February 18, 2015:
An op-ed piece in today's NYTimes brings to mind once more the eleven days I spent in Hudson River Psychiatric Hospital so many years ago, checking myself in--or being checked in by a friend--in order to find out what it was like to be a mental patient. I was doing research for a book, eventually called Reality Police, on the mental health system and no one at the hospital knew about my deception. They thought I was a real patient. I wasn't. I was taking notes. My friend told the admitting doctor that he had picked me up on the road, let me stay in one of his cabins, and I had smashed a radio with an ax. I had been hearing my separated wife's voice on the radio when it wasn't turned on accusing me of things, and he had brought me in. I just sat there while he told this story and stared at the floor. They gave me a shot of thorazine and put me on a ward where I slept on a bed with sheets, and under them rubber sheets. Everybody else on that ward was a real patient.
Eleven days. Orderlies checking your mouth after they administered the drugs to make sure you had swallowed them. Once in a while, group therapy, if you were lucky. Bad food--that goes without saying. Other patients who were in some cases weird, like the guy who walked around, never said a word, and picked things up off the floor to put in his mouth (his own turds on one occasion), another guy who, at every meal, obsessively took nine or ten slices of bread, a third who had a cassette recorder, plugged a different tape into it every thirty seconds or so, never listened to a song all the way through. Frantic energy on his part. Add that to the noise from the ward TV set, which went 24 hours a day.
And there were patients who weren't weird at all, just quiet. You talked to them, listened to their problems, and you saw that they weren't so much crazy, as far as you could make out, but just couldn't manage daily life, literally didn't know how to live. There was a pathetic air about them that was sort of touching. You felt for them. These are the ones who wound up in programs designed to teach them how to manage in the world. The one I remember is the box-making program. Cardboard boxes. Several of them were in this program, and they all knew how demeaning it was. How limited their lives were always going to be. How impossible it would be ever to be proud of themselves. It made them permanently anxious.
The piece in the Times is by Christine Montross, a psychiatrist, and she writes about the necessity of re-opening the old giant mental hospitals, which is what Hudson River Psychiatric was, because the closing of them in the last quarter of the twentieth century merely substituted one institution for another--hospitals for jails and prisons. At the time I was writing, drugs like Thorazine were suppressing schizophrenic symptoms and making it possible for patients, once they were stabilized, to re-enter the community. The drugs had inspired the movement for community mental health centers to serve as transition facilities. But the money never really became available. The mental hospitals had always been a huge budgetary load on the states, intensified by the powerful unions that represented the people who worked in them. Once relieved of that burden, they breathed a sigh of relief and forgot the mental patients. As for the drugs, they had awful side effects, and lots of patients stopped taking them once they were free of supervision.
And that's how things stand today. Historically, nobody has ever known what to do with, or about, the severely mentally ill, and that's still true. They are not, as the public supposes, violent, although a few are. Mostly they're just badly damaged, for reasons that remain hidden in brain chemistry, or in deep childhood, or whenever the bad luck intent on doing you in takes root in your soul. Back to the state hospitals? The Supreme Court ruled years ago that you can't confine, against their will, people who have committed no crime unless they're a danger to themselves and others. The bulk of mental patients aren't a danger to anyone. We can't go back. And because psychiatry doesn't actually have answers, to put people in its charge is not necessarily a good thing. On that subject, you can read my book, if you can find it.
Ah yes, my book. It never sold out its first printing. I was sued for libel. Defending myself cost me nearly $50,000. The case was ultimately thrown out, but that took nearly eight years. When it was remaindered for forty-nine cents apiece I literally could not afford to buy more than one copy. So much for muckraking. I did wind up on some television shows, but that changed nothing. According to a FB friend who has read my book and had some experience with the mental health system, nothing has changed. With much that is wrong with the world, nothing changes. For so many people, it's a bitter place.
For my readers, by the way, I have decided to allow comments. For the first time. I can't promise that I'll post them all. Through my wife's blog I've seen how often comments are nasty and/or uninformed. Be interesting to see what, if anything, happens.