Paris Hilton Goes to Washington
110 Years after Clifford Beers’ mission to curb institutional abuse was hijacked.
Paris Hilton went to Washington in October 2021 to advocate for passage of the Accountability for Congregate Care Act after having succeeded along with other activists in urging the state of Utah and other states to pass laws to curb abuse in youth residential treatment facilities.
Recently, while writing a commentary on the contemporary mental hygiene movement known as ‘mental health awareness’, it occurred to me, that it would be advisable to actually read the book that Clifford Beers wrote, ‘A Mind that Found Itself’. I now recognize that I was wrong for apportioning much of the blame for the detrimental consequences of the Mental Hygiene Movement to the man most sources credit as its founder, Clifford Whittingham Beers. I thought that he meant well and was sincere, but mistakenly mistook the author as the mastermind behind the movement.
I refer to Beers in a previous blog post titled How Physical Illness Became “Mental Illness”. In my writings, there have been scant references to Beers, but in that post, while stating a belief that his reports of abuse were certainly true, I also obliquely suggested the possibility that some of his perceptions of abuse may have been a reflection of his illness. When a person is neurologically detached from reality, their brain can perceive anything or anyone in that environment as a mortal danger and misinterpret certain therapeutic interventions as malicious abuse. Hospitalization for someone in the throes of florid so-called psychosis can be a terrifying experience.
Clifford Beers wrote the book to tell the world about the abuses he and others endured while committed to institutions for the “insane”.
Paris Hilton was certainly not so-called mentally ill when she was sent off to boarding schools by worried parents — who certainly had her best interests at heart but were deceived by the insidious operators of at least one of these facilities and by extension the industry as a whole. She was by her own admission — rebellious. Rebellious and ‘impossible to control’ is one thing, but by no means so-called mentally ill. But clearly, there are young people in these facilities that do have serious cerebral disorders and exhibiting neurobehavioral symptoms -so serious that they are unable to live in the family home.
The question begs, for anyone that comprehends that conduct issues, behavioral problems and mental health issues are in a different realm from serious brain function disorders (like bipolar, autism, and so-called schizophrenia). These are serious neurological disorders (the vast majority of people don’t know this). They affect mentation and behavior in very serious ways but they are not “behavioral or conduct disorders”…which are mental health or psychosocial issues, not medical issues. The term ‘Mental Health” is a metaphor that refers to how we cope with the problems of everyday living…from the benign to the serious. Mental Health does not refer to medical disorders…despite the wrong way the term is being used by almost everyone, even the federal government.
Why are these populations ending up in the same institutional settings? Why would a so-called troubled teen be in a facility where physicians are prescribing pharmaceuticals that should be reserved for medical conditions?
A look at some of the websites for these facilities and the issues their program services cover makes it very clear that there is a mix of conduct issues that are not medical in nature, others under the label of quack psychoanalytical diagnoses…like Oppositional Defiance and Reactive Attachment Disorders… and medical illnesses that have serious neurobehavioral symptoms.
Flashback to 110 years ago, Clifford Beers set out on a mission, with crystal clear vision and with great hopes to put an end to the physical, emotional, and psychological abuse of residents of institutions. Had his mission not been hijacked by psychosocial psychiatry, there might have been better oversight of the types of facilities in which Paris Hilton and other victims were abused.
The Philosophy of “Moral Treatment”
During the first half of the 1800s, activists endeavored to reform the way the “mentally disordered” were treated and moved to get them out of the squalid madhouses and jails where they were subject to whipping, beating, bloodletting, shocking, starvation, and isolation — among other horrors. So-called mental illness was often viewed as deliberate disobedience, liable to criminal punishment — and remains so today because neurobehavioral symptoms of cerebral illnesses are still profoundly misunderstood by society and the criminal adjudication system. These reformers subscribed to the philosophy of “Moral Treatment” and incorporated its methods into the management of residents of the asylums they worked to establish.
Moral Treatment, with its admixture of American protestant piety (as one source characterizes it), could be deemed an early form of psychotherapy, based on the idea that a person with a so-called mental disorder could be restored to sanity by being treated kindly in a clean, comfortable environment , opportunities for occupational and social activity, therapeutic recreation (reminiscent of Troubled Teen Wilderness Therapies) , therapeutic conversation with physicians and attendants, and “humane discipline”. Pharmaceutical treatment for “psychosis” (which is a neurological symptom) was not yet available and would not be until the early 20th century.
