Keywords

Introduction

It is difficult to imagine being institutionalized in a mental hospital or asylum without having experienced it yourself. Does institutionalization resemble depictions in popular culture, such as in the film One Flew over the Cuckoo’s Nest (1974)? Or should we allow ourselves to be seduced by the institutional buildings that stand as beautiful monuments in the Danish landscape? The largest Danish institution for the intellectually disabled, the Kellerske Anstalt in Brejning, now operates as a modern conference center and spa resort.

In this chapter, we try to get a deeper view of the experiences of institutional placement of persons with intellectual disabilities during the so-called golden age of the Danish welfare state—from the 1930s to the 1980s. We focus on a specific spatial setting: institutions established to care for persons with intellectual disabilities. Often, these institutions were located in remote areas and took the form of small self-sufficient units of living. From the 1930s, triggered by eugenics, these institutions developed into a combination of Erwing Goffman’s “total institutions” and Michel Foucault’s “disciplinary institutions”.Footnote 1 The spatial setting regulated almost all aspects of the residents’ lives, including a knowledge-based regime combining medical knowledge, bodily practices, discipline, and care. We are interested in how this specific institutional context marked and formed the experiences of its inmates.

The chapter is based on an investigation carried out at the behest of the Danish Ministry of Social Affairs during the period of January 2019 to March 2022.Footnote 2 In the wake of accounts of abuse and protests over treatment within the Danish child institutional placement system, the government requested a study of placements within the so-called special care area covering the period from 1933 to 1980. The institutional placements covered individuals who, in the parlance of the time, were classified as “mentally deficient” (åndssvage), deaf, blind, epileptics, disabled (vanføre), and speech-impaired.Footnote 3 Not everyone in these categories was institutionalized, but many—especially within the “mentally retarded” group—were institutionalized for large parts of their lives. This historical study, which was published in March 2022, was based on extensive archival materials and interviews with former inmates and staff of the special care facilities.

In recent decades, there has been a growing research interest in the institutionalization and treatment of disability groups in Denmark, including in the history of mental health care. Often, this has been based on the critical—Goffman and Foucault-inspired—analytical framework developed by a pioneering scholar in Danish disability research, Birgit Kirkebæk.Footnote 4 Her work, emphasizing aspects such as categorization, social control, and the abuse of power within the institutions, have influenced several studies analyzing the historical development of specific institutions or persons.Footnote 5 As we have the most historical records related to the large so-called total institutions,Footnote 6 the images of these institutions have dominated the narratives about institutionalization in mental health care, even though a very large proportion (40–60 per cent) were placed in smaller (often private) institutions or in family care.Footnote 7 Systematic studies of the sector as such are scarce and often focus on negative aspects of institutionalization, such as violence and abuse, the widespread use of restraints, and the use of eugenically inspired “bio-power” through forced sterilization and other population policy instruments.Footnote 8

In the empirical sections below, we discuss the themes that have emerged in our study of how inmates experienced their placement in Danish institutions of mental health care. Overall, our findings seem to confirm the influence of structural features of the “total” and “disciplinary” institutions as impersonal and alienating, as stigmatizing, interventionist, regulatory, and controlling, etc. The experiences, we find, include institutionalization as a way of life, broken family ties and lack of social relationships, loss of autonomy, and experiences of injustice and abuse. We do not claim that these are the only relevant themes in the experience of placement. However, these themes recur in the interviews and in the written material. In dividing the experienced placement thematically, we risk overlooking how the themes mutually reinforce or balance each other, and we might potentially overlook the overall individual experience. On the other hand, a thematic division allows for a degree of generalization that would be difficult to achieve were we to restrict ourselves to descriptive individual narratives.Footnote 9

In what follows, we will first set the scene and describe the Danish special care system as a placement system. We then discuss the analytical challenges of describing the experienced history of a strongly marginalized group, which is articulated to only a limited extent in the historical source material. Finally, we present the main themes of those inmates who were placed in institutions as they emerged in our studies: experiences of institutionalization, lack of autonomy, abuse, and stigmatization.

