Political abuse of psychiatry, also commonly referred to as punitive psychiatry, is the misuse of psychiatry, including diagnosis, detention, and treatment, for the purposes of obstructing the human rights of individuals and/or groups in a society.
In other words, abuse of psychiatry (including that for political
purposes) is the deliberate action of having citizens psychiatrically
diagnosed who need neither psychiatric restraint nor psychiatric
treatment.
Psychiatrists have been involved in human rights abuses in states
across the world when the definitions of mental disease were expanded to
include political disobedience.
As scholars have long argued, governmental and medical institutions
code menaces to authority as mental diseases during political
disturbances. Nowadays, in many countries, political prisoners are sometimes confined and abused in psychiatric hospitals.
Psychiatry possesses a built-in capacity for abuse that is greater than in other areas of medicine. The diagnosis of mental disease allows the state to hold persons against their will and insist upon therapy in their interest and in the broader interests of society. Psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. The use of hospitals instead of jails also prevents the victims from receiving legal aid before the courts in some countries, makes indefinite incarceration possible, and discredits the individuals and their ideas. In that manner, whenever open trials are undesirable, they are avoided.
The political abuse of the power entrusted to physicians, and particularly psychiatrists, has a long and abundant history, for example during the Nazi era and the Soviet rule when religious and political dissenters were labeled as "mentally ill" and subjected to inhumane "treatments". In the period from the 1960s up to 1986, abuse of psychiatry for political and ideological purposes was reported to be systematic in the Soviet Union, and occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. The practice of incarceration of religious and political dissidents in psychiatric hospitals in the Eastern Bloc and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Political abuse of psychiatry also takes place in the People's Republic of China. Psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the USSR were used for political purposes.
Psychiatry possesses a built-in capacity for abuse that is greater than in other areas of medicine. The diagnosis of mental disease allows the state to hold persons against their will and insist upon therapy in their interest and in the broader interests of society. Psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. The use of hospitals instead of jails also prevents the victims from receiving legal aid before the courts in some countries, makes indefinite incarceration possible, and discredits the individuals and their ideas. In that manner, whenever open trials are undesirable, they are avoided.
The political abuse of the power entrusted to physicians, and particularly psychiatrists, has a long and abundant history, for example during the Nazi era and the Soviet rule when religious and political dissenters were labeled as "mentally ill" and subjected to inhumane "treatments". In the period from the 1960s up to 1986, abuse of psychiatry for political and ideological purposes was reported to be systematic in the Soviet Union, and occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. The practice of incarceration of religious and political dissidents in psychiatric hospitals in the Eastern Bloc and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Political abuse of psychiatry also takes place in the People's Republic of China. Psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the USSR were used for political purposes.
By country
Canada
The Duplessis Orphans were several thousand orphaned children that were falsely certified as mentally ill by the government of the province of Quebec, Canada, and confined to psychiatric institutions.
Donald Ewen Cameron's operation was running from what is today known as the Allen Memorial Institute (AMI), part of the Royal Victoria Hospital, and not to be confused with the non-governmental organization based in Montreal, AMI-Québec Agir contre la maladie mentale.
China
In 2002, Human Rights Watch published the book Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era written by Robin Munro and based on the documents obtained by him.
The British researcher Robin Munro, a sinologist who was writing his
dissertation in London after a long sojourn in China, had traveled to
China several times to survey libraries in provincial towns and while he
was there, he had gathered a large amount of literature which bore the
stamp 'secret' but at the same time, it was openly available. This literature even included historical analyses which were published during the Cultural Revolution
and it concerned articles and reports on the number of people who were
taken to mental hospitals because they complained about a series of
issues.
It was found, according to Munro, that the involuntary confinement of
religious groups, political dissidents, and whistleblowers had a long
history in China. The abuses began in the 1950s and 1960s, and they became extremely widespread throughout the Cultural Revolution.
