Category Archives: Legal and Historical Perspectives

Legal and Historical Perspectives in the Treatment of the Seriously Mentally Ill (Introduction): Who flew over the cuckoo’s nest?

If most of us are not familiar with Ken Kesey’s revolutionary novel, One Flew Over The Cuckoo’s Nest, then most of us are familiar with the blockbuster movie of the same name. In a nutshell, the main theme of the book/film (yes, I’ve read the book, but it’s been some time) is, if I recall correctly, two-fold.

The main theme is that seriously mentally persons should have the same civil liberties as the general population. The underlying theme is that persons afflicted with serious mental illnesses simply experience the universe in a different manner than most. The implication is that we all experience the world around us in different ways, so that doesn’t make any one person’s experience any better or worse than anyone else’s.

This 1960s idealism, of which Ken Kesey’s novel was a subscriber/proponent, resulted in the “letting go” of many thousands of seriously mentally ill persons out of asylums and into the general population. Was this a good thing, though?

The following few paragraphs are from The Treatment Advocacy Center’s website:

Quote from a California prison psychiatrist in 1971, two years after California enacted the Lanterman-Petris-Short Act:

“We are literally drowning in patients, running around trying to put our fingers in the bursting dikes, while hundreds of men continue to deteriorate psychiatrically before our eyes into serious psychoses. . . . The crisis stems from the recent changes in the mental health laws allowing more mentally sick patients to be shifted away from the mental health department into the department of corrections. . . . Many more men are being sent to prison who have serious mental problems.”

Before giving my own interpretation, I would like to quote the noted psychiatrist, E Fuller Torrey:

“How can so much degradation and death – so much inhumanity – be justified in the name of civil liberties? It cannot. The opposition to involuntary committal and treatment betrays a profound misunderstanding of the principal of civil liberties. Medication can free victims from their illness – free them from the Bastille of their psychoses – and restore their dignity, their free will and the meaningful exercise of their liberties.” 

The above quote is again referenced on the Treatment Advocacy Center’s website:

The Treatment Advocacy Center 

My personal belief is that Dr. Torrey is 99.99% correct. This de-institutionalization of seriously mentally patients was, for the vast majority of us, a tragedy and, although counterintuitive to the layperson’s commonsense (which is often erroneous), actually resulted in a loss of civil liberties for the seriously mentally ill.

In this series, entitled “Legal and Historical Perspectives in the Treatment of the Seriously Mentally Ill,” I plan to begin with this pivotal point in the history of the treatment of the seriously MI. I chose this point, because of the dramatic leap that took place at the recent treatment of persons with serious MIs. 

Prior to this important juncture, there was a “contain, maintain, and treat” strategy for treating persons with serious MIs.

This series is biased in many ways. The most obvious way is that it is slanted toward Western civilization. I may do a series on the same subject but from the Eastern civilization perspective. If I do, I will make it clear that I am focusing on such a perspective.

My hope is to bring some breadth and depth to this subject, to provide an historical framework for understanding the present, and — within that framework — to attempt to ask questions and (possibly) to provide my own ideas about where we as a society (or even better, as a group of societies) can form our futures.

Pretty big endeavor, I know. Hopefully, I can do it justice. 

There will be plenty of gaps in this series. Some may be small, while others may seem rather large. Please, if you read this series and have additional insights, feel free to add to this. The more people who are involved, the more educated and insightful we all will be. Hopefully, that will lead us to more effective solutions to the dilemma.

Thanks and take care…

Edwin

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