The Unitarian Universalist Congregation of Salem, Oregon

THE STIGMA

The Reverend Richard R. Davis 

April 11, 2010

            In 1841 a rather timid, middle aged Unitarian woman volunteered to teach R.E. – i.e.,  religious education, or Sunday School class, as it was known at the time – to women inmates in the East Cambridge Jail in Massachusetts .  Nothing unusual about this – we have members here who go into the prisons to teach or just to visit.   Sometime soon the Rev. Emily Brault, the Unitarian Universalist Chaplain at Coffee Creek Women’s correctional facility wants me to lead a class in meditation there – glad to do it.  It’s good thing when our religious vision and values spur us to get out of our usual ruts to encounter those we might not otherwise meet.  Many of you here do that when you volunteer to work with the homeless families who stay here several times a year or when you care for the foster children who come here every month or when you serve at the soup kitchen.  (ask for show of hands of those who participate)  These experiences open our eyes.  We may read about harsh social and economic conditions that affect so many people and thus become intellectually aware, but when you actually meet those affected by social injustice and neglect you become spiritually aware.  It almost seems to me that our society conspires to prevent such encounters – socio-economic walls are maintained which prevent this from happening.  Most people go along with this because such encounters take us out of our comfort zones and are not easy to witness, but they are important in that they awaken the conscience and lead to positive change. 

            Even so, I hope that none of us ever encounter such a shocking sight as this 19^th Century Unitarian Sunday School teacher.  A large proportion of the inmates in this Massachusetts jail were guilty of no other crime than suffering from mental illness and having no families to care for them.  These poor souls were crammed into small, foul smelling, unheated, unfurnished cells.  Many had been chained naked to the wall for years, their bodies wasting from lack of movement.  They were struck and lashed with rods and whips – authorities in those times seemed to think that you beat some sense into the mentally ill. This Sunday school teacher was shocked beyond words by this hellish vision, stunned that fellow human beings were treated with such cruelty in a so called civilized nation.  She felt such outrage that she forgot that she was supposed to be a timid soul, not to mention a woman in a time when women’s voices mattered little, and she confronted the authorities and demanded an explanation for this outrage. 

            And the authorities had a ready explanation.  She was told that these inmates were treated like this because “the insane do not feel heat or cold.”  Besides which, it was commonly believed that insanity had a divine origin and those who suffered must be guilty of some sin. So really, society generally felt that it didn’t matter that those who suffered from mental illness spent their lives in such abominable conditions. 

            Well, it did matter to Dorothea Dix – on that day she discovered the primary purpose of her life, which was to advocate for the rights of the mentally ill.  She is little known today – scarcely mentioned in psychology texts because she was not a psychologist who contributed to the scientific understanding of mental illness, she was just a humanitarian.  Her unique calling was to advocate for the humane treatment of those who suffer from mental illness.   In truth, Dorothea Dix had no interest in being remembered, but still, it seems to me that since she may well have done more than any person in history to insure humane treatment of the mentally ill, that she deserves to be remembered.  

            Time does not allow me to detail the remarkable achievements of this sole woman.  Let me simply note that she  travelled all across the United States advocating for humane treatment of the mentally ill, playing a major role in the founding of 32 mental hospitals and 15 schools for intellectually challenged (formerly known as “the feeble minded”)  in the U.S.  Likewise, she travelled widely across Europe and had a profound impact in changing their practices.  

Until this lay person stepped into the fray, many of the “experts” had a fatalistic attitude toward those who suffer from mental illness, believing that it was incurable and the only thing to do was to warehouse the afflicted in abominable conditions.  Yet, after society adopted humane practices advocated by Dix, positive changes occurred.  As she put it: "some may say these things cannot be remedied, these furious maniacs are not to be raised from these base conditions. I know they are...I could give many examples. One such is a young woman who was for years 'a raging maniac' chained in a cage and whipped to control her acts and words. She was helped by a husband and wife who agreed to take care of her in their home and slowly she recovered her senses."  

            It’s shocking to learn of how the mentally ill were once treated.  Yet where are we today in this regard?  Certainly, we’re better off in so many ways.  Yet I can well imagine a time in the future – say 50 or 100 years hence – when a social commentator or a preacher or historian will speak of conditions today, and people of that future age will feel shocked and saddened to learn of our own inhumane treatment and neglect.

            To be sure, such treatment is not as egregious than in times past.  Today, our primary social sin is not our barbarous treatment of the mentally ill but our neglect.  A shockingly high proportion of the inmates in our prison systems suffer from some form of mental illness.  Many would likely have never run afoul of the law if adequate treatment was available.  By and large prison personnel do their best to deal with inmates who suffer from mental illness, but jails and prisons – so full of anger, fear and bitterness - is the very last place those who suffer from mental illness need to be.   Yet, there they are:  we don’t chain people suffering mental illness to walls or beat them.  Mostly, we ignore them.  That is our great social sin in regards to mental illness today – a not so benign neglect.  They are swept under a rug like so much human refuse we don’t want to see.