During the period of the Cultural Revolution, from 1966 to 1976, the
political abuse of psychiatry reached its apogee in China, which was
then under the rule of Mao Zedong and the Gang of Four, who established a very repressive and harsh regime. No deviance or opposition was tolerated, either in thought or in practice.
The documents described the massive abuses of psychiatry that
were committed for political purposes during the rule of Mao Zedong,
when millions of people were declared mentally sick. In the 1980s, according to official documents, fifteen percent of all forensic psychiatric cases had political connotations. In the early 1990s, the number of such cases had dropped to five percent, but with the beginning of the campaign against Falun Gong, the percentage of such cases increased quite rapidly.
Official Chinese psychiatric literature distinctly testifies that
the Communist Party's notion of 'political dangerousness' was
institutionally engrafted as the main concept in the diagnostic armory
of China's psychiatry for a long time and its most important tool for
suppressing opposition was the concept of psychiatric dangerousness.
Despite international criticism, the People's Republic of China seems to be continuing its political abuse of psychiatry.
Political abuse of psychiatry in the People's Republic of China is high
on the agenda and it has produced recurring disputes in the
international psychiatric community.
The abuses there appear to be even more widespread than they were in
the Soviet Union in the 1970s and 1980s and they involve the
incarceration of 'petitioners', human rights workers, trade union
activists, members of the Falun Gong movement, and people who complain
about injustices that have been committed against them by local
authorities.
It also seems that, China had no known high security forensic institutions until 1989.
However, since then, the Chinese authorities have constructed an entire
network of special forensic mental hospitals which are called Ankang which means 'Peace and Health' in Chinese. By that time, China had 20 Ankang institutions and their staff was employed by the Ministry of State Security. The psychiatrists who worked there wore uniforms under their white coats.
The political abuse of psychiatry in China only seems to take
place in the institutions which are under the authority of the police
and the Ministry of State Security but it does not take place in those
institutions which belong to other governmental sectors. Psychiatric care in China falls into four sectors which are hardly connected with each other.
These are the Ankang institutions of the Ministry of State Security;
those which belong to the police; those which fall under the authority
of the Ministry of Social Affairs; those which belong to the Ministry of
Health.
The sectors which belong to the police and the Ministry of State
Security are all closed to the public, and, consequently, information
about them hardly ever leaks out.
In the hospitals which belong to the Ministry of Health, psychiatrists
do not have any contact with the Ankang institutions, and they have no
idea of what occurred there, which means they can sincerely state that
they were not informed about the political abuse of psychiatry in China.
In China, the structure of forensic psychiatry was to a great extent identical to that which existed in the USSR. On its own, it is not so strange, since psychiatrists from the Moscow Serbsky Institute visited Beijing
in 1957 in order to help their Chinese 'brethren', the same
psychiatrists who promoted the system of political abuse of psychiatry
in the USSR. As a consequence, diagnostics in China were not much different than those which were made in the Soviet Union. The only difference was that the Soviets preferred 'sluggish schizophrenia' as a diagnosis, and the Chinese generally cleaved to the diagnosis of 'paranoia' or 'paranoid schizophrenia'. However, the results were the same: long hospitalizations in mental hospitals, involuntary treatments with neuroleptics, torture, abuse, all of which were aimed at breaking the victim's will.
In accordance with Chinese law which contains the concept of
"political harm to society" and the similar phrase dangerous mentally
ill behavior, police take "political maniacs into mental hospitals,
those who are defined as persons who write reactionary letters, make
anti-government speeches, or "express opinions on important domestic and
international affairs".
Psychiatrists are frequently caught involved in such cases, unable and
unwilling to challenge the police, according to psychiatry professor at
the Peking University Yu Xin.
As Liu's database suggests, today's most frequent victims of
psychiatric abuse are political dissidents, petitioners, and Falun Gong
members.
In the beginning of the 2000s, Human Rights Watch accused China of
locking up Falun Gong members and dissidents in a number of Chinese
mental hospitals managed by the Public Security Bureau. Access to the hospitals was requested by the World Psychiatric Association (WPA), but denied by China, and the controversy subsided.
