I wrote this paper today as the FINAL project for college course History 411: History of Science Activism at UMass Amherst with Professor Sigrid Schmalzer.
Word Count: 1972
As responses to certain issues and social injustice, new knowledge, including theories and practices, about mental health was produced and used in the 1970-80s US in the ways of challenging current authority in hearing (law); intended or unintended simultaneous work between the public, companies, and states; generalizing the outcomes of certain practice to explain its biosocial nature in theory; valorizing the groups that were ignored and harmed in previous knowledge; utilizing personal experience for individual and group advocacy; Movements’ organizing in hospitals and streets; as a result of or avoiding previous failures or lack of time in utilization; creating new theories for future research and practice.
Between the 1970s and 1980s, the United States committed ground troops in Vietnam from 1965 to 1973 for the Vietnam War, and suffered physical and mental casualties. The anti-war movement rose to protest against the Vietnam War, and on November 15, 1969, “half a million people attended a mostly peaceful demonstration in Washington” (The Learning Network, 2011). As a response to the anti-war movement, Science for the People (“the most important radical science movement in US history” that aimed for science for social justice, 1969-1989) and the Union of Concerned Scientists (“a national nonprofit organization founded by scientists and students of MIT”) were founded in 1969.
Although SftP worked on many issues across disciplines, fought against systematic “racism, sexism, and classism in science,” and “sought to demystify scientific knowledge and embolden ‘the people’ to take science and technology into their own hands,” SftP discussed little about mental health in their publications between 1969-1989. Under Chapter 4: “Biology and Medicine” edited by MD/PhD candidate in the history of science, Harvard University, Alyssa Botelho in the book Science for the People: Documents from America’s Movement of Radical Scientists (UMass Press, 2018), members of SftP reviewed the issues of genetic and evolution deterministic view of abnormal behaviors, recombinant DNA research, and cancer research. SftP also described the social responses to these issues, where debates and collaborations between researchers, administrators, and local residents happened.
The one document tackling knowledge about mental health is The Genetic Engineering Group, “Actions on XYY Research,” Science for the People 7, no. 1 (January 1975): 4. The Genetic Engineering Group belonged to Boston SftP. This article was a mobilized protest against Boston Lying-in Hospital’s screening of newborns’ XYY chromosomes for mental disability (antisocial behavior). After explaining the no causal relationship between XYY chromosomes and antisocial behavior and the harms of claiming this relationship, the Genetic Engineering Group showed the process of producing new knowledge about mental health by challenging the review of this screening in a hearing (on October 4, 1975), before a special committee, against Harvard Medical School professionals.
Advocates of the Genetic Engineering Group were not experts in the relationship between XYY chromosomes and antisocial behavior. Harvard Medical School Faculty Professionals thus viewed the advocates’ criticism unprofessional, “surprising and upsetting,” and even threatening to the faculties’ “academic freedoms.” (The Genetic Engineering Group, 1975, 93) The faculties did not consider the critique itself before jumping to judgment.
The special committee accepted part of the critique and “recognized that truly informed consent was not being obtained,” and the research was potentially harming participants. Nonetheless, “the committee was clearly worried that if one study was stopped, the same could happen to other investigations with human subjects. The power of research precedent was also raised in the opposite context; the researchers implied that the existing screening programs (e.g. for the metabolic defect phenylketonuria—PKU) justified their chromosomal screening studies.” (The Genetic Engineering Group, 1975, 93) This clinical research also received support from the Crime and Delinquency Division of the National Institute of Mental Health. Together, the committee, research team, and the Crime and Delinquency Division of the National Institute of Mental Health suggested that clinical investigations should not be stopped even if they are risky and harmful, and that the mere existence of irrelevant previous research could justify this research. The Medical School Professionals considered the advocates’ critique untrustworthy because they were not trained in this field. There was a clear cut between professionals and advocates.
