A reminder that history repeats itself if let it

eBook Link (free to download and read)

This eBook titled “A Plea for the Insane in the Prisons and Poor-houses of Pennsylvania” By Pennsylvania. State Board of Public Welfare, was published in 1873 and has documents  about the arguments being made at that time to move people with mental illnesses out of prisons and poor houses and into state hospitals.  I haven’t finished reading it yet, but what I have read could easily be seen in today’s media as we debate over how people with mental illnesses should be treated.  At the time this book was written, state hospitals were the solution that society had come up with, but over time society decided that state hospitals were not the answer, but community based treatment was the answer.  So community based became the target treatment option, but society opted not to properly fund it or expand it so that the community based services could meet the demand.  So now society is sitting back scratching their heads completely baffled that people with mental illnesses would be ending up warehoused in jails and prisons.  There is now a trend that seems to show to me that the pendulum is swinging back in the direction of state hospitals as the answer to the problem.   I have to ask why we as a society are repeatedly making the same decisions and consistently expecting a different outcome?  I feel that state hospitals and prisons are opposite extremes when it comes to solutions, and that while both serve a purpose, neither is an adequate solution.  The bills I’m seeing proposed seem to focus on the needs and desires of the families of the mentally ill and neglect to acknowledge that the person with the illness is the one who is getting bounced around by society’s whims.  Yes, families are affected, but I also know that forced treatment is a short-term solution to a crisis …. it is NOT a long-term solution.  Assisted Outpatient Treatment is a politically correct way of candy coating forced or coerced treatment.  I strongly suggest that people look over the history of the decisions made by society before jumping on board with any of the bills being proposed.  History can teach us valuable lessons if we listen.

This book is also available in printed paperback  from Amazon by clicking this link “A Plea for the Insane in the Prisons and Poor-Houses”  (costs about $16 for the printed version at

Location map of Pennsylvania, USA

Location map of Pennsylvania, USA (Photo credit: Wikipedia)

the time of this post)

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5 Responses

  1. Hi, I read this comment with great interest and agree whole heartedly that at a minimum people are not thinking deeply enough about solutions, nor including the patient/prisoner/mental illness sufferer in the decision-making. You might be interested in my 2.75 minute video on Youtube ( https://www.youtube.com/watch?v=YduDk8BbRF4 ) where I testify before the CT legislature against AOT because of my many past experiences with forced in-patient treatment. Not only have doctors and researchers proven that the most psychotropic (anti-psychotic and anti-depressant) drugs are of questionable value from their inception (read J Moncrieff or R Whitaker’s books) but I feel certain, from my own experiences, that the very brutality with which they have treated all prisoners, not to mention mentally ill prisoners in prisons or hospitals, has produced a huge part of the problem they now face. Violence leads to violence, every time. But they never want learn the lessons the Quakers taught, that gentle humanity and humane treatment actually produces cures better than forcing anything. Why, because they really believe the lie that “time is money” and that taking time to cure someone costs more than a lifetime of forced medication and policed enforcement of it. It doesn’t but they are in cahoots with Big Pharma and stand to get some of those big dollars…

