By Jason Miller
Like wolves among sheep, America's Plutocracy preys on the weaker and less fortunate members of society. Since America's founding, they have leveraged their economic power to dominate the government and the media, the vehicles through which they advance their avaricious agenda. In early American history, they employed an imperialistic foreign policy to ensure the expansion of US boundaries and interests. Along the way, they virtually annihilated the Native American population. Once they had attained as much of the North American continent as they were able, they used “Manifest Destiny” and the “Communist threat” as rationalizations to invade other nations (i.e.The Philippines)and to support ruthless dictators in other nations (Augusto Pinochet in Chile) who have tortured and killed millions. Recently, legislation favoring corporations over workers and consumers has sharply diminished the power of labor unions and opportunities for small entrepreneurs, while historically, corporations have maimed and killed their employees and their customers with hazardous working conditions and unsafe products. The wealthy elite class has dominated American politics via dynasties like the Bush clan and the Kennedy family. The predominance of regressive over progressive taxes has virtually guaranteed that the majority of America's riches remains in the hands of the Plutocrats. Throughout American history, the Plutocracy has severely victimized black Americans, through enslavement and through ongoing gross social injustices. Latin American immigrants face open discrimination for their language and cultural differences while armed vigilantes calling themselves "Minute Men" now patrol the US-Mexican border. Other racial minorities, some religious groups, Gays and the disabled also face discrimination and suppression of rights at the hands of the "straight", "Christian" Plutocracy dominating the government and media in the United States.
Suffering in silence
Overshadowed and often forgotten is the plight of yet another minority group which has suffered tremendously at the hands of the ruling elite. The “Land of the Free” has not been particularly kind to the mentally ill. People with mental disorders have faced many forms of abuse and discrimination before and since our founders penned the Declaration of Independence and the Constitution.
Most early colonists in America viewed the mentally ill as demon-possessed. Mental illness was considered to be a weakness of the spirit. Some thought the mentally ill were "magically" influenced by the moon, hence the term "lunacy". Acting on the primal emotions that drive most bigotry, early Americans banished "lunatics" from the community for life by confining them under deplorable conditions. Viewing people with mental illnesses as sub-human animals, their "keepers" had few reservations about abusing them physically and mentally, “straight-jacketing” them, and keeping them shackled almost all of their lives. Early treatments to "cure" the mentally ill involved such enlightened methods as dunking them in ice until they slipped from consciousness, inducing vomiting and "bleeding" patients. Draining the "bad blood" from the patient often killed the patient or left them incapacitated for life.
In the early 19th Century, Europe introduced more humane ways of dealing with those with mental illness. Patients in asylums (early mental hospitals) were viewed and treated as human beings. Facilities offering comfortable beds, artwork, landscaping, recreational activities and opportunities to work replaced the brutal conditions of the asylums’ predecessors. Unfortunately, this ray of sun for those with mental illness was short-lived in the United States. After the Civil War, America's state institutions were flooded with veterans suffering from what we know today as post traumatic stress disorder. Crushing over-population led to the return of ice baths and shackles, and the experimental use of opium as a drug treatment.
For a brief period in the late 19th Century, there was a vastly increased number of asylums and markedly improved care in the US. Unfortunately, asylums and institutions accepted virtually anyone, and many people abused the ease of entry as a means to get free food and shelter. This caused the asylum populations to sky-rocket beyond capacity. This renewed crisis of over-crowding was also exacerbated by people and communities institutionalizing their "unwanted". Once again, barbarism returned as shock baths and electro-convulsive therapy became the treatments of choice.
Horror masquerading as healing
In 1935, Antonio Moniz spawned one of the most savage, inhumane "medical procedures" in human history. He performed a type of psychosurgery which involved removing a portion of the frontal lobe of a patient's brain in an attempt to rid them of unwanted anxieties, neuroses, or psychoses. This notorious procedure, known as the lobotomy, usually resulted in impairment of the patient’s sex drive, spontaneity, impulse control, and problem-solving capacity, leaving them a mere shadow of their former selves. Despite the high risks and extremely disturbing after-effects associated with the treatment, the US medical profession raced to embrace the lobotomy as a technique to treat patients with serious illnesses.
