[Marxism] Dick Osborne on schizophrenia and de-institutionalization
lnp3 at panix.com
Tue Jul 5 07:38:25 MDT 2011
This was a comment on my Jared Loughner/Henry Cockburn post. Dick
Osborne is a psychotherapist in the Albany area who was a comrade
in the Boston SWP in the early 70s.
Interesting piece. It raises a number of important issues about
the intersection of our mental health and criminal justice
systems. The irrationality of medicating someone who is psychotic
and deluded so that they become sane enough to successfully
prosecute and punish strikes me as the ultimate game of legal
“gotcha!” In any case, the determination of legal “competence” is
an extremely low bar to clear and, contrary to public perceptions,
is not at all the same as establishing sanity or the absence of
paranoid delusions. Unfortunately, the hostility to the insanity
defense is now a deeply entrenched attitude.
It is part of a larger shift over the past 30 years towards an
ever more punitive approach to crime pushed by cynical politicians
who have come to understand that there is much to gain and very
little political downside to playing the tough on crime,
lock-the-bastards-up-and-throw-away-the-key card. Cable TV aids
and abets this with its ubiquitous crime porn – reality cop shows
with harsh take downs of various bogey men and low lifes; true
crime shows with their endless documentaries of serial killers;
reality prison shows in which viewers can guess the next victim of
prison rape. And flowing underneath this, aimed at the dim
irrational regions of the limbic system, a steadily flowing
undercurrent of racism as viewers witness what they often perceive
as the revolving door between the inner city (where they’re all
welfare cheats, of course) and America’s now vast gulag of
The idea that someone can actually lose their minds and kill
someone is deeply disturbing to many. They prefer to embrace the
common attitude that the insanity defense is a scam used by sleazy
liberal lawyers trying to do an end run around the notion of
personal responsibility as the bedrock of our justice system.
Cockburn’s writing on deinstitutionalization and the failed
promise of “community mental health” is interesting. Apparently,
the UK and and US ran on parallel tracks in this regard. Having
worked in state mental hospital at the beginning of my career I
can attest to their Spartan and even grim conditions. But sleeping
on heating grates and being victimized by street criminals has
never struck me as preferable — nor as “freedom”.
The story of why the move towards deinstitutionalization came to
be so persuasive and unstoppable is interesting in itself and has
not, to my knowledge, been adequately explicated. Money
undoubtedly played its role. But deeper ideological forces were
also at work. The state mental hospitals came to be perceived as
analogous somehow to the concentration camps of the Soviet gulag.
The history of Left Psychiatry – especially RD Laing and Thomas
Szasz (and later Foucault) – played an auxiliary role in promoting
deinstitutionalization with its suggestion that Psychiatric
illness was “socially constructed” as a form of social control.
Anyone who has actually worked in a Psychiatric hospital and had
to deal with someone in the grip of a psychotic episode knows how
silly some of these ideas actually were. It provides an
instructive case study in the limits of constructivism.
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