Review: ‘The Crusade for Forgotten Souls,’ by Susan Bartlett Foote
A number of respected bioethicists and psychiatrists have lamented that America's massive effort to deinstitutionalize mental hospitals went too far, too fast, and they have issued frank calls for bringing back the asylums that were mostly shuttered by the 1960s. President
But those pining for a return to an era when more than half a million Americans were confined to segregated mental hospitals -- often for life -- should at first confront the institutions' tragic history, and the monumental effort it took to dismantle a discriminatory system that was responsible for decades of abuses.
If these modern-day reformers wish to understand the perils of isolating people in controlled environments, they should begin by reading an extraordinary new book on the history of mental health care reform in
Setting her story against the backdrop of the enormous stigma attached to mental illness in the early 20th century, Foote describes the arrogance of an entrenched elite of psychiatrists and state administrators who resisted the input of outsiders and stuck with barbaric methods, including prefrontal lobotomies, long after they were discredited. Foote also weaves a dense and rich narrative about how a small group of selfless citizens defied these elites and built a statewide social movement.
Many of the official historical accounts of the postwar reforms to
Foote breaks new ground by unearthing the grass-roots origins of the postwar reforms to
Schey's name does not appear in the many press accounts and official records of the time. Yet it was Schey who became indignant at the inhumane conditions in the hospitals, and persuaded a group of reform-minded Unitarians to make it a central focus of their efforts to improve the human condition.
Fortunately, Schey kept detailed personal journals during her time working at the
The prevalence of experimental treatments was astounding. In the early 1940s, nearly 800 of the more than 1,500 patients at the state mental hospital in
Schey's relentless effort to call attention to these abuses would pave the way to more humane care and one of the great policy achievements of the past century -- a commitment to treat people in their homes and communities, rather than institutions.
Even so, as Foote points out in her epilogue, much of Schey's work remains unfinished: The state and the nation have yet to create a comprehensive system of care that responds to a person's evolving needs at each stage of life.
The Crusade for Forgotten Souls
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