Robert W. Gibson

MENTAL DEFICIENCY AS A BASIC DISCIPLINE IN THE TRAINING OF A PSYCHIATRIST

The field of mental deficiency is one with which the psychiatrist is not always familiar. By the time he has obtained his training in the psychoses and neuroses, explored psychosomatic medicine, and spread his wings towards the horizon of social psychiatry, too often the opportunity is neglected to gain a full experience in this particular field. Mental deficiency has been described as the Cinderella of psychiatry. The simile is apt, not merely in the opening scene, but also in the denouncement, as is soon apparent to those who tarry longer. The number of defectives in the community has been variously estimated, and is probably about 2%. This is a considerable figure, and even if we refrain from adding the much larger borderline group the magnitude of the subject is obvious. Its significance to psychiatry is likewise becoming more apparent, and it is hardly a coincidence that in Britain candidates for the diploma in this specialty are being increasingly required to undergo a period of training in a mental deficiency institution. By its very nature mental deficiency has firm connections with general medicine and genetics, whilst its ramifications extend into the kindred fields of education and sociology. It thus offers on the one hand a close bond with the basic disciplines of medicine, and at the same time through its wide contacts in the educational sphere it opens to the embryo psychiatrist a more sweeping vista and a broader conception of the field he is setting out to cultivate. To such a one, early in his career, mental deficiency is well placed to offer that contact with the ground that may yet serve to keep his feet firmly on the path as he gropes his way through the mist of psychological speculation. To this end the mental deficiency institution can bring forward its wards, its school and training centres, and its clinics.