Tag Archives: mental health

Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum

Non-fiction book about the history of an asylum in Georgia, USA

Content warning: racism, ableism, massacres, eugenics, neglect, abuse, slavery, forced sterlisation

I received a copy of this eBook courtesy of the publisher.

“Administrations of Lunacy: Racism and the haunting of American psychiatry at the Milledgeville Asylum” by Mab Segrest is a history of a mental health asylum from when it opened as the Georgia State Lunatic, Idiot, and Epileptic Asylum in 1842 and how it stood by, was influenced by, was complicit in and actively participated in features of American history such as the massacres of first nations people, slavery, the American Civil War, Jim Crow, forced labour, eugenics, forced sterilisation and the prison-industrial complex until its closure in 2010.

This is an exceptionally well-researched book. According to the acknowledgements, Segrest spent many years investigating the enormous institution that at one point was the largest mental health facility in the USA and the many threads that connected this facility to the American historical context. Under several iterations, and many more superintendents, the asylum is thoroughly deconstructed by Segrest who explores, through newspaper articles, annual reports, journals and clinical records, the impacts of racism, sexism, ableism and white supremacy on its administration and its patients. I felt like the case studies of individual patients who found themselves, one way or another, admitted to the asylum. Their stories were equal parts fascinating and heartbreaking, giving the reader a real appreciation of the impact of segregation, neglect, starvation, hard labour and forced sterilisation on the tens of thousands of individuals who lived and died there.

I thought that Segrest’s research clearly illustrated how dependent the conditions of the asylum were on personal views of those in charge – especially when it came to legislation and funding. As demonstrated by the way people with disability continue to fall through the cracks, better legislation and funding is critical to ensuring that they receive the support and dignity they deserve. It is clear that even in 2020, people with disability are still incredibly vulnerable to abuse. In just the past week here in Australia there have been three devastating stories of unfathomable abuse and neglect that demonstrate that on a systematic level as well as an individual level, people with disability are still being failed. The strongest parts of this book were the anecdotes about the day-to-day life of the patients who found themselves admitted to the asylum.

As is often the case with well-researched books, it can be difficult to decide what to include and what to leave out. There is no question about the breadth of Segrest’s research on this topic, and she follows up every single lead that might provide more understanding about the asylum and how it came to be. However, I think at times the breadth of this book was at the expense of the depth. While I appreciate how important political history is to the American psyche, and historical periods and events were to the nature of the asylum, I think a stronger focus on the asylum itself would have made the book a little easier to follow. Particularly in the earlier parts of the books, Segrest peppers the book so liberally with metaphors and historical and cultural references that it does at time result in quite dense reading.

Segrest approaches psychiatry with a level of skepticism informed by the circumstances through which the field has developed and evolved. She critically examines the social factors experienced by patients admitted to the asylum and offers alternative explanations for symptoms of mental illness including environmental factors such as poverty, physical illness, malnutrition, culture, abuse and prolonged exposure to trauma. I agree that these factors are important to consider, and I can understand Segrest’s reluctance to lean too far into genetic causes for mental illness and disability given the horrors of eugenics policies.

However, having worked in mental health, I feel that she did downplay the impact that untreated and unsupported mental illness can have on an individual’s life outside a clinical setting and that this too can leave them vulnerable to abuse, neglect and homelessness in the community, especially without families or friends equipped to care for them. Regardless of her views on the utility of diagnostic tools such as the DSM-5, I think that we must accept that sometimes people do have symptoms of a mental illness or disability that do not have an environmental cause. I think by accepting people for who they are without looking for an external explanation (and unintentionally apportioning blame), we can better design a system that works for the individuals affected.

An important and thoroughly-researched book whose proverbial forest was at times obscured by the (pecan) trees.

 

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Filed under Advanced Reading Copies, Book Reviews, eBooks, Non Fiction

The Bell Jar

Classic literature about a young woman living with depression

Content warning: mental illness, depression, suicide

This is a book that really doesn’t need an introduction. To be honest, I’m not entirely certain where I found my copy. It has no price on it. It’s a 2005 edition so the pages are starting to yellow a little but it’s in good condition. Maybe I found it in my street library, or someone else’s. I’ve had it sitting on my to-read shelf for a long time and, look, I’m not going to lie, I picked it up and put it down a few times, but eventually I managed to settle into it.

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The backdrop of this photo is from Issue 1 of Lost Magazine, unfortunately no longer in print. The photographer of the model is Simon Tubey.

“The Bell Jar” by Sylvia Plath is a novel about Esther, a university student in her late teens who wins a prestigious summer internship in New York with a group of eleven other young women. From a lower middle-class family in Boston, it’s the opportunity of a lifetime for Esther. However, up close, the lifestyle isn’t as glamorous as she anticipated. When her run of winning scholarships and opportunities suddenly runs dry, Esther’s mental state plummets and after attempting suicide she is admitted to a psychiatric ward.