Tracing Experiences of Institutionalization

In this chapter, we see the study of experiences as “a study of a blurred mediating category, where cultural meanings, subjective identities, social relations, and societal structures shape individual perceptions into experiences proper.”Footnote 10 Hence, describing people’s experiences in institutional placement is a far from easy task. The experiences are individual and subjective, and there are major challenges in terms of sources. The extensive written sources about the placement system and the individual inmates (such as personal records) are produced by the system itself (officials and employees at the institutions) with an administrative or legitimate scope, thus allowing little insight into how the individual inmates experienced their placement.

In this chapter, we have used three main types of source material. First, we have used interviewsFootnote 11 with former inmates and employees. These interviews provide access to the individual’s experienced placement from a life-historical perspective. Naturally, this also entails the risk of forgetting and post hoc rationalization, although research indicates that the more traumatizing aspects of placements follow individuals throughout their lives.Footnote 12 The most significant challenge, however, is the limited scope and bias of the material. It is resource-intensive to collect these types of life histories, and we therefore have only a few of them.Footnote 13 Those we have originate predominantly from the more resilient and articulate among those placed. The care system for the intellectually disabled contained groups without the ability to speak or with very limited cognitive resources, and we know very little about the experiences of these people. For ethical reasons, all interviews used in the following are anonymized.Footnote 14

Second, individual inmates also appear in the system’s written source material. This is most directly in the form of letters or complaints addressed to the special care system’s central management organs or to authority figures outside the system. In 1942, for example, an inmate placed at Ebberødgård requested the intervention of the Danish King so that he could be discharged.Footnote 15 In most cases, however, the voices of those placed in institutions appear only second-hand, when, for example, they were questioned in relation to a formal investigation into complaints of abuse after the family had complained on behalf of the inmate or when a doctor documented the need for a placement or recommended that a patient be discharged. Throughout the period examined here, parents’ associations became increasingly vocal, advocating for the more vulnerable groups of inmates and putting more focus on their needs. These sources provide some insight into the hopes and dreams of the inmates, especially their reactions to perceived abuses or injustices. For this source group, however, it is especially the most robust and articulate inmates who appear in the source material.

Third, insight into the treatment and attitudes of the inmates can be partly deduced from the system’s source material regarding the physical setting. It is possible to describe the everyday setting and to some extent also to document the occurrence of abuse and dissatisfaction among the inmates. However, not all violations are documented; many violations of prohibitions against physical punishment go undocumented in the material. It is also difficult to extrapolate from individual cases of physical violence or the extent to which inmates had a fear of physical violence from staff or other inmates as part of their experience of placement.

To summarize: the sources of how inmates experienced their placement are analytically challenging. We have a few scattered pieces of a complicated puzzle. There are repressed memories, silent groups, fears, taboos, etc.Footnote 16 Furthermore, the material has a built-in bias, where especially the weakest (and silent) groups of inmates rarely come forward, and we have no material that might allow for a systematic generalization of individual experiences. What at first hand appears to be a “community of experiences” might only be representative for the most vocal or resourceful of the institutionalized persons in question.Footnote 17

The Danish Care System for the Intellectually Disabled, 1933–1980

This chapter focuses on the experience of placement in the Danish care system for the “mentally retarded” (åndssvageforsorg), as it was then termed, from the period of 1933 to 1980. The Danish placement system was established in 1933 as part of a comprehensive social reform. Under the reform, specific client categories, including the intellectually disabled, were separated from the “normal” social welfare system and brought under state care, in what was termed “special care” (særforsorg).Footnote 18 The special care system was based on already existing institutions, set up in the 1800s with partial state support. From 1933 onwards, the state took over most of the responsibility and funding; a central government coordination system was established, the National Care System for the Mentally Retarded (Statens Andssvageforsorg). During these early decades, the management organs of the local institution had a high degree of autonomy. This was reflected in the local forms of placement, which exhibited wide variation, such as the large total institutions Den Kellerske Anstalt in Brejning or Ebberødgård, north of Copenhagen, to very small institutions and care in private families. Throughout the period, central national leadership was gradually strengthened. The comprehensive administrative reform in 1959 divided the Danish care for the intellectually disabled into 11 care centers, and the power of doctors at the individual institutions was reduced.Footnote 19

