Caring: A Family Affair
Caring: A Family Affair

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Caring: A Family Affair

3.2.1 Words and images

Words like ‘mental defective’ are also linked with images. Together, the words and the images make a powerful impact.

Activity 9 Words and images

0 hours 10 minutes

Look at the photographs of ‘mental defectives’ below. These images and captions are taken from a standard textbook entitled Mental Deficiency published in 1947 (Tredgold, 1947).

Figure 1.5
A. Quadriplegic idiot
Figure 1.6
B. Epileptic ament with mania
Figure 1.7
C. A group of Mongols

What sort of ‘care’ do you think these people require?

Answer A, B, or C to match each photograph to one of the care needs listed below.

  1. Loving care of a family or family type environment.

  2. A form of care preventing contact with the public.

  3. Medical care and a good deal of looking after.


I found these images conjured up several types of care needs for me.

Photograph A is apparently taken in a hospital. The subject is naked, contorted and helpless. The photo suggests that he needs medical care to remedy the effects of the quadriplegia, and probably a good deal of looking after as he is apparently helpless.

The children in photograph C are also in some kind of institution. They are wearing uniforms. At first sight I thought they were probably orphans, and would benefit from loving care in a family or family type environment, but the caption labels them as ‘Mongols’, not ordinary children.

The man in photograph B is labelled as an ‘epileptic ament’. He may be a nice chap, but he looks decidedly alarming, and the label is, to a contemporary reader, both mystifying and alienating. Maybe he needs a form of care which would stop him coming into contact with the public?

Together, the term ‘mental defective’ and the images appear to stress difference. The message is that these people are abnormal, not like us.

Of course, you would want to know more about all these individuals before making any pronouncements. But the point of the activity is to show that knowledge that they are mental defectives, combined with the images, tends to lead to a particular set of assumptions about who they are and what sort of care they might need.

Nowadays, as explained earlier, the term ‘person with learning disabilities’ has largely superseded the earlier labels – mental defectives, mentally handicapped, sub-normal. Along with the changing names come changing ideas about the care needs of people so labelled.

The photographs below conjure up very different images.

Figure 1.8
Figure 1.9

Sara is a woman with learning disabilities but, unlike the people in the previous set of photographs, she is portrayed as active and competent, doing the ironing.

Although she is obviously disabled, Shirley is in her own home, an ordinary house, not an institution. She has aids to help her with daily living – a wheelchair and a communication device on the arm of the wheelchair. Probably she will need some special support, especially if the built environment is not wheelchair-accessible. But she looks far from being someone who needs either medical care or looking after.

The message from these words and images taken together emphasises what these people have in common with other people, what is shared, not what is different.

The photographs show contrasting images of people who are categorised as being in need of care.

  • The mental defective label is linked to a highly medicalised form of care. These people, the photographs tell us, are very different from normal human beings. They need specialised medical treatment.

  • The learning disability label linked with the more positive images presented here is associated with a rather different type of care – care as a helping hand with life, for people who are not so very different from the rest of humanity.

The changing images of people with learning disabilities shown in the photographs are not conclusive proof that changing labels brings changed realities for people like Lynne. But they do suggest that language both shapes attitudes and reflects changes in attitude.

Activity 10 Changing labels

0 hours 10 minutes

Another group of people whose labels have changed over the past century is people who experience mental illness. Make a list of labels for them that you can remember and then consider what the name changes say about them.


The broad range of terms has changed from ‘lunatic’ in nineteenth-century legislation through ‘insane’ or ‘mad’ to ‘mentally ill’ to ‘people with mental illness’ or ‘people with mental health problems’. Particular medical conditions also give rise to labels – a ‘schizophrenic’, a ‘manic depressive’, a ‘psychopath’. What is noticeable is that the range of terms moves from ‘lunatic’ which completely defines a person according to their mental state, rather like ‘mental defective’, to labels which put ‘people’ first and the condition second – like ‘people with learning disabilities’ or ‘people with mental health problems’. The message is that they are not only ‘a problem’, they are also people. It is considered more humane to make the label secondary to what the person has in common with the rest of humanity.

Some people who have experienced care in mental health services go further than this. Founded in 1986, Survivors Speak Out is an organisation composed of ‘users’ of mental health services. They argue for the term ‘survivor’ because it switches the location of the problem from the person to the operation of the health and social care system itself.

Words can carry very different messages, and that is why the question of what people are called is often the subject of heated debate.


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