

By David Gonzalez David Gonzalez is the recipient of the 1999 NYAPRS Brendan Nugent Leadership Award, the first person with a mental illness to receive the National AAPD Paul G. Hearne Award for People with Disabilities, and the recipient of the New York State Department of Mental Health’s Office of Consumer Affairs 2000 Consumer Advocacy Award. He has created an anti-stigma workshop from the research generated for this article entitled "Stigma- History’s Best Kept Secret." This workshop was first presented at the 18th Annual NYAPRS Conference held in September 2000. David can be contacted at or Accurately identifying the various causes behind the criminalization of the mentally ill can only be accomplished by an impartial examination of our society’s preconceived notions of the mentally ill. This can be done by examining society’s treatment of the mentally ill throughout the course of history. Stigma clearly plays a major role in the criminalization of the mentally ill because of society’s inability to accept the dualistic and sometimes vile impulses of human nature inherent in all human beings. Therefore, society seeks to explain away unjustified acts of violence and aggression as symptoms of a mental illness, in effect scapegoating the mentally ill. And whom better to scapegoat than those people who because of their psychiatric disabilities are the least capable of defending themselves! It’s a propaganda goldmine and a public relations coup. Not only do you have a ready-made population to scapegoat, but if it is ever discovered that you have twisted and manipulated the facts to hold the whole mental health community hostage because of violent acts of a small percentage, so what? There’ll be no repercussions and no one will care. While there are certainly occasional acts of violence committed by people who are mentally ill, no laws or medications can prevent these acts of violence, any more than they can prevent acts of violence committed by the general population (which has a far greater propensity for violence). Why aren’t unjustified acts of violence committed by police officers considered a mental illness? Ironically, police officers have the highest suicide rate in the nation, and suicide is recognized by the mental health community as the symptom of a mental illness. Since the dawn of civilization, society has had its scapegoats. Human beings whose intentions are basically decent and who tend to be tolerant of other peoples have bought into the scapegoat mentality when confronted by media manipulators playing upon the fears of society. I believe that this was clearly illustrated in recent times by the Jewish Holocaust. This holocaust was committed by a highly cultured society of civilized people who gave birth to some of the greatest thinkers of the 20th century, people who were the foremost leaders and intellectuals in this era of enlightenment. Yes, even society’s most educated classes have needed scapegoats. It is a sobering reality of human nature that closed-minded intellectuals have difficulty coming to terms with. How could cultured and enlightened people commit such a heinous crime against humanity and be so intolerant of other people because of their heritage? I highlight this painful example of scapegoating not to condemn or to judge, but to point to mankind’s incessant need for scapegoats. Even here, in the United States, during the McCarthy era of the 1950's, just the mere belief that you were sympathetic to the ideology of the Communist Party was enough to get you scapegoated. The mentally ill have historically been society’s scapegoats and have been universally blamed for the ills of society. In ancient Greece, during the times of the plague, the mentally ill (who were forced to live on the outskirts of town - ancient history’s version of the homeless) were stoned to death as part of the ritual purification of the city. Obviously, they were blamed for the outbreak of the plague, and were therefore treated as outcasts. This ritual purification was called pharmakos, a Greek word which means "something to be eliminated," which is the root source of our modern day work pharmaceutical. During the Middle Ages, it was widely accepted and believed that the mentally ill were possessed by demons and evil spirits. In 1489, with the publication of the infamous witch finders manual (the Malleus Maleficarium) various symptoms of mental illness were ascribed to witchcraft. This conveniently opened the door for society to criminalize its mentally ill and rid itself of its "undesirables." Thousands of those who were burned at the stake by the un-Holy Inquisition were more than likely victims of some form of mental illness. In fact, if Joan of Arc were alive today, she would probably be found in one of our city’s psychiatric wards. Most Americans are unaware that in Nazi Germany, preceding the Jewish Holocaust, the first people to lose their rights were the physically and