History and concepts

Mental retardation and psychiatric services were separated in the mid-nineteenth century. Mental retardation virtually vanished from psychiatric training curricula and generations of psychiatrists did not see people with mental retardation, though some were involved with administrative functions or the prescription of sedative medications.

Important postwar developments in psychiatry had little effect in the mental retardation field. The introduction of neuroleptics in the mid-1950s, the therapeutic community movement of the 1960s, the increased interest in methods of empirical research in the 1970s, and the emphasis on classification in the 1980s, had a great impact on psychiatry. All these virtually bypassed services for people with mental retardation.

Instead ideologies, sociological theories, civil rights issues, and the normalization philosophy prevailed. (1.,2) Together with families' organizations they inspired current care practices and directed the way mental retardation services developed.

Jacobson(3) argues that the growing interest in people with mental retardation and mental health problems following the Second World War in the United States was the direct result of a combination of sociopolitical factors and professional interest. One dimension was the vast growth of the population. About the same time social and political organizations, for example the Association of Retarded Citizens, a parents' organization in the United States, became very influential on policy matters and joined forces with the American Association for Mental Retardation.

Similar initiatives took place in other parts of the world, for example the Australian Association for the Mentally Retarded which was formed in the early 1950s. In the Republic of Ireland, public funds became available to support the work of religious, parents', and friends' groups in serving people with mental retardation. In 1960, the Kennedy administration in the United States, through key enabling legislation, established a federal role in the financing of mental retardation services. As a result, university affiliated programmes (professional training, research, and service centres), mental retardation research centres, and the National Institute of Child Health and Human Development at the National Institutes of Health were established.

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