The institutions and placement policy were aimed primarily at solving societal problems. They were characterized by the general social policy development of the time, where the more philanthropic activities of the nineteenth century were taken over by the state and where the agendas were increasingly influenced by science and experts. Seen from today’s vantage point, the institutions of the time were paternalistic, for better or for worse. Care and social control went hand in hand. This paternalism can also be seen in those institutions charged with caring for the intellectually disabled. However, in the period examined, there were two ideas which particularly came to affect care for the mentally retarded: the eugenicsFootnote 20 movement in the early phase and the so-called “normalization policy” in the later phase.Footnote 21

In connection with the 1933 social reform, the social legislation differentiated “socially dangerous” groups—such as the intellectually disabled, as mentioned—from the “normal” population, who were covered by the general social legislation. The idea was to give these people a dignified life while also subjecting them to restrictions in connection with key life decisions, such as pregnancy, marriage, and residence.Footnote 22 These restrictions—and the treatment of people categorized as intellectually disabled—were motivated largely by the eugenicist ideas of the time. The basic idea in the Danish eugenic policies was a concern that those who at the time were considered to belong to genetically and morally “defective” groups would negatively affect the “quality” of the population, and their reproduction would impose large welfare/care costs on the state. Therefore, society had to protect itself from this possibility by regulating the reproduction of these groups.Footnote 23 In the words of the Minister of Social Affairs K.K. Steincke, as an intellectual disability “from the very beginning and throughout life makes the person in question more or less unfit for work in society, and as a general rule quite unfit to fulfil household provider and childcare duties,”Footnote 24 it was precisely these intellectually disabled people who became the primary target of the eugenically motivated legislation. This eugenics-based complex of laws included the sterilization laws of 1929, 1934, and 1935, the abortion law of 1937, and the marriage law of 1938.Footnote 25 In connection to these laws, Steincke pointed out the obligation to report:

The main emphasis, of course, is on creating a better system in the entire abnormal care system, and alongside this, the various rules for reporting obligations, not least for the mentally retarded, where the current conditions—especially in certain places—cry out and show us a legislative power that funds one large institution after the other, but which seems otherwise rather indifferent to the tumult in the lives of the mentally retarded—with the associated breeding of new mentally retarded [children].Footnote 26

If schools, doctors, or the local social committee suspected mental retardation in a child, the child would be examined, and if mental retardation was found, the child would be enrolled in special care. In 1934, this was followed up with the Act on Measures Concerning the Mentally Retarded (Lov om foranstaltninger vedrørende åndssvage), which established more comprehensive legislation for the intellectually disabled.Footnote 27

In the decades after 1945, eugenics was downplayed in favor of general social policy considerations. In a parliamentary debate in 1947, it was stated that care for the intellectually disabled was aimed at “the unfortunate fellow creatures who are both spiritually and physically defective and can therefore be an unusually heavy burden for a home, especially for the small households where there is neither time, advice, or space to give them the necessary care.”Footnote 28 However, several studies of placement practice have shown that the specific situation changed only very slowly, and the sterilization policy continued through the 1960s.Footnote 29 The discrepancy between the general development of welfare and the conditions of care for the intellectually disabled led to new legislation in 1959, where the emphasis was now placed on a “normalization policy.” Those assigned to the care system for the intellectually disabled—according to the policy motivations—should live a life closer to a normal life, with increased autonomy and freedom. Since life had to be lived within the same institutions as prior to the reform, the changes took place only slowly and gradually, especially for the most vulnerable of those placed. In 1980, the National Care for the Mentally Retarded (Statens Åndssvageforsorg) was eliminated, and responsibility for the institutions was transferred to the municipalities and counties.Footnote 30

Institutionalization as a Way of Life

As stated above, care placements for the intellectually disabled were implemented over a wide range of institutional types, from individual placements in family care to smaller private facilities to large total institutions. In the following, we focus on individuals who resided in these large institutions.Footnote 31 There exists extensive source material on the physical setting and formal operational framework of the large institutions. This material gives us pictures of a life without privacy, with large dormitories and shared toilet and bathing facilities. Quite soon after 1933, these institutions became overcrowded, and studies from the mid-1950s revealed significant space problems, with beds in the dormitories just 20 cm apart. Twenty years later, in the mid-1970s, the Parliamentary Ombudsman issued reports that continued to show horrendous conditions at the large and unmodernized institutions.Footnote 32 The impersonal dormitories, the toilet conditions, and the like were referred to by the Ombudsman as “extremely objectionable” with a “forced community” devoid of “any significant individual privacy.”

