suggests that the register should be compiled in the following manner:—
(1.) It would be a statutory duty of all School Medical Officers to report to the Department the names of all feeble-minded or epileptic children in their districts.(2.) It would be the duty of the District Education Board to report any child of school age who was not attending school because of feeble-mindedness or epilepsy.(3.) It would be the duty of the Superintendent, owner, or licensee of every hospital, private hospital, industrial school, or reformatory prison to notify the Department upon the admission of any person suffering from feeble-mindedness or epilepsy.(4.) It would be the duty of the Superintendent of every mental hospital to notify the name of every person discharged from a mental hospital.(5.) It would be the duty of every Judge or Magistrate in all cases brought before him in which there appears to be mental enfeeblement or epilepsy to call to his assistance an alienist, and, if the report is confirmatory, to order such person's name to be placed upon the register.
(1.) It would be a statutory duty of all School Medical Officers to report to the Department the names of all feeble-minded or epileptic children in their districts.
(2.) It would be the duty of the District Education Board to report any child of school age who was not attending school because of feeble-mindedness or epilepsy.
(3.) It would be the duty of the Superintendent, owner, or licensee of every hospital, private hospital, industrial school, or reformatory prison to notify the Department upon the admission of any person suffering from feeble-mindedness or epilepsy.
(4.) It would be the duty of the Superintendent of every mental hospital to notify the name of every person discharged from a mental hospital.
(5.) It would be the duty of every Judge or Magistrate in all cases brought before him in which there appears to be mental enfeeblement or epilepsy to call to his assistance an alienist, and, if the report is confirmatory, to order such person's name to be placed upon the register.
N.B.—In the case of sections 1, 2, and 3 the Department would apply to a Magistrate for an order to register the person concerned. In section 4 the process would be automatic.
The Committee consider the machinery suggested for the purpose of compilation of the register very suitable, subject to such modifications as may be found necessary in practice, but have come to the conclusion that it would be preferable for many reasons to keep cases of this kind, as far as possible, free from Courts, a large part of whose work consists in trying persons charged with criminal offences, and to follow the plan which seems to be working very well in several American States—namely, to set up a Board of experts to deal with these cases.
The Board, which might be called the Eugenic Board, should be a central Board associated with a special Department or sub-department, of which the head should be a man of sufficient personality, energy, and organizing-power to grapple effectively with this question—first, by taking the necessary steps to compile a reasonably exhaustive register, and afterwards, by co-ordination with cognate Departments or by independent departmental action, to build up the necessary machinery to provide for the care, segregation, supervision, or treatment of the class with which his Department is required to deal.
The compilation of the register is a departmental matter, but legislative authority will be necessary, to provide for compulsory notification and to prescribe the means. A well qualified departmental officer should at once be detailed to take this matter in hand and formulate from the evidence given to the Committee and from other sources of information the method and means of obtaining complete registration.
The first step towards the formation of the Board should be the early selection and appointment of a thoroughly trained and experienced psychiatrist. Irrespective of the necessity for the employment of such a man as the scientific member of the proposed Board, the Committee are of opinion that the Departments of Health, Mental Hospitals, Prisons, and the Special Schools Branch of the Education Department are at present suffering from the lack of expert advice in this direction, and that it is high time the Government had in its service at least one trained psychological expert, with recourse to the services of other men with similar training in the four centres.
The Eugenic Board should be vested with power to examine all cases notified and, after due investigation, to place on the register—
(1.) Such persons as in its judgment come within the definition in the Mental Deficiency Act of feeble-minded;(2.) Persons afflicted with epilepsy associated with automatism or other conditions rendering them especially liable to dangerous, immoral, or otherwise anti-social manifestations, and in the case of juvenile epileptics the mere frequency of fits rendering them unsuitable for attendance at ordinary schools;(3.) Moral imbeciles as defined in the English Mental Deficiency Act; and(4.) Persons discharged from mental hospitals.
(1.) Such persons as in its judgment come within the definition in the Mental Deficiency Act of feeble-minded;
(2.) Persons afflicted with epilepsy associated with automatism or other conditions rendering them especially liable to dangerous, immoral, or otherwise anti-social manifestations, and in the case of juvenile epileptics the mere frequency of fits rendering them unsuitable for attendance at ordinary schools;
(3.) Moral imbeciles as defined in the English Mental Deficiency Act; and
(4.) Persons discharged from mental hospitals.
It should be the function of the Board to order or recommend to the Minister the segregation, supervision, or treatment of the different classes. Cases receiving adequate care in their homes would not, of course, be interfered with.