It’s difficult to read this book entirely as fiction given that Plath herself died after committing suicide shortly after its publication. It is beautifully written and over 50 years after publication is still refreshing in its frankness. There is a brilliant scene early in the book where after attending a very fancy function, the entire contingent falls ill with food poisoning. It sounds a bit trite to say, but this book reads like it must have been far ahead of its time. Plath is scathing about how meaningless the work at the magazine is, and depicts the way Esther’s cynicism begins to bleed into everything and how she fails to find meaning in her life in nothing short of a brilliant way. I also thought that Plath’s description of life in a psychiatric ward, and the experimental and harmful treatments from the time that Esther is put through, was both horrifying and very well done.

When reading books that were written long ago, I always get the strange feeling that nothing and everything is different. There were certainly plenty of observations that Plath made about sex, sexism, the commodification of beauty and class that still hold true today. However, one of the most difficult things about reading older books is seeing the way that race – even indirectly – was handled. There are quite a few instances where Esther compares her own appearance unfavourably towards people of different ethnicities or describes a person of colour’s appearance in a stereotyped way, and honestly, it is jarring when it happens. I also wasn’t super happy with how Joan, Esther’s boyfriend’s ex-girlfriend who is also a lesbian, was handled. And yes, yes, I know that people are a product of their times, but that doesn’t make people intrinsically right and ideas and attitudes, no matter how reflective of the time they were expressed in, can never be immune to criticism.

This is a short, sharp novel that is an illuminating snapshot of the time and still, to this day, has a lot to say about mental health, gender equality and class. It is difficult to separate the book from the author’s own life, but it does stand on its own and remains a cutting and raw exposé of life as a young woman struggling with mental illness and straddling a class divide.

 

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Filed under Book Reviews, Classics, General Fiction

The Skeleton Diaries

If there is anything that gets me out of the house to an event, it’s books. Last year I was invited to go along to a young professionals networking event, which sounded the exact opposite of how I’d normally spend my time. However, something caught my eye on the e-invite. It was being held at Muse, one of my favourite Canberra bookstores, and there was going to be an author talk. Well, that was enough for me! I went along, and once the networking part was out of the way, Australian National University graduating student Rachael Stevens took the stage to talk about mental health, overcoming anorexia and her self-published book. After the event, she stayed back and signed copies – and of course I bought one.

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“The Skeleton Diaries” is a memoir by Rachael Stevens about when she was hospitalised in 2007 at 15 years old for anorexia. The memoir begins when her mother takes her to see a counsellor who suggests she keeps a diary. At first, Rachael’s diary entries feign confusion about what’s going on, distancing herself even further from others. However, as the book progresses and Rachael’s health reaches breaking point, she is forced to acknowledge the truth: she has anorexia and her body is shutting down. Rachael is first admitted to a paediatric ward before being transferred to a youth psychiatric ward and there is placed on an unrelenting and unsympathetic treatment regime. However, while suffering outwardly from the state of her body and the treatment by hospital staff, inside Rachael begins to cultivate the tiniest flower of hope which helps her to overcome her disordered thinking.

This book is a powerful insight into disordered thinking: the disordered thinking of a person suffering from anorexia, and the disordered thinking of society around the treatment of mental health. Some of the most striking passages in this book are about Rachael’s silent cries to be treated as a person, and not have her worth determined as simply a collection of symptoms or numbers on a scale. Although only 15 when she first wrote in her diary, I was really impressed by Stevens’ clear yet compelling writing style. It is a brave thing to do to send your story out in the world, especially when you are so young, and I did feel compared to other memoirs of this nature, Stevens was rather guarded about the details of her life and the trauma and abuse she experienced. However, the focus of this story is really on anorexia and the havoc it wreaks on your mind and body.

A really important book that is a stark reminder that this country still has a long way to go when it comes to prioritising, understanding and funding mental health issues.

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Filed under Australian Books, Book Reviews, Non Fiction, Signed Books

Small Things

I first heard about this little graphic novel in the news a few weeks ago. It had made news because already renowned Perth graphic novelist Mel Tregonning had committed suicide before she finished it. Her family contacted Shaun Tan, arguably Australia’s most well-known graphic novelist, and asked him to help them finish it in her memory. I saw one of Canberra’s loveliest bookstores Book Passion had some copies, and they very kindly kept one aside for me until I could pick it up on the weekend.

“Small Things” by Mel Tregonning is a graphic novel about a young boy who seems to be struggling. At school and at home he is plagued by tiny shadows and he starts to feel like the cracks are starting to show. His only solace is his little nightlight that chases the shadows away at night, but it’s not enough to help him from withdrawing more and more into himself.

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No book exists without some kind of context, and the story of how this book came to be is as heartbreaking as the story contained within its pages. There are no words, only images but it is crystal clear that this is a graphic novel about depression.  “Small Things” is an important work and really highlights the need for empathy and to reach out to one another.

Some things speak louder than words, so I won’t write more about this than to say that this is one of the finest books I’ve read this year and I highly recommend it to everyone.

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Filed under Book Reviews, Graphic Novels