            Walk down the street of any major city in our country today and you will see someone who is clearly delusional.  Everyone skirts around them – the are off their meds and on their own.  If they get too unruly, the police will be called in. 

            One friend of mine, who suffers from bi-polar disorder, knows what that can be like.  He was delusional and a Portland police officer, who was ill prepared to handle the situation, drew his revolver and threatened to shoot if my friend did not cooperate.  Of course this just added fuel to the fire.   My friend was physically restrained, incarcerated and deeply traumatized by the experience.  Yet the last time I talked to him he told me he had just participated in program to help the police work more effectively with citizens who suffer from mental illness.  So progress is possible.   

            But there is so far to go.  There are so many barriers to humane and adequate treatment of those who suffer from mental illness – in discussing these I could go off in a number of directions.  We could talk about grossly inadequate funding and lack of health insurance coverage and other gaping holes in our social services safety net that results in so much suffering and neglect;  or we could talk about well intentioned government regulations to protect patient privacy that has resulted in cutting parents off from their young adult children during the onset of their mental illness.  What a tragic mess that has turned out to be.   Those are all necessary and important discussions.

            But the thing I most feel called to talk about here, now, in this religious community, is not large scale issues like that but the reality of mental illness in our own community.  Call it an elephant in the room. 

            Think about it.  During our joys and concerns - a time when we acknowledge the heartbreak and hardship we encounter – people often share their sorrow and their pain:  we learn about the deaths, diseases, job losses, divorces and other painful realities.   Yet we rarely – I won’t say “never” – hear someone light a candle and say “my son/daughter/mother/father is struggling with depression, schizophrenia, schizoaffective disorder.”   And I don’t blame people for not publicly acknowledging such heartbreaking challenges – why?  For two reasons:  because of the stigma associated with mental illness and because those who suffer often cannot recognize this in themselves and it would be inappropriate for us to mention this publicly. 

            Even though mental illness is not often openly acknowledged, it is most certainly present amongst us.  Most, if not all of us, personally suffer or have family members or friends who suffer from some form of mental illness.  Years ago the prolonged mental illness of a member of my family of origin caused my family and I heartbreak and despair.  So many of you here today could tell of similar heartbreaks, past and current.  Believe me, I know. This is not a problem “out there.”  It is here amongst us, too.   We are called to make this be a place where members and friends know that we provide a compassionate haven for those whose lives are damaged and diminished by mental illness in all its distressing forms.

            Sad to say, but today there are some religious communities where there is still an implicit a “blame the victim” mentality in regards to mental illness – it is seen as stemming from some spiritual flaw in those who suffer – they have fallen away from God, made some poor lifestyle choices.  In society at large there is more of a passive, fatalistic and too often, uncaring attitude.  It is regarded as a permanent feature of the human landscape and there’s no help for it.   There is little funding for care and cure and too little compassion for those who either end up on the streets or in prison or whose socially isolated families struggle on with too little support.

            Yet this Unitarian Universalist congregation is a place the indomitable spirit of Dorothea Dix dwells in our collective memory.   So what do you suppose she would say to us here today concerning the current conditions of mental health care?   Here’s what she would say, in so many words.  “There is no stigma in suffering from mental illness any more than from other forms of illness.  You who suffer and you who are their family members should feel no shame.  The only shame that should be felt is among those who neglect those who suffer.  Don’t any of you dare give up on striving to alleviate this suffering!  Over a century ago I helped show that there are effective treatments for mental illness and since my day you have learned so much about the physical causes of mental illness.  Can you not imagine a time when there will be very effective treatment for those who now suffer?   Can you not envision a time when society recognizes its responsibility to truly care for those who so suffer? 

“I beg of you to remember this.  Those who suffer from the varieties of mental illness are not different than you.  They feel the cold and heat and pain and sorrow just as surely as you do.  Do not walk around them, do not ignore them, do not ostracize them.  Listen to them, Empathize with them, Agree with the challenges they face and partner with them (LEAP) as they journey toward a fruitful and fulfilling life.   Above all, have faith that you, just one person, can make a profound difference in this world.” 

            Let me (Rick) just add one final note in closing.  Today, April 11 is YomHaShoah, a time to remember victims of the Nazi holocaust.  Many of those whom the Nazis killed suffered from mental illness - the Nazis deemed those with mental illness “life unworthy of life” and put them to death.  In 1941 at the Hadamar Psychiatric Institute in Germany 10,000 mentally ill adults were gassed and creamated.  Let us remember all those who died today, let us never forget them and resolve to make ours a society that recognizes the seeks to redeem such inhumanity by recognizing the precious worth of each person in our world.