The Eugenic Board, of course, should have power to remove any name from the register if it is of opinion that there is no longer any need for registration. There should be the right of appeal to a Judge of the Supreme Court against the decision of the Board to place a person on the register, and there should also be power to apply to a Judge for the removal of the name from the register in cases where the Board declines to do so. These provisions should, it is considered, effectively safeguard the liberty of the subject.
The machinery necessary to deal adequately with this vital question—vital in its influence on the purity of our race—must be somewhat extensive, but use should be made as far as possible of existing governmental and private agencies and organizations.
The work requires organization, and the first essential is, therefore, the appointment of an organizing head. Unless such an appointment is soon made the matter will drift. The heads of the existing Departments of State under whom such an organization might be placed have already more business to handle than they can comfortably overtake. Some one must be selected to specialize on this work and this work alone.
The question naturally arises as to the Department of State to which the proposed sub-department for the care of the feeble-minded might best be attached. In the judgment of the Committee the education of feeble-minded children should be continued by the Education Department, which has evolved a very successful system and is administering it well. After everything possible has been done in the matter of education a large proportion, as they grow up, will be quite unable to hold their own in the world, and for their own protection and safety, and in the interests of society, must be cared for in some institution, where they may be kept usefully occupied in gardening or farming, or in some handicraft which will serve to keep them in health and help to recoup the State some part of the cost of their maintenance. It is, of course, most essential that they should not be allowed to reproduce their kind, thus further enfeebling and deteriorating the national stock, adding to the burden of the community and to the sum of human misery and degradation. "To produce but not to reproduce" sums up the best scheme of life for these unfortunates.
Looking at all the circumstances of the case, it appears to the Committee that it would be better if the compilation of the register, the provision of the farm and industrial colonies, and the after-care of adult feeble-minded patients coming under Classes V and VI and "moral imbeciles" were entrusted to a special branch of the Mental Hospitals Department. It is essential that the feeble-minded shall be kept separate from the insane, while the feeble-minded themselves, of course, require careful classification.
It is very important that marriages with registered persons should be made illegal, and, as a corollary to this, that it should be made an indictable offence for any person knowingly to have carnal knowledge of a registered person. It should also be provided that any parent or guardian who facilitates or negligently allows any registered person to have carnal intercourse with another person shall be guilty of an indictable offence.
A question which has given the Committee much anxious thought is as to whether sterilization should be adopted as a method of preventing the propagation of the feeble-minded. That it would be an effective method as regards the persons operated on goes without saying. The operation of vasectomy in the case of males is a very simple one, which may be performed with the aid of a local anæsthetic, and may be said for all practical purposes to be unattended by any risk to the patient. In the case of women a similar operation on the Fallopian tubes, which is known as salpingectomy, is an abdominal operation and cannot be said to be entirely free from danger, although it is not regarded as very serious. Except for the prevention of fertility, the operation does not interfere with the sexual powers of the patient and has little or no effect on sexual desires. It has been stated that a process of sterilization by means of X-rays can be applied to either sex. The only evidence available, however, shows that this method is still in the experimental stage, and the Committee, for this reason, cannot recommend it, especially as there is a danger that it might damage the cells producing the internal secretions which influence the secondary sexual characteristics and so injuriously affect the general health and mentality.
Several States in America have passed laws providing for the sterilization of persons in State institutions who are—(1) Insane, (2) feeble-minded, (3) criminalistic.
In some of the States an appeal was made to the Supreme Court, and, the law being pronounced unconstitutional, no attempt was made to enforce it. In other States the law has been allowed to become a dead-letter. Up to the 1st January, 1921, the latest date dealt with by the most recently published work on the subject, there have been 124 State institutions legally authorized to perform operations for sterilization, of which thirty-one have made more or less use of their authority, while ninety-three have not. The total number of operations performed up to the date mentioned was 3,233, divided into classes as follows: Feeble-minded, 403; insane, 2,700; criminalistic, 130. Of this total of 3,233 operations the State of California contributed no less than 2,538, and in this State a single institution (the State Hospital for the Insane at Patton) is responsible for no fewer than 1,009 cases. A Bill introduced in 1924 into the Senate to legalize sterilization of mental defectives, &c., was rejected.