    • Thank you for your comment Pamela, I completely understand the situation you described in your testimony, it is a story that can be told and retold a million times across the country. I have been trying to figure out how to convey what you have said, and I honestly don’t know that I could have done better. My personal opinion is that forced treatment is done because it is cheap and at the same time convenient for society. I have always felt that society would like nothing less then for me to stay out of sight and remain silent so they don’t have to be reminded that I am a person with an illness who deserves to be treated with dignity and respect. I recall over the years being told after asking “why do I need medication” the response so often was “just like a diabetic needs to take insulin for the rest of their life you will need to take medication for the rest of your life”. I have actually asked how many people with diabetes got tackled, stripped of their clothing and physically restrained by people or leather restraints for refusing their insulin though. If I need my medication like a person with diabetes needs their insulin, then doesn’t it seem like the person with diabetes would also need to be tackled, stripped of their clothing and physically restrained if they refuse their medication? Or is it just one of many ways that society has come up with to maintain power and control over the mentally ill by comparing our needs to the needs of someone with a completely different illness. Someone with cancer can say “I’ve had enough of my treatment, let me go home to my family” but someone with a mental illness says the same thing, and we are given “choices” like “either sign yourself in or we will wake up a judge and have him sign you in” or in regards to medication, I think Nurse Ratchet sums it up best when MacMurphy is questioning his medication and his need to take it, Nurse Ratchet responds with “If Mr. MacMurphy doesn’t want to take his medication orally, I’m sure we can come up with another way for him to take it” this is not just a made for Hollywood scenerio, this type of forced treatment occurs in the real world and has been happening for a long time. Rep. Tim Murphy has proposed a controversial mental health reform bill and in it it talks about increased use of “Assisted Outpatient Treatment (AOT)”. AOT is basically a candy coated politically correct way of using forced or coersed treatment. I have been on the receiving end of forced treatment, and there is nothing therapeutic bout being locked away on a locked ward against your will and being told to comply or we’ll make you comply. People who receive forced treatment from my experience tend to resent being there, they are less likly to want to comply with what is asked of them and in general will not benefit as much as someone who is in the same place that wanted to be there. I suggest that either cancer patients start receiving forced treatment or we as a society rethink our approach to how we treat people with mental illnesses. tackling someone doesn’t comfort or calm them it pisses them off and makes them feel violated, and I’m pretty sure that a cancer patient wouldn’t be treated the same way and neither would a person with diabetes so why are the mentally ill treated this way?

      • Wow, I didn’t really understand that I was NOT actually alone in my experiences…Oddly enough, I have felt completely isolated, as if I had been singled out by these hospitals for brutality of the extreme sort that I have undergone in recent years, to the point that I was nearly killed a couple of times by security guards who jumped on my neck in restraining me and the nurse refused to listen to me when I croaked,”I can’t breathe…”

        Yes, I “knew” that it had to have been done to others, because the logical side of me said, they have done this dozens of times before, I am not that special..but the hurt and harmed and traumatized side of me thought, really believed, that I was so evil and bad that ONLY I had deserved such grotesquely inhumane treatment, or had at least been singled out as louder and most obstreperous than the other patients..After all, I never saw other patients being stripped and restrained, or beaten or strangled…Yet as I think of it now, of course not! They never saw it happen to me, either. That is the point. It is always done away from everyone else in secret and in soundproof rooms so as I wrote on a youtube site, not even the doctor who orders it is aware that security guards are forcibly stripping me of all my clothing and leaving me naked in a freezing cold supermax-cell-like seclusion room. Oh, god, how stupid I am. I knew this, yet I didn’t really understand that of course it happens to people all the time (It must, at least in CT.)

        But I thought PA had given up the use of Seclusion and Restraints, I thought PA was a leader in the field of mental health and compassionate treatment. I guess i was completely mistaken. From what you have written here at any rate. Am I wrong? From what I had read, it seemed to me that PA state hospitals at any rate were the first to go restraint-free. Ah, but here too, Connecticut Valley State hospital uses seclusion and restraint far less than the city hospitals and the once posh private (no longer) retreat known as Hartford Hospital’s Institute of Living, which is one of the worst offenders and was brutal to me just last winter.

        Anyhow, if you want to know more about my experiences in the recent years feel free to check out my blog. It is painful but you need only do a search for “restraints and seclusion” or the reverse, and you will get an “earful” or a search of any of my “open letter” formats will likely do the same.

        Thank you so much for your blog and for your response to my comment. I hope you have the time to stay in touch, I literally have NEVER had the opportunity to speak/write/communicate to another patient or even former patient who has these experiences…(Even when in a hospital I do not socialize at all, and sometimes am prevented from making contact even with staff.)

        TYFTBOMH

        Pam Wagner

        • State hospitals in PA have all but eliminated the use of restraints and seclusion, but last I knew, the smaller non-state hospitals still use them. As far as our role as leader, I feel that our current governor has made so many cuts to funding and such related to mental health services that we are floundering right now. Not saying that good stuff isn’t happening, it’s just getting more and more difficult for progress to continue when there are more mandates and less funding.

          • Im sorry to hear this. The situation is much the same in CT, at least vis a vis state hospitals which were under greater scrutiny to shape up and so they tried harder. But the smaller, or not so smaller general hospitals get away with murder literally because the Joint Commission doesnt even track r and s use in psych units as a separate thing…they dont give a damn about “mental patients”, no one does, esp adult patients.

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