30 years with the normalization principle

AutorIn: Elith Berg
Textsorte: Artikel
Releaseinfo: Kyushu & Okinawa, Nov. 1991. Lecture given on the invitation of the AIKU-organizations in Kyushu and Okinawa. © by Elith Berg. Danish Services for mentally handicapped persons. Former International Coordinator of the Danish Ministry of Social Affairs, Copenhagen, Denmark.
Copyright: © Elith Berg, 1991

Introduction

For 30 years the normalization principle has been the guide-line for services for mentally handicapped people in Denmark, both in legislation, in administration and in practices. It has given Denmark a leading position in the field of mental retardation services and has motivated many international visits and studies in Denmark.

Many professional groups and individuals from Japan have visited Denmark in order to know more about our services, and I have had the pleasure of meeting with many of them. I am very glad to have received the generous invitation to pay this visit to Japan, giving me the opportunity to talk about Danish experiences in this field and at the same time to see Japanese institutions and to meet and exchange views with Japanese parents and professionals.

In this presentation I shall give a sketch about the origin of the normalization principle, a summary of the development in Denmark over the last 30 years and, finally, give a description of the present Status of Danish Services for mentally handicapped persons. I will conclude with some remarks concerning the international cooperation in the field.

Background

Denmark is a small country of 43.000 square kilometers with only 5 million inhabitants. It is historically a member of the Nordic family of countries together with Norway, Sweden, Finland and Iceland with which we have close cultural and political relations. In ancient times this was the seat of the viking people that dominated the seas and coasts of Northern Europe and found their way to Greenland and the American continent.

As a nation Denmark is more than 1000 years, and it is the oldest Christian monarchy of Europe. Denmark has always been an open country, taking part in developments in Europe and in the world. Today Denmark is a member of NATO and the European Community, and our country has a leading position as to its contribution to developping countries.

From being traditionally an agrarian country, Denmark has developped to be a modern industrialized country, exporting not only agricultural high class products, but also electronic products even to Japan.

Culturally Denmark has contributed to the world culture by authors like Hans Christian Andersen and the philosopher Soren Kierkegaard and the founder of the Danish folk high school idea, Grundtvig. In the field of discovery I could mention Vitus Bering, and also in natural science Denmark has fostered great persons. Even here in Japan I venture to mention the Danish physicist Niels Bohr who made basic inventions for the utilization of atomic energy, but he also warned the world against the dangers involved.

100 years of social welfare

The industrialization in the l9th century gave Denmark a high rate of economic growth, and by chosing the open market trade policy we learned early to compete with the best in the world. But as in other countries, industrialization gave new problems, urbanization by immigration from the countryside, concentration in small dwellings, splitting up of the families and loss of the natural local solidarity.

A democratic constitution was introduced in Denmark in 1849 through a peaceful development, and an activation of mass organizations and political parties was facilitated through compulsory education since 1814 and a relatively high level of general education and training. Finally, the Danish population is traditionally relatively homogenuous, and this gives the Basis for a national solidarity which is also promoted by an uncomplicated geography and easy internal communication.

This is the Basis for Danish social welfare which has developped over 100 years, beginning in 1891 with the introduction of the first old age pension system, financed by the state. During the first third of the 20th century, the social welfare system developped to encompass other marginalized groups in society, especially children and handicapped persons. The procedure was often that the state supported private initiatives and in some cases took over responsibility from the private organizations in order to cover the whole population. And in the year of 1933, in the middle of the world wide economic crisis, Danish social welfare was consolidated through a comprehensive legislation, introducing the right of the citizen to have social assistance of different types and specifying the responsibility of the state and the local governments.

For handicapped persons, children or adult, the state by this legislation took over the full responsibility for their maintenance, education, training and care, either by reimbursing the costs of private institutions or by providing for it directly through state run institutions. Thus the state-financed system still gives room for private institutions and organizations, but in the running of services the private organizations play a far smaller role in Denmark than in other European countries. Characteristic for modern Danish services is also that all the staff is employed by the public institutions or administrations and that the role of voluntary workers is practically nil.

By the direct public responsibility handicap policy in Denmark has become an integral part of public policy - for the good and the worse - on line with other public functions such as fire protection, traffic, health and defense.

