Chapter 8 – Society

Historical Perspective

During the past 40 to 50 years there have been numerous changes in our society with respect to the management and treatment of people with disabilities. In addition, there have been many advancements in medical care. As a result, more are surviving those events resulting in more opportunities for an individual to become disabled.  Most of these individuals reside in the community rather than institutions and depend upon community-based private practitioners for oral health care.

Prior to the twentieth century, social attitudes reflected the view that persons with disabilities were unhealthy, defective and deviant.   For centuries, society as a whole treated these people as objects of fear and pity. The prevailing attitude was that such individuals were incapable of participating in or contributing to society and that they must rely on welfare or charitable organizations.

Generally speaking, prior to the late 1800’s, people with mental retardation, cerebral palsy, autism, and/or epilepsy resided at home and were cared for by their families. Life expectancy for severely and profoundly disabled individuals was not as long as it is today.

Beginning in the late 1800’s, institutions were built by state and local administrative agencies to house people with developmental disabilities. These institutions were usually built on the outskirts of town. Societal attitudes fostered this segregating style of management. Unfortunately, segregating from society further stigmatizes people.

Changing Attitudes

Many legislative and societal changes occurred in the 1960’s and 70’s which had a great influence on the treatment of and attitudes toward people with disabilities.

 

• A Presidential Panel established by President John F.
  Kennedy, affirmed that mental retardation is not a hopeless condition; it is subject to prevention and amelioration.
• President Kennedy passed the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963.  This fostered the establishment of University of Affiliated Facilities which provided care to people with disabilities.
• Medicaid and Medicare were established in the mid-1960’s, making it possible for many developmentally disabled persons and their families to secure medical and other long-term care in their communities.
• President Lyndon Johnson established a permanent presidential committee on mental retardation in 1965.
• The Civil Rights Act was passed in 1964; tenets of which were
  subsequently applied to many disadvantaged groups, including people with developmental disabilities.  The civil rights movement spread and consumers began to organize.
• Legal Advocacy by groups such as the ACLU in the “public interest” resulted in numerous judicial decisions expanding the rights of people with developmental disabilities.
• President Nixon established a goal of moving 1/3 of the nation’s 200,000 institutionalized individuals with mental retardation into supportive community living.   He issued presidential directives that required the Attorney General enforce the rights of mentally retarded and that the Department of HUD create ways to improve their housing.
• A mandate included in the Rehabilitation Act of 1973 required states to address the vocational rehabilitation problems of the severely disabled as a first priority.
• Creation of Supplemental Security Income (SSI) and
  supportive social services (Title XX of the Social Security Act) provided federal aid for services for the developmentally disabled.
• Section 504 of the Rehabilitation Act of 1973 prohibits discrimination against “otherwise qualified” handicapped persons in any federally supported program.
• New standards were created for Intermediate Care Facilities for the Mentally Retarded (ICF/MR facilities) receiving Medicaid support.
• The Education for all Handicapped Children Act (PL 94-142) was passed in 1975.
• The Air Carrier Access Act of 1986 prohibited discrimination in the air travel industry.
• Amendments to the Fair Housing Act prohibited discrimination in selling and renting of public and private housing.  Landlords required to make accessibility modifications at their own expense.
• Finally, the Americans with Disabilities Act was passed in July
  26, 1990.   Essentially, this law is civil rights legislation for persons with disabilities.  The ADA attempts to guarantee the rights of full inclusion into the mainstream of American life for all persons with disabilities.

A Lou Harris poll conducted in 1991 was revealing and positive.   For example, 98% of individuals questioned believe that all people, regardless of one’s ability, should have an opportunity to participate in mainstream society.   Furthermore, there was a strong sentiment toward increased employment of persons with disabilities; 92% polled believed that employment of persons with disabilities would be economically beneficial to society.
There is a strong trend toward acceptance.   These attitudes are in sharp contrast to the prevailing attitudes of the first half of this century.