The WPA attempted to confine the problem by presenting it as
Falung Gong issue and, at the same time, make the impression that the
members of the movement were likely not mentally sound, that it was a
sect which likely brainwashed its members, etc. There was even a diagnosis of 'qigong syndrome' which was used reflecting on the exercises practiced by Falung Gong. It was the unfair game aiming to avoid the political abuse of psychiatry from dominating the WPA agenda.
In August 2002, the General Assembly was to take place during the next WPA World Congress in Yokohama.
The issue of Chinese political abuse of psychiatry had been placed as
one of the final items on the agenda of the General Assembly. When the issue was broached during the General Assembly, the exact nature of compromise came to light. In order to investigate the political abuse of psychiatry, the WPA would send an investigative mission to China.
The visit was projected for the spring of 2003 in order to assure that
one could present a report during the annual meeting of the British Royal College of Psychiatrists in June/July of that year and the Annual Meeting of the American Psychiatric Association in May of the same year.
After the 2002 World Congress, the WPA Executive Committee's
half-hearted attitude in Yokohama came to light: it was an omen of a
longstanding policy of diversion and postponement.
The 2003 investigative mission never took place, and when finally a
visit to China did take place, this visit was more of scientific
exchange. In the meantime, the political abuse of psychiatry persisted unabatedly, nevertheless the WPA did not seem to care.
Cuba
Although Cuba has been politically connected to the Soviet Union
since the United States broke off relations with Cuba shortly after the
dictator Fidel Castro
came to power in 1959, few considerable allegations regarding the
political abuse of psychiatry in this country emerged before the late
1980s. Americas Watch and Amnesty International published reports alluding to cases of possible unwarranted hospitalization and ill-treatment of political prisoners. These reports concerned the Gustavo Machin hospital in Santiago de Cuba in the southeast of the country and the major mental hospital in Havana.
In 1977, a report on alleged abuse of psychiatry in Cuba presenting
cases of ill-treatment in mental hospitals going back to the 1970s came
out in the United States.
It presents grave allegations that prisoners end up in the forensic
ward of mental hospitals in Santiago de Cuba and Havana where they
undergo ill-treatment including electroconvulsive therapy without muscle relaxants or anaesthesia.
The reported application of ECT in the forensic wards seems, at least
in many of the cited cases, not to be an adequate clinical treatment for
the diagnosed state of the prisoner — in some cases the prisoners seem
not to have been diagnosed at all.
Conditions in the forensic wards have been described in repulsive terms
and apparently are in striking contrast to the other parts of the
mental hospitals that are said to be well-kept and modern.
In August 1981, the Marxist historian Ariel Hidalgo was
apprehended and accused of 'incitement against the social order,
international solidarity and the Socialist State' and sentenced to eight
years' imprisonment.
In September 1981, he was transported from State Security Headquarters
to the Carbó-Serviá (forensic) ward of Havana Psychiatric Hospital where
he stayed for several weeks.
India
It was reported in June, 2012, that the Indian Government has approached NIMHANS, a well known mental health establishment in South India, to assist in suppressing anti-nuclear protests regards to building of the Kudankulam Nuclear Power Plant. The government was in talks with NIMHANS representatives to chalk up a plan to dispatch psychiatrists to Kudankulam, for counselling protesters opposed to the building of the plant. To fulfill this, NIMHANS
developed a team of 6 members, all of them, from the Department of
Social Psychiatry. The psychiatrists were sent to get a "peek into the
protesters' minds" and help them learn the importance of the plant
according to one news source.
In July, 2013, the same institution, NIMHANS, was involved in a controversy where it was alleged that it provided assistance to the Central Bureau of Investigation relating to some interrogation techniques.
Japan
Japanese
psychiatric hospitals during the country's imperial era reported an
abnormally large number of patient deaths, peaking in 1945 after the
surrender of Japan to Allied forces.