The Legislation of 1959

The years after the Second World war saw a further development of legislation for handicapped people. An important factor was, that Denmark did not suffer so much destruction through the war as did other countries in Europe and in Asia. So shortly after the war - also helped by the American Marshall Aid - Denmark could resume a normal life and continue the development of social welfare.

On the basis of the law from 1933 modern forms of services were introduced in the 1950ies for the blind, for the deaf and hard-of hearing. Improved education and guidance was established for these groups, both for children and adults. And very important was the establishment of boards of cooperation between the responsible state institutions and the organizations of the blind, the deaf and hard-of hearing. The same was the case with physically handicapped people. At the same time the only form of services for the mentally handicapped persons was the big residential institution with a life-long segregated care.

The beginning of a new development was made when parents of mentally handicapped children in 1952 formed a national parents organization in Denmark. They formulated an appeal to the government, describing and criticising the existing conditions of the institutions for mentally retarded persons. They criticised the overcrowding of the institutions, the lack of qualified personnel, the lack of education for children and work for the adults and the discrimination in general in relation to the rest of the population.

The appeal had a positive response from the government which in 1954 set up a government committee to consider the situation and make proposal for a revised legislation. The committee held representatives of the different ministries involved, of experts and from the parents organization. In 1958 the committee came out with a project for a special law, and in 1959 the Danish Parliament passed the Law on National Services for Mentally Retarded Persons.

The law established a state run and state financed special system of services for mentally handicapped persons in Denmark. It was based on a central administration and regional centers under the Ministry of Social Affairs. The purpose was to give mentally handicapped persons all kind of services from birth to death, kindergartens, schools, workshops, treatment and care, in short a life "as close to normal as possible". This was the beginning of the normalization principle.

There was no exact formulation of the principle, and it is not a theory or a dogma. On the contrary, there is a clear Danish pragmatism in the words "... as possible", but many things were possible in Denmark in the 1960ies with a positive economic development and with positive attitudes in Parliament. In the first band normalization meant better material, economic conditions for the mentally handicapped and their families, based an the demand of equal political rights. Later there has been a lot of discussion of the meaning and consequences of normalization, not only in Denmark, but all over the world. In Denmark we can say that we have obtained a high degree of normalization in the form of "hardware", meaning the economic and personnel resources necessary, but the important thing now is the "software", meaning the attitudes around the mentally handicapped, the devotion they are met with, not only from their families but also from the professionals. It is factors like respect for the individual, care and love that give them security and makes it worth living for the handicapped as for other persons. Normalization in Denmark is based an a Christian humanitarian tradition, even if services are not run by religious organizations and institutions.

Based an the 1959-legislation the 1960ies saw a rapid expansion and diversification of services for mentally handicapped persons in Denmark. A comprehensive network of kindergartens, schools and workshop was established for mentally handicapped children and adults, becaused it is normal that children go to kindergartens and schools, and that adults have a work place. And of course, all these facilities were built outside the old institutions.

Many of the old institutions were reduced and substituted by smaller and more humane residential facilities. The remainder of the old institutions were modernised with smaller unit and smaller dormitories and finally individual bedrooms. The principle concerning housing for mentally retarded persons was: It is normal that children live with their parents, and that adults live independently. On these grounds different possibilities were established to help parents in keeping their handicapped child at home. The Instruments were: economic assistance to cover the extra costs of having a handicapped child, daycare also for very small children, short stay homes to leave the child for a period and advice and guidance from professionals to help the parents practically and psychologically to cope with the problem. By these means Denmark has succeeded in reducing considerably the number of small children being placed in residential institutions in later years.

On the other hand, in Denmark it is normal that young persons at a time leave their parents' home and start living independently. Of course this is not so easy for handicapped youngsters, but of course the burden of having a handicapped child increases with the age of the child and of the parents. To meet this problem a number of small institutions especially for young retarded persons were built in Denmark in the 1960'ies, and training for adult and independent life became a natural part of training in special schools and institutions.

The next natural step towards normalization of housing would be to make it possible for a mentally handicapped person to live independently in his own housing. An important step in this direction was made in 1965, when - after a long fight by the parents' organization - mentally retarded persons through legislation obtained the same right as other handicapped persons to receive a disability pension when living outside an institution. An important condition for the progress obtained in the 60'ies and later on was an intensive public relations activity run in part by the parents' organization, in part by the state administration through publications, meetings and conferences on a national and local level.

