Political abuse of psychiatry
Political abuse of psychiatry is the misuse of psychiatry, including diagnosis, detention, and treatment, for the purposes of obstructing the fundamental human rights of certain groups and individuals in a society.:491 In other words, abuse of psychiatry including one for political purposes is deliberate action of getting citizens certified, who, because of their mental condition, need neither psychiatric restraint nor psychiatric treatment. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience.:6 As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances.:14 Nowadays, in many countries, political prisoners are sometimes confined and abused in mental institutions.:3 Psychiatric confinement of sane people is a particularly pernicious form of repression.
Psychiatry possesses a built-in capacity for abuse that is greater than in other areas of medicine.:65 The diagnosis of mental disease allows the state to hold persons against their will and insist upon therapy in their interest and in the broader interests of society.:65 In addition, receiving a psychiatric diagnosis can in itself be regarded as oppressive.:94 In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials.:65 The use of hospitals instead of jails prevents the victims from receiving legal aid before the courts, makes indefinite incarceration possible, and discredits the individuals and their ideas.:29 In that manner, whenever open trials are undesirable, they are avoided.:29
Examples of political abuse of the power entrusted in physicians, and particularly psychiatrists, are abundant in history and seen during the Nazi era and the Soviet rule when political dissenters were labeled as “mentally ill” and subjected to inhumane “treatments.” In the period from the 1960s up to 1986, abuse of psychiatry for political purposes was reported to be systematic in the Soviet Union, and occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia.:66 The practice of incarceration of political dissidents in mental hospitals in Eastern Europe and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Political abuse of psychiatry also takes place in the People's Republic of China. Psychiatric diagnoses such as the diagnosis of ‘sluggish schizophrenia’ in political dissidents in the USSR were used for political purposes.:77
The Duplessis Orphans were several thousand orphaned children that were falsely certified as mentally ill by the government of the province of Quebec, Canada, and confined to psychiatric institutions.
Dr Donald Ewen Cameron's operation was running from what is today known as the Allen Memorial Institute (AMI), part of the Royal Victoria Hospital, and not to be confused with the non-governmental organization based in Montreal, AMI-Québec Agir contre la maladie mentale.
In 2002, Human Rights Watch published the book Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era written by Robin Munro and based on the documents obtained by him. The British researcher Robin Munro, a sinologist who was writing his dissertation in London after a long sojourn in China, had traveled to China several times to survey libraries in provincial towns and had gathered a large amount of literature which bore the stamp ‘secret’ but at the same time was openly available.:242 This literature included even historical analyses going back to the days of the Cultural Revolution and concerned articles and reports on the number of people who were taken to mental hospitals because they complained of a series of issues.:242 It was found, according to Munro, that the involuntary confinement of religious groups, political dissidents, and whistleblowers had a lengthy history in China. The abuse had begun in the 1950s and 1960s, and had grown extremely throughout the Cultural Revolution.:242 During the period of the Cultural Revolution, from 1966 to 1976, it achieved its apogee, then under the reign of Mao Zedong and the Gang of Four, which established a very repressive and harsh regime. No deviance or opposition in thought or in practice was tolerated.
The documents told of a massive abuse of psychiatry for political purposes during the leadership of Mao Zedong, during which millions of people had been declared mentally sick.:242 In the 1980s, according to the official documents, there was political connotation to fifteen percent of all forensic psychiatric cases.:242 In the early 1990s, the numbers had dropped to five percent, but with beginning of the campaign against Falun Gong, the percentage had again increased quite rapidly.:242
Chinese official psychiatric literature testifies distinctly that the Communist Party's notion of ‘political dangerousness’ was long since institutionally engrafted in the diagnostic armory of China's psychiatry and included in the main concept of psychiatric dangerousness.:4
Despite international criticism, the People's Republic of China seems to be continuing its political abuse of psychiatry. Political abuse of psychiatry in the People’s Republic of China is high on the agenda and has produced recurring disputes in the international psychiatric community. The abuses there appear to be even more widespread than in the Soviet Union in the 1970s and 1980s and involve the incarceration of ‘petitioners’, human rights workers, trade union activists, followers of the Falun Gong movement, and people complaining against injustices by local authorities.
