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Review:
How Dangerous are Our Mental Institutions?
The Hippocratic Oath is to, first and foremost, "Do No Harm." When registered nurse Carolyn McKinnon began a job at a state mental institution, little did she know her experiences would be so disturbing that the only catharsis would be to publish them. "I wanted to make a statement," says McKinnon, author of Insanity, Inc. (Audenreed Press, 1996) "about a system which I believe promotes abuses of power, opportunism, and exploitation of those of us who fund it, and those of us entrusted to its care. "
What occurred at the mental hospital could have been a scene from One Flew Over the Cuckoo's Nest. Patients were overdrugged and left to sleep on the floor. Food was withheld as behavior modification "therapy". Her employment ended after she protested the abuse. However, her protests were instrumental in having the Governor form a task force to investigate. Their findings resulted in the termination of directors and programs found to be of no benefit to the patient and an unnecessary burden on the taxpayer.
In a letter from Tipper Gore, McKinnon was commended for her interest in reforming our nation's mental health care system. Ms. Gore praised the book by saying "your unique insights into the conditions of mental health facilities are truly moving and thought provoking. Your story will stay with me as I continue to fight for the changes we so desperately need."
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Excerpts from INSANITY, INC.
"The 'good' ones just lie around or sit quiet and don't make any trouble", nurse Angley informed Laurie during her orientation. "We don't have much staff to give psychotherapy, but we're proud of the care we provide. Undertakers tell us that the bodies coming from this Institution are in better condition than the bodies they get from any hospital around".
When Virgie noticed Randy paying special attention to Ellie, she kept careful notes on when and how long. On one occasion, she "accidentally" opened Ellie's door during one of her "treatment" sessions. Although Randy quickly pulled up the sheet, it was clear that both he and the young patient were naked. Virgie smiled as she closed the door, knowing that she could just as easily close the door on his career.
Grace watched impassively as Virgie's violent convulsing splashed water over the sides of the tub, her legs extending in the water, pulling her head down and under. She watched as the convulsion stopped and Virgie's eyes became fixed as she drew water deep into her lungs. The sight became more disturbing as the water grew murky with blood from her chewed tongue and the contents of her bladder and bowels which had been evacuated during her seizure.
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Carolyn McKinnon, RN., a psychiatric nurse from Bangor, Maine, has witnessed many injustices and abuses of power m the various mental institutions where she has worked, These incidents are now revealed m a mystery novel Insanity Inc., a fictionalized account set in a state mental hospital. Her characters are composites of the patients and staff McKinnon has encountered during her career.
"I was shocked to hear that my book was banned at the (state's largest) mental hospital," McKinnon says. "Apparently staff was told not to bring the book on grounds or even to discuss it!" Of come, as is usually true of censorship, the controversy has created huge sales in area bookstores. One angry letter to the editor insisted that the characters portrayed in the book insulted mental health workers by inaccurately portraying them as sadistic, neglectful and greedy. Some believe the story to be too exaggerated to be believable.
McKinnon is puzzled by this criticism. "Had I never encountered any abusers of power or scheming opportunists," she says, "I would have had neither the material nor the inspiration for writing my book. McKinnon also says she makes it clear that the typical care-giver is hard-working and compassionate. "It is those in power who put their owm advancement above the needs of the patients that I wanted to expose."
Many of the incidents in the book that readers find shocking are based on McKinnon's experiences as a psychiatric nurse. "In fact," she says, "one incident was significantly toned down during editing because the truth was so outrageous it wasn't credible."
The real-life patient memorialized in her story was actually left maimed and disabled. Allegations of an attack on this patient resulted in a Grand Jury hearing with extensive media coverage. An entire program was terminated. "So you see," says McKinnon, "I didn't make up these abuses of power -- some of them are a matter of public record."
Although McKinnon was very nervous about presenting her story to the reading public, she has been gratified by the response from readers. And the country's current mental health care crisis has made her message a timely one. She reminds herself, when criticized, what motivated her to write the book. "If we are unwilling to acknowledge the abuses in how society cares for the powerless, how will we ever eliminate the abuses?"
