By Marvin Ross
I just recently came across a documentary on Youtube put out by Mental Health America called From Asylums to Recovery – a celebration of the so called consumer survivor, anti-psychiatry movement in the US and beyond. After showing some images of the horrific conditions that people were forced to live in in asylums, we are greeted with the statement that in the late 1950’s and early 1960’s, there were 550,000 people locked up in asylums. Many, the documentary goes on to say, were locked up by their families and the courts because no one believed that those with mental illness could recover.
Horrific conditions did exist and no one can deny that but people were in the institutions because they could not usually recover in those days. Recover isn’t even the right word which really should be that their symptoms could not be dealt with appropriately. Recover really means to be cured and that is not possible for illnesses like schizophrenia and bipolar disorder.
The doc then states that today there are about 50,000 people in psychiatric facilities and that the system has improved. This reduction, they claim, is the result of 100 years of patient/consumer/survivor advocacy. The documentary then goes on to try to explain how this reduction in patients and improvement came about by interviewing many of those who were involved in the consumer/survivor movement.
What is missing, of course, is that from the early 1960’s on, new medications came along that, for the first time, could treat the worst of the symptoms of schizophrenia, bipolar disorder and major depression. In fact, the first anti-psychotic, chlopromazine, was discovered in the 1950’s and its first North American use was in Montreal in 1954.
That was the beginning and over the years, more anti--psychotics were developed so that doctors now can experiment to find the one that works best for a particular patient.
Lithium, the gold standard treatment for bipolar was first used in 1954 but not introduced into the US until the 1970’s. The US was late to the game as it was the 50th country to start using this agent to treat bipolar disorder.
Anti-depressant drugs to treat major depressive disorder began about 1957 with the appearance of the MAO inhibitors. This class of drugs had their problems with interactions with some food products such as cheese. However, other classes of drugs such as the tricyclic anti–depressants, the SSRI’s and now other agents like ketamine are in use.
Those in asylums were able to have the worst of their symptoms treated successfully and to be released from hospital. Mental Health America fails to mention any of this and attributes the emptying of hospitals to the works of the consumer survivors and anti-psychiatry advocates. The problem, however, was that governments were too anxious to release people without first setting up proper community resources to aid and assist those being discharged.
Known as deinstitutionalization, the process has resulted in sick people being left in the community to fare for themselves. As a result, many of the homeless and those incarcerated are suffering from untreated mental illness. Is being homeless or in jail an improvement on the asylums of old? I think not!
All of this (drug development and deinstitutionalization) is ignored in this documentary designed to celebrate the 100+ years that MHA has existed. It began life in 1909 as the National Committee for Mental Hygiene. An organization that has been around for that long I would hope would have more understanding of mental illness than displayed in this documentary. The popular media, in my opinion, displays a greater understanding.
If you are a fan of the TV series Homeland, and have not seen season 7 then stop here unless you want the ending. The protagonist, Carrie Mathison, is a CIA agent with bipolar disorder. In this season, she is captured by the Russians and held prisoner before eventually being exchanged for a Russian spy held by the Americans.
As part of her torture, the Russians withhold her bipolar meds. After a significant time without medication, Carrie is returned to the US in the state that anyone who understands mental illness and the role of medications would understand. She is an incoherent mess and basket case. If Hollywood can understand this, why can an agency involved in the mental health field not understand it?