mentally disabled. It was Heinrich Himmler in 1939, head of the infamous SS who ordered that all "inferiors"(then a psychiatric ward catchword which was eventually adjusted to include "racial inferiors") be exterminated. Thousands of psychiatric inmates (a word traditionally used to identify criminals) in Hitler’s Third Reich set the stage in a practical and ideological way for the extermination of six million Jews. By the end of World War II in 1945, approximately 300,000 "psychiatric inmates" were killed by gassing, starvation, injection of deadly drugs and other experiments. Contrary to popular belief, the first gas chambers did not open at Auschwitz. The first gas chambers opened up in Brandenberg in 1939, one of six death camps operated in Nazi Germany to exterminate the mentally ill. Two years later, in 1941, Auschwitz was launched [[opened? AP]]. In September of 1941, the first official gassing took place in that camp. The victims were 250 "mental patients" and 600 Russians and Jews. These are just a few of the classic examples of how the mentally ill have been historically scapegoated. In our new millennium of politically correct terminology, this is called "Kendra’s law" (Involuntary Outpatient Commitment - IOC). This law implies that in a very ambiguous way that all those who are affected by this law are capable of committing the same types of crimes which Andrew Goldstein committed (pushing Kendra Webdale off a subway platform). According to my dictionary, this is an excellent example of scapegoating: Scapegoat: 1. "One who is made to bear the blame of others"(Webster’s Encyclopedia Unabridged Dictionary - 1989). One of the biggest lessons that I learned in high school was that "those who don’t learn from the mistakes of history are doomed to repeat them!" Is this the dawn of a new holocaust? Media hysteria also leads to the criminalization of the mentally ill. In November 1999, in mid-Manhattan on 42nd Street, an innocent young woman named Nicole Barrett was tragically struck in the head with a brick by an unknown assailant. All the local papers alleged that the perpetrator had to be mentally ill and was probably homeless (due to the fact that many of the city’s mentally ill are indeed homeless). None of the local papers indicated why a mentally ill, homeless person would want to commit such a senseless crime. In fact, the New York Daily News front-page headline read: "Get the Violent Crazies off our Streets" (11/19/99). Not only does this hysteria promoting headline imply that the mentally ill are violent and crazy, but more disturbingly, it boldly implies that New York City streets are reserved for a select few ("our streets" versus "the streets"). As a result Mayor Giuliani subsequently ordered a full scale roundup of the city’s homeless and arrested those who refused to enter the city’s shelters. Even when the assailant was eventually captured, and it was discovered that he "did not have a mental illness" (and he was not homeless), none of the local papers retracted their allegations, nor offered an apology. In fact, the exact opposite took place. More media headlines began to appear demanding forced hospitalizations of the mentally ill and involuntary outpatient commitment. In order to fully understand the media’s potential for influencing public opinion about the mentally ill, it is necessary to recognize the persistent negative stereotypes in which people with mental illnesses are frequently portrayed. Negative images of the mentally ill are so common in movies and on television that the public’s perception of mental illness is one of fear and paranoia bordering on mass hysteria. The recent trend toward so-called real-life television has created a new era in yellow journalism. This trend which started with the televison show "Cops" spawned a cornucopia of similar shows which ultimately inspired the creation of the ill-fated television series "Wonderland!" This show, which ABC reluctantly "pulled off the air" amid a massive public outcry from the mental health community, took the word exploitation to new heights. In its first episode, which aired on March 30, 2000 with little fanfare, a mentally ill patient stabs a pregnant doctor in the abdomen with a hypodermic needle, threatening the life of the unborn baby. Sally Satel, an advocate of involuntary outpatient commitment laws from the Treatment Advocacy Center (TAC) in Arlington, Virginia, was so delighted by the show that she wrote an editorial in the April 3 issue of the New York Times calling Wonderland’s violent and sensationalistic portrayal of people with mental illness "one of the best things to happen." Less than three weeks after the airing of this show, a Dr. Stephen Pack from Montefiore Hospital, stabbed his pregnant lover Joy Schepis six times with a hypodermic needle containing an abortion inducing drug. Dr. Pack’s lawyer, Andrew Rubin, said that his client had been "showing symptoms of depression for