It also seemed that, China had hardly known high security forensic institutions until 1989.:243 However, since then, the Chinese authorities have constructed the entire network of special forensic mental hospitals called Ankang which in Chinese is for ‘Peace and Health.’:243 By that time, China had had 20 Ankang institutions with the staff employed by the Ministry of State Security.:243 The psychiatrists who worked there were wearing uniforms under their white coats.:243
The political abuse of psychiatry in China seems to take place only in the institutions under the authority of the police and the Ministry of State Security but not in those belonging to other governmental sectors.:243 Psychiatric care in China falls into four sectors that hardly connect up with each other.:243 These are Ankang institutions of the Ministry of State Security; those belonging to the police; those that fall under the authority of the Ministry of Social Affairs; those belonging to the Ministry of Health.:243 Both the sectors belonging to the police and the Ministry of State Security are the closed sectors, and, consequently, information hardly ever leaks out.:243 In the hospitals belonging to the Ministry of Health, psychiatrists do not contact with the Ankang institutions and, actually, had no idea of what occurred there, and could, thereby, sincerely state that they were not informed of political abuse of psychiatry in China.:243
In China, the structure of forensic psychiatry was to a great extent identical to that in the USSR.:243 On its own, it is not so strange, since psychiatrists of the Moscow Serbsky Institute visited Beijing in 1957 to help their Chinese ‘brethren’, the same psychiatrists who promoted the system of political abuse of psychiatry in their own USSR.:243 As a consequence, diagnostics were not much different than in the Soviet Union.:244 The only difference was that the Soviets preferred ‘sluggish schizophrenia’ as a diagnosis, and the Chinese generally cleaved to the diagnosis ‘paranoia’ or ‘paranoid schizophrenia’.:244 However, the results were the same: long hospitalization in a mental hospital, involuntary treatment with neuroleptics, torture, abuse, all aimed at breaking the victim’s will.:244
In accordance with Chinese law that contains the concept of “political harm to society” as legally dangerous mentally ill behavior, police take into mental hospitals “political maniacs,” defined as persons who write reactionary letters, make anti-government speeches, or “express opinions on important domestic and international affairs.” Psychiatrists are frequently caught involved in such cases, unable and unwilling to challenge the police, according to psychiatry professor at the Peking University Yu Xin. As Mr. Liu’s database suggests, today’s most frequent victims of psychiatric abuse are political dissidents, petitioners, and Falun Gong members. Psychiatrists are frequently caught involved in these cases, unable and unwilling to challenge the police, according to psychiatry professor at the Peking University Yu Xin. In the beginning of the 2000s, Human Rights Watch accused China of locking up Falun Gong members and dissidents in a number of Chinese mental hospitals managed by the Public Security Bureau. Access to the hospitals was requested by the World Psychiatric Association (WPA), but denied by China, and the controversy subsided.
The WPA attempted to confine the problem by presenting it as Falung Gong issue and, at the same time, make the impression that the members of the movement were likely not mentally sound, that it was a sect which likely brainwashed its members, etc.:245 There was even a diagnosis of ‘qigong syndrome’ which was used reflecting on the exercises practiced by Falung Gong.:245 It was the unfair game aiming to avoid the political abuse of psychiatry from dominating the WPA agenda.:245
In August 2002, the General Assembly was to take place during the next WPA World Congress in Yokohama.:247 The issue of Chinese political abuse of psychiatry had been placed as one of the final items on the agenda of the General Assembly.:251 When the issue was broached during the General Assembly, the exact nature of compromise came to light.:252 In order to investigate the political abuse of psychiatry, the WPA would send an investigative mission to China.:252 The visit was projected for the spring of 2003 in order to assure that one could present a report during the annual meeting of the British Royal College of Psychiatrists in June/July of that year and the Annual Meeting of the American Psychiatric Association in May of the same year.:252 After the 2002 World Congress, the WPA Executive Committee’s half-hearted attitude in Yokohama came to light: it was an omen of a longstanding policy of diversion and postponement.:252 The 2003 investigative mission never took place, and when finally a visit to China did take place, this visit was more of scientific exchange.:252 In the meantime, the political abuse of psychiatry persisted unabatedly, nevertheless the WPA did not seem to care.:252