The patients of these institutions were mistreated mainly because they
were considered a hindrance to society. Under the Imperial Japanese
government, citizens were expected to contribute in one way or another
to the war effort, and the mentally ill were unable to do so, and as
such were looked down upon and abused. The main cause of death for these
patients was starvation, as caretakers did not supply the patients with
adequate food, likely as a form of torture and a method of sedation.
Because mentally ill patients were kept secluded from the outside
world, the large number of deaths went unnoticed by the general public.
After the end of Allied occupation, the National Diet of Japan passed the Mental Hygiene Act (精神衛生法,, Seishin Eisei Hō)
in 1950, which improved the status of the mentally ill and prohibited
the domestic containment of mental patients in medical institutions.
However, the Mental Hygiene Act had unforeseen consequences. Along with
many other reforms, the law prevented the mentally ill from being
charged with any sort of crime in Japanese courts. Anyone who was found
to be mentally unstable by a qualified psychiatrist was required to be
hospitalized rather than incarcerated, regardless of the severity of any
crime that person may have committed. The Ministry of Justice tried
several times to amend the law, but was met with opposition from those
who believed the legal system should not interfere with medical science. After almost four decades, the Mental Health Act (精神保健法,, Seishin Hoken Hō)
was finally passed in 1987. The new law corrected the flaws of the
Mental Hygiene Act by allowing the Ministry of Health and Welfare to set
regulations on the treatment of mental patients in both medical and
legal settings. With the new law, the mentally ill have the right to
voluntary hospitalization, the ability to be charged with a crime, and
right to use the insanity defense in court, and the right to pursue
legal action in the event of abuse or negligence on the part of medical
professionals.
Germany
By 1936, killing of the "physically and socially unfit" became accepted practice in Nazi Germany. In the 1940s, the abuse of psychiatry involved the abuse of the "duty to care" on an enormous scale: 300,000 individuals were sterilized and 77,000 killed in Germany alone and many thousands further afield, mainly in eastern Europe.
Psychiatrists were instrumental in establishing a system of
identifying, notifying, transporting, and killing hundreds of thousands
of "racially and cognitively compromised" persons and the mentally ill
in settings that ranged from centralized mental-hospitals to jails and death camps. Psychiatrists played a central and prominent role in sterilization and euthanasia, constituting two categories of the crimes against humanity.
The taking of thousands of brains from euthanasia victims demonstrated
the way medical research was connected to the psychiatric killings. Germany operated six psychiatric extermination centers: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein. They played a crucial role in developments leading to the Holocaust.
New Zealand
On 21 October 2018 the New Zealand Member of Parliament (MP) and former member of the New Zealand National Party Jami-Lee Ross was "taken into mental health care",
apparently by police.
This action sidelined the MP - who had resigned from the Party (the largest represented in the New Zealand Parliament)
two days earlier - in his declared campaign against corruption in the
National Party. "A National Party spokesman said: 'Over the past several
weeks the National Party has taken seriously the mental health concerns
raised by Mr Ross and the medical professionals he has been involved
with. That has included seeking advice from medical professionals and
involving Police wherever necessary to ensure support is made available
to Mr Ross. [...]'"
Romania
In Romania, there have been allegations of some particular cases of psychiatric abuse during over a decade. In addition to particular cases, there is evidence that mental hospitals were utilized as short-term detainment centers. For instance, before the 1982 International University Sports 'Olympiad', over 600 dissidents were detained and kept out of public view in mental hospitals. Like in the Soviet Union,
on the eve of Communist holidays, potential "troublemakers" were sent
to mental hospitals by busloads and discharged when the holidays had
passed.
The People's Republic of Romania held to a doctrine of state atheism. Many Christians, including those from the Baptist Church and Lord's Army wing of the Orthodox Church, were forced into psychiatric hospitals where they died.
