There's a story in the May 28th New Yorker called Framed. It's the story of a
family, of a man in particular, who was incarcerated after being one of
hundreds that a particular Chicago cop has framed and then arrested for
possession and selling of drugs, over decades. It's a true story, but
horrifying because it helps you know the individuals, and understand what the
system does to millions of people in individual terms. I mention it because the
mentally ill poor and working people in this country are helpless victims, just
like this young black man, raised in poverty, whose parents were damaged by
poverty, and who was almost sacrificed like so many others. Perhaps our true
heroes are people like the Catholic workers and the other folks who open homes
in poor areas that are like the settlement houses once were, where People like
Phillip Berrigan's daughter, live in those houses and try to help in whatever
way they can, one person at a time while we fantasize about changing whole
political and economic systems.
Miriam
-----Original Message-----
From: blind-democracy-bounce@xxxxxxxxxxxxx
<blind-democracy-bounce@xxxxxxxxxxxxx> On Behalf Of Carl Jarvis
Sent: Friday, May 25, 2018 9:43 PM
To: blind-democracy@xxxxxxxxxxxxx
Subject: [blind-democracy] Re: The Legacy of the Anti-Psychiatry Movement
Very interesting.
What I remember about the early 70's was the dumping of a large number of
people who had been living in institutions, onto the streets.
If sticking people away in isolated mental hospitals was cruel, so was turning
them out to fend for themselves.
I was operating the snack bar in Spokane's city hall at the time. My facility
was in the lobby by the front door. For the first time the city had a homeless
problem. The folks who wandered into my location looking for free food, were
mostly people with very low IQ's. One fellow said he had been "hired" by a
nursing home, and his job was that of Janitor. He had a room that had been
partitioned off from the furnace, just big enough for a single cot and a four
drawer dresser.
But that didn't matter since he worked six full days each week, on call all
day, and unless he left the building on Sunday, he was on call then, too. His
"pay"? Room and board and $5 per week for spending money.
The other folks who stand out in my memory was a couple. They had met at a
shelter following their discharge from Eastern Washington Hospital. By the
time they began hanging around my snack bar, they had figured out how to
produce a baby. They walked up to my counter and sat their 6 month old baby
smack in the middle of the counter.
"Squish!" went the baby's diaper. And poop squeezed out. The poor little
fellow stunk to high Heaven, and so did the parents. The father stepped up to
the counter to ask me for "a loan", and I literally gagged.
I had one employee at the time, a fellow who had been sentenced to Lake Land
Village some 30 years earlier. He was both blind and had seizures. His
stepfather was afraid of him and had him committed.
Harold had the IQ of a genius. He worked as a Braille transcriber, and became
a skilled organist, and was "allowed" to leave to attend a local church, where
he played. After 30 years, our organization of the blind learned of his
incarceration, and we petitioned for his release. He had a fairly decent
monthly income from a family endowment, and he was hired by the Lincoln Bank to
play the chimes each day at noon. He found a decent apartment and with the
help of our Spokane chapter, furnished it tastefully. He was a fixture in
Spokane for many years. I hired him because he was efficient, punctual,
personable, honest to a fault, and very much loved by the people who stopped by
the snack bar. Having lived so many years at Eastern Washington/Lake Land
Village, Harold knew most of the people being turned out. He spent his
afternoons assisting them in locating decent lodging and meals.
There were far better ways of relocating those people who had been held captive
for such a long time. But the governor seemed to be more focused on how much
we could save, than whether the people, now turned victims, could survive.
Carl Jarvis
On 5/25/18, Miriam Vieni <miriamvieni@xxxxxxxxxxxxx> wrote:
The Legacy of the Anti-Psychiatry Movement
A scene from "One Flew Over the Cuckoo's Nest." (YouTube)
Last week marked 40 years since Franco Basaglia's revolutionary work
in Trieste, Italy, led to the groundbreaking Legge 180 (Law 180, also
known as "Basaglia Law"), which ended the practice of involuntary
confinement in asylums throughout Italy. The anti-psychiatry movement
was part of a larger intellectual and professional movement promoted
through the efforts of Basaglia, Michel Foucault in France, R. D.