With the rapid expansion of facilities in the 1960'ies there was a corresponding increase of staff and budget of the special services, employing about 10.000 persons to take care of about 20.000 persons being registered as mentally retarded (corresponding to 0.43% of the population). A special three years training of care personnel was established to work in residential institutions. The regional boards of directors included physicians, teachers, social workers and administrators.

The new legislation

After some years with the special legislation for mentally retarded persons under the normalization principle it was realized that it was inconsequent to have a special legislation for this one group of society, and that the outmost consequence of the normalization principle would be that there should be no special legislation, but that all regular legislation should contain the necessary special consideration for handicapped people. At the same time there was a tendency to decentralize administrative and political power in Denmark from the national government to the local and regional authorities.

The backgroud was an administrative reform in 1970 which reduced the number of local governments and at the same time gave them new and more efficient structure to enable them to take over political and administrative functions from the state. To some degree this was done also for the corresponding regional authorities.

The consequences of this reforrn for social legislation was deliberated by a special social reform committee. The purpose of the social reform was to decentralise services to the local and regional authorities and to collect the rules about social services, now spread in different laws, into one law on social assistance and services. This could be called a legislative and administrative normalization and integration which should facilitate the individual normalization and integration.

For the staff working in the institutions a new and broader three years training was established for jobs in relation to all kinds of handicap and other marginal groups.

The idea was that services for handicapped and other marginalized groups should not be run by the state but by the same local and regional authorities that in general were responsible for public services such as schools, hospitals etc.

And at the same time it was decided that problems of handicapped people should not only be a matter for the Ministry of Social Affairs, but also for other goverment departments, so that the problems should be dealt with and solved in the sectors where they arise. So it was decided that education of handicapped people in future should come under the Ministry of Education, the health problems should come under the Ministry of Health, transportation problems under the Ministry of Transportation etc.

The new law came into force in 1976, and the decentralization was carried through in 1980. The Act on Social Assistance gathered the rules from different laws about services for the blind, the deaf, the mentally handicapped, together with laws about child and youth welfare and services for elderly people into one law. Instead of grouping services around each of the mentioned groups the law contains a catalogue of all forms of services with indication of criteria for allocation, the scope of the assistance and the placement of responsibility for allocation with the local or the regional government.

The reorganization of services was accompanied by a reorganization of the financing, to be shared by the three administrative levels. While leaving most direct responsibility to the local

and regional governments, the state remained with some important functions, namely the legislative initiative, some planning functions and an appeal administration to be responsible for the final interpretation of the law in cases of conflict.

Under the new law, the influence of the organizations of the handicapped people was secured by the establishment of a national handicap council and corresponding councils on local and regional level. The old committees for the blind, the deaf, the mentally handicapped etc. were substituted by one national council to be treating the whole area of handicap questions.

The national handicap council is composed by representatives of the organizations for people with disabilities on one side and on the other side representatives of the responsible authorities on the state, local and regional level. On the state level all the ministries involved are represented, based on the idea that handicap questions concern many sides of society, although the Ministry of Social Affairs still has the role of coordination. The council must hold meetings at least four times a year. It has the task to follow development in society for handicapped people, it can take initiatives and make proposals to change laws and regulations pertaining to the conditions for handicapped people in the country.

Advice and guidance

In the catalogue of the new Social Assistance Act the first form of service is advice and guidance. Everybody who has a social problem is entitled to advice and guidance by professionals. The first authority responsible is the health and social welfare administration of the municipality. It gives assistance both according to the Social Assistance Act and the health legislation, and if necessary it coordinates also with the educational guidance according to the educational legislation. The advice and guidance is normally given by a contact person, but behind the contact person a team of social workers is responsible for the quality of the guidance. The guidance is the same for handicapped people as for other persons, but where a special expertise is needed, it is available from the regional social welfare administration which covers a greater population and therefore has a higher degree of specialization in its services. Thus the regions (counties) will have specialists in services for the different handicap groups. Finally the state supports special advisory functions for the different groups of handicapped.

For families of mentally handicapped persons the public advice and guidance services are supplemented with the supportive activities of the parents' association on a national and a local level. The parents' organisation runs courses and conferences for mutual information and support.

