The fight to be released from a
psychiatric institution
OF all the unusual correspondences into which I have stumbled via the
Internet, the most colourful must be my ongoing virtual association with
Rodney Yoder, a 42-year-old American who has been held inside a mental
institution against his will for the past 10 years.
Like many who
promote their causes on the web, Yoder is relentless and passionate,
squeezing every ounce from the communicational technologies the web
offers.
To cut a long story short, Yoder received a four-year
sentence in 1989 for aggravated battery after assaulting his wife. He
pleaded "guilty but mentally ill", based on admitted alcoholism. He was
sent to the Menard Correctional Centre and was transferred against his
will to Chester Mental Health Centre when his initial sentence was up.
That happened in 1991, beginning what Yoder calls his "extra-judicial,
natural-life incarceration".
Every time Yoder has earned a review
of his case, state-paid psychologists have convinced juries that Yoder
would be dangerous if freed. Several lawyers who have represented him and
a growing number of medical professionals say he's no more a threat than
many people who are not locked up.
Under Illinois law (which
governs the Chester Mental Health Centre), as in most other U.S. states,
an involuntarily committal can be initiated by an adult. A "qualified
examiner" - a psychiatrist or other mental health professional - must
certify that the person is mentally ill and dangerous, or unable to care
for himself or herself. The committed person can then be held for 96
hours, whereafter successive hearings must be held to extend the
committal.
Whether Yoder is mentally ill and dangerous is what
will be tested as he continues to appeal against his incarceration. But it
may well be Yoder's remarkable ability to care for himself - having
conducted the bulk of his own legal defence for the past decade - which is
experienced as most threatening to those who'd like to see him live out
his days at Chester.
Interestingly, the law in Western democracies
does not make provision for the detention of previously convicted violent
criminals after their sentence has run simply on suspicion that they may
be violent again. But there is a temptation for law enforcement officials
to rely on psychiatric institutions to detain people on the grounds of
mental illness which they argue will predispose them to violence to
themselves or others.
That's the bull's eye of Yoder's protest and
he has won the support of a number of leading anti-psychiatry campaigners
in the process.
He commented acerbically in a recent interview with
the St Louis Post Dispatch, hinting at his formidable command of both
psychiatric diagnoses and the legal convolutions he encounters on trying
to shake these diagnoses from his record.
But Yoder's plight,
regardless of how real his own aggressive inclinations may be, highlights
a fundamental question about the role of psychology and psychiatry in
civic life.
The mental health profession occupies both the
position of an instrument of the state and an ostensibly neutral and
scientific way of categorising people into desirable and undesirable when
the authorities feel the law is not doing the job they would like.
In the grand old democracy that is the U.S., one is innocent until
proven guilty. But once declared insane by a jury of one (state-employed)
mental health expert, the label tends to stick.
Freedom is not
earned by serving a sentence but by defying what are typically lifelong
and unshakeable diagnoses. If Yoder is feeling a little mad, it's probably
a good prognostic indicator.
Through all the renewals of Yoder's
commitment to Chester, he has never been evaluated by a mental health
professional who wasn't paid by the state and only once has he had a
lawyer who wasn't on the public payroll.
Daniel Cuneo, clinical
director at Chester, has performed all but one of Yoder's evaluations,
testifying in a 1999 hearing that Yoder suffers from paranoid personality
disorder and has the delusion that he is being persecuted. He said Yoder
could "erupt" and hurt people if released.
Yoder, for his part,
has refused all medication and therapy and argues that the label "mental
illness" is a convenient way of keeping him inside.
But the
greatest irony of Yoder's case is the role that labels have played in the
debacle. He earned a reprieve from a prison sentence with the designation
of self-admitted alcoholism. But the first label was swiftly transmuted
into the paranoid personality disorder that his new captors applied when
his sentence had run its course.
Yoder, while decrying the notion
of mental illness, seems to have developed a fondness for psychiatric
labels himself. He told me of a life-threatening attack on himself by "one
of the sociopaths here", which he said had been encouraged by a "Ku Klux
Klan, Neo-Nazi biker". Surely, I thought, for Yoder the point should not
be the label he could attach to the transgressor of his rights, but the
nature of the transgression.
Yoder is now struggling for the right
to have his next hearing transferred out of Randolph County to ensure a
fair hearing. Whether paranoid or delusional or alcoholic, for Yoder the
stakes are extreme. In his words: "If I fail, I die here."
John Soderlund is a psychologist and publishing editor of New Therapist magazine.