Although Cuba has been politically connected to the Soviet Union since the United States broke off relations with Cuba shortly after the dictator Fidel Castro came to power in 1959, few considerable allegations regarding the political abuse of psychiatry in this country emerged before the late 1980s.:74 Americas Watch and Amnesty International published reports alluding to cases of possible unwarranted hospitalization and ill-treatment of political prisoners.:75 These reports concerned the Gustavo Machin hospital in Santiago de Cuba in the southeast of the country and the major mental hospital in Havana.:75 In 1977, a report on alleged abuse of psychiatry in Cuba presenting cases of ill-treatment in mental hospitals going back to the 1970s came out in the United States.:75 It presents grave allegations that prisoners end up in the forensic ward of mental hospitals in Santiago de Cuba and Havana where they undergo ill-treatment including electroconvulsive therapy without muscle relaxants or anaesthesia.:75 The reported application of ECT in the forensic wards seems, at least in many of the cited cases, not to be an adequate clinical treatment for the diagnosed state of the prisoner — in some cases the prisoners seem not to have been diagnosed at all.:75 Conditions in the forensic wards have been described in repulsive terms and apparently are in striking contrast to the other parts of the mental hospitals that are said to be well-kept and modern.:75
In August 1981, the Marxist historian Ariel Hidalgo was apprehended and accused of ‘incitement against the social order, international solidarity and the Socialist State’ and sentenced to eight years’ imprisonment.:75 In September 1981, he was transported from State Security Headquarters to the Carbó-Serviá (forensic) ward of Havana Psychiatric Hospital where he stayed for several weeks.:76
It was reported in June, 2012, that the Indian Government has approached NIMHANS, a well known mental health establishment in South India, to assist in suppressing anti-nuclear protests regards to building of the Kudankulam Nuclear Power Plant. The government was in talks with NIMHANS representatives to chalk up a plan to dispatch psychiatrists to Kudankulam, for counselling protesters opposed to the building of the plant. To fulfill this, NIMHANS developed a team of 6 members, all of them, from the Department of Social Psychiatry. The psychiatrists were sent to get a "peek a into the protesters' minds" and help them learn the importance of the plant according to one news source.
In July, 2013, the same institution, NIMHANS, was involved in a controversy where it was alleged that it provided assistance to the Central Bureau of Investigation relating to some interrogation techninques.
Japanese mental institutions during the country's imperial era reported an abnormally large number of patient deaths, peaking in 1945 after the surrender of Japan to Allied forces. The patients of these institutions were mistreated mainly because they were considered a hindrance to society. Under the Imperial Japanese government, citizens were expected to contribute in one way or another to the war effort, and the mentally ill were unable to do so, and as such were looked down upon and abused. The main cause of death for these patients was starvation, as caretakers did not supply the patients with adequate food, likely as a form of torture and a method of sedation. Because mentally ill patients were kept secluded from the outside world, the large number of deaths went unnoticed by the general public. After the end of Allied occupation, the National Diet of Japan passed the Mental Hygiene Act (精神衛生法, Seishin Eisei Hō?) in 1950, which improved the status of the mentally ill and prohibited the domestic containment of mental patients in medical institutions. However, the Mental Hygiene Act had unforeseen consequences. Along with many other reforms, the law prevented the mentally ill from being charged with any sort of crime in Japanese courts. Anyone who was found to be mentally unstable by a qualified psychiatrist was required to be hospitalized rather than incarcerated, regardless of the severity of any crime that person may have committed. The Ministry of Justice tried several times to amend the law, but was met with opposition from those who believed the legal system should not interfere with medical science. After almost four decades, the Mental Health Act (精神保健法, Seishin Hoken Hō?) was finally passed in 1987. The new law corrected the flaws of the Mental Hygiene Act by allowing the Ministry of Health and Welfare to set regulations on the treatment of mental patients in both medical and legal settings. With the new law, the mentally ill have the right to voluntary hospitalization, the ability to be charged with a crime, and right to use the insanity defense in court, and the right to pursue legal action in the event of abuse or negligence on the part of medical professionals.
By 1936, killing of the "physically and socially unfit" became accepted practice. In Nazi Germany in the 1940s, the abuse of psychiatry was the abuse of the 'duty to care' in enormous scale: 300,000 individuals were sterilized and 77,000 killed in Germany alone and many thousands further afield, mainly in eastern Europe. Psychiatrists were instrumental in establishing a system of identifying, notifying, transporting, and killing hundreds of thousands of "racially and cognitively compromised" persons and mentally ill in settings that ranged from centralized mental hospitals to jails and death camps. Psychiatrists played a central and prominent role in sterilization and euthanasia constituting two categories of the crimes against humanity. The taking of thousands of brains from euthanasia victims demonstrated the way medical research was connected to the psychiatric killings. There were six psychiatric extermination centers: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein. They played a crucial role in developments leading to the Holocaust.