Russia
Reports on particular cases continue to come from Russia where the
worsening political climate appears to create an atmosphere in which
local authorities feel able, once again to use psychiatry as a means of
intimidation.
Soviet Union
In 1971 detailed reports about the inmates of Soviet psychiatric
hospitals who had been detained for political reasons began to reach the
West. These showed that the periodic use of incarceration in psychiatric institutions during the 1960s had started to become a systematic way of dealing with dissent, political or religious. In accordance with the doctrine of state atheism, the USSR hospitalized individuals who were devout in their faith, such as many Baptist Christians.
In March 1971 Vladimir Bukovsky sent detailed diagnoses of six individuals (Natalya Gorbanevskaya and Pyotr Grigorenko among them) to psychiatrists in the West. They responded
and over the next 13 years activists inside the USSR and support groups
in Britain, Europe and North America conducted a sustained campaign to
expose psychiatric abuses. In 1977 the World Psychiatric Association
(WPA) condemned the USSR for this practice. Six years later, the Soviet
All-Union Society of Neuropathologists and Psychiatrists seceded from
the WPA rather than face almost certain expulsion.
During this period reports of continuous repression multiplied,
but Soviet psychiatric officials refused to allow international bodies
to see the hospitals and patients in question. They denied the charges
of abuse. In February 1989, however, at the height of perestroika
and over the opposition of the psychiatric establishment, the Soviet
government permitted a delegation of psychiatrists from the United
States, representing the U.S. government, to carry out extensive
interviews of suspected victims of abuse.
The delegation was able systematically to interview and assess
present and past involuntarily admitted mental patients chosen by the
visiting team, as well as to talk over procedures and methods of
treatment with some of the patients, their friends, relatives and,
sometimes, their treating psychiatrists. The delegation originally sought interviews with 48 persons, but saw only 15 hospitalized and 12 discharged patients.
About half of the hospitalized patients were released in the two months
between the submission of the initial list of names to the Soviet
authorities and the departure from the Soviet Union of the US
delegation.
The delegation concluded that nine of the 15 hospitalized patients had
disorders which would be classified in the United States as serious
psychoses, diagnoses corresponding broadly with those used by the Soviet
psychiatrists. One of the hospitalized patients had been diagnosed as having schizophrenia although the US team saw no evidence of mental disorder.
Among the 12 discharged patients examined, the US delegation found that
nine had no evidence of any current or past mental disorder; the
remaining three had comparatively slight symptoms which would not
usually warrant involuntary commitment in Western countries. According to medical records, all these patients had diagnoses of psychopathology or schizophrenia.
Returning home after a visit of more than two weeks, the
delegation members wrote a report which was highly damaging to the
Soviet authorities.
The delegation established that there had been systematic political
abuse of psychiatry in the past and that it had not yet come to an end.
Victims continued to be held in mental hospitals, while the Soviet
authorities and the Soviet Society of Psychiatrists and
Neuropathologists in particular still denied that psychiatry had been
employed as a method of repression.
The American report and other pressures, domestic and external, led the Politburo
to pass a resolution (15 November 1989) "On improvements in Soviet law
concerning procedures for the treatment of psychiatric patients".
United States
- Drapetomania was a supposed mental illness described by American physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity. In addition to inventing drapetomania, Cartwright prescribed a remedy. His feeling was that with "proper medical advice, strictly followed, this troublesome practice that many Negroes have of running away can be almost entirely prevented." In the case of slaves "sulky and dissatisfied without cause"—a warning sign of imminent flight—Cartwright prescribed "whipping the devil out of them" as a "preventative measure". As a remedy for this disease, doctors also made running a physical impossibility by prescribing the removal of both big toes.
- In the United States, political dissenters have been involuntarily committed. For example, in 1927 a demonstrator named Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of Sacco and Vanzetti.