A reader cannot help but take note that Beers was possessed of sterling intellect (so-called mental illnesses can transiently or persistently impair domains of cognition but they are not classified as intellectual disorders) and held well-reasoned views where matters of institutionalization of “insane” persons was concerned.
In 1904, during a period in which he was not hospitalized, Beers had begun to contemplate writing a book to tell the story about the abuses he experienced and witnessed. He had read the book “Les Misérables” and it had made a profound impression on him.
“…Hugo’s plea for suffering Humanity — for the world’s miserable — struck a responsive chord within me. Not only did it revive my latent desire to help the afflicted; it did more. It aroused a consuming desire to emulate Hugo himself, by writing a book which should arouse sympathy for and interest in that class of unfortunates in whose behalf I felt it my peculiar right and duty to speak.
In January of 1905 he wrote:
In writing about my project, I said, “Whether I am a tool of God or a toy of the devil, time alone will tell; but there will be no misunderstanding Time’s answer if I succeed in doing one-tenth of the good things I hope to accomplish…. Anything which is feasible in this philanthropic age can easily be put into practice…
Just writing a book to tell his story would not be enough, however. He began to envision a much more expansive mission of reform to curb institutional abuse. But psychosocial ideologies of psychiatry would soon steer his mission off course…eventually laying a cornerstone in the foundation for what is now commonly called the “broken mental health system”.
Beers was astute enough to know that he would have to tap into the resources of powerful, influential people to make a success of such a daunting mission. He knew that he had to harness forces from outside of the regime of authorities that had administrative control over the institutions where these abuses were taking place. There are illuminating passages in the book which reveal that Beers’ goals were initially quite different than the direction that the Mental Hygiene Movement would ultimately take. Putting his vision into the context of the book “Uncle Tom’s Cabin” and the imprint it had made on the societal consciousness:
Why cannot a book be written which will free the helpless slaves of all creeds and colors confined to-day in the asylums and sanitariums throughout the world? That is, free them from unnecessary abuses to which they are now subjected.
That is…he clarified…free from abuses, not free from confinement. He goes on to clarify further, speaking also to the matter of the burden and abuse of stigma: Of course, an insane man is an insane man and while insane should be placed in an institution for treatment, but when that man comes out he should be as free from all taint as the man is who recovers from a contagious disease and again takes his place in society.
Misguided civil liberties and disability rights activists decades later would wage a war on institutionalization. Lacking the keen understanding and insight that Clifford Beers had, however, their mission succeeded in “freeing” people to be homeless, and re-institutionalized in America’s jails and prisons where they are unjustly punished.
Beers also dreamed of a day when science would find causes and cures. The book, however, was written as a retrospective, and at the time of its publication in 1908, Beers had already come under the influence of those that had steered the mission off the course of reform. In the fall of 1907, Clifford Beers met Adolf Meyers, then regarded as an esteemed psychiatrist, wanting Meyers to review the manuscript for “A Mind That Found Itself”.
Like Sigmund Freud, although they each had certain uniquely strange, extravagant and disordered theories of their own, Meyers believed the cause of “mental disorders” was rooted in social environment (especially family life) and early childhood experiences. Adolf Meyers was a psychologizer, a person that perceives and conceptualizes neurological phenomenon as psychogenic…and perhaps it’s the way their brains are wired.
Psychologizers believe that so-called mental illness or “psychotic reactions” to be a product of dysfunctional and maladaptive personality not a pathology of the brain. Some believe that there are psychogenic alterations of brain function (consistent with the contemporary concept of “biopsychosocial”) and that psychotherapy can alter the brain physically. A psychologizer will believe this no matter what science may prove otherwise (which is not to say that our life experiences do not play a role in how our brains are “wired” — just not to the degree of pathology that is caused by organic or neurodevelopmental disorders. Science also established the idea of neuroplasticity, which along with epigenetics have been co-opted by psychosocial psychiatry with wild and harmful exuberance).
Meyers envisioned a society where there would be systematic approaches to promote mental health, thereby preventing so-called mental illness. Recognizing a prime opportunity, the fertile ground that could be cultivated by a receptive public, Meyers seized the moment and hijacked Clifford Beers’ Mission. If you ever wonder why the topic of Mental Health is saturating media content today to a bizarre degree of excess…if you really stop to think about it, this was how it all started.