There have been a few accusations about abuse of psychiatry in Norway. See Arnold Juklerød.
In Romania, there have been allegations of some particular cases of psychiatric abuse during over a decade.:73 In addition to particular cases, there is evidence that mental hospitals were utilized as short-term detainment centers.:73 For instance, before the 1982 International University Sports ‘Olympiad’, over 600 dissidents were detained and kept out of public view in mental hospitals.:73 Like in the Soviet Union, on the eve of Communist holidays, potential “troublemakers” were sent to mental hospitals by busloads and discharged when the holidays had passed.
Reports on particular cases continue to come from Russia where the worsening political climate appears to create an atmosphere in which local authorities feel able, oonce again to use psychiatry as a means of intimidation. In today's Russia protestors and activists are often sent for psychiatric assessment but comparatively few, so far as is known, have actually been committed to in-patient treatmentthus far. As of 2015 the wide abuse of psychiatry practised under Brezhnev and Andropov has not been revived.
In 1971 detailed reports about the inmates of Soviet psychiatric hospitals who had been detained for political reasons began to reach the West.  These showed that the periodic use of incarceration in psychiatric institutions during the 1960s (see the biography of Vladimir Bukovsky) were now becoming a systematic way of dealing with dissent, political or religious. 
In March that year Vladimir Bukovsky sent detailed diagnoses of six individuals (Natalya Gorbanevskaya and Pyotr Grigorenko were among them) to psychiatrists in the West. They responded  and over the next 13 years there was a sustained campaign by activists inside the USSR and support groups in Britain, Europe and North America to expose these abuses. In 1977, the World Psychiatric Association condemned the USSR for this practice. Six years later, the All-Union Society of Neuropathologists and Psychiatrists seceded from the WPA rather than face almost certain expulsion.
During this period reports of continuous repression multiplied, but Soviet psychiatric officials refused to allow international bodies to see the hospitals and patients in question. They denied the charges of abuse. In February 1989, however, at the height of perestroika and over the opposition of the psychiatric establishment, the Soviet government permitted a delegation of psychiatrists from the USA, representing the U.S. Government, to carry out extensive interviews of suspected victims of abuse. :69
The delegation was able systematically to interview and assess present and past involuntarily admitted mental patients chosen by the visiting team, as well as to talk over procedures and methods of treatment with some of the patients, their friends, relatives and, sometimes, their treating psychiatrists.:69 The delegation originally sought interviews with 48 persons, but saw only 15 hospitalized and 12 discharged patients.:69 About half of the hospitalized patients were released in the two months between the submission of the initial list of names to the Soviets authorities and the departure from the Soviet Union of the US delegation.:69 The delegation concluded that nine of the 15 hospitalized patients had disorders which would be classified in the United States as serious psychoses, diagnoses corresponding broadly with those used by the Soviet psychiatrists.:69 One of the hospitalized patients had been diagnosed as having schizophrenia although the US team saw no evidence of mental disorder.:70 Among the 12 discharged patients examined, the US delegation found that nine had no evidence of any current or past mental disorder; the remaining three had comparatively slight symptoms which would not usually warrant involuntary commitment in Western countries.:70 According to medical record, all these patients had diagnoses of psychopathology or schizophrenia.:70
Returning home after a visit of more than two weeks, the delegation members wrote a report which was highly damaging to the Soviet authorities.:125 The delegation established that there had been systematic political abuse of psychiatry in the past and it had not yet come to an end. Victims continued to be held in mental hospitals, while the Soviet authorities and the Soviet Society of Psychiatrists and Neuropathologists in particular still denied that psychiatry had been employed as a method of repression.:125
The American report and other pressures, domestic and external, led the Politburo to pass a resolution (15 November 1989) "On improvements in Soviet law concerning procedures for the treatment of psychiatric patients"  This put a formal end to psychiatric abuse in the USSR.
- Drapetomania was a supposed mental illness described by American physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity.:41 In addition to identifying drapetomania, Cartwright prescribed a remedy. His feeling was that with "proper medical advice, strictly followed, this troublesome practice that many Negroes have of running away can be almost entirely prevented." In the case of slaves "sulky and dissatisfied without cause" — a warning sign of imminent flight — Cartwright prescribed "whipping the devil out of them" as a "preventative measure". As a remedy for this disease, doctors also made running a physical impossibility by prescribing the removal of both big toes.:42
- In the United States, political dissenters have been involuntarily committed. For example, in 1927 a demonstrator named Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of Sacco and Vanzetti.
