Early Champions for Change for Dignity in Mental Health Treatment
"Speak up for those who cannot speak for themselves; ensure justice for those being crushed." ~ Proverbs 31:8
History of institutions and treatment of mental illness
Asylums - what words and images come to mind when you hear this word? Institutions, madhouses, loony bins, nut houses, insane asylums, most likely. It may bring to mind descriptions of conditions in such places as dark, dank, cold, cruel, and inhumane. Patients in asylums were called freaks, maniacs, mad, crazy, loony, lunatics, insane, and nut cases. It's interesting to find the definition of asylum in the dictionary. Here are a few:
1. (esp. formerly) an institution for the maintenance and care of the mentally ill, orphans, or other persons requiring specialized assistance. 1
2. A place offering protection and safety; a shelter 2
3. Any secure retreat. ibid
What a paradox! Today when someone seeks asylum it is to find a place of safety and refuge. But in earlier centuries, asylums were not safe, secure places of refuge. They were places to put away the outcasts of society; they were places of terror, abuse, abandonment, neglect, and cruelty. The horrors of treatment were as horrifically inhumane, all in the name of care. The living conditions were deplorable.
Allison M. Foerschner describes a case study at La Biectre Hospital in Paris, France.
"...starting with patients shackled to the wall in dark, cramped cells. Iron cuffs and collars permitted just enough movement to allow patients to feed themselves but not enough to lie down at night, so they were forced to sleep upright. Little attention was paid to the quality of the food or whether patients were adequately fed. There were no visitors to the cell except to deliver food and the rooms were never cleaned up (Butcher 37). 3
Other treatments in asylums all over the world were just as bad if not worse. Lobotomies, bloodletting, ice bath treatments, morphine and opium, and other powerful drugs, skull drilling, straight jackets and iron restraints, beatings, starvation, many deprivations, and so many more. Patients were demeaned, humiliated, verbally, sexually, physically, and emotionally abused and violated. If ever there seemed to be no hope for those struggling with mental health conditions, it was at that time.
Champions of change
There were a few early champions along the way who initiated changes in the treatment of those suffering from mental illness by instituting and promoting humane treatments. Here are three of the most renown.
Psychiatrist Philippe Pinel was one of the earliest advocates for better treatment of people suffering from mental illness. Pinel believed that mental illness could be cured and/or improved by moral, caring treatment. This humane treatment was often referred to as moral therapy or moral treatment. 4
As chief physician at the famous Paris asylum, Bicêtre, Pinel was outraged at the heinous conditions the patients were subjected to. Among the most disturbing were patients chained in dungeons, treated like animals, and horribly abused. As administrator of the institution, he required all patients be loosed from chains and for all inhumane treatments to cease. Reform began with changes in the living environments in the institutions and hospitals. It began with basic human and physical needs:
- Exposure to open air
- The practice of good hygiene
- One-on-one friendly, compassionate interactions between Doctor and patient
- Providing patients with constructive work projects 5
Pinel also instituted a basic form of behavior modification and spent much time classifying various mental disorders.
Pinel ordering removal of chains from patients
Dorothea Dix wore many hats in her lifetime, beginning as an educator in her teens, and onto social advocacy for many inhumane institutions such as jails, and what was then dubbed as insane asylums, in the United States and Europe during the 1800's.
Dorothea's family lived in poverty growing up; her mother suffered from mental illness and her father, an itinerate preacher, was a raging alcoholic. With parents unable to fulfill their parenting responsibilities, Dorothea grew up caring for her two younger brothers. 6 It seems this is what planted the seed of caring and motivated her advocacy for those who could not care for themselves.
Dorothea began her advocacy for prison reform while teaching Sunday School at Ms. Dix took her concerns to the legislature and new reforms were set in place for institutions. The reforms, once being instituted, began to confirm that treating the mentally ill and the incarcerated necessitated those major improvements in treatment. It revealed that full recovery for many was possible. Dorothea Dix helped in founding mental hospitals, schools for the intellectually challenged and those who were blind. Dorothea Dix was a powerful model of an effective advocate for the underdog.
