Jonas Robitscher

Moving Patients Out of Hospitals—In Whose Interest?

No one would argue that state mental hospitals in the United States have fulfilled any kind of promise of providing a therapeutic atmosphere for the mentally ill. Or is it their purpose to provide a therapeutic atmosphere? Does furnishing a custodial milieu provide sufficient benefits for some patients who would be worse off without the hospital so that their commitment seems justifiable? Until recently no one could be found to say a good word for the state mental hospital system; now that we are beginning to see the results of new policies that restrict the use of state hospitals, many people are beginning to see the state hospital system as preferable to moving disturbed and incompetent people out into the community.

Labeling and Discrimination in Mental Health

When the label of “mental illness” is placed on an individual, a number of consequences follow. Some of these consequences are beneficent. Those who have been labeled mentally ill are given special protections and helps; they have the advantage—if it is an advantage—of stays of unlimited duration at state hospitals and of disability income provided by the state; they have a host of social work programs for their care and rehabilitation; and they have such special legal benefits as an excuse for criminal action and protection against disadvantageous contracts. (Some of these advantages are illusory. The theoretical entitlement to unlimited stays in government- supported hospitals, for example, may in real life be a series of short stays in a revolving-door system of commitment and discharge. The principle of special helps and benefits for the mentally disabled, however, is firmly entrenched in our legal and political systems.)

Isaac Ray Lecture II: psychiatric control of behavior.

Last night we spoke of the power of the psychiatrist and how little it is subject to review and control. Even in situations in which it is generally assumed that psychiatrists are only giving advisory opinions, courts and administrative agencies usually yield to the special expertise of the psychiatrist-who is, after all, the master of mysteriesand merely rubberstamp the psychiatric opinion, and in most other decision-making situations psychiatrists are not advisers but final authorities. I said last night that the psychiatrist is the most important nongovernmental decision-maker in modern life, and he has more power than most government officials.

The Retarded Offender

RE FARDATION IS A CONDITION which affects children more than adults. The attrition rate is high for those low in intelligence, and a figure of three percent, which represents the portion of the newborn which will be diagnosed at some time during life as having mental retardation, drops to a figure of only slightly more than one percent for the population as a whole.’ The drop results from a significantly higher mortality rate in the more profoundly retarded and also because many in the group labeled mildly retarded during school years disappear from the category in later life by being reabsorbed into the general population. Retardation has both criminal and civil law ramifications. While