Dr. H. H. Laughlin, of the Psychological Laboratory of the Municipal Court of Chicago, has devoted several years to the study of this question, and has recently published the result of his researches in a book entitled "Eugenical Sterilization in the United States." He publishes the texts of all the laws past and present, gives his idea of a model sterilization law, together with the necessary forms for putting it into effect. He also deals with the physiological and mental effects of sexual sterilization. A reviewer of his book, writing in theJournal of Heredityof October, 1923, states forcibly the case for the opponents of sterilization. He expresses the opinion that "The release of sterilized individuals with feeble inhibitions or anti-social tendencies is the equivalent to the creation of so-many new and virulent foci of venereal diseases and promiscuity."
Furthermore, the Central Association for Mental Welfare of Great Britain, which was formed in 1913 to act as a co-ordinating and representative body on all questions affecting mental defectives and their relations to the community, not long ago referred the question to their standing Medical Committee, who gave the considered opinion that "sterilization at the present time is not a practical proposition."
The Committee of the Central Association being in complete agreement with this view, the Association decided not to advocate the policy of sterilization, because they consider that it would have only a limited influence in preventing the increase of mental deficiency, that it would be attended with certain harmful results in other directions, and because its adoption is impracticable. The Association's statement on this subject goes on to say: "It is very important to remember thatalthough propagation by defectives is one of the causes of mental deficiency, nevertheless this is by no means the only social menace attaching to their presence in the community. If left unguided and unprotected, their lack of stability and control may lead them to commit serious crime, such as theft, arson, assault, and even murder. Their inability to maintain economic independence results in vagrancy and destitution. Their helplessness in the face of obstacles frequently brings about their complete collapse at the first rebuff which they have to meet. The interest of the community can only be adequately protected by the segregation of a considerable proportion of these persons in suitable institutions. A sterilized defective would not be any less liable to these happenings than would one who was unsterilized. A defective woman, from the fact of her being sterilized and incapable of bearing children, would be more prone to illicit intercourse, to adopt a life of prostitution, and to spread venereal disease. It follows that segregation would still be needed in the case of a very large proportion of defectives, but, if they are segregated, sterilization is unnecessary. On the other hand, there can be very little doubt that any general adoption of sterilization would, in actual practice, lead to the non-segregation of a large number of defectives who should be under care and thus to an increase of the foul evils mentioned."
Having thus stated the arguments against sterilization the Committee must now present the other side of the question.
In the first place, it is evident that, as far as the United States is concerned, the extension of sterilization of the mentally defective has received a grave set-back by reason of the declaration of the Supreme Court of the United States that the laws in certain States permitting sterilization are unconstitutional. This ruling, of course, does not apply to New Zealand.
Further, opponents of sterilization ask to be shown its good results; but obviously the results cannot emerge in one generation or in a comparatively short space of time, but only in the ultimate lessening of the proportion of mental defectives in the community by diminishing the hereditary supply.
There is no doubt also that much confusion exists in the minds of the public as to the meaning of sterilization and desexualization or castration. The process of sterilization, as has been shown, involves only a simple and safe operation and has the sole effect of preventing reproduction. Sterilization, therefore, should not be loaded with the objections which apply to the far-reaching effects of castration. The former, unlike the latter, is not prone to produce harmful effects upon the mind or morals of the sterilized individual.
The assertion that "sterilization at the present time is not a practical proposition" is difficult to understand. It is certainly practicable, and is as likely to be favoured as opposed by public opinion, especially that section of the public that understands the difference between simple sterilization and desexualization. As regards the suggestion that sterilization may lead to new foci of venereal disease, it must be borne in mind that the unsterilized feeble-minded are already prone to sexual promiscuity, and there is no evidence that sterilization would increase this tendency. The opponents of sterilization offer as an alternative only permanent segregation to prevent the transmission of mental defect. It is evident, however, that the cost of the segregation of all mental defectives capable of reproducing other mental defectives would be exceedingly heavy. The Committee advocates powers of segregation and of sterilization, these powers to be placed in the hands of the Eugenic Board, under proper safeguards and the right of appeal.
Sterilization in suitable cases is not a high price to pay for liberty. There are in our mental hospitals to-day men and women who suffer from recurrent insanity, who are admitted to the mental hospitals from time to time and discharged when they are better, and in the intervals between their admission cohabit with their wives or husbands, as the case may be, and bring more defective children into the world. If discretionary power were given to the Board as suggested it should, and no doubt would, be exercised cautiously and tentatively.
Sterilization gives the patient liberty to do useful work in the community, is less drastic than segregation for life, and on the whole a much slighter interference with the rights of the individual, which are surely subordinate in such cases to the rights of the State.
