Recent gun violence has shone new light on mental health issues. There is renewed focus on meeting the needs of people with mental health challenges and that is a good thing. But an exhibit at a public library in Ithaca, New York serves as a reminder that extreme caution must be exercised as the mental health establishment addresses the complex topics of how to insure accurate assessment and improve services.
The Lives They Left Behind: Suitcases from a State Hospital Attic, mounted by the Tompkins County Public Library and the National Alliance on Mental Illness/Finger Lakes, is an emotional exhibit and a chilling reminder of what can go wrong when individual practitioners and health systems fail to understand their patients and assume too much power over the lives of others.
When Willard Psychiatric Center closed in 1995, hundreds of suitcases were found in the attic of an abandoned building. The suitcase contents bear witness to the lives of their owners before they were incarcerated at Willard. They were individuals with jobs, families and friends who led normal lives. But because many of them suffered loss and grief, poverty, unemployment and other life stresses they were diagnosed, labeled, and sent off to an asylum that they never left.
Over 50,000 people were admitted to Willard during its 125-year history. Many of them died there, alone and quite possibly driven insane by the experience.
Among them was a Scottish woman named Margaret who lived at Willard for thirty-two years until her death. A nurse in London, her fiance' was killed in World War I, after which she emigrated to the States. While doing graduate work, Margaret suffered a serious head injury; then she contracted tuberculosis. Still, she traveled, worked and enjoyed her friends. While hospital records report that she became paranoid, a friend described her as "a woman to be admired, easy to entertain, pleased with so little." Margaret was committed to Willard at the age of forty-eight. When she told her intake interviewer that she felt "like a fly in a spider web," he had neither the imagination nor, it seems, the intelligence to understand her metaphor and so she was locked up and subjected to experimental, high-dose psychiatric medication until she died.
Ethel was another inmate. She married young and had two children. Her husband proved to be a violent alcoholic and womanizer. Later she lost three more children, after which she left her husband, sewing to support herself. Alone and desperately sad, she took to her bed. Her landlady had her committed. She spent forty-three years at Willard, probably in part because she resisted regulations. Her two surviving children visited her only three times. In her suitcase were family photos, silverware and linens, a bible, and a set of handmade baby clothes.
In their important book Women of the Asylum: Voices from Behind the Walls, 1840 - 1945, Jeffrey Geller and Maxine Harris share the stories of twenty-six women like Margaret and Ethel whose first-person accounts of incarceration in mental institutions are horrifying and moving. (Some of them were put there by husbands who found their unpopular views or behavior inappropriate for proper ladies.) One of them wrote, "How little did I know where I was and what I was put into that house for. Such a crime I never read of, and it is covered up under the garb of derangement, and I am the poor sufferer."
In my 2002 anthology, Women's Encounters with the Mental Health Establishment: Escaping the Yellow Wallpaper, contemporary women tell their stories in poetry and prose. What's startling is that they are saying the same things that the women of the asylums did, often using the same words to describe their experiences.
And that is why knowing about the suitcase exhibit, especially as the fifth edition of the "psychiatrist's bible" or DSM-V (Diagnostic and Statistical Manual), has recently been published, is important. For while asylums like Willard no longer exist (and while not only women were put there), and in spite of the fact that some people really do suffer terribly from mental illnesses, a very real danger still lurks within the broad range of psychiatric assessment and care.
It continues to be all too easy to mislabel, to assume, to wield power over, to not understand, to misdiagnose when people face emotional challenges and traumatic life events. Whether females, veterans, children, or others who find life daunting extra care must be taken, and deep compassion called upon, among the helping professions as they encounter mental and emotional suffering.
It is too easy, even for "experts," to miss the real stuff of people's lives, to jump to conclusions, to confuse pain with pathology. Therefore the pledge to "do no harm" must be urgently recalled. Not doing so could be catastrophic, as Margaret, Ethel, and multitudes of others could attest to, if they'd ever been allowed to speak the truth of their lives.