Laing in Great Britain, Thomas Szasz in the United States and Erving
Goffman in Canada. These thinkers critiqued the legal powers conferred
on psychiatrists to detain and treat individuals with mental health
disorders, which contributed to the medicalization of madness.
They also championed the notion that personal subjectivity is
independent from any hegemonic mandate of normalcy imposed by
organized psychiatric medicine. This movement even suggested that
mental illness might not exist at all outside of the language to frame
the other. Basaglia's work in the asylum in Trieste became a model for
radical psychiatrists internationally who had been laboring in their
own countries to end the forced institutionalization of patients and
attempting to forge a new model of mental health care.
Part of the post-war anti-psychiatry movement, Basaglia's political
ethos was born from his six-month internment in Venice's Santa Maria
Maggiore prison for his participation in the Italian resistance.
Basaglia and other prisoners escaped in April 1945, months before the
end of the Second World War.
After receiving his medical degree in 1949 from the University of
Padua, where he trained in the school of psychiatry, his experience as
director of a provincial asylum in Gorizia (now located in Slovenia)
would affect his political and philosophical ideas. In was at this
point, early in his career, that Basaglia was pushed from Padua to
Italy's border regions for having been critical of the medical
profession's confinement model. In Gorizia, shocked by use of chains,
straitjackets, bars and other modes of confinement, Basaglia sought to
understand why an institution that was ostensibly about helping people seemed
very much to punish them.
Inspired by Goffman's "Asylums: Essays on the Social Situations of
Mental Patients and Other Inmates" (1961) and Foucault's "Madness and
Civilization:
A History of Madness in the Classical Age" (1961), Basaglia became a
fierce critic of what he referred to as the "total institution," which
turned people into "non-persons" and produced a discourse of deviance
in which individuals were excluded from and broken down by society.
Basaglia viewed "mental illness" not as a disease, but as an
expression of human needs. From Gorizia, he took a director role of
the asylum in Trieste, where he would stay until 1979. In Trieste, 90
percent of the 1,182 patients in the psychiatric hospital were
nonvoluntary, living in conditions similar to those in Gorizia. It was
here that Basaglia's work would become a beacon of change-one that
would finally end psychiatric institutionalization in many parts of
the world.
Basaglia instituted open staff meetings and involved the local
community in cultural events outside the institution's walls. The
hospital staff, together with the patient-turned-subject, staged
cultural performances, joining forces with actors, musicians,
repertory companies and artists from around the world.
Basaglia transformed the "total institution," from one built on
hard-and-fast rules in which medical violence was kept from public
view into an open, creative space in which freedom and participation
by those inside and outside its walls served as a model for the new
"anti-asylum." By creating cultural events inside and outside the
hospital that included performances by the likes of Ornette Coleman,
as well as airplane excursions and art exhibits, the contained space
of "mental illness" was demystified and opened to an inclusive model
of society.
As a result of Law 180, Basaglia's work became the basis for radical
psychiatric reform around Europe and beyond-even extending to New
Zealand and Australia-with hundreds of institutions closing over the next
decade.
With each closing, the abuses of power within these hospitals became
better known-as did the reasons for confining individuals to them.
Anna Marchitelli and Annacarla Valeriano have documented how the
mental hospital was used to contain women who had merely broken out of
roles imposed by the patriarchy and were deemed "mentally ill" for
their refusal to get married, stay home or have children, as were
women who were labeled "nymphomaniacs" or deemed loquacious,
incoherent and exhibitionistic. They also note that asylums have been
used to lock up artists, people suffering from social exclusion and
medical debt, those whose political ideas were viewed as dangerous,
and even to contain and "cure" homosexuals. Yet the long-term effect
of the movement to deinstitutionalize the mentally ill has had harsh
consequences in countries where the absence of solid social structures
and services have ushered in the liberalization of the mental-health market.