As a result of this advocates’ challenge in hearing, the committee was “deliberating the issue” and was “scheduled to report out their findings about Christmas time.” (The Genetic Engineering Group, 1975, 94) The advocates suggested that they would “bring the issue to public attention via newspaper coverage, magazine articles” if the committee decided to continue the research. The decision was still up to the special committee, which composition was opaque. The credibility belonged to Medical School Professionals who were trained in the particular field and proposed the clinical investigation. The advocates did not show enough credibility to end the research when the article was published, but their credibility might rise if they proceeded to advocacy.
What more was happening in the 1970-1980s US on producing and using knowledge about mental health? Isabelle Linguiti, class of 2020 at Hampshire College, briefly reviewed, in their Division III paper “Stigma and Mental Health Care: A Philadelphia Case Study,” (2020) the history of mental health care in the United States. In the 1950s, “the combination of public outrage, pharmaceutical treatment advances and the state’s desire to shift the cost to the federal government, led to the successful push for deinstitutionalization (Linz & Sturm, 2013).” (Linguiti, 2020, 7) In the late 1960s, state psychiatric hospitals were closed, leaving space for community mental health care so that people can “integrate into the community”. (Linguiti, 2020, 7) Deinstitutionalization happened as a result of the simultaneous voices from the public for inhumane conditions in the facilities, the pharmaceutical companies for more inquiries for meds and privatization, and the states for saving cost. The public, pharmaceutical companies, and states together produced the theory that institutionalization was no longer appropriate, and pushed for the practice of deinstitutionalization and community mental health care.
Linguiti argued that during deinstitutionalization, the states did not invest in the practice of mental health care and relevant social resources, leading to “dramatically increased rates of homelessness and incarceration of people with mental illness over the last 50 years (Perez, Leifman & Estrada, 2003).” (Linguiti, 2020, 8) The 1970-1980s US was thus a period of criminalization of mental illness, a theory “first used by Abramson (1972).” “It refers to people with mental illness being arrested and prosecuted for minor offenses. Compared to other inmates, people with serious mental illness are four times more likely to have been arrested on minor charges such as disorderly conduct or threats (Torrey, n.d).” (Linguiti, 2020, 8) In face of the higher likelihood of going into jails for people with mental health concerns, who had no proper treatment due to lack of treatment and resources, a new theory, as knowledge about mental health, was produced to explain the biosocial nature of community mental health care.
In this context of community mental health care and other radical health movements, Mental Patients’ Liberation Front (Boston, 1970s) and The Psychiatric Survivors’ Movement (a branch of previous MPLF, a result of divergent beliefs of mental health care in the MPLF, 1980s) rose in the US to “turn to one another [people with mental illnesses] for strength, for support, for understanding” (UMass Amherst Special Collections and University Archives, MS 768 Series 2 Organization: Conference on Human Rights and Psychiatric oppression, third, 1975), offer possibilities of treatment other than clinical, “challenge the power of psychiatry and the definition of madness,” valorize the knowledge of people with mental disorders, and advocate for human rights and resources for these people and against stigma of mental disorders.
Judi Chamberlin, a founder of The Psychiatric Survivors’ Movement (also called The Peer Support Movement) and leader of Mental Patients’ Liberation Front, “psychiatric survivor” of chronic schizophrenia (as diagnosed by psychiatrists), challenged the medical etiology of mental illnesses and argued that “societal pressures caused her emotional distress that led her to voluntary and involuntary commitments to psychiatric hospitals in the late 1960s.” (UMass Amherst Special Collections and University Archives) Chamberlin used her knowledge and experiences of mental health care to advocate for psychiatric survivors as part of various mental health care and civil rights organizations and movements. Some methods she incorporated include delivering public speeches, writing about her own experiences of being treated inhumanely in psychiatric hospitals in the late 1960s, other forms of organizing, and collecting news, zines, letters, and other documents that discussed and spread knowledge about mental health.
UMass Amherst Special Collections and University Archives wrote, in the background of Chamberlin, on MPLF’s organizing actions like distributing booklets and marching for liberation of people with mental illness, “when Chamberlin joined the group, they [Mental Patients’ Liberation Front] were focusing on in-hospital organizing by distributing a booklet called Your Rights as a Mental Patient in Massachusetts to the patients at the Boston State Hospital. The MPLF sponsored the Fourth Annual Conference on Human Rights and Psychiatric Oppression in 1976, marching around the Massachusetts Mental Health Center and the Harvard Medical School with a sign bearing the slogan: ‘Smash Psychiatric Oppression!!!’”