Economic assistance

A very important instrument to help "normalize" the life of a family with a handicapped child is economic support to cover the extra costs involved, and the Social Assistance Act entitles parents to the payment of such costs from the municiaplity. These costs may include extra clothing for the child, extra bedlinen or the like, costs of diet and transportation and finally in some cases compensation for the loss of work income of the parents. This money is given disregarding the income of the family .

This form of assistance to families - together with daycare and short stay facilities - has contributed very much to avoiding the placement of small children in residential institutions in Denmark.

For adult handicapped persons the most important basis for existence is the disability pension which is awarded according to the pension legislation. It is given from the age of 18 and based on an objective medical-social evaluation of a person's working capacity.

Practical assistance

Another form of help to a family with a handicapped child is the allocation of practical assistance in the home of the family. This form of help is given most of all to old people who need assistance to remain living in their own homes, but the rules of the Social Assistance Act make it possible also to give such help occasionally to a family with a handicapped child as a relief. And also adult handicapped persons can get such assistance when necessary for maintaining an independent living, especially in a group.

Technical aids etc.

Handicapped people, as well as old people, who are in need of technical aids, such as wheelchairs, are intitled to have such aid from the municipality free of charge, and it will normally be given as a loan. To facilitate the service with technical aids, the regional governments run technical aids centers which have exhibitions of technical aids and give demonstration both to the clients and to the staff of municipalities. For persons living in institutions, the institutions will provide and finance the necessary technical aids, and this goes both for institutions of the social welfare as for hospitals. Equipment needed in education is provided by the educational institutions.

The Social Assistance Act further allows for a technical adaptation of the flat of a family with a handicapped member, if it is necessary for remaining in the flat. But it is also part of the advisory function of the social welfare center to help a family to find an adequate housing if that is necessary.

In cases where a car is needed for the transportation of a handicapped child or adult, the Act makes it possible for the municipality to give economic support to the purchase of a car.

Collective housing

A new form of supported private housing for mentally handicapped adult persons was introduced in 1985 by a small amendment to the Social Assistance Act. The concept collective housing was introduced as an alternative to institutions. The idea is that young adults live together in a small group in a private flat or house, where they support each other practically in their daily living. They pay their rent out of their disability pension, but have the advantage of getting a rent subsidy according to the respective legislation. Furthermore they can get practical aid in the housing according to the Assistance Act, and the new thing is that they can get a special aid as a group to maintain a collective housing, provided they are able to live for themselves under these conditions.

The establishment of this new form of independent living for adult mentally handicapped persons has been a great success. Up to the beginning of 1991 there had been established 743 such groups with a total of 2000 residents. The participants in the collective housings come partly from residential institutions, partly directly from their parents' homes, and it has proved to be a good alternative to institutional care.

Day-institutions

According to the Social Assistance Act the municipalities are obliged to establish the necessary number of places in day-institutions for preschool children, and the counties (the regional governments) are obliged to establish the needed day-institutions and other special services for children with handicaps. The system offers various degrees of integration of a handicapped child. According to the individual possibilities of integration the handicapped child may be placed in a regular day-institution, either in a special group of handicapped children, or - may be later - integrated in a regular group of children. The integration of handicapped children is supported by attaching extra personnel to the handicapped child or to the group.

Where integration is not considered possible - at the moment handicapped children are served in special day-institutions run by the counties. These day-institutions have personnel specially qualified to serve handicapped children, having special training in for instance speech-therapy, physiotherapy and psychology. Such day-institutions are run in close cooperation with the center for special advice and guidance run by each county, and these centers also give assistance to regular day-institution having handicapped children integrated.

In Denmark it is normal that preschool children go to day-institutions, because nearly all mothers go to work. It is also necessary that small children socialise outside the family part of the day, because families in Denmark are small, the average number of children per family being 1.4. So for handicapped children it is even more necessary that they have a chance to socialise together with other children. That is why the Social Assistance Act contains rules of preference for handicapped children in cases where there, is a local scarcity of places in day-institutions.