Leveraging his ideological goals off the success of Clifford Beers’ book, he would be a facilitator to help Beers to connect with people of power and influence that could help operationalize a mental hygiene movement. Psychiatry would no longer be cloistered inside the walls of institutions; it would introduce itself into the expanse of society. Meyers believed that psychiatrists should work with community leaders and organizations to promote mental health. The concept was labeled “mental hygiene” (A term first used by William Sweetzer in 1843).
Adolf Meyers edited Beer’s manuscript and made suggestions to further his own agenda. He encouraged Beers to soften his portrayal of abusers, shift blame away from individuals (doctors and other allied staff) and redirect it to the factors of understaffing and underfunding. He also influenced Beers to focus on prevention of so-called mental illness. In 1909, in collaboration with Meyer and other people of influence, the National Committee on Mental Hygiene was launched. Seated in the period known as the Progressive Era (which is a historical fact, not meant to signify any kind of lefty bent to the mental hygiene movement) the movement took loft in a political environment that fostered eager receptivity. The Progressive Era was a period of assertive social activism and political reform in the United States.
He encouraged Beers to soften his portrayal of abusers
This Mental Hygiene Movement tracked along scientific advances in the understanding of what were mistakenly believed by the psychologizers to be functional disorders. A functional disorder is believed to ‘mimic’ the outward manifestations of true medical conditions (such as encephalopathies, seizure disorders, and other illnesses that can cause dysmentation, hallucinations, delusions, and other neurogenic or biogenic causes). If you ever hear or read content that contrasts so-called psychiatric disorders like “schizophrenia” with medical disorders, this is a blantantly false notion. So-called schizophrenia is indeed a medical disorder and therefore does not “mimic” medical conditions.
Adolph Meyer’s vision would bring public service psychiatry into prominence, turning away from the gloom and doom of the prevailing perceptions of chronic “mental illness” toward the therapeutic optimism of prevention, away from the needs of the most seriously ill toward the psychological wellness of the population as a whole — and resources (including research funding by government and other sources) would follow this shift in focus.
Ensuing from the Mental Hygiene movement, “Mental Health” became a socio-political movement in which the belief systems undergirding ‘Mental Hygiene’ leeched into every aspect of our lives at the level of public policies. Society became consumed in ignorance about the essential nature of cerebral illnesses and thus became incapacitated to protect the most vulnerable people from the abuse of homelessness, lack of access to care, and unjust criminalization. The system was broken.
It would be over 70 years later before an Act of Congress was passed to address institutional abuse of so-called mental ill persons, but the Mental Hygiene Movement which morphed into today’s Mental Health Awareness moved forward without dropping a second on the clock.
The PAIMI ACT — Intended to curtail abuse but undermined by Consumer Movement ideology.
The Protection & Advocacy for Individuals with Mental Illness Act was passed three quarters of a century after Clifford Beers launched a movement with the intent to put an end to abuse and neglect in congregate care facilities.
The PAIMI Act of 1986 established the PAIMI Program. It was modelled after the Developmental Disabilities (DD) Act, which narrowly focused on Intellectual Disabilities to the exclusion of people with so-called psychiatric disabilities. According to a 2011 report produced by SAMHSA (Substance Abuse and mental Health Services Administration, a government agency with serious problems of its own), the Act was “crafted at a time when numerous reports of abuse and neglect in state psychiatric hospitals were substantiated”.
The Act intended to assist states to establish and operate a protection and advocacy system for so-called mentally ill individuals.
The term ‘abuse’ means any act or failure to act by an employee of a facility rendering care or treatment which was performed, or which was failed to be performed, knowingly, recklessly, or intentionally, and which caused, or may have caused, injury or death to an individual with “mental illness”, and includes acts such as:
Rape or sexual assault
Other forms of physical assault, such as striking or slapping
The use of excessive force when placing an individual in bodily restraints
The use of bodily or chemical restraints which is not in compliance with Federal and State laws and regulations.
The term “neglect” means a negligent act or omission by any individual responsible for providing services in a facility rendering care or treatment which caused or may have caused injury or death to an individual with “mental illness” or which placed an individual with “mental illnes” at risk of injury or death, and includes an act or omission such as the failure to establish or carry out an appropriate individual program plan or treatment plan for an individual with “mental illness”, the failure to provide adequate nutrition, clothing, or health care to an individual with “mental illness”, or the failure to provide a safe environment for an individual with “mental illness”, including the failure to maintain adequate numbers of appropriately trained staff.