Loren R. Mosher, MD, the first Chief of the Center for Studies of Schizophrenia at National Institute of Mental Health (NIMH), published an article “A research design for evaluating a psychosocial treatment of schizophrenia” in Hospital and Community Psychiatry in August 1972 (Judi Chamberlin Papers MS 768, UMass Amherst SCUA). NIMH remained the “the lead federal agency for research on mental disorders” as part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.
In this article, Mosher argued three reasons why little research was done to evaluate the effectiveness of clinical treatment of schizophrenia, “this lack of investigative interest may reflect a view of schizophrenia as an incurable disease, a view resulting from general frustration about its treatability. In addition, some psychological treatments – family and group therapy, for example – have only recently came into wide-spread use for schizophrenics, which perhaps accounts in part for the dearth of evidence about their efficacy.” (Mosher, 1972, 17)
The first reason was that clinical researchers and practitioners believed that schizophrenia is untreatable because previous attempts at treatment were ineffective. In this case, the new clinical theory and practice (knowledge) about mental health – the belief that schizophrenia is incurable – was produced after previous failures. The second reason was that psychotherapy with more than one person was still new as a treatment option for people with schizophrenia. Here, knowledge about the clinical practice of family and group therapy was limited due to the short time they were utilized.
Mosher continued to suggest the third reason, “rather than accepting and building upon the contributions of past studies, psychotherapists have used the flaws as an excuse for eschewing further research and for continuing instead to present case reports – clearly a less arduous task.” (Mosher, 1972, 18) Here, clinical researchers and practitioners used their knowledge about mental health – being pessimistic about researching the effectiveness of treatment (individual, group, and family psychotherapy) for schizophrenia – to abstain from critiques and innovations of treatment by research and to move towards reporting the status quo.
Mosher presented his criteria/theory (knowledge) of evaluating the effectiveness of psychotherapy in six categories: theory and technique, patient characteristics, therapist characteristics, process, context, and outcome. To apply these criteria, Mosher conducted a five-year case study in Soteria House, where people with schizophrenia could “explore, understand, and finally learn from it.” This project challenged the medical authority of psychiatrists and staff and the rigid performance of patients. It also built on previous failures as “each area covered is one that a previous study failed to address.” Mosher opened a gate for future research and practice of psychotherapy (knowledge) when this case study was published and cited.
To respond to certain issues, new knowledge, including theories and practices, about mental health was produced and used in the 1970-80s US in various ways.
Bibliography
Isabelle Linguiti, 2020. Stigma and Mental Health Care: A Philadelphia Case Study. Division III, Hampshire College.
Botelho, Chard, Schmalzer, eds., Science for the People: Documents from America’s Movement of Radical Scientists (UMass Press, 2018).
The Learning Network, “Anti-Vietnam War Demonstration Held.” Nov. 15, 2011. https://archive.nytimes.com/learning.blogs.nytimes.com/2011/11/15/nov-15-1969-anti-vietnam-war-demonstration-held/
Science for the People. “About SftP.” Accessed May 22, 2023. https://scienceforthepeople.org/about-sftp/
Union of Concerned Scientists. “About.” Accessed May 22, 2023. https://www.ucsusa.org/about?gclid=CjwKCAjwgqejBhBAEiwAuWHioI6hohDKGv984bN9c3p5dSpSLQgOairNc1_bt1haL2p5A6ZEh5eslhoCkA8QAvD_BwE&gclsrc=aw.ds
UMass Amherst Libraries Special Collections and University Archives. “Judi Chamberlin Papers.” Accessed May 22, 2023.
http://findingaids.library.umass.edu/ead/mums768
A research design for evaluating a psychosocial treatment of schizophrenia, August 1972. Judi Chamberlin Papers (MS 768). Special Collections and University Archives, University of Massachusetts Amherst Libraries