Commitment to mental hospitals

In short, even without counting those persons who are deprived of liberty because of mental retardation, more than twice as many Americans lose their freedom on account of mental illness than on account of crime. This loss of freedom, moreover, cannot be morally justified as either protection for the community or as treatment for the patient. Nevertheless, the American Civil Liberties Union has not only failed to oppose this practice but, on the contrary, has actively supported it. In his book on the history of the Union, Charles Markmann relates, with what seems to me badly misplaced pride, that toward the end of the Second World War, The [American Civil Liberties] Union. . . began to draft model statutes for the commitment of the insane.. . . Twenty years after the first Union draft of a model bill for commitments to mental hospitals. Congress enacted for the District of Columbia a law closely following the Union s proposals. ... 

Carol Loeb Shloss speculates in Lucia Joyce To Dance in the Wake that whatever condition Lucia Joyce had, it was worsened by family members who forced her to give up her career in modem dance— something at which she excelled. Alas, Lucia was frequently abandoned by men she loved. Her mental health declined. Lucia s brother had her committed to a hospital and insisted that she remain locked up in institutions where she was used as a human guinea pig by psychiatrists testing their nutty theories. When she was 28 years old, the Joyces put her in an asylum near Paris, and she never lived on the outside again. James Joyce loved her dearly and never believed that she was insane. He tried desperately to get her out of occupied France. Unfortunately, he died suddenly in 1941, and Lucia was abandoned to remain in mental hospitals for the rest of her life. She died in 1982 at the age of 75. 

Many eminent persons have had children with serious mental problems and have had at least one child take his or her life. Robert Frost s daughter was committed to the state mental hospital and another daughter had a nervous breakdown. One of Albert Einstein s children was diagnosed as schizophrenic. Ambrose Bierce s oldest son committed suicide, and his other died of alcoholism at age 27. Thomas Edison had two children who became alcoholics, one of whom committed suicide. Alfred Stieglitz s daughter was psychotic and committed to a mental institution. James Joyce had two children. His son became an alcoholic his daughter went mad and, as discussed, was admitted to an asylum for schizophrenia. Numerous other examples demonstrate the frequent problems of geniuses children. Many of these children tried unsuccessfully to pursue careers similar to their eminent parents, but it is not clear if this played any role in their mental problems. 

LSD trip. He became depressed and was sent, accompanied by Gottlieb s assistant, to see Dr. Harold Abramson. Reluctantly, Olson agreed to enter a mental hospital. The night before commitment, he died after crashing through a window on the tenth floor of the New York Stader-Hilton Hotel. 

Fear of hospitalization and involuntary commitment is often the reason given for avoiding treatment (Sussman et al. 1987). Unfortunately, there is some truth in that belief. African Americans are more likely to be hospitalized or involuntarily committed (Flaherty and Meagher 1980 Lawson et al. 1994 Lindsey et al. 1989 Paul and Menditto 1992 Strakowski et al. 1995). Consequently, African Americans have a different perception of the mental health system, often not seeing it as a resource for consensual treatment. 

If psychiatrists really wanted these things, all they would have to do is to unlock the doors of mental hospitals, abolish commitment, and treat only those persons who, like in nonpsychiatric hospitals, want to be treated. This is exactly what I have been advocating for the past fifteen years. ... 

In the same way, in procedures for mental illness bail is not allowed. If the accused admits mental illness, he is hospitalized, often for life if he denies it and is found to be sick in a sanity hearing conforming to all the requirements of due process, he is committed to a mental hospital and treated against his will by any means necessary until he gains insight into his condition. ... 

A person who is involuntarily committed to a mental hospital, declares the Union, is deprived of his freedom of movement and association and in many communities faces being branded with the stigma of insanity. It is therefore essential that no one be committed without a careful hearing and jury trial which includes all... 

At the time of the Spanish Inquisition, observed Maurice Maeterlinck, the opinion of good sense. . . was certainly that people ought not to burn too large a number of heretics extreme and unreasonable opinion obviously demanded that they should burn none at all. Today it is the same with involuntary mental hospitalization. The opinion of good sense now is that psychiatrists ought to commit only those mental patients who are "very ill, or dangerous to themselves or others extreme and unreasonable opinion obviously demands that no one should be committed. 

The parallel between the Inquisition and Institutional Psychiatry was put in more complete form by Mrs. E. P. W. Packard, who was committed to the Jacksonville State Hospital in Illinois, in i860, by her clergyman husband. This commitment, as best one can reconstruct the case, was based on disagreements between the Reverend Packard and his wife over matters of religious faith and observance. After Mrs. Packard secured her release—through what must be one of the earliest writs of habeas corpus sustained by a mental patient in the United States—she published an account of her experiences in the hospital. In it she wrote ... 

By medical definition, every homosexual act is the symptom of a mental disease. The homosexual is thus subject also to the penalties of mental hygiene laws, and may be confined involuntarily in a mental hospital. In Massachusetts, for example, a person is considered a fit subject for involuntary mental hospitalization if he conducts himself in a manner which clearly violates the established laws, ordinances, conventions or morals of the community. Although homosexuals are rarely committed for their sexual con-... 

What is true for the fascist or communist ideologist, is true as well for the psychiatric. He understands that the statement John Doe is mentally ill. really means Commit John Doe to a mental hospital (or Take away his driver s license, his job, his right to stand trial, etc. ). Nearly all the deprivations of human rights which so-called mental patients suffer are traceable to this source. 

One of the more controversial, if not paradoxical, developments in mental health law has been the establishment of a patient s right to treatment, followed by its legal counterpoint-the right to refuse treatment (18). Although some contend that there is no conflict between these two rights, the reality is that they are often at odds. The problem is most obvious with involuntarily committed patients, where the right to refuse treatment contradicts the reason for their hospitalization. 

Publishing more than four decades ago, my 1964 study Coercion of Voluntary Patients in an Open Hospital remains the only peer-reviewed scientific article that systematically investigated the various threats and outright forms of coercion used to control mental patients, including drugs, electroshock, and commitment. 

If the policy on civil commitment of the American Civil Liberties Union is ill conceived, its recommendations for further improvements are nothing less than terrifying "Anyone hospitalized for mental illness, the statement asserts, is entitled to medical and psychiatric care, appropriate to his particular case. In making this declaration, the American Civil Liberties Union not only supports commitment on the basis of an undefined concept of mental illness and as a legitimate medical function, but also advocates psychiatric treatment, regardless of whether or not the patient consents to it or of how dangerous or destructive such "treatment might be. Does the American Civil Liberties Union really believe... 

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