On the Usefulness of First-Person Accounts

The apparently perpetual revisiting of issues related to the care and treatment of seriously mentally ill persons is no better illustrated than by examining patients' first-person accounts across the decades. We have recently done so in compiling an anthology, Women of the Asylum (9), and we see these issues reflected across time.

More than simply cataloging patients' treatment and mistreatment experiences, first-person accounts can educate us to do better. If we listen closely to what the individuals who choose to publicize their experiences through this column have to tell us, perhaps our patients will be the beneficiaries of psychiatric care and treatment that derives from a more enlightened direction rather than from another cyclic repetition in the name of reform.

Throughout the 19th century, first-person accounts were often an anathema to mainstream psychiatry. In 1883 John Callender (10), in the first presidential address at an American Psychiatric Association annual meeting, said: "Amid all the din and pother under the name of ‘rights of the insane,’ and their protection against improper confinement and abuse, and the prurient itch for innovation on methods approved by experience, and the fantastic foolery of spurious reform which now and then escapes from the disturbed brains of half-recovered patients, and becomes a squirming maggot in brains which claim to be sounder, this Association has preserved its equanimity."

We cannot agree with Dr. Callender's rather callous assessment of the usefulness of first-person accounts. We can, however, whole-heartedly endorse the very next sentence of his speech, one we believe speaks to the heart of the value of first-hand accounts: "The prime and indefeasible right of every insane person is to have his or her diseased condition recognized and respected, and all other rights pertaining must revolve about that one."