Institutionalization also had a strong impact on daily life. The mental care facilities were a kind of society within a society, with their own rules, practices, and social hierarchies. In the early decades, both inmates and staff wore uniforms, and the inmates were divided not only according to gender, age, and need but also according to their ability to work. There were limited activities for those judged unable to work, and several employees told of groups who sat passively around the clock. It was not until the 1950s that general educational activities were introduced for some of the inmates. There were rules for proper conduct that could include more or less formal sanctions. The large institutions had their own “cell-like” units and closed sections that could be used as punishment, and there were also various forms of physical restraint that could be deployed as an informal sanction.Footnote 33

The physical setting and the lack of personal freedom have undoubtedly shaped the experience of being institutionalized. An interviewee, placed as a young person under the intellectually disabled care system in Brejning from 1958 to 1975, described the staff: “They were strict sometimes. Other times they were a bit irritating. But they never ever said ‘No.’ Only once in a while did they say ‘Hello [name], how are you?’”Footnote 34 There was great variation in the institutional experience, and we know very little about the lives of those placed prior to being institutionalized. A consistent feature in the interviews is an experience of institutionalization as a negative event in their life. Complaints from inmates as well as in interviews show that the highly regulated life was experienced as restrictive. A person placed at Ebberødgård in the 1950s recounted: “We had to go to bed at seven, because we had to get up early. Some went to bed as early as four o’clock, but I went to bed at seven. There were also some who were in bed all day, so you just lay there talking and looking at each other, and then at 11 o’clock, the night watchman came in and checked if there was anything.”Footnote 35 Another person, employed at Ribelund from the end of the 1960s, explained: “Calm, cleanliness, and going by the rules prevailed.”Footnote 36

In the complaints raised by the inmates, it was not only the bedtimes and the forced passivity that were criticized, but also the food, the pocket money, and the lack of opportunity to decide things for oneself (for further discussion on the lack of autonomy, see below).

Broken Family Ties and a Lack of Social Relationships

The relationship with the family is central to the narratives of the inmates, and the separation from and at times sparse contact with family members is highlighted as painful and incomprehensible.Footnote 37 This applies especially to the care for the intellectually disabled, where many individuals were institutionalized as children and for long periods of time. A former inmate, placed in the care of the system, said that being handed over by his parents at Brejning as a very young child had left its mark: “What I was exposed to that day was feeling like a discarded piece of rubbish that should just be thrown away. I was something that was wrong, so my parents handed me over to Asylgården.”Footnote 38 A mother of an inmate described how, as an 18-year-old in the mid-1950s, on the advice of her physician, she went to the Ribelund mental institution with her husband, of the same age, and their six-month-old son for an examination:

We came down to a chief physician. When we finished with the examination, he took my husband out. When he [the doctor] came out to me, he said: “It’s [the child] a losing ticket [en nitte]. Try again. And if it’s the same, don’t try.”Footnote 39

The son was placed in the institution.

Life in an institution also affected the inmates’ family relationships for shorter or longer periods. Some informants talked about how they had regular contact with their family, who either visited them at the institution on pre-announced days, or the informants were permitted planned holidays at home.Footnote 40 However, many were placed far away from their homes, and the physical—and in time often also psychological—distance could become so challenging that family relationships came under pressure or disappeared altogether.

