A study of the care and treament of the mentally subnormal

Abstract

The history of mental health reform is largely the history of changing public attitudes. This is not to imply that reform came only in response to mass pressures, but rather that governments have always shown themselves particularly sensitive to public opinion in this connection and been careful to ensure that the law never moved far ahead of it. It is equally true that reforms have themselves affected and influenced public opinion in a liberal direction. This seeming paradox derives from the
fact that there are in any social context at least two distinct aspects of public opinion which are sometimes in conflict. First there is the collective or majority view of comparatively small groups who show interest in a particular subject and take the trouble to inform themselves. These are sometimes called opinion-formers and very often they will have their spokesmen in positions of influence in and around government. Such minority groups are apt to speak with a voice, and weild an influence, greater than their numerical strength might justify. It is from this kind of group that pressures for mental health reform in
the past has usually come. Then there is, on the other hand, the mass public opinion, largely subjective and emotional in character, and far harder to distinguish. In the context of mental disorder, it has been made up chiefly of ignorance, deep seated if irrational fears and age old prejudices. These are the mass attitudes that have in the past governed reform, acting as a brake upon it. At the same time, mass opinion tends gradually to change as a direct result of reform, once reform is brought about.