There are, of course, numbers of mental defectives who can never be allowed their liberty, and in the case of these the question of sterilization need not be considered. There are many cases of mentally defective girls, liberated from institutions in New Zealand for the purpose of engaging in domestic service or other work, returning afterwards the mothers of illegitimate children, probably also mentally defective. Unless such are to be maintained for years as wards of the State in institutions, should they ever again be allowed their liberty unless they undergo the operation of sterilization?
This is the question: Can the propagation of mental defect by mental defectives and the debasing of the race thereby be greatly checked if not completely prevented? The answer is assuredly, Yes, by segregation and by sterilization.
The Committee recommends that both methods be placed in the hands of the Eugenic Board, with powers to discriminate as to which method is the more suitable for each individual case. The two methods are complementary, not antagonistic, and suitable safeguards for the liberty of the subject are provided.
The Committee recommends that the Eugenic Board should be given the power in suitable cases to make sterilization a condition of release from any of the institutions under the charge of the Department of Mental Hospitals or removal of their names from the register on probation, but that in no case should the operation be performed without the consent of parents or guardians of the persons concerned.
The Committee consider that the persons so operated upon and liberated should be released on probation and kept under supervision for a reasonable period, and that they should be returned toinstitutional care if found to be leading an immoral life, or unable to support themselves, or for any other reason which the Eugenic Board may consider sufficient.
If the recommendation as to sterilization being authorized under the conditions specified is adopted, the Committee think it would be advisable to introduce some provision as in the American Acts, making it unlawful to perform operations whose object is the prevention of reproduction in cases not authorized by the Board unless the same shall be a medical necessity.
It will be neither possible nor desirable to segregate all mental defectives. Feeble-minded children who are receiving adequate care and training in their own homes will, of course, be left there. When they reach the age of adolescence the question of their disposal should be considered by the Board. In many cases the inmates of special schools, after they have received some training, would do well if returned to their homes or boarded out in selected foster-homes under supervision.
The real difficulty arises, especially in the case of girls, when the age of adolescence is reached.
In the opinion of the Committee it is of the utmost importance that mental defectives should be prevented from reproducing. No person who has been placed on the register should be allowed to marry until the Eugenic Board has given its consent by removing the name from the register.
It is altogether wrong to suppose that there is any unkindness in taking the feeble-minded, who are unable to battle for themselves, under the care of the State and preventing them from bringing forth another generation of defectives. The real unkindness consists in allowing such unfortunates to be brought into the world.
In school, and still more in the after-struggle for existence, the feeble-minded find themselves the butts of their fellows, and the "inferiority complex" thus developed tends to make them sink lower in the scale both in intellect and morals.
"On the other hand, it is the general experience of those who have had many years' practical experience with defectives that the majority are far happier in suitable institutions engaged in congenial occupations, and having the companionship of their mental equals, than when they are exposed to the difficulties of an outside world to which they are incapable of adapting themselves. In many cases, indeed, such freedom amounts to the infliction of positive cruelty."
This statement is taken from the memorandum of the Central Association for Mental Welfare of Great Britain, to which reference has already been made, and this Committee can, from their own observation, endorse the views thus expressed.
It seems desirable, however, to point out the fallacy of a popular idea that the world could easily stamp out defectives and degenerates by merely adopting a vigorous policy of segregation and sterilization. Even if it were possible by these means to prevent all manifest mental defectives from reproducing, it cannot be expected that this class will be thereby eliminated from the population, since mental defectives may be the offspring of apparently normal stocks, or may be descended from stock in which only minor manifestations of impaired nervous vitality, such as instability, eccentricity, &c., have hitherto been evident, and in a large proportion of cases they are no doubt the progeny of persons belonging to the higher grade of distinctly degenerate stock—persons who have not themselves necessarily shown any marked traits of instability or degeneracy, and to whom therefore sterilization or segregation would be inapplicable.
It will probably be objected that the plan for cutting off as far as possible further additions to the mental defectives of the Dominion will involve increased expenditure. This is, unfortunately, the case; but will it not be a much more costly process to allow the present unrestricted multiplication of these defectives to continue in an ever-increasing ratio? If they are allowed to multiply, their unfortunate offspring will have to be provided for in one way or another—some by means of charitable aid, some in our prisons, some in our mental hospitals. Take the case of the defective couple, case No. 4,page 9, themselves in receipt of charitable aid, who have already produced eleven children, all of whom are being provided for by the State, while, as the couple are still living together and the woman is still of child-bearing age, it is quite possible that the total may yet be increased. This family, it is estimated, will cost the State at least £16,000. Will any one seriously contend that it would not have been sound economy if this couple had been taken in the first instance, placed in separate farm colonies where they would have lived fairly useful lives, and been prevented from casting such an excessive burden on the State? We might take each of the cases quoted in an earlier part of this report, and many others which we have not quoted, and ask the same question in regard to each. There is no doubt whatever that from the purely financial point of view it is very much to the interest of the community that this problem should be taken boldly in hand at once while the evil is within fairly manageable proportions, instead of allowing it to grow into an intolerable burden.