A relative of an inmate at Ribelund at the end of the 1950s recounted:

When my brother was a little younger, well, he may have been eight years old. I remember that I was there to visit him at the institution. But we were never able to get in. It was something like we sat in a waiting room and then he was washed and they put nice clothes on him, and then he came out, and then we had maybe two hours when we could be together with him and then we had to hand him back again. We never got around to seeing where he lived. They [the parents] did not question the fact that you were not allowed to enter. You were very respectful of authority.Footnote 41

In the mid-1970s, this same informant ended up working at the institution Ribelund and in this connection, got the feeling that his brother was not being treated well. However, the informant never told his parents about it:

I kept it completely to myself. I would not have gotten anything out of telling my mother and father that he was washed with cold water, because they couldn’t take him home, and they couldn’t shout at [the staff] in [the institution].Footnote 42

Communication between the person in custody and next of kin could be controlledFootnote 43:

Each week, I received a package and a letter from home, but the package and letter were opened. There was censorship. When we children wrote a letter, we were told that it had to be read by the foster mother […] I don’t know whether my parents knew that the mail was being censored. There was no such thing as phone calls. I only remember talking on the phone once for my birthday, and that was even though my parents had a phone at their shop.Footnote 44

For some inmates, being together with the other inmates could develop into friendships and social relations. Friendships could be formed through long stays within the large institutions for the intellectually disabled. “We supported each other. We didn’t gossip about each other, you didn’t do that,” said an informant from within the care system about the community they experienced.Footnote 45 Another informant talked about moving from one ward to another:

You were also not allowed to show emotions, like the first night, when I [the informant was approximately four years old] was on the new ward. I was sad and cried myself to sleep. It was probably because I missed the ward I had lived on before. But I was told by the night watchman that I had to stop whining.Footnote 46

In several of the testimonies of former inmates, they described their feelings of being of less value and excluded. These feelings of low self-esteem are recalled from the time during the placement itself, but also when describing the feelings they still have. A sense of objectification and stigmatization is expressed in several of the inmates’ accounts. These emotions are often linked to experiences of not being part of normal society or being exhibited as different. Describing the people who lived in proximity to the institution, an informant concluded: “They obviously thought that we were someone who was contagious.”Footnote 47

Although the physical distance between the institution and the local community was small, the social distance could be great. A former inmate described:

It was only when we had to go to the priest, when we were to be confirmed, that we met them [other children and young people from the local area]. We met them down there in the confirmation hall with the priest. And I remember that it was a very strange experience. I had no idea how to behave with them. … It was very strange. … People from an alien planet … that’s about it.Footnote 48

The experience of stigmatization also appears in the individual complaints, where discharged inmates wanted to waive the monitoring visits at home because they were experienced as stigmatizing.Footnote 49

Lack of Autonomy

The physical setting tended to impose strict limits on gaining privacy and individual freedom. The informants frequently emphasized a lack of privacy combined with the feeling of being constantly monitored. One inmate in the care system for the intellectually disabled placed in 1966 described the situation thus: “We didn’t really have a door. I’m glad it’s not the old days anymore […] Thank God, I’m glad about that.”Footnote 50 Another inmate talked about life in the 1950s and 1960s at the institution in Brejning:

If you didn’t learn anything else out there, you at least learned to walk sideways because the beds were so close together. Later on, it became an eight-person room, then a six- and finally three-person room. It also ended up with us each getting our own bedside table—almost a chest of drawers with space for some private things—books, letters, and whatever else you had.Footnote 51

The absence of privacy also included the conditions in the toilets and when bathing, and these most intimate bodily activities could be experienced as greatly frustrating under institutional conditions. A former employee at the institution for the intellectually disabled in Løgumgårde explained that “there was a fixed toilet time, it didn’t matter that you had to go to the toilet when you needed to.”Footnote 52 A former inmate from Andersvænge experienced the bathing situations as follows: “It was a cold bath that we had back then […] a cold shower. They were really mean. We sat on a bench and they showered us with cold water.”Footnote 53 A former inmate from Vodskov emphasized that one of the worst things was when they all had to take a shower on Friday, and the staff lined up and got ready to perform their respective functions:

It was almost like being on an assembly line. One [staff member] washes your hair, then you were washed all over your body, and then you went under the shower, where you were allowed to stand for two or three minutes, then it was out again, you were dried off, and then you had your nails cut. I had a very hard time with that. And it was humiliating that right up to the age of 14, I had to stand and be naked in front of women who had to wash you in one place and then the other. You also have feelings, and you also have pride. For example, I think that I was washed too much in the crotch. I think so. Sorry to say this.Footnote 54

