The Development of Welfare for the People with Mental Retardation

 It has traditionaly been considered that the people with mental retardation would be best treated in institutions.
  In Japan, we are finally entering a new age in terms of promotion of welfare of people with mental retardation, with "their active participation" in the process.
  At first I would like to speak how the welfare system for the people with mental retardation has been developed, what it is like and what we would expect for the future in this country.


1891
  The first private facility for children with mental retardation was established.

1891 to 1947
  Welfare services provided by charity organization.
  By the time of the enactment of the Child Welfare Law(1947), it is said that 27 facilities for children with mental retardation were operated as charity work.

1947
  With the enactment of the Child Welfare Law, public welfare measures for children with mental retardation started.
  At first, establishing a residential care facilities was main policy.
  The age of welfare administration started.

1960
  The enactment of the law for the people with Mental Retardaion, for the purpose of completing welfare facilities for adults with mental retaradation so that service could be offered to not only children with mental retardation but also to such adults.

  Both law, at the beginning, residential care has been oriented. That is to say, both law provided the legal framework for the creation and regulation of facilities.
   These facilities are residential in nature.

1957
  Day care centers for children with Mendal Retardation were added to the law.  This allowed the children to commute each day.

(1958  The national home for children with Mental Retardation  was opened to accommodate children with either severe disabilities or multiple disabilities.)

1967
  Hospital homes for severely physically and mentally retarded children were created by legislation in the child welfare law.

Around 1970
  When the organizational structure of various facilities for the Mental Retardation was almost completed, home based measures were budgeted by government one after another.
  These measures include counselores for people with Mental Retardation, insurance system for the rearing of the children with Mental Retardation, home helpers, the provision of instruments and equipments for daily living, handbook for the people with mental retardation, dental care, short stay system, home visit examinations, counseling and guidance, and the provision of some of the services of the residential facilities to the community.

Also around 1970
  Along with the countermeasures for the home bassed measures, additonal measures were requested.
  The measures to enable people with Mental Retardation who are deemed employable to find suitable employment, after receiving appropriatetraining at facilities.
 Dormitories which provide housing for people wiht mentatl retardation who are capable of commuting.
 Otherhands, Welfare homes, Welfare factories were also established.

1981
  International year of persons with disabilities

1983-1992
 United nations decade of persons with disabilities.
  Normalization
  Institutional care  →  community living
                family support

1989
  So called group home was created by legislation.  This is designed to support several people with Mental Retardation  who live in the community.



Administrative structure

 The Secretarat of the Headquarters for Promoting the Welfare fo Persons with Disabilities, Prime Minister's Office (19 ministries and agencies)



The Laws Closely involved in the People with Disabilities

a) Fundamental Law for Persons with Disabilities(Shougaisya Kihonnho, 1970)
  This Law diffines the range of the handicap, secures the human rights of persons, with disabilies, states the responsibilities of national and local government, and also defines the neccessity of medical care, welfare,education, and employment.

b) Child Welfare Law (Jido Fukusiho, 1947)
 A comprehensive law concerning all children under the age of 18.
  The welfare facilities for children with mental retardation are defined in this law.

c) Law for the Welfare of the People with Mental Retardation (Chitekisyougaisya Fukusiho, 1960)
  The law defines assistance (home care, facility countermeasures, etc.) for people with mental retardation who are 18 years old and over (acutually this law is applicable to people with mentall retardation who are 15 years old and over.)

d) Other Related Laws
 -Maternal and Child Health Law (Boshi Hoken-Ho)
(Prevention and early detection of the occurence of menal retardation and
other disabilities.)
 -Law for providing family allowance for sepcial children(financial aid).
 -The National Pensions Act- Basic pension for the handicapped(financial      aid.)
 -Social Welfare Service Law.
 -Law for the welfare of the people with phisical disabilities.
 -Mental Health Law and other Laws.
 -Law concerning persons with disabilities' Employment Promotion



Government Measures for Persons with Disabiliteis: Present and Future
  Approaches taken by the United Nations, ESCAP and Japan
  The United Nations proclaimed 1981 as the 'International Year of Disabled
Persons.'
  Then proclaimed the period 1983-1992 the 'United Nations Decade of Persons with disabilities.'

  The United Nations Economic and Social Commission for Asia and the Pacific
(ESCAP) adopted a resolutuion naming the period 1993-2002 the 'Asian and PacificDecade of Persons with disabilities.'

1982
 Japanese Government adopted 'Long-Term Programme for Government Measures for Disabled Persons'

1987
 Japanese Government adopted 'Long-Term Programme for Government Measures
for Disabled Persons: Priority Measures During the Second Half of the United Nations Decade of Disabled Persons.'

1991
  'Long-Term Programme for Gvernment Measures for Disabled Persons:
Promotion of Priority Measures During the Final Period of the United NationsDecade of Disabled Persons'

1993
  Japanese Government formulated 'New Long-Term Programme for Government
Measures for Disabled Persons---Towards a Society for All.

1993
 Amendment of the 'Fundamental Law for Countermeasures for Mentally and
Physically Disabled Persons' (1970) to further promote independence and their participation in society.
 → changed the name of the Law 'Fundamental Law for Disabled Persons'



System and Organaizations For Children
 -Child Guidance Centers, the Prefectures plus Hokkaido.
 (Public Welfare Offices Fukusi-jimusho, Family and Children's Guidance Rooms-Kateijido Soudanshitsu)
   Consultation and Advice.
   Evaluation (medical, psychological, and vocational).

 For Adults
-The prefectures, cities, towns, and villages that are the auspices of public offices.

-Counseling Centers for rehabilitation of the people with mental retardation technically specialized agency



Expense
a) National and Local government financial aid for building welfare facilities.
b) Necessary costs for running welfare facilities.
    -Expences chraged by the national government.
    -Expenses chraged by the local public bodies.
c) Costs paid by persons accepted by welfare facilities.



 Welfare measures for people with mental retardation

〇Early Detection
 health examination for 18-month-old baby, 3 year old children

〇Early Treatment
 day care

〇Welfare Services
   Home based or community based welfare system
   Measures on facilities

〇Allowance & Pension



Characteristics of Japan's social welfare system for the MR in the 40 years of its history.
  Classifications of facilities by the levels of severity of disabilities.   
  Dependence on residential care life-time protection
 Protection and Guidance  ADL is emphasized.  (now QOL)
 passive life rather than active life

Transformation to Normalization
 Central emphasis must be replaced by new thinking
(1) Principles of social welfare from to give to share
(2) Shift from institutional welfare to community based welfare
(3) Change of treatment method   possibility of the use of non standard treatment
(4) Change of the laws. Major revision of laws took place

Future prospects
  Establishment of the welfare system based on the idea that assistance shall be provided so that the persons with disabilities could lead their life as indivisual members of the society.

  Assurance of human rights should be made for the further development of their welfare.  Prejudice, or discrimination must be shut out.

Others 
 A society that shuts out a number of its members is an impoverished  society.


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