Section 9.—Policy for the Future.
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.
Proposed Eugenic Board.
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.
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.
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.