The theoretical roots of the anti-psychiatry movement in the United
States date to the late 1950s. Szasz, a psychiatrist and
psychoanalyst, first criticized the legitimacy of "mental illness" as
a legal term in an article he wrote in 1958 for the Columbia Law
Review. At the time "Psychiatry, Ethics, and the Criminal Law" was published,
only five states in the U.S.
barred involuntary commitment of people with "mental illness."
Drawing parallels between the practice of committing patients to
mental hospitals and the prison system, Szasz maintained that
psychiatrists were given the power to command a sentence of "insanity"
and to indefinitely intern patients who are suffering, all the while
treating them like criminals. Szasz kicked off the anti-psychiatry
movement in North America while foreshadowing the privatization of mental
health care in the future:
"All 'hospitals' should function essentially as private medical
institutions do at present." In response to what he saw as a dangerous
collaboration between the state and psychiatry, Szasz was instrumental
in forming the Libertarian Party in 1971, whose primary platform
called for the end of government collaborations with psychiatry.
Unlike in Italy, in the U.S., the deinstitutionalization of mental
health care took place in phases. The first occurred just after 1963,
when President John Kennedy signed the Community Mental Health Act,
which encouraged the shift of mental health care from large
institutions back to the community. Later, President Lyndon Johnson
signed into law the Social Security Act Amendments of 1965, which
created Medicaid, which would pay for the health care of low-income
families. But this had a detrimental effect on people in mental health
care institutions who were transferred into nursing homes.
The 1966 U.S. Court of Appeals case Lake v. Cameron established that
psychiatric care should take place in the least restrictive setting
possible, and the following year, California's Gov. Ronald Reagan
signed the Lanterman-Petris-Short Act. While this law ended the
practice of institutionalization, it resulted, in the following year,
in the twofold increase of the mentally ill in California's criminal
justice system.
Later administrations were more conscious of the need for
community-based centers, with President Jimmy Carter signing the
Mental Health Systems Act of 1980 to fund more community health
centers. This still did not address chronic mental illness treatments.
But this act was quickly repealed by President Reagan's devastating
Omnibus Budget Reconciliation Act of 1981, which moved funding to the
state level through block grants. This forced mental health centers to
compete with other public programs, including public housing, food
banks and drug programs. As a result, mental health rarely received
funds, and the 1980s was marked by an increase in homeless people who
were mentally ill. This was particularly notable in metropolitan centers.
There were also some unlikely figures in the anti-psychiatry movement
in the U.S. For instance, L. Ron Hubbard, the founder of Scientology,
joined forces with Szasz in 1969 to create the Citizens Commission on
Human Rights, a watchdog for psychiatric human rights. And between the
publication of Ken Kesey's "One Flew Over the Cuckoo's Nest" in 1962
and the release of its film adaptation in 1975, public opinion the
U.S. shifted radically against the asylum model.
The U.S. anti-psychiatry framework differed slightly from Italy's in
how the long-term changes eventually took effect. After the asylum
model was abandoned in most states by the late 1970s, with a shift to
community-based care, it was not until the Reagan administration that
the larger deinstitutionalization movement came into force in 1981.
This move accounted for the scenario in which approximately one-third
of all homeless people in the U.S. had severe mental health issues,
which had repercussions for how mental health care would be accessed
in the future.
First, for those who can afford it, mental health care is accessible
in the private market. Of the 300,000 inmates in the U.S. prison
system diagnosed with mental health problems, 30,000 receive treatment
in psychiatric facilities. The remaining prisoners, like many homeless
people with mental health problems, are left without any support.
Starting in 2009, as a result of the Great Recession, states cut $4.35
billion in public mental-health spending over the next three years.
This was the largest reduction in funding since deinstitutionalization
began. Today, there are approximately 37,679 psychiatric beds in the
United States, which is about 12 beds for every 100,000 people, a
lower ratio than in 1850. With increasing numbers of mental-health
patients in American jails, there is a serious problem in how
deinstitutionalization has been abandoned and replaced by the private
model-or left unexamined.
We must revisit the ideals of the anti-psychiatry movement in the
U.S., because it is clear that deinstitutionalization simply moved the
furniture around. This left other institutions to take over the role
of mental health care, leaving the most vulnerable with no treatment and no
community.