The school system

The 1959-legislation on services for mentally retarded persons established a special school system for this group of children under the Ministry of Social Affairs. Also for other groups of handicapped children - blind, deaf and hard-of hearing and severely physically disabled - special schools were run under the Ministry of Social Affairs. Very few children were accepted in the regular school system, and the few ones accepted were not mentally retarded.

In 1980, as part of the decentralization and legislative and administrative integration, all schools for handicapped children were transferred to the Ministry of Education. Thus all handicapped children in Denmark fall under the regular school legislation , and that means among other things that compulsory education is the same for disabled children as for other children, that is 9 years of schooling. The system has been built out so much that we can say that no disabled child in compulsory school age is today without education, and only in few cases education is provided out of school or with a number of lessons lower than the number given to other children of the same age.

As for preschool children there are different degrees of integration for children in school age. Also here the specialized, segregated network of special schools for handicapped children are run by the counties, whereas regular schools are run by the municipalities. The placement of the children is decided in cooperation with the parents by the school psychological service which is well built out both at the municipal and the county level. The principle is "as integrated as possible" corresponding to the capacity of the child. Children with relatively small educational problems are integrated into regular classes, possibly supported by extra teachers and extra hours of special education. Other children with handicaps are educated in special classes in regular schools, and the most severe cases visit special schools. Out of 10.000 pupils having segregated education, about 6.000 go in special classes in regular schools, and 4.000 go to special schools. This corresponds to 0.5 % of all children at school age being taught outside normal school environments.

Vocational training and employment

It is part of the Danish school system to give young persons an orientation about their future employment possibilities through vocational orientation. Together with the labour market authorities the school shall help the young persons find a vocational training as normal as possible, and if it is not possible to give a normal vocational training, not even with extra support of economic, social and technical character, it is the obligation of county administration to provide a special programme of vocational training and employment. For this purpose the counties according to the Social Assistance Act run a network of institutions for vocational training and employment of mentally handicapped persons. This complies with the normalization principle - it is normal for adults to have a work and the Danish constitution which gives the citizens the right to employment.

Besides the training and employment the sheltered workshops provide the handicapped young and adult persons a social stimulation and a meaningful life, and it prevents the decay of health and social capacity which would follow from a passive existence. Thus the purpose of the workshops are not only productivity, and the deficit of their activities are paid by the regional government. The workshops produce and sell many kind of products, and in periods when the markets are bad - as they are presently because of the high general unemployment in Denmark - they can engage in non-productive activities. For the severely and profoundly handicapped persons the counties run activity centers where the purpose is to provide the mentally handicapped with social and physical activities and to give the profoundly handicapped stimulation of mobility and senses. These day-time activities make it possible for many families to keep their mentally handicapped son or daughter at home instead of sending them to an institution. For the more gifted young persons the final goal of the training is to help them afterwards to find a job in the normal labour market, and to stimulate the possibility of finding such a job, the law makes it possible for the public authorities to subsidise the salary of a handicapped person working in normal industry. On the other hand, Denmark does not - as many other countries - have a quota system for employment of handicapped persons in industry.

In principle the production in the sheltered workshops is arranged "as normal as possible", but the rules allow for a great flexibility in accordance with the needs and capacity of the clients working there. The staff is in part technicians, in part care personnel with a social pedagogical training. The workers, in principle, are paid in accordance with their productive performance, but generally the payment is low, and practically all clients who do not live in an institution, live on their disability pension.

Adult education

As all other children in Denmark, handicapped, including mentally handicapped children, have the right to supplement their 9 years of regular schooling with three years of youth school which has the purpose of stimulate their maturity and widen their horizon. Furthermore Denmark has a special legislation on adult education and a law on free time education which is open for the whole population. Handicapped adults can take part in these forms of education partly integrated in regular classes and partly as special groups. In any way the legislation gives handicapped persons preference both as to the payment for the education and as to the size of the groups necessary to start a course.

A special form of adult education is the folk high school a school based on ideas formulated about 100 years ago by the Danish author Grundtvig. It is a school for adults with no purpose of professional qualification but with the purpose of strengthening the social orientation and personal development of the individual. These courses normally last for some months and are mostly run in connection with boarding at the school.

The folk high school system has been applied also for mentally handicapped persons, and with great success, first in one pioneer school for the whole country, but later more schools have been established all over the country. The courses normally last for ten months, and the purpose of the school is to stimulate the independence and self-esteem of the pupils, to make them aware of their handicaps and to help them live with it.

