Mr. Whitaker’s testimony
excerpts in support of the “Five Fundamental Rights/Fresh Air” bill, September 23, 2009, before the Joint Committee on Mental Health and Substance Abuse.
We were lucky to once again have Robert Whitaker contribute his eloquent words and tremendous historical knowledge. A former writer for the Boston Globe, Mr. Whitaker is the prize-winning author of the classic Mad In America: Bad Medicine, Bad Science and the Enduring Mistreatment of the Mentally Ill, as well as the historical novels The Mapmaker’s Wife and On The Laps of Gods (The latter is a fascinating account of a mostly-forgotten racial atrocity in the Jim Crow South).
Today, we like to think that our treatment of the hospitalized mentally ill is both humane and effective. But if the past is any guide, denying hospitalized patients access to fresh air is neither…
In the early 1800s, a Scottish physician, William Buchan, wrote a book titled Domestic Medicine, which was a best seller in the United States. Here was the advice he gave for treating the melancholic patient:
The patient ought to take as much exercise in the open air as he can bear . . . to ride or walk a certain number of miles every day, it would tend greatly to alleviate his disorder, but it would have still a better effect, if he were obliged to labour a piece of ground. By digging, hoeing, planting, (and) sowing, both the body and mind would be exercised. A long journey, or a voyage…with agreeable companions, has often very happy effects. A plan of this kind, with a strict attention to diet, is a much more rational method of cure, than confining the patient within doors, and plying him with medicines.”
Here in Massachusetts, the McLean asylum opened in 1918, and it provided a form of care called moral therapy, developed by Quakers. One of the main principles of moral therapy was that an asylum should be located in the countryside…nature was seen as having a healing touch.
We might find such therapy “quaint” today. But historians have determined that more than 50% of the “first-episode” patients admitted to moral therapy asylums were discharged within a year. Moreover, a long-term follow-up study of 984 patients discharged from Worcester asylum from 1833 to 1846 found that 58 percent remained well throughout their lives and were never again rehospitalized.
In contrast, hospitalized patients today tend to become chronically ill, many cycling through hospitals on a regular basis.
The guiding principle of moral therapy was that the patients should be treated in a humane manner, as brethren…I would pose this question to the members of the Committee. If M-POWER and the Disability Law Center presented their fresh-air legislation to the Quakers that founded moral therapy, what do you think they would do?