Societal views on the mentally ill plays a huge role on the treatment they are offered. In the 1750’s, society viewed the mentally ill as “mad”, “crazy” and unfit to be a part of society, which led to the creation of a mental hospitals-where they were locked away as prisoners, not patients. Currently, we have shifted our mindset to be more accepting, but still lack the means to provide patients with the medical help they deserve. treatment of mentally ill patients has progressed but the stigma surrounding and the dehumanization of these people still remains. Over the centuries, mental institutions have dehumanized the mentally ill and served as a holding place, keeping them from society, rather than actually providing adequate treatment. While the medical treatment of mentally ill patients has progressed over time, the stigma surrounding and the dehumanization of these people still remains.

In the mid 18th century, leaders joined together in Philadelphia and founded one of the first mental hospital in America, Pennsylvania Hospital (1753). The motivation behind the construction was to bring the “mad” medicine found in Europe but mainly to keep people protected from the lunatics (Whitwaker 4). Society decided there were way too many lunatics roaming the streets and they felt as they were in danger. The “mad people” were placed in the hospital, that was more like jail, which led to a prevalent connection in society as “inmates”. The lunatics were ruled over by “keepers” who could use their whips freely, and they were kept in gloomy, foul smelling cells (Whitwaker 4). The patients that did not cooperate with the keepers would be “chained to rings of iron” around their hands and ankles. Society began to dehumanize mentally ill patients and treated them like animals

Domestic issues in America, especially the American Revolution, influenced society’s morals in the late 1700’s about the treatment of the mentally ill. Post-revolutionary sentiment enlightened society to view everyone as equal, as stated in the new Declaration of Independence. In 1796, a humanitarian reformist, Benjamin Rush, advocated that a new wing of the hospital for the mentally ill should be created. In this wing, the patients would be treated with compassion, kindness, respect (Whitwaker 5). Despite his humanitarian beliefs, Rush was also a physician and kept up with medical procedures being administered by qualified European “mad-doctors”. Rush believed that the madness was caused by “morbid and irregular” blood vessels in the brain, which could be due to any injury to the brain, such as too much labor, intense study, masturbation, extreme weather, worms, constipation, and too much imagination (Whitwaker 14). He kept the hospital up to date with the modern medicine by practicing treatments that required bleeding patients. He believed that “fourth-fifths of the blood in the body” should be released (Whitwaker 14). One of the treatments created blisters on the back of the neck or ankles of patients and kept open. Also, patient’s heads would be shaved so they could dump water and ice to “normalize the blood flow”. 

Rush, in contrary to his belief of treating patients with kindness, would compare them to animals like “tyger, the mad bull, and the enraged dog” (Whitwaker 15). He used these words to intimidate patients in order to discipline and help cure them. He continued with different treatments like the spinning therapy where a patient would be strapped to a board and spun quickly until they passed out or were so dizzy they couldn’t not think and have “wild thoughts” (Whitwaker 15). Rush even invented his own treatment, the tranquilizer chair, in which patients would be immobilized and their vision blocked. They would be kept there for hours, even days, with a fecal bucket placed beneath them. Rush, like many other physicians during this time, abused their power and subjected their patients to inhumane treatment as a means of “curing them.” The ultimate dehumanization of mentally ill patients justified their cruel and unusual treatments. 

Towards the end of the 19th century and early to mid 20th century, scientific discoveries and books like Charles Darwin’s Origin of Species, made society see the mentally ill as carriers of a defective “germ plasm” (Whitwaker 41). Patients carrying this germ plasm were seen as “social wastage”, a burden and a threat to the future health of the American population (Whitwaker 42). The mentally ill were the most unfit in society and needed to be removed from the population. The ratio drastically changed from 1850, one in every 1,345 people were insane, to 1900’s, where one in every 554 people were mad. Laws were passed in most states to prohibit the mentally ill from marrying, hence stopping them from reproducing and spreading the germ plasm. Patients would be sterilized, getting their tubes tied, against their will. To back this up, physicians used logic, “they have no right in the first instance to be born, but having been born, they have no right to propagate their kind” (Whitwaker 58). It was ruled constitutional by the U.S Supreme Court in the Buck v Bell case in 1927 (Whitwaker 59) as it was a small sacrifice the mentally ill should repay society with. Patients no longer had the choice of consent and were forced to acquiesce to the, sometimes excruciating painful, treatments deemed necessary by physicians.