Freedom also includes the right to shape one’s own life. A pessimistic assessment from a former employee in the care system for the intellectually disabled was that “having influence over one’s own life didn’t exist back then.”Footnote 55 In the inmates’ accounts, the absence of autonomy often concerned very specific activities. Several inmates recounted how they were not allowed to wear the clothes that they had brought with them from home. An informant placed in the care system for the intellectually disabled talked about the patient gowns that all the women inmates wore during the day:

It went all the way down to the shoes. That’s how it was. You could hardly walk […] but when my mother came to visit me, I could have my own clothes on, on the other days you were not allowed to wear your own clothes.Footnote 56

The same informant also explained that at night she slept naked, which she found humiliating, especially when she was menstruating. Another informant, an inmate at Brejning from 1956, described:

They were some horrible old, ragged clothes we wore back then […] We wore canvas workpants [drejlsbukser], and if you so much as walked, they squeaked, and long stockings with elastic in them, no they were austere times […] and we had shoes from someplace called Koda Bicycle Factory, and you know, on the sides [of the shoes] there was fabric and the bottom was made of bicycle tires.Footnote 57

The experience of a lack of personal freedom was also linked to dreams of a life outside the institution. This is evident in the many petitions for discharge, where the inmate motivated their request with the desire to have normal work and a family life. The requests also concerned education—at least for some of the inmates who had the opportunity to leave the institution as adults.Footnote 58 Until the 1950s, within the Danish system of care for the intellectually disabled, there was a limited focus on education and the development of skills, apart from when the inmates were included in the daily practical work of the institutions or when they worked on tasks on the outside while supervised by the institution. For some, this gave hope of a life outside the institution, but the hopes were not always fulfilled.Footnote 59

Another important aspect of the inmates’ perceived lack of freedom in institutional life concerned romantic partners, sexual relationships, and establishing one’s own family. Institutional life was sharply divided by gender, and the eugenicist thinking of the time led the institutions to be acutely preoccupied with the inmates’ sexual behavior in connection with enrolment and discharge and during their period of residence.Footnote 60 Especially for the younger inmates, until the 1960s, the restrictions on intimate relations were described as a strict set of rules prohibiting boyfriends/girlfriends and the girls and boys being separated unless supervised. However, several inmates also mention how they found ways to have relationships in secret. A former inmate within the intellectually disabled care system recounted how when the girls and boys reached the age of 15–16 at Vodskov, they had a system where they flashed a light from ward to ward after their 19:30 bedtime: “If we blinked once and they blinked three times, then we would meet down in the singing room. And here we had romance.”Footnote 61

Other former inmates within the care system for the intellectually disabled reported harsh sanctions and degrading treatment at the slightest suspicion of an interest in the opposite sex. A female informant talked about her time at a Pietist (indremissionsk) institution in the 1960s:

Me and a lady, we were sitting on a bench one day and we could look down the road. Then a truck came. He pulled into a parking lot not too far away. He waved to us and we waved back. Do you know what we got for that? Eight days in bed! And you weren’t even allowed to go to the toilet, no, they placed a toilet bucket in there.Footnote 62

A former male employee from Brejning talked about the sharp division of the sexes: “If I was on my way home from a shift, for example, and I saw a female and male resident talking to each other, I was actually obliged to report it, and then the two could easily risk some form of punishment—a day in bed or solitary confinement.”Footnote 63 However, sexual morality was changing throughout the period examined, and this liberalization could also be observed within the system for special care in the 1960s and 1970s. Relations between the sexes in the institutions became somewhat more relaxed.Footnote 64 However, sexuality was still subject to regulation; for example, masturbation was considered problematic, and former employees and inmates within the care system for the intellectually disabled reported sanctions against this practice right up to the end of this period. An informant who resided at Ribelund in the 1960s, for example, when questioned about the extent to which one had the right to privacy in relation to masturbating responded: “No, we weren’t allowed to.” The interviewer then asked what would happen if one was discovered masturbating. The informant replied: “Then we got scolded. Then we had to stay in our rooms for four or five days. Then we weren’t allowed to come out.”Footnote 65