Consider the humanitarian aspect. Surely it is a kindly act to give the protective care of the State to those unfortunate persons who are unable to hold their own in the struggle for existence, and who, if left to their own devices, will fall miserably by the way and in many cases become a menace to society.
Lastly, there is the national question to be considered. Surely it is important that our stock should be kept as sound and virile as possible, and that where a process of deterioration has been detected every attempt should be made to stop it as soon as possible and by every means in our power.
The Committee feel very strongly that any attempt to check the multiplication of mental defectives in the Dominion will to a large extent be labour thrown away if the greatest care is not at the same time taken to prevent the introduction of feeble-minded and other undesirable persons from overseas. The distance of New Zealand from Europe and the cost of the long passage have on the whole had a selective influence on the character of the immigrants and tended to keep up the standard of quality. As already mentioned, however, serious mistakes were made in the "seventies" of last century. Very striking testimony to this effect is contained in the report of the late Dr. Macgregor, Inspector-General of Hospitals and Charitable Institutions, presented in 1888, an extract from which appears in the Appendix of this report. In the brief space of fifteen years the dire consequences of the mistakes made in previous immigration without due regard to its quality had already become apparent, and in the most impressive terms Dr. Macgregor, who was an exceedingly able and far-sighted public servant, pointed out that the evil done by the introduction of an undesirable class of immigrant is never finished.
"The impaired health, low morality, and insanity descend to the offspring, and are a continued drain upon this community."
The benefit of a well-regulated stream of immigration into this country is not open to question. A substantial addition to our population is now more than ever needed if this country is to progress and its resources are to be developed sufficiently to enable it to bear with ease the heavy burden imposed on the community by the Great War. The point which it is desired to emphasize is that constant vigilance is necessary to keep up the standard of quality of the new-comers in view of the very natural desire to send off to a new land those who are physically or mentally unable to maintain themselves in the land of their birth. Such vigilance, it need hardly be pointed out, is especially necessary at the present time when the volume of immigration is greatly increased owing to the condition of affairs in the Mother-country.
As a matter of fact, there seems no doubt that immediately after the conclusion of the war the system of control and medical inspection was not so strict as it should have been, especially in the case of the Imperial Government's overseas settlement scheme for ex-service men and women. The New Zealand Government, however, sent Home an officer from the Immigration Department to rectify matters and to provide for a more thorough examination of assisted immigrants.
Under the system at present in force a special roster of medical referees has been compiled, and no person is accepted as an assisted immigrant without a certificate of physical and mental fitness from one of these doctors. The medical examiner, in the instructions, is particularly requested "To satisfy himself that the applicant is in every way a fit subject to pass a thorough medical examination, as applicants are liable to rejection both at the port of embarkation and at the port of arrival." Finally, the doctor is required to sign the following statement: "Having read and made myself conversant with the instructions contained in Form KA supplied me, I certify that I have this day examined the above-named, and am of the opinion thatis inhealth and of sound constitution.is not suffering from any mental or bodily defect which in my opinion would unfitfor earningown living as a."
The form provides for a very complete examination, but as regards certain conditions, especially previous mental diseases, the examiner is necessarily dependent on the statements of the applicant.
The Committee were informed that New Zealand has now the reputation with the Imperial authorities of being the hardest and most exacting of all Dominions regarding the health and physical fitness of immigrants.
The Committee think that, in addition to the precautions already taken, inquiry should be made, as far as may be possible, into the family and personal history of assisted immigrants, particularly as to whether they disclose any cases of insanity, epilepsy or feeble-mindedness, crime, or dependence on charitable aid.
The Committee are further of opinion that the time has now arrived when closer supervision should be exercised over those persons who come as ordinary passengers with the intention of remaining in the Dominion.
The Immigration Restriction Act, 1908, provides that "When any passenger arriving on board any ship is either lunatic, idiotic, deaf, dumb, blind, or infirm, and is likely to become a charge upon the public," the owner, master, or charterer of the ship shall be required to enter into a bond in the sum of £100 for every such passenger, the person entering into the bond and his sureties being bound to pay to the Minister all expenses incurred within the space of five years for the maintenance of such passenger.
Under the Act the following are made "prohibited immigrants":—