After World War II, Americans came to the realization that they had their own version of concentration camps: state mental hospitals. Pictures of the mistreatment of the mentally ill were published everywhere. They included “mentally ill men huddled naked in barren rooms, wallowing in their own feces; barefoot women clad in coarse tunics strapped to wooden benches; sleeping wards so crowded with threadbare cots that patients had to climb over the foot of their beds to get out” (Whitwaker 67). In any article published, you would consistently see unsanitary hospitals, patients cuffed, strapped in chairs, or wrapped in wet sheets. The patients had no real medical care, they would barely see a doctor and were kept by attendant that beat or sedated them. Shock therapy became the main treatment and the drug curare was given to paralyze the patient to limit their thrashing of trying to escape and breaking their bones from the intensity of the therapy. Some patients, after a few times of therapy, would accept they could not escape and would sit there trembling, sweating and call out for help (Whitwaker 103). 

Brain damage was now seen as a miracle therapy and got a lot of support from society. Insulin coma, electroshock, and metrazol were the main methods, but the new surgical treatment of the prefrontal lobotomy became a hit. Freeman and Watts, two neurologists, practiced prefrontal lobotomies in an initially successful way, and a cure was finally found. The prefrontal lobe was responsible for memories, information, and especially personality. The good outcomes declared by Freeman and Watts’ procedure, would be based on if the patient would be quiet and not disturbing to other people, not whether they actually recovered from their disorder. In some cases, patients would undergo the surgery a second or third time and if no change happened, they would be institutionalized again for vigorous shock therapy. The lobotomy soon became an illusion as the cure in medicine and a humanitarian empathy for the mentally ill. 

Literature at this time also reflected the horrors that occured in mental institutions. The novel One Flew Over the Cuckoo’s Nest by Ken Kesey (1962) exposes mental institutions for their inhumane treatment of the mentally ill that was geared towards making them into mindless yes-men rather than helpful treatment. Our antagonist, Nurse Ratched, is the manifestation of all the abuses that occur in mental institutions. She makes it her mission to mentally breakdown each patient into submission by demeaning them and stripping them of their manhood. Nurse Ratched strikes fear into the men to keep them under her control. While she is almost always successful, our protagonist McMurphy poses a threat to Nurse Ratched by questioning her authority and refusing to submit himself to her will. “The guys won’t meet her look; they’re all looking for hangnails. Except McMurphy. He’s got himself an armchair in the corner, sits in it like he’s claimed it for good, and he’s watching her every move” (Kesey 29). Nurse Ratched has invoked so much fear into the patients that they can’t even look her in the eyes, by McMurphy carefully watching her, he is standing his ground and undermining her authority. Throughout the novel, there is a constant power struggle between Ratched and McMurphy. Nurse Ratched does everything in her power to mentally breakdown McMurphy into submission by referring to him as McMurry, threatening him with electroshock therapy, and going out of her way to make his everyday life increasingly more difficult. Nonetheless, McMurphy remains vigilant and refuses to submit himself to her. Since Nurse Ratched could not get him under her control using mental abuse, she decided to send him for a lobotomy. Nurse Ratched has now won my reasserting her authority over all of the patients by turning their symbol of hope into a mindless drone. 

This shows how the mental institutions were never able helping the mentall ill, it was about dehumanizing them, asserting authority over them, and subjecting them to countless inhumane practices simply because there is no one there to stop them.The objective is to keep the mentally ill away from the rest of society. The road to recovery for a mentally ill patient is like that of a rigged game. With each step you get closer to being “cured”, there are two steps back towards staying in the mental institution. Being mentally ill devalues you as a person as you are seen as unfit to be apart of a society (Lake 1). Now that you are no longer seen as a human being, it makes it all that much easier for you to be abused by those in authority, much like that of Nurse Ratched. You are kept away from society’s gaze, left to be forgotten over time, subjected to numerous “treatments” that are supposed to help you, but they never actually do.

