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Mental Illness Is Considered a Real and Treatable Disease in the Age of Biological
Psychiatry NEW ON AMAZON!

by Thomas S. Szasz

These are the books that


kick-started the libertarian
movement after WWII.

A lmost 50 years have passed since I first proposed that the


concept of mental illness and the profession of psychiatry rest
on fictitious foundations. Mental illnesses (henceforth without
scare quotes) are behaviors, not diseases. Psychiatry is religion,
rhetoric, and repression, not medicine. The basis for understanding
mental illness lies in semiotics (the study of signs and symbols). The
basis for understanding psychiatric practices lies in ethics,
philosophy, law, and criminology.

Not surprisingly, psychiatrists and the public have not been eager to
relinquish a system of ideas and interventions sanctioned by tradition
as necessary and proper, and by medical science as true. I was
prepared for this. In The Subjection of Women (1869), John Stuart
Mill wisely observed: GET IT FOR KINDLE

So long as an opinion is strongly rooted in the feelings . . . the worse


it fares in argumentative contest, the more persuaded its adherents
are that their feeling must have some deeper ground, which the
arguments do not reach; and while the feeling remains, it is always
Featured Course
throwing up fresh intrenchments of argument to repair any breach in
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the old . . . [T]he understanding of the majority of mankind would
need to be much better cultivated than has ever yet been the case,
before they can be asked to place such reliance in their own power
of estimating arguments as to give up practical principles in which
they have been born and bred and which are the basis of much
existing order of the world, at the first argumentative attack which
they are not capable of logically resisting.
Economics in One Day
Exactly such has been the case with my effort to expose the myth of
mental illness and abolish psychiatric coercions and excuses. Instead Learn about scarcity, prosperity,
of yielding to the arguments supporting this view, psychiatrists and values, cooperation, character,
markets, spontaneous order, and
their adherentsrelatives of the mentally ill, politicians, pundits, and
entrepreneurship. You'll see the
the publichave replaced what had been a shaky house of random
profound effect of free markets on
cards (the unstable mixture of the state hospital and psychoanalysis)
our standard of living across the
with a solid house of pure aces (the stable mixture of biological globe and over hundreds of years.
psychiatry and neuropharmacology).

Until well past the end of World War II, the model mental illness
FREE COURSE
was hysteria, that is, a person complaining of pain or paralysis
without an organic basis for his, more often her, disability. I
showed that hysteria was not a disease, but a type of non-verbal
communication. Psychiatrists adopted this view as if it had always
been their opinion, deleted hysteria from their official list of mental
diseases, and replaced it with schizophrenia as the sacred symbol
of the new biological psychiatry. They then declared that certain
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drugs were effective treatments for this disease and discharged Flipboard
most of the patients from state mental hospitals. Now,
deinstitutionalization and psychiatric miracle drugs make up the
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building blocks of the new psychiatric house of aces. Flipboard Articles

The masses of mental patients are, and have always been, poor and
imprisonedthat is, confined against their will. Psychiatrists deny,
and have always denied, this. They maintain (as they must, to justify
their practices) that mental illness is like any other illness and that
mental hospitals are like medical hospitals, to which patients are
admitted and from which, after successful treatment, they are Follow FEE on Medium
discharged.

So, after 300 years of psychiatric reformsand 100 years of


scientific advances, crowned with a Nobel Prize for the inventor Medium Articles
of lobotomywhere are we?
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The Mental Hospital as Prison

The Economist reports: When many of the countrys mental?health


hospitals were shut down in the 1960s, the idea was that patients Support
would be looked after by local health systems. Instead . . . many Foundation for
have ended up in jail. Many medical hospitals have also shut down,
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but medical patients have not ended up in prisons. When you shop at smile.amazon.com,
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A widely reported study by Human Rights Watch concludes that
jails and prisons have become the nations default mental health
system, that one in five of the 2.1 million Americans in jail and
prison are seriously mentally ill, far outnumbering the number of
mentally ill who are in mental hospitals. In 1999 the Justice
Department estimated that 16 percent of state and federal prisoners
and inmates in jails were suffering from mental illness. These
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illnesses included schizophrenia, manic depression (or bipolar
disorder) and major depression. There are no objective biological
tests for these illnesses. Hence, how many prisoners, if any, have
these diseases is pure guess.

Persons who know that mental illnesses exist and are real, and that
the mentally ill are or may be dangerous to themselves and others,
are not interested in asking questions about psychiatric principles and
practices. They simply want better services. For persons willing to
entertain doubts about the foundations of psychiatry, I offer the
following brief comments.

1. The authorities who lament the presence of many mentally ill


persons in prisons do not claim that the prisoners are innocent of
lawbreaking. If the incarcerated individuals are, in fact, guilty of the
crimes with which they have been charged, it seems reasonable that
they are in prisons rather than hospitals; if they are mentally ill, they
ought to be treated in the prison. Prisoners who have medical
illnesses receive treatment in prison. The lamenters, after all, insist
that mental illnesses are like other illnesses.

2. Most of the hundreds of thousands of mental patients who, prior


to deinstitutionalization, lived in mental hospitals, were housed there
because they were, in effect, homeless: poor, rejected by their
relatives, they were committed as dangerous to themselves and
others. In plain English, they were imprisoned, but their prisons
were called hospitals, and they were called patients instead of
inmates.
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3. Psychiatrists do not acknowledge that it is deinstitutionalization,
their latest reform, which led to the re-housing of mental patients
from asylums to jails. Instead, they advocate the large-scale drugging
of mental patients as a method of crime-preventionas if crime
were caused by mental illness and if all mental patients were
properly medicated, crime would disappear.

4. Because mental illness is a fiction, there can be no treatment for


it. In the golden era of hospital psychiatry, prior to World War II,
mental illness was considered a real but untreatable disease: most
mental patients were left unmolested by doctors. Looking back, we
call the hospitals snake pits and the patient management neglect.
Today, in the golden era of biological psychiatry, mental illness is
considered a real and treatable disease: mental patients are forcibly
drugged, in prisons and prison-like facilities and while on psychiatric
parole (outpatient commitment). Future observers will decide what
names to attach to the now-fashionable psychiatric delusion and
brutality.

Thomas S. Szasz

D r. Thomas Szasz (1920-2012) was a


Psychiatrist, academic, and champion of
individual rights. He devoted much of his life to campaigning against
many aspects of conventional psychiatry, in particular involuntary
psychiatric treatment and commitment.

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