“I come to present the strong claims of suffering humanity. I come to place before the Legislature of Massachusetts the condition of the miserable, the desolate, the outcast. I come as the advocate of helpless, forgotten, insane men and women; of beings sunk to a condition from which the unconcerned world would start with real horror.”— Dorthea Dix
Clifford W. Beers
Here is a man who was the epitome of courage, resilience, and determination. In my mind, he is more than a great champion for change in the treatment of mental illness, but a hero. What makes Beers' story so remarkable is that with grit he openly wrote about his confinement in an asylum after a suicide attempt, in his autobiography, A Mind That Found Itself. With the extreme, archaic stigma present in his day, this was at great risk of his reputation and credibility. With no-holds-barred, he revealed the cruel and deplorable conditions of his confinement. Like his fellow crusaders, Pinel and Dix, Beers became a catalyst for change in the treatment of people with mental illness.
Later on, Beers founded Mental Health America, a national organization that advocated for change in the treatment of people with mental illness, to educate people on the faulty stigma's of mental illness, and to work towards mental illness prevention. Today, Mental Health America continues to advocate and facilitate ongoing change in the area of mental health.
" A Mind that Found Itself" is Clifford Beer's story of his confinement in a mental institution. It has been an inspiration to many mental health professionals and those seeking to better understand or treat mental illness.
A pen rather than a lance has been my weapon of offense and defense; for with its point I have felt sure that I should one day prick the civic conscience into a compassionate activity and thus bring into a neglected field earnest men and women who should act as champions for those afflicted thousands least able to fight for themselves.”— Clifford W. Beers - A Mind That Found Itself (1907)
Thank you Pinel, Dix, and Beers
We who have struggled with mental health challenges appreciate these three selfless and compassionate human beings, and those who have since taken the baton and pushed for dignity and compassion through their advocacy for those with mental illness.
The Mental Health Bell - A powerful story of a symbol of hope
In the 1950s Mental Health America created a symbol representing hope and change in mental health treatment. It is called the Mental Health Bell. Mental Health America contacted all the asylums and institutions who used iron chains and restraints and requested that they send them the discarded items. They then took those chains and restraints and melted them down and created a bell, the Mental Health Bell, which symbolizes hope and freedom for the mentally ill by changing mental health treatment.
On the Bell is this inscription:
Cast from shackles which bound them, this bell shall ring out hope for the mentally ill and victory over mental illness."
To hear the Mental Health Bell ring brings a chill to my spine and tears to my eyes in gratitude for the brave and mighty efforts of Clifford Beers and Mental Health America, for the advances and changes in mental health treatment, and for the brotherhood of all of us who have suffered from mental illness.
- Mental Health Support - Mental Health Recovery and Advocacy
Mental Health America is a leader in mental health support, recovery and advocacy.
- The Stigma About Mental Illness: Dispelling the Myths and Learning the Facts
Throughout time, throughout the world, stigams have abounded. They come and they go. However, the stigma of mental illness continues with power, and people are suffering. Here is some valuable information to dispel the myths and learn the facts.
- Actress Glen Close Fights the Stigma of Mental Illness
Glen Close and her family have gone public with the family's battle with mental illness. Why would Ms Close do this? To dispel the myths, and the stigmas which are based on fear and ignorance.
1 Random House Kernerman Webster’s College Dictionary. (2010). Retrieved July 1 2015 from http://www.thefreedictionary.com/asylum
2 American Heritage® Dictionary of the English Language, Fifth Edition. (2011). Retrieved July 1 2015 from http://www.thefreedictionary.com/asylum
3 Foerschner, A. M. (2010). "The History of Mental Illness: From 'Skull Drills' to 'Happy Pills'." Student Pulse, 2(09). Retrieved July 01, 2015, from http://www.studentpulse.com/a?id=283
4 Markov, Sergey. (2014). "Philippe Pinel - The Father of Modern Psychiatry." Biographies of Geniuses. Retrieved July 01, 2015, from https://geniusrevive.com/en/philippe-pinel-the-father-of-modern-psychiatry/
5 The J Rank Psychology Encyclopedia, Famous Psychologists & Scientists. Retrieved July 01, 2015, from http://psychology.jrank.org/pages/494/Philippe-Pinel.html
6 History.com. (2009). "Dorothea Lynde Dix." Retrieved July 02. 2015, from http://www.history.com/topics/womens-history/dorothea-lynde-dix
7 Dorothea Dix. (2015). The Biography.com website. Retrieved July 02, 2015, from http://www.biography.com/people/dorothea-dix-9275710.
© 2012 Lori Colbo