Old age policy

For mentally retarded in old age Denmark has no special policy. The general policy for old people in Denmark is at first stage to help old persons to remain in their usual surroundings, that means to give the necessary support in the form of home help, home nursing and technical equipment to secure continuity -in their lives and the use of their own physical and mental resources. Only when these forms of ambulatory aid are not sufficient, old people are admitted to residences to be provided by local governments. For the mentally handicapped persons who have been living all their lives in an institution it is natural that they remain there also in old age. For those who live independently the normal old age policy applies, meaning that they are entitled to ambulatory assistance as long as this is practically possible, and when they come to need institutional care, it is natural that they are integrated into regular old age care institutions.

While disability pension can be paid out from the age of 18, the old age pension is paid from the age of 67 for both men and women. But there is a tendency - because the high rate of unemployment - to retire from the labour market with a labour market pension earlier, often from the age of 60.

Full disability pension is higher than old age pension, which is based on the assumption that younger people have higher needs. Both disability pension and old age pension is supplemented by different economic advantages of which the most important is rent subsidy. This subsidy is paid out by local government with an amount to secure that pensioners with no other income pay a rent corresponding to a maximum of 150 of the person's income, subject to conditions concerning the size and quality of the housing etc. Also other low-income groups get rent subsidies on both a collective basis as support to housing companies and on an individual basis based on the size and income of the family, the size and quality of the housing etc. For all these groups the rent subsidy system has contributed to maintaining a relatively high standard of housing in Denmark, and for the handicapped persons it has contributed to facilitate their integration in regular housing.

Sexual education

Both for children and adults sexual education is part of regular education. Sexual education is part of the curriculum in regular schools, and when the special school system in 1980 was integrated in the regular school system, sexual education was also taken up in special schools. The principle is that sexual education in the small classes is given in an integrated form, that means as part of general education, whereas for bigger children sexual education is given as a separate discipline.

Especially for mentally handicapped persons the problem of sexual education became acute when the old institutions were opened and when mentally retarded youngsters started living in small institutions, where - after some years of separation of the sexes - young men and young women came to live very close to each other. It was no longer possible to prevent love affairs and their consequences, and it was no longer acceptable for the personnel to intervene negatively. Instead sexual education was at an early time of the "new era" taken up in the staff training and was made part of the general social training in the schools and institutions. This is of course to be seen in the context of a more liberal attitude in Denmark towards sexual phenomenon, including prevention and provoked abortion.

The practical problems arise naturally in small institutions where both sexes live together, but of course also where young persons live on their own, either individually or in a group. Here it is the job of the staff to help the young persons with their problems, not only by administrating normal preventivs measures but also to give them psychological and moral support as part of the general care.

Until a few years ago mentally retarded persons were not allowed to marry without a special permission. But gradually the practice of permission was liberalized, and some couples married without permission. At the same time there was a tendency in the population in general that young people lived together without marriage, and many mentally retarded couples did the same.

Now mentally retarded persons in principle can marry as other people, and in such cases it is the natural obligation of the local social welfare authorities to give such couples the advice and guidance they need in all matters, including prevention measures. The problem of possible children of such couples has been discussed very much in Denmark. The advice given to them will often be not to get children, and in many cases a voluntary sterilization is considered the right means to avoid it. However, as it cannot be prevented by force (as it could years ago), it does happen that such couples get children. Some research has been done on the conditions of these families, especially the children. The results show that the children are not always borne handicapped, but it is clear that they are borne into problems for themselves, for their parents and for society. It is also clear that such problems are taken up by the local social welfare center on line with all such problems.

New developments

Such new developments in society present new challenges to the services for mentally retarded persons and to the application of the normalization principle. The principle has a dynamic character, so that something that was normal ten years ago may not be normal today. And what is normal in one country may not be considered normal in another country.

In the 30 years with the normalization principle in Denmark, there have been some changes in legislation to modernise services and keep them in accordance with the normalization principle. But also within the existing legislation there is a need currently to find new ways to improve services, whether the economic possibilities are improving or not, because the procedure of changing legislation is relatively slow. For many years research and development has played an important role in Danish social welfare development. A special Social Research Institute is currently making scientific research in the social welfare situation and needs of the population. The reports of this Institute have formed the basis of initiatives for changes of existing laws. But also the local and regional governments in common run a research institute to analyse existing problems and give suggestions for changes in administration.