Dr. Walter Freeman invented and popularized the Tran orbital lobotomy, which involved placing an ice pick just above the patient's tear duct, driving it into the frontal lobe with a rubber mallet, and wiggling it around to decimate the frontal lobe of the brain. Hailed as inexpensive, simple and non-invasive, US care-givers performed over 40,000 lobotomies between 1936 and 1950. Freeman traversed the country (in his van which he called his "lobotomobile") shamelessly touting his procedure. His advocacy for the "ice pick lobotomy" as a "cure all" even led to its use to manage misbehavior in children. Rosemary Kennedy represents a classic high profile case of the abuse of this twisted form of treatment. Her father, Joe Kennedy, patriarch of the Kennedy clan, authorized a lobotomy for his 23 year old daughter in 1941 to "cure" her mild mental problems. The ice pick lobotomy left her profoundly retarded. For the innovation of this human butchery, Moniz won a Nobel Prize in 1949. Family members of lobotomy victims have lobbied the Nobel Foundation to revoke his award, but their pleas have fallen on deaf ears.
Not without hope
Fortunately for the seriously mentally ill, in 1952 the medical community introduced a drug called Thorazine, which alleviated serious symptoms such as delusions and hallucinations. While it was later discovered that Thorazine had significant side effects, it did enable seriously debilitated patients to gain a reasonable capacity to function on their own, and more importantly, opened the door to the field of psychopharmacology. Thorazine was the first of many psychotropic medicines which have greatly enhanced the lives of the mentally ill. New hope had dawned for those with mental illness to gain dignity, rights, and involvement in the community. Perhaps equally as significant was the fact that lobotomies were reduced to an ugly stain on the pages of human history.
Equally as fortunate for the mentally ill is that advocacy for their cause does exist. Clifford Beers, a Yale graduate from Connecticut, was institutionalized in 1900. In 1908, he wrote his autobiography called A Mind That Found Itself in which he exposed the abusive and incompetent nature of health care for the mentally ill. His work spawned a movement on behalf of the mentally ill to improve attitudes about mental illness and its victims, to improve care for the mentally ill, and to promote mental hygiene and health. By the mid Twentieth Century, a national organization known as the National Mental Health Association had grown into a powerful force for educating the public and advocating Congress on behalf of the mentally ill. In 1953, they created a symbol of hope and affirmation for those suffering from mental illness by casting a bell from metal restraints that had been used in psychiatric institutions across the country.
The bell’s inscription reads:
"Cast from shackles which bound them, this bell shall ring out hope for the mentally ill and victory over mental illness."
With a strong advocacy group, psychotropic medications to alleviate severe symptoms, the end of the lobotomy, and the end of the use of other barbaric tactics like shackling, the mentally ill had overcome many obstacles to their dignity and equality. However, new ones were quick to emerge.
Darkness abates, but deep shadows remain
Exercising misguided intentions, President Kennedy signed the Community Mental Health Centers Act in 1963. His stated purpose was to integrate institutionalized individuals back into the population. From that day until 1980 when the law expired, the population in the nation's mental health institutions dropped by 70%. With inadequate numbers of community mental health centers, psychiatrists, and therapists to help the newly released mentally ill individuals integrate into the community, many of them wound up living on the street or in prisons.
"Increasingly, individuals with mental illnesses are left to fend for themselves on the streets, where they victimize others or, more frequently, are victimized themselves. Eventually, many wind up in prison, where the likelihood of treatment is nearly as remote."