An employee at the same place between 1974 and 1977 described how she experienced the pressures of having a more modern view of the inmates’ sexuality while the management had instructed all staff to take measures to prevent masturbation:

If we came in and we saw it, we would simply make sure they knew: “Now you have to get up and take a shower, and you have to do it now,” and they shouldn’t be allowed to do that, because it was something filthy. They [the management] will simply not have it. And then they came up, and if it was such that it was too much, we could just give them some cold water […] There was a shower, so you could just give them some cold water. Then I said that I simply didn’t want to do that.Footnote 66

Experiences of Injustice and Abuse

As mentioned in the section on sources of the inmates’ experience, their experience becomes vivid in the letters of complaint. The topics of complaint could include very different aspects, from everyday matters, such as food and clothing, to more fundamental issues, such as having suffered abuse, disappointment, and a lack of rights. Those who complained rarely made explicit reference to standards and rules in “normal” society, but they are implicitly grounded in a subjective experience of injustice. A former inmate, placed in Brejning in the 1950s, remembered that “there was also a girl on my ward who complained about the food. She called it dog food. The chief medical officer, Wildenskov, acknowledged that she was correct, but she was nevertheless still punished and placed in the ‘cell’.”Footnote 67 Another inmate from the mental institution, also resident in the 1950s, described the food: “It was some kind of dog food. You could risk finding adhesive bandages in the goulash and beer bottle caps in the beer bread. We were forced to eat up.” Meals also took place in complete silence.

It was a silent game. If it was not silence, or if someone was playing with the cutlery, there was a risk that the maids would come and collect the plates. When you got a plate again, it was random which plate you got. You could get some food that one of the others had been messing around with.Footnote 68

Complaints were not limited to mundane matters of food and clothing. The complaint materials contain many requests to be discharged. The coercive element in connection with enrolment and especially discharge was the ultimate expression of a lack of autonomy. Several inmates expressed a general desire to leave the institution and live a more free and normal life on the outside. It was the local chief physician who decided whether the inmate could be discharged, and the actual exit process could be long and gradual, including demands made on the inmate in return for discharge.Footnote 69

A number of applications for discharge (or complaints about not being discharged) were based on wishes to enter into marriage, but the eugenic thinking of the time pushed the system to ensure that a discharge did not lead to pregnancy.Footnote 70 For those inmates of fertile age, submitting to sterilization was often a condition for discharge.Footnote 71 Some of the inmates experienced this as an abuse or injustice. There were inmates who on several occasions refused to “voluntarily” accept sterilization, and there were inmates who accepted sterilization but were never discharged.Footnote 72 We can also observe that from the 1950s, there were more reactions to the sterilization policy. More complaints were submitted and lawsuits filed by those who had been sterilized.Footnote 73 Very few cases led to any form of compensation, but the cases show how sterilization was experienced as a form of abuse. In 1976, a man complained that he had been sterilized in the early 1950s at the asylum in Vodskov:

I was 19 years old when I finally got out of there. In order to get out, it was necessary for me to sign a form that they could sterilize me. I think that this was extortion, and I believe that it must be possible to give me compensation for that. … Now I have been on the outside for approximately 24 years, and I am married, and I would have liked to have children, but as you already know, it has been made impossible for me.Footnote 74

In both the interviews and in the archival materials, we have come across testimonies from women who were inmates within the intellectual disability care system and who were sterilized. Later on, they felt stigmatized by others because of the placement and the intervention.Footnote 75 For some women, the procedure also brought feelings of shame. A former inmate described in an interview her decision to tell her future husband about her past, which she had otherwise kept hidden:

My husband told me that it meant nothing to him. But on many occasions, his own family poked fun at him, saying, “Think, with her, you won’t have any children.” They said this all the time. But he just told them that I had told him all about it. And then he didn’t want to hear any more about it.Footnote 76