In the field of technical aids there is a close cooperation between the government and the technical high schools in Denmark, but a special Institute for Technical Aids has been established to coordinate information and research concerning technical aids for handicapped persons.

Also in the field work of services for mentally retarded and other handicapped persons there has been a stimulation of research and experimental activities. In the time of the special service system for mentally retarded a special account financed research and experiments in the field. And with the integration of legislation and administration a big fund was made available for research and development in the field. The same goes for the Ministry of Education.

The main purposes of the present development work is to strengthen the participation of handicapped persons and other marginal groups in all decisions about their lives, and to increase the preventive measures in services to avoid deterioration of the individual. In the organization of services the purpose is to improve cooperation between the sectors - health, social welfare and education - and to reduce bureaucratic obstacles. The viewpoint of the government in the economic crisis we are having presently in Denmark is that it is possible to improve services without quantitative expansion but through qualitative improvements.

International aspects

Services for mentally handicapped persons are the responsibility of national authorities, and it is not an object of international competition. But it is normal to make international comparisons in the field, and over the years a comprehensive international cooperation has developped both between organizations of parents and between professional groups. For Denmark it has been a natural thing for many years to work closely together with the four other Nordic countries. Besides the informal cooperation through visits between the countries, we have a special organization for exchange of information in the field, the Nordic Association for Mental Handicap.

The organization holds conferences in the Nordic countries, and both parents and professionals are represented in its work. Because of the similarity between the Nordic countries, culturally, politically and economically, there is also a high degree of similarity in the services in the five countries.

On the general international scene there are two non-governmental organizations that are playing an important role. It is the International League of Societies for Persons. with mental Handicap and the International Association for the Scientific Study of Mental Retardation which was founded in Denmark in 1964. They are fora for exchange of information in the field, and the International League made the preparatory work for the formulation of the U.N. declaration of the rights of mentally retarded persons. The League has a branch in Asia, and I suppose Japanese organizations take part in this regional cooperation.

Also in Europe there is a regional branch of the International League, and besides a new branch has been established for countries of the European Community. For improving the conditions of mentally handicapped persons and their families it is important that the question is raised not only on a national level but also in the international organisations and institutions which deal with health and social welfare problems of the world and its regions.

On the global level the declaration by the United Nations of the year 1981 as the year for disabled persons was a major step to draw the attention of the World Community to the situation of handiapped persons all over the world. As a follow-up the U.N. in 1982 adopted the "World Programme of Action Concerning Disabled persons". The programme contains a description of the problems of disabled persons in the world as a whole and particularly in developping countries. It further has a long list of proposals for action on the national, the local and the international level, to promote information about disabilities and to improve the conditions for disabled persons in the world in the form of equal rights and the right to form organizations and to have services, participation etc.

Concluding remarks

I want to finish by saying that the normalization principle is universal, but of course the practical implications of using it are different from country to country. I have given some illustrations of how we interprete the normalizations principle in Denmark in respect to legislation and practice in services for and with mentally retarded persons.

What is normal in Denmark may not be normal in Japan or in other countries. But it is normal that countries exchange views and try to get inspiration from another. I know that Danish experiences have given inspiration to many other countries, may be especially to Germany, our neighbour country.

From Japan we have also had many visitors, both professionals, parents and voluntary social workers. From the books I know that Japan has a high level of services for handicapped persons, and I look forward to knowing it in practice. I should be very happy if my visit to your country, your associations and institutions would inspire more Japanese people to visit Denmark, and I shall be glad to help organise the relevant visits in my country.

Thank you.

Author's address:

ELITH BERG

Strandvaenget 1st.

2100 Copenhagen O

DENMARK

Email: e.berg@post.tele.dk

Quelle:

Elith Berg: 30 years with the normalization principles.

Kyushu & Okinawa, Nov. 1991. Lecture given on the invitation of the AIKU-organizations in Kyushu and Okinawa, © by Elith Berg. Danish Services for mentally handicapped persons. Former International Coordinator of the Danish Ministry of Social Affairs, Copenhagen, Denmark.

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