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As a social worker in the 1980s, I had to visit a patient with an intellectual disability in one of the long stay hospitals that was still functioning at the time. I was just leaving when another hospital patient approached me, asking if he could get a lift to the bookies. I was unsure about the protocol here, so I approached a nurse who told me that it was fine to give him a lift. During the car journey, he explained an aspect of betting I did not fully understand, and I found myself wondering if he really had an intellectual disability. On my next visit, I bumped into the nurse who told me that he was ‘chronically institutionalised as a result of his twenty-plus years living here’ and described him as having an ‘environmental disability’. Sadly, over the course of my 25 years of NHS employment, I have heard my health colleagues tell many similar stories. So how is it that people have been institutionalised like this, and often for the most dubious of reasons such as pregnancy, petty thieving, and vandalism?
Answering this question is at the core of Sarah Wise’s book, which looks at the operation of the most significant legislation for people with intellectual disability, the 1913 Mental Deficiency Act, finally repealed 46 years later in 1959. Once admitted to hospital under this Act there was no right of appeal, with 30% of those admitted being detained for 10 to 20 years and 5% for 30 years. The Act was interpreted in such a way that many people without an intellectual disability, like the patient who wanted a lift in my car, were institutionalised for significant periods of time. ‘Thousands of lives were wasted in the mental deficiency system in the forty-six years of the Act’s operation – a colossal squandering of human potential’ (p. 236).
Wise is an award-winning scholar, specialising in the Victorian period, who has delved into the history of the Mental Deficiency Act, the debacles around it and its impact today. She is particularly interested in the category