Читать книгу The Moral State We’re In - Julia Neuberger - Страница 19

We are not alone in our attitudes towards mental health. Many countries, many systems, are the same. How we treat people with enduring mental illness is a blot on the consciences of most of the developed nations, and on quite a few of the developing nations as well. In addition, there has always been the risk of political manipulation: in many countries those who have opposed the ruling system have found themselves confined to the asylum. This was most prevalent in the former Soviet Union, when dissidents were pumped full of drugs and left in the mental wards to rot. Nazi psychiatrists, too, took part in the most appalling destruction of people with mental illness and learning disabilities in the 1930s, long before the extermination of Jews and gypsies. The so-called T-4 programme was devised by psychiatrists alongside Nazi ideologues. The programme was finally ended in 1941, but not before an estimated 80–100,000 people had been killed, including the so called mercy killings of the ‘insane’ and of roughly five thousand ‘deformed’ children.*

This history of the use of psychiatry as a means of social control led to a critique of psychiatry in the late 1960s and early 1970s led by Thomas Szasz, Professor of Psychiatry at Syracuse University, New York. He argued that mental illness was a man-made myth and suggested that psychiatry as a discipline was a pseudo-science, comparable to alchemy and astrology. Michel Foucault, the profoundly influential French historian of culture and ideas, rather agreed. For him, and for Szasz, psychiatrists became, as Roy Porter puts it, villains, and their discipline akin to a form of magic. Martin Roth and Jerome Kroll argued precisely the opposite–that there had been real progress in the study, diagnosis, and treatment of madness and psychopathologies and that there was a real organic basis to mental illness.

The truth is that there has been a terrifying and disgraceful history of using psychiatry and its antecedents as a means of social control, whilst at the same time some of the treatments, both pharmacological and psychotherapeutic ‘talking’ remedies, have proved beneficial and effective for some, but not all, sufferers.

To understand how we view mental illness now, at the beginning of the twenty-first century, we must look back at the history of mental illness and its treatment.

Possession by demons and other evil spirits may not be part of our intellectual armoury now, yet when we bury our dead (in Jewish ritual anyway, and in many other practices) we still stop up bodily orifices to prevent them being invaded by evil spirits, and pause on our walk to the grave to shake off any lurking demons. Belief in evil spirits is just below the surface in many of us, as we touch wood, avoid walking under ladders, and look askance at black cats. Yet all this is intimately tied up with how we view those who have mental illness. Do we think they are possessed? (Sufferers themselves often take that view.) Or do we regard them in the same way as we would do if they had a physical illness? If so, why don’t we allocate them the same resources, and treat them with the same consideration, as those suffering from physical illness? Do we believe they need to be controlled, as their containment in the old asylums would suggest? If so, is that for their protection or ours? All these questions may have half-answers in our minds; but society is split, and individuals within it are confused, about mental illness and how to care for those who suffer from it.