---Sen. Daniel Patrick Moynihan in the Congressional Record, July 12, 1999
In 2003, Human Rights Watch issued a study that showed that jails and prisons house three times as many mentally ill people as do psychiatric institutions. People with mental illnesses are 64% more likely to get arrested than those who are mentally healthy. The Los Angeles County jail system and Rikers Island act as the two largest inpatient institutions for the psychiatric patients in America, housing 3,400 and 3,000 respectively. The Justice Department itself has acknowledged that 16% of American jail and prison inmates (283,000) suffer from a serious mental illness. Sadly, the mentally ill residing in the penal system are often brutally abused by other inmates while their severe psychological maladies go virtually unattended. Perhaps Kennedy's move to de-institutionalize was not so altruistic after all. Now that prisons house more mentally ill than psychiatric institutions, the Plutocratic American government stands to profit from institutionalizing them. The prison industrial complex provides ridiculously cheap labor to major corporations, work for architectural firms and contractors to build new prisons, profits for suppliers of inmate necessities, and enables the existence of large corporations (i.e. CCA and Wackenhut) which governments contract for prison administration. Prevention and treatment of mental illness cost money, but it is imperative that a strong, enlightened and compassionate society absorb that cost rather than punishing those with an affliction and profiting from their suffering.
Of the 3.5 million homeless in America, an estimated 25% are mentally ill. Some need to be institutionalized. Others simply need community mental health centers to provide them with the necessary tools for coping. Some estimates show that 93% of the 875,000 mentally ill homeless could live independently and respectably if they had the proper government assistance. Instead, many are living under bridges and eating from garbage dumpsters in the world’s wealthiest nation. A government that spends $500 billion each year building armies and weapons (half of the military expenditures of the entire planet), and chooses not to increase funding which would provide a roof, food, and some human dignity to almost a million of its people reflects how morally bankrupt America's Plutocrats truly are.
Ignorance, fear, and bigotry fuel a struggle for equality
Discrimination is another bleak reality which the mentally ill face living in this "beacon of liberty" to the rest of the world. Insurance companies are the first in line to serve inequitable treatment to those with mental illness. Many insurance plans place restrictions on mental health benefits that do not exist with respect to physical maladies. For example, private insurers generally allot a limited number of days per year for inpatient mental health services while allowing virtually unlimited inpatient days for general health problems. Because mental illness often interferes with a person's capacity to work, many of the mentally ill are uninsured. Medicaid, the government stop gap for the uninsured, will not pay for stays in state psychiatric hospitals, motivating states to deny patients the institutional care they need. Since Medicaid was originated in 1965, the population of inpatients in state psychiatric hospitals diminished from 500,000 to 60,000 in 1999. If you remain unconvinced that insurance companies discriminate against people with mental conditions, consider the fact that under our current system, 66% of people with a diagnosable mental disorder do not get treatment, while only 5% of those with a serious disorder receive adequate treatment. Ultimately, a society is only as strong as its weakest members, and it is obvious that America is doing very little to strengthen the mentally ill.
Despite the fact that 25% of American families are affected by mental illness, and in a given year estimates show that about 20% of Americans over 18 are diagnosed with a mental illness, shameful social stigmas still dog the mentally ill. The Americans with Disabilities Act, which became law in the early 1990's, has done little to improve the quality of life for the mentally ill, who qualify for protection under this federal law. Employers are often unwilling to hire or train the mentally ill due to stereotypes that they are incapable or dangerous. Ignoring federal mandates to tend to the employment needs of the mentally ill, state agencies have all but ignored them. Surveys indicate that the general public considers the mentally ill to be the least desirable segment of the disabled community, rating them below people with mental retardation and substance abuse problems. While statistics indicate that very few suffering from mental illness are violent, the media perpetuates the myth in the public mind that the mentally ill are dangerous by placing glaring spot-lights on those few who are (i.e. John Hinckley, Jr.)It would seem that American attitudes toward the mentally ill have not evolved all that much over the years. Much like the prejudice that exists against blacks and other minorities, bias against those with mental disorders become more covert because it is no longer "politically correct". Since bigotry and cowardice often go hand in hand, most of the grossly intolerant have gone undercover. While the bigotry may be hidden, it remains a powerful obstacle to individuals with mental illness.