A central theme that appears in accounts of institutionalization is violence and abuse. This is also documented in the care for the intellectually disabled in Denmark.Footnote 77 Despite the fact that sexual assault and physical violence throughout the entire period violated both criminal law and the care system’s own rules, it is documented that it took place. There was abuse by the employees and among the inmates. The cases cover a wide spectrum, from sexual assault and serious violence (cases that ended up in the legal system) to examples of the use of physical punishment. However, we know only of those cases that were registered in the archival material or appeared in the media, so it is not possible to assess precisely how widespread violence and abuse were in the care system for the intellectually disabled.Footnote 78

However, we can observe in the recollections and the complaint petitions that this is both emphasized and strongly articulated by the inmates. In addition to the traumatization of experiencing an assault, we can see that the testimony of the inmates has often not been judged as credible (for example, in connection with the investigation of cases). In other cases, it appears that in some institutions, the use of physical punishment was part of the institutional culture.Footnote 79 Overall, it may have created an atmosphere where inmates feared being subjected to violence and abuse. One informant from the care system recalled their fear of a certain staff member:

He would decide to hit you, and it wasn’t just on one side of the head, no, it was on both sides of the head, and then with both hands and then … he would lift you up and you were thrown down on the floor. He worked in the ward for many years, and I was uneasy around him. If the headmistress had seen it, it would have been “Goodbye and good luck” for him. But we didn’t dare say it.Footnote 80

Conclusion

It is not easy to summarize how inmates experienced the Danish care system for the intellectually disabled in the decades from 1933 to 1980. While we have a wealth of source material on the system’s development and practice, we have only a few scattered sources describing how the inmates themselves experienced being in the institutions. We have used interviews with former inmates (and staff) and the voices that emerge in the system’s own archive materials (including letters of complaint) to draw an overall picture of the experience of placement.

The experiences, we find, were characterized by a lack of autonomy, institutionalization as a way of life, stigmatization, ruptured family relations, and a fear of violence. In many ways, experiences and feelings closely related to the specific institutional setting of “total” and “disciplinary” institutions in which they lived.Footnote 81 There were, of course, changes throughout the period investigated here. From the 1950s, there was a gradually increasing focus on granting the inmates more legal rights and personal autonomy, and 1959 saw the introduction of the so-called “normalization policy,” which emphasized that the conditions of those in institutions should increasingly follow the general development of society. Nevertheless, the question remains: How quickly did things change? In a sense, experiences can be relative—a moving target—referring to the potential differences between ideals and reality, and as the living standards and individual empowerment improved in the “normal society,” the experience found a new base line.Footnote 82

Another question is worth asking: Did it change for everyone? The source material tends to reveal the voices of those inmates who were most resourceful or articulate. However, the Danish system of care for the intellectually disabled also included very vulnerable inmates with severely limited cognitive and communicative resources. We hear very little from them and know very little about them. They were largely left to themselves, and when in the late 1960s there was an increased focus on the use of physical restraints, it became clear that some of the inmates were physically restrained and understimulated for large parts of the day.Footnote 83 In 1978, in a critique of the conditions at Ebberødgård, the Ombudsman emphasized that the “the clients rocking back and forth should have the opportunity for human contact, among other things.”Footnote 84 What at first hand might appear to be a “community of experiences” might only be representative for the most vocal or resourceful of the institutionalized persons in question.Footnote 85 Arguably, the structural selectivity of the so-called “normalization policies” from the late 1950s offered new life chances and de-institutionalization for the most resourceful in the institutions, but potentially further marginalized and stigmatized the least resourceful.

Another aspect of the experience of institutionalization is that the interviews in particular show that the feeling of being institutionalized does not stop at discharge, but most often lives on and shapes the individual’s life long after leaving the institutional setting. A striking example is a man who for five decades was interned in various institutions. After being discharged in 1956, he complained about his forced institutionalization for more than 20 years. In his final letter of complaint, dated 1979, the man was over 80 years old. He addressed the Ministry of Justice:

I am a man who has been forcibly placed in care for 50 years. Since I was discharged (about 20 years ago), I have tried in vain to have my case reviewed because I believe that I am entitled to compensation … but without any result. … I hope you can do something for me, so that I can still have time to enjoy life a little. Yours sincerely ….Footnote 86