In the rare care that you were able to be deemed fit to re enter into society, your journey is only halfway through. Now that you have made it through the physical treatment of the mental institution, you now have to endure society’s treatment in the process of rehabilitation. After being dehumanized for so long, you now have to regain your identity as a human being. Once it was believed that mentally ill people could leave the asylums and join the community, a movement called deinstitutionalization was implemented (Carney 1). The 1999 Olmstead decision by the U.S Supreme Court further supported this idea by requiring states to provide mental health treatment in communities where needed. Despite some people starting to support the mentally ill, the stigma around them stood even to this day. Although we as a society have now developed an open discussion on mental health, not all mental illnesses are created equally. While it is deemed acceptable to talk about depression and anxiety, the stigma still surrounds the rest of the mental illnesses and those afflicted by them. 

Unsurprisingly, the mistreatments the mentally ill once faced in the 1800’s are growing again (Rogers 1). The federal government has documented a pattern of sexual and other violent assaults among patients at the psychiatric unit of Kings County Hospital Center, located in Kings Park, Long Island. Some incidences in the hospital included a woman being raped and a 14-year-old who was forced to partake in oral sex by a 16-year-old (Hartocollis 1). This only confirms the narrative that mental institutions to this day only serve as holding spaces for the mentally ill. Mental institutions dehumanize the mentally ill and leave them vulnerable to a myriad of abuses when they are supposed to be receiving actual treatment. While we have made advances in individual treatments such as electroconvulsive therapy for severe depression and mania, the overall treatment of the mentally ill has not changed. They are still dehumanized and outcasted from the rest of society.

As we continue to modernize and grow as a society, it is important that we first fix our current flaws. We must reevaluate our treatment of the mentally ill. We must breakdown the stigma surrounding mental illness and those afflicted by it by reforming our mental institutions (Sisti). Mental institutions should no longer be a holding place for the mentally ill until they die, mental institutions should actively work towards helpful treatment that will allow the patient to eventually reintegrate into society. The dehumanization of the mentally ill has gone on for too long and we as a society need to get rid of this stigma and welcome the mentally ill back into society through rehabilitation. The mentally ill should be treated with respect, compassion, patience and most importantly acknowledgement. Society’s ignorance has hindered the importance of proper treatment for the mentally ill. 

 

Works Cited

Carney, Caroline. “Mental Illness in Society.” Merck Manual. https://www.merckmanuals.com/home/mental-health-disorders/overview-of-mental-health-care/mental-illness-in-society* 

Hartocollis, Anemona. “Abuse is Found at Psychiatric Unit Run by the City.” NY Times. http://www.nytimes.com/2009/02/06/nyregion/06kings.html* February, 2009.

Kesey, Ken. One Flew over the Cuckoo’s Nest. Macmillan Company of Australia.

Lake, James, and Mason Spain Turner. “Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care.” The Permanente journal vol. 21 (2017): 17-024. doi:10.7812/TPP/17-024

MindFreedom. “Top 10 Forms of Psychiatric Institution Abuse.” CCHR International. https://www.cchrint.org/2014/11/13/top-10-forms-of-psychiatric-institution-abuse/* November, 2014.

Rogers, Chris. “Inside the ‘world’s most dangerous’ hospital.” BBC. http://www.bbc.com/news/magazine-30293880* December 2014. 

Sisti, Dominic. “Psychiatric Institutions Are a Necessity” NY Times. https://www.nytimes.com/roomfordebate/2016/05/09/getting-the-mentally-ill-out-of-jail-and-off-the-streets/psychiatric-institutions-are-a-necessity* May, 2016.

Whitwaker, Robert. Mad in America. Basic Books, 2001