What is not articulated even within the enlightened advocacy community, however, is that it is a form of abuse in and of itself to have a medical disorder misclassified and psychologized. As a thought exercise, consider the case of someone that psychologizes Alzheimer’s Disease and what the consequences might be for a person with that diagnosis. They could be subjected to psychotherapy or behavioralist interventions. The reader might think it is very unlikely that someone would psychologize a dementia, i.e. attribute a degenerative brain disorder to family dynamics, “adverse childhood experiences”, or other psychosocial causes, but a psychologizer can formulate a psychogenic cause for any medical disorder of the human body.
What Went Wrong?
The National Disability Rights Network (NDRN) is the nonprofit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and the Client Assistance Programs (CAP) for individuals with disabilities.
Excerpting from MentalIllnessPolicy.Org
The Protection and Advocacy Program was founded with the noble purpose of preventing neglect and abuse of persons with serious mental illness in institutions…Today PAIMI has morphed. It construes its mandate to be protecting people with mental illness from having to receive treatment, rather than insuring those who need it gain access.
An analysis of the SAMHSA 2011 Evaluation of PAIMI reveals PAIMI ignores the institutionalized, minorities, and people with SMI (Serious so-called Mental Illness). Rather than focus on abuse and neglect they use the rubric of ‘civil rights concerns’ to allow them to focus on whatever they find ideologically palatable. They engage in activities harmful to the seriously ill (threatening states that implement AOT and working to close hospitals). SAMHSA has looked the other way and implemented little oversight.
In a nutshell, NDRN is a Consumer Movement-Oriented institution with an ideological concept of abuse. Government agency SAMHSA, which is supposed to be making sure the program is executing its mission in accordance with the intent of the law, has been strongly criticized for becoming a Consumer/Recovery Movement-focused agency that is oriented toward Mental Health (which, as is stated above, is not medical) and consumer empowerment rather than serious brain function disorders.
By thwarting reform measures and programs intended to increase vital treatment for the people that need it and by lobbying to decrease what is already a severe shortage of treatment beds for people with cerebral illnesses, NDRN is pushing vulnerable people into homelessness and into a criminal adjudication system that does not understand their illnesses…thereby transinstitutionalizing people into jails and prisons where abuse and neglect are a feature of the program, not a bug. This is a country where the segment of the of the population most influential on the ruling class wants people to suffer as an extrajudicial feature of their punishment.
Within the mental health industrial complex, housed in one wing is the seedy cohort of behavioralists and deranged therapists that run troubled teen programs and other institutions. In another wing are the psychologizers running the perpetual contemporary mental hygiene movement known as Mental Health Awareness, the stewards, or the “good guys” of which are psychosocial psychiatrists, clinical and research psychologists, and psychotherapists that the media courts for their purported expertise on the human mind and behavior and whose ideas have misinformed legislation and public policies.
In the PAIMI Act we already have a legislative act at the federal level that was intended to curtail the kind of institutional physical and psychological abuse that brought Hilton to Washington. The Act may or may not be expansive enough to regulate the “Troubled Teen Industry”. As this commentary spoke to earlier, there are people in these programs that have mental health and conduct issues — which are not so-called mental illnesses (which are more appropriately called brain function disorders…like bipolar, autism, called schizophrenia, and other medical conditions that involve neurobehavioral symptoms). Passage of yet another act is of questionable benefit unless federal and state governments make a serious commitment to regulate these providers instead of permitting special interests to undermine enforcement.
1975 — Developmental Disabilities Bill of Rights Act (The DD Act)
1986 — Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act — expanded in 2001 to include people living in home and community-based settings.
1996 — Protection and Advocacy for Individual Rights (PAIR) — to cover people with physical disabilities, mental health conditions not covered by PAIMI, disabling medical conditions, and other types of disability.
Perhaps instead of passing all of these narrowly tailored acts of legislation, there should be one Act that is comprehensive, that would include all institutional or community-based services, and that would have components of the Act that would address special populations. Perhaps the Act that Hilton is advocating for should be that one Act.
National Disability Rights Network should be replaced. If they were doing the work that the PAIMI Act charged them to administer, then why are these abuses running rampant? Before yet another Act is passed, perhaps Congress needs to “investigate” and audit itself, to find out why over 40 years later after the first of these Acts was instituted, Ms. Hilton came knocking on their door.