several months . . . If the facts are accurate, it certainly doesn’t appear that anything he did was done with any rational criminal intent." Here is a lawyer who is conveniently preparing a defense for his client by equating an unjustified act of violence with mental illness (depression)! Was his client one of those viewers influenced by the first episode of "Wonderland?" Does Sally Satel from the TAC still feel that this show was "one of the best things to happen?" Movies such as Maniac (1934, 1963, 1978 and 1981), Deranged (1974), Psycho (1960 and 1998) and The Lunatic (1992), all portray the mentally ill as psychotic and deranged lunatics capable of snapping at the slightest provocation. Movies such as these add to the misconceptions of the mentally ill and eventually influence the opinions of judges, district attorneys, police officers, parole officers, correction officers, politicians, and the average citizen, ultimately culminating in laws such as Kendra’s law. As far back as the 1950's, laws similar to Kendra’s law have been established in a majority of states allowing for the compulsory hospitalization and incarceration of the mentally ill. Hospitalizations included such forms of treatment as chemotherapy, electric shock, hypnosis, and even the possibility of a frontal lobotomy. Over the centuries - as an added result of stigma - mankind’s treatment of the "insane" has been insane. Everything from medieval chiseling of the skull to "let the devil escape" to bloodletting and drowning out the madness (Dr. Jan Baptista Van Helmont [1577-1644] argued that water shock, near to the brink of death, could halt an insane person’s too violent and exorbitant form of fiery life); to electroshock and the 1940's ice-pick lobotomies of Dr. Walter Freeman, then president of the American Board of Psychiatry. In 1948, Dr. Freeman performed his most famous lobotomy on the actress and movie star Frances Farmer. Her communist sympathies and rebellion against authority had offended too many people. Dr. Freeman’s mistreatment of the mentally ill illustrates the violence that can happen because of stigma. One gloomy October morning, in front of an eager audience of psychiatrists and journalists, a group of female patients was wheeled into an operating room. After a brief lecture on the wonders of "psychosurgery," Dr. Freeman went to work. The first patient was wheeled into the operating room. He put electrodes on her temples and shocked her into a faint. He then lifted her left eyelid and plunged an icepick into her head. As he pulled out the icepick, another woman was wheeled before him for the same treatment. He continued this production line of state-controlled violence until even the director of the state hospital (near nausea) had to leave the room. The violence against the mentally ill has always occurred. Even Dr. Benjamin Rush, one of the founding fathers of American psychiatry, and one of the privileged few to sign the Declaration of Independence, recommended relentlessly swinging people with mental illnesses in order to "shake the madness out of them." Perhaps no single group in history has undergone more widespread experimentation than the destitute mentally ill living in state run asylums. What’s particularly ironic is the outstanding reputation of many of the highly praised doctors devising these Torquemada-like cures. The antiquated belief (which persists today) that we, the mentally ill, are prone to acts of violence because we are possessed, makes us the arch-typical villain (criminal), in spite of the fact that the mentally ill are more likely to be the victims, rather than the perpetrators of violent crime. According to a 1993 University of California study on the prevalence of behavior disorders in the United States in the mid 1980's, being laid off from a job was a much more significant factor in determining the risk of violent behavior, than having a history of mental illness. Yet mental illness is still erroneously singled out as the major cause of unjustified violence and aggression in by American law enforcement, resulting in the criminalization of the mentally ill. Why has the media failed to report on the 95% of law abiding mental health recipients, who raise families and pay bills, who hold offices and are respected members of society? A great many mentally ill people are civil servants, doctors, lawyers, professors, judges. Many more operate community agencies which serve the homeless, the destitute and the mentally ill. Why then does the media persist in painting us in negative images? Is it because there is no one else to conveniently scapegoat? Is it only because sensationalism sells? Or is it the dawn of a "Brave New World" wherein truth is an idle distraction and where the media doesn’t actually report the story, but in fact creates the story. We must be vigilant about speaking out against negative stereotypes and scapegoating if we wish to reduce stigma and prejudice.