- When Clennon W. King, Jr., a black pastor and civil rights activist attempted to enroll at the all-white University of Mississippi for summer graduate courses in 1958, the Mississippi police arrested him on the grounds that "any nigger who tried to enter Ole Miss must be crazy." Keeping King's whereabouts secret for 48 hours, the Mississippi authorities kept him confined to a mental hospital for twelve days before a panel of doctors established the activist's sanity.
- In the 1964 election, Fact magazine polled American Psychiatric Association members on whether Barry Goldwater was fit to be president and published "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." This led to the banning of diagnosing public figures when you have not performed an examination or been authorized to release information by the patient. This became the Goldwater rule.
- In the 1970s, Martha Beall Mitchell, wife of U.S. Attorney General John Mitchell, was diagnosed with a paranoid mental disorder for claiming that the administration of President Richard M. Nixon was engaged in illegal activities. Many of her claims were later proved correct, and the term "Martha Mitchell effect" was coined to describe mental health misdiagnoses when accurate claims are dismissed as delusional.
- In 1972 Thomas Eagleton was forced to withdraw as a vice presidential candidate for being treated for depression.
- In 2006, Canadian psychiatrist Colin A. Ross's book was published, titled The C.I.A. Doctors: Human Rights Violations by American Psychiatrists. The book presents evidence based on 15,000 pages of documents received from the CIA via the Freedom of Information Act that there have been systematic, pervasive violations of human rights by American psychiatrists during the recent 65 years.
- In 2010, the book The Protest Psychosis: How Schizophrenia Became a Black Disease by psychiatrist Jonathan Metzl (who also has a Ph.D. in American studies) was published. The book covers the history of the 1960s Ionia State Hospital located in Ionia, Michigan and now converted to a prison and focuses on exposing the trend of this hospital to diagnose African Americans with schizophrenia because of their civil rights ideas. The book suggests that in part the sudden influx of such diagnoses could traced to a change in wording in the DSM-II, which compared to the previous edition added "hostility" and "aggression" as signs of the disorder.
- Some people, notably clinical psychologist Bruce E. Levine, argue that Oppositional Defiant Disorder, which can be easily used to pathologize anti-authoritarianism, is an abuse of psychiatry.
- In 1973, the American Psychiatric Association declassified homosexuality as a mental disorder and The American Psychological Association Council of Representatives followed in 1975.
- In 2014, Mercury News published a series of articles detailing questionable use of psychotropic drugs within California's foster care system where bad behavior is attributed to various mental conditions, and little care is provided besides drugs. Likewise, many experts questioned the long-term effects of high dosages on developing brains, and some former patients reported permanent side effects even after stopping the meds.
- According to journalist Jonathan Turley and Newsweek magazine, in June 2015, U.S. District Judge Richard M. Berman ordered conservative film maker and activist Dinesh D'Souza to continue Psychological Counseling for a four-year period despite numerous recommendations to the contrary by well respected private and court appointed mental health personnel. D’Souza pleaded guilty to a single count of making illegal contributions in the name of others as part of the campaign of Wendy Long for New York Senate. This occurred during a post confinenment hearing. D’Souza was seeking to reduce the four year community service sentence by reference to his home confinement period. Berman balked and said that he said the two periods as distinct — a position that courts would likely take in similar cases. In referring to the psychological counseling aspect, D’Souza’s counsel submitted evidence that the court-ordered psychiatrist found no indication of depression or reason for medication. His own retained psychologist also provided a written statement concluding there was no need to continue the consultation. However, Judge Berman simply disagreed and said that he thinks more counseling will help while noting that this is not punishment: “I only insisted on psychological counseling as part of Mr. D’Souza’s sentence because I wanted to be helpful. I am requiring Mr. D’Souza to see a new psychological counselor and to continue the weekly psychological consultation not as part of his punishment or to be retributive.” The court insisted “I’m not singling out Mr. D’Souza to pick on him. A requirement for psychological counseling often comes up in my hearings in cases where I find it hard to understand why someone did what they did.
Whistle-blowers who part ranks with their organizations have had their mental stability questioned, such as, for example, the NYPD veteran who alleged falsified crime statistics in his department and was forcibly committed to a mental institution.
- The Protest Psychosis: How Schizophrenia Became a Black Disease
- Global Initiative on Psychiatry
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