- When Clennon W. King, Jr., an African-American pastor and activist of the Civil Rights Movement, attempted to enroll at the all-white University of Mississippi for summer graduate courses in 1958, the Mississippi police arrested him on the grounds that "any nigger who tried to enter Ole Miss must be crazy." Keeping King's whereabouts secret for 48 hours, the Mississippi authorities kept him confined to a mental hospital for twelve days before a panel of doctors established the activist's sanity.
- In the 1964 election, Fact magazine polled American Psychiatric Association members on whether Barry Goldwater was fit to be president and published "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." This led to the banning of diagnosing public figures when you have not performed an examination or been authorized to release information by the patient. This became the Goldwater rule.
- In the 1970s, Martha Beall Mitchell, wife of U.S. Attorney General John Mitchell, was diagnosed with a paranoid mental disorder for claiming that the administration of President Richard M. Nixon was engaged in illegal activities. Many of her claims were later proved correct, and the term "Martha Mitchell effect" was coined to describe mental health misdiagnoses when accurate claims are dismissed as delusional.
- In 1972 Thomas Eagleton was forced to withdraw as a vice presidential candidate for being treated for depression.
- In 2010, the book The Protest Psychosis: How Schizophrenia Became a Black Disease by psychiatrist Jonathan Metzl (who also has a Ph.D. in American studies) was published. The book covers the history of the 1960s Ionia State Hospital located in Ionia, Michigan and now converted to a prison and focuses on exposing the trend of this hospital to diagnose African Americans with schizophrenia because of their civil rights ideas. The book suggests that in part the sudden influx of such diagnoses could be traced to a change in wording in the DSM-II, which compared to the previous edition added "hostility" and "aggression" as signs of the disorder.
- Clinical psychologist Bruce E. Levine, argues that Oppositional Defiant Disorder, which can be easily used to pathologize anti-authoritarianism, is an abuse of psychiatry.
- In 2014, Mercury News published a series of articles detailing questionable use of psychotropic drugs within California's foster care system where bad behavior is attributed to various mental conditions, and little care is provided besides drugs. Likewise, many experts questioned the long-term effects of high dosages on developing brains, and some former patients reported permanent side effects even after stopping the meds.
- According to law professor Jonathan Turley and Newsweek magazine, in June 2015, U.S. District Judge Richard M. Berman ordered conservative film maker and activist Dinesh D'Souza to continue psychological counseling for a four-year period despite numerous recommendations to the contrary by well-respected private and court appointed mental health personnel. D'Souza pleaded guilty to a single count of making illegal contributions in the name of others as part of the campaign of Wendy Long for New York Senate. This occurred during a post-confinenment hearing. D'Souza was seeking to reduce the four-year community service sentence by reference to his home confinement period. Berman balked and said that he said the two periods as distinct—a position that courts would likely take in similar cases. In referring to the psychological counseling aspect, D'Souza's counsel submitted evidence that the court-ordered psychiatrist found no indication of depression or reason for medication. His own retained psychologist also provided a written statement concluding there was no need to continue the consultation. However, Judge Berman disagreed and said that he thought more counseling will help while noting that this is not punishment: "I only insisted on psychological counseling as part of Mr. D'Souza's sentence because I wanted to be helpful. I am requiring Mr. D'Souza to see a new psychological counselor and to continue the weekly psychological consultation not as part of his punishment or to be retributive." The court insisted "I'm not singling out Mr. D'Souza to pick on him. A requirement for psychological counseling often comes up in my hearings in cases where I find it hard to understand why someone did what they did."
California
- "5150 (involuntary psychiatric hold)" – There are many instances of usage of California law section 5150, which allows for involuntary psychiatric hold based on the opinion of a law enforcement official, psychological professional (or many other individuals who hold no qualification for making psychological assessment), which have been challenged as being unrelated to safety, and misused as an extension of political power.
New York
Whistleblowers who part ranks with their organizations have had their mental stability questioned, such as, for example, NYPD veteran Adrian Schoolcraft
who was coerced to falsify crime statistics in his department and then
became a whistleblower. He was forcibly committed to a psychiatric
hospital.