The mentally ill also find their status as human beings diminished at the voting booth throughout much of America. While each of the 44 states prohibiting the mentally ill from voting has a different law, most of the prohibitions apply to individuals found to be "mentally incompetent" and placed under legal guardianship by the court. Collectively, these oppressive laws affect 1.2 million people. Many state constitutions use such denigrating terms as "idiots" and "insane" to describe those with mental illness. In two states, Massachusetts and Minnesota, all it takes to lose one's right to vote is to be placed under legal guardianship. With assistance in understanding the issues and balloting process, many of the "mentally incompetent" could vote. However, in 88% of the states of our nation, all men are not created equal. If we are to truly strive to embody the ideals of the two hallowed documents which forged our nation, we need to allow and empower the mentally ill to participate in the voting process.
Still more hindrances to mental wellness
Several factors coalesce to deter or discourage the mentally ill from seeking proper treatment. I have already discussed the barriers erected by social stigma and inadequate insurance coverage. Yet another barrier is false propaganda perpetrated against therapists, counselors, and psychiatrists. A myriad of groups, led prominently by the "Church" of Scientology, decry the mainstream treatment of mental illness as oppressive, a form of "quackery", abusive, and deceptive. Their complaints include that the diagnoses that mental health professionals use are fraudulent labels on existential life crises or alternate means of interpreting the world and that psychotropic medications prescribed by psychiatrists are "toxic" and have long-term detrimental effects on a patient's well-being. While historically the mental health profession had provided woefully inadequate and abusive treatment to the mentally ill (i.e. lobotomies), over the last 30 years, they have evolved into a humane, effective resource for the mentally ill to alleviate their suffering and to manage their conditions. Certainly there are unethical individuals working in the profession (as with any human endeavor), there are psychotropic drugs developed which have dangerous side effects, and the pharmaceutical industry is rife with corrupt ties with the Plutocracy governing the United States, but the negative aspects of the mental health industry do not negate the fact that many caregivers and medications provide the tools and relief that the mentally ill need to find the dignity, peace and capacity to move toward self actualization which they deserve. The mental health profession is not the only legitimate means of management and recovery available to the mentally ill. There is certainly room for them to incorporate self help activities and twelve step work into their spiritual/intellectual regimen for management and recovery along with the tools and medication they receive from mental health professionals. Unfortunately the false propaganda disseminated by entities like Scientology, a cult based on the "teachings" of a science fiction writer, deters some of the mentally ill from seeking help from a professional community made up of individuals who have spent years studying human behavior, the human mind, mental illness, therapeutic tools for coping with mental illness, and psychotropic medications to help alleviate the symptoms of mental maladies.
Means to minimize suffering are at hand
Increases in federal funding to allow for larger monthly stipends of SSI (the form of social security in place to assist the disabled) and food stamps (or Vision cards), expanded Medicaid benefits to include inpatient psychiatric treatment at state facilities, federal assistance to provide a more comprehensive community mental health system, less incarceration and more treatment for the mentally ill, stronger efforts to overcome the efforts of groups like Scientology by reaching out to the mentally ill to get them to engage with professional mental health care providers, and stronger enforcement of the ADA (Americans with Disabilities Act) are necessary steps to integrate the mentally ill into our society as productive citizens rather than banishing them to the street or locking them into prisons. As a members of the human race, are our leaders too blind to see that diverting a fraction of the obscene amount spent on the military industrial complex to alleviate the suffering of the mentally ill in our nation is a moral imperative? It is unlikely that the moral issues concern them, but pragmatically, ignoring a problem which affects the 53 million Americans who suffer from mental illness (in some form) is bound to lead to a bitter harvest for the entire nation, including the Plutocrats, since they depend on their underlings to prop them up by laboring, paying taxes to feed the military industrial complex, and fighting their imperialistic wars
Guns get reloaded while butter gets the axe
Sadly, the reality is that under Bush's proposed budget for 2006, the mentally ill will suffer. As they have in many areas, the Plutocrats continue to turn back the clock on the social reforms of the Twentieth Century. Despite its inadequacies in some areas, Medicaid is still the largest source of public funding for the mentally health services. Bush has proposed $60 billion in Medicaid cuts over 10 years, which would dramatically reduce access to sorely needed services for the mentally ill. The axe is set to diminish the budget for the Center for Mental Health Services, which sponsors PATH (a program providing services to prevent homelessness amongst the mentally ill) and federal services aiding the mentally ill in asserting their rights. Programs mandated by the IDEA (Individuals with Disabilities Education Act, a federal law requiring states to implement special education services) will be significantly short-funded.
Chop, chop, chop…where will the axe fall next?
In spite of the Plutocratic call to patriotism, funding to the Veterans Administration will virtually assure a decline in mental health services provided to veterans. Assistance to the mentally ill in training for, finding and maintaining employment will diminish. Funding for housing for the disabled will be cut in half. While a majority of discrimination complaints filed with HUD and other fair housing enforcement agencies are filed by the disabled, the Plutocrats are ready to cut the funding for fair housing enforcement by 20%. A new federal law (The Mentally Ill Offender Treatment and Crime Reduction Act) to provide money to states to emphasize treatment over incarceration will receive no money under Bush's proposed budget. (Think IDEA, No Child Left Behind, rapacious Plutocrats, and appeasement of the masses….then look for a pattern) The Byrne Discretionary Grants, which provide money to states for crisis intervention and mental health courts, will become history. Juvenile justice programs, which can provide early intervention to prevent the mentally ill from becoming future victims of the prison industrial complex, will be cut by 46%. While the mentally ill find themselves staring at an austere federal assistance package, the plutocrats are increasing military spending and devoting 30.7% of government spending to the military (this figure includes military expenditures embedded in the budgets of the Departments of Justice and Energy and of NASA). Is this what “compassionate conservatism” looks like?
A nation in desperate need of soul-searching
As Matthew Rothschild (the editor of the Progressive) so aptly pointed out, it is important for vehement critics of America's Plutocracy to acknowledge that the United States is not responsible for all evil acts of humanity. I agree with him. I recognize that many other nations and societies throughout history have committed atrocities and contributed to the darker chapters of humanity. There are other nations and rulers in the world today perpetrating crimes against humanity. However, as an American with a conscience and a powerful desire for the proliferation of human rights and social justice, I will continue to invest a great deal of energy into helping to expose the evils perpetrated by our government, as most of them have been white-washed from mainstream books and media. The bloated, corrupt government of the United States of America spends $500 billion per year on its "glorious" military industrial complex to ensure that it our Plutocratic rulers maintain their possession of much of the world's wealth and domination over the world. When they do provide military or financial aid to other nations, it is with the covert (and sometimes overt) purpose of furthering the interests of the Plutocrats, and often results in suffering and death for many (i.e. “collateral damage” caused by the US military operations). Hypocrisy reigns as the world’s largest terrorist state perpetrates imperialistic wars like the one in Iraq under the banner of "moral superiority". That same "moral superiority enslaved a race of people and nearly decimated the indigenous population of North America. The sad part is that America could be the moral leader of the world. As a people, Americans need to find a way to meet our fellow citizens of the Earth as equals and to channel our vast resources toward bettering humanity and the planet on which we live. A great place to start would be to ensure the rights, dignity, and well-being of our own people, including the oft-forgotten mentally ill.
Jason Miller welcomes responses at firstname.lastname@example.org.