Topics covered include the history of the mental health system, where the stigma against the mentally ill originates, possibilities for healthy mental health, and statistics on violence.

1. Michal Willinger
Positive Psychology
8th June, 2010
Inserting Positive Psychology into the Mental Health System
Synopsis
The following presentation will present facts, information and media clips relating
to the mental health system. All the facts I will present here are true and may be cross-
referenced by scholarly, peer-reviewed journals as to their validity. Media clips contain
straight facts as interpreted by relevant subjectivities within the mental health system and
bear no exaggerations or inferences. This is the history and present state of the
worldwide mental health system as it is right now.
It is the aim of this presentation to guide our understanding of current closed unit
psychiatric care of major mental illness in a historical context. Most of our work here as
been done for us by Michel Foucault, an academic and researcher who taught and wrote
on the history of thought-systems. From a historical context the presentation directs us
toward not only recognizing the thought-system paradigm we reside in currently, but
concrete steps toward shifting our paradigm in alignment with principles of Positive
Psychology.
Positive Psychology in particular seeks to use growing-tip statistics, practical
idealism and viable alternatives in order to meet goals set forward to meet human
happiness and well-being. Pioneered by Martin Seligman, the field can apply to the
mental health system in specific and important ways.
Once a historical context of thought and positive psychological applications have
been proposed, we will conclude with what we are able and may do next to move from
theory toward action. Creating viable happiness for major mental disorders is not only
possible, but likely given the correct methodology. It must first require an opening of
previously held models of mental illness and willingness to absorb a new thought-system
of what it means to identify and treat cases of mental illness.
PART I: TODAY AND YESTERDAY
From the Patient’s View
First and foremost, the experience of mental illness is by nature patient-focused.
In any model, mental illness begins at the individual level of experience and the societal
reaction against it. Please take the first few minutes of this presentation to watch this
video created by a patient confined in a unit for attempted suicide. With music and text,
she expresses her story in simple words that give us a sense of what it means to address

2. the mental health system from a patient-centered approach. This testimony is accurate to
a typical inpatient experience.1
What is normal? The origin of mental health
“Those who suffer and complain about themselves are usually classified as
"neurotic"; those whose behavior makes others suffer , and about whom others complain,
are usually classified as "psychotic."”2
Dr. Thomas Sczaz writes the above in 1974 after decades of engagement with the
mental health system. Mental illness is first defined sometime during the Renaissance,
which, according to Prof. Michel Foucault, is the beginning of man’s break with reality
becoming considered something other than a normal phase of the life process. Overall to
date, Foucault in several published works provides us with the most comprehensive
overarching history of not only the coming of definitions of mental illness, but the
sociopolitical structure that enforces, delivers and perpetuates it.
To understand the mentally ill we must first understand what was once a
dangerous enemy of European urban society: leprosy. From the time of Christ, leprosy
was common and thought to be contagious. We now know that 95% of most populations
are naturally immune to the bacteria that causes leprosy and that it is spread through nasal
drip or close respiration. So the city-dwellers of the Middle Ages had some reasoning in
sequestering lepers. Jews and lepers were the only groups Christian society required to
wear special clothing to identify themselves as such. Lepers were also made to carry a
special begging bowl, a bell and were even sometimes declared legally dead by the state
so it could legally seize their assets. In urban France, Germany and England, lepers
resided in special in-city colonies. In France alone, there were as many as 19,000.3
By the 17th century, leprosy was virtually eliminated in Europe, much like the
world is virtually eliminated of smallpox today. In 1656, King Louis XIV of France
found himself with thousands of abandoned institutions with no one to put in them. He
issued an Edict to re-build the largest former leper home, re-named it L’Hôpital Général,
and filled it with 4,000 Parisian criminals, alcoholics and gamblers, and mentally ill. The
new containment plan was so effective that soon Germany, England and the rest of
Europe followed suite. By royal decree, the new “hospitals” were outside the jurisdiction
of judicial law. They used two main methods of control for the inmates: isolation and
physical restraint. Often the hospital also withheld food and water, took away bedding or
other amenities, induced forced labor and used iron chains on the neck, wrists and ankles
to control and “cure” inmates. The result was that the hospital was usually at maximum
capacity and that at any time 1% of the population of Paris was held there.4
Hospital inmates are poor. Guards do not differentiate between addicts, mentally
ill and criminals. Parallel to the bourgeoning use of the hospital in confining society’s
unwanted is the advent of the medical industry. In the next portion we will describe in
detail the reforms of 1801 under Dr. Pinel and his extremely influential Treatise on
Insanity. France decrees that the mentally ill are now under the charge of physicians, not

3. prison workers, and in 1830 the “asylum” is invented exclusively for curing the mentally
ill.
However, the asylum continues the leper condition of confinement under the
control of modern medicine.5 A power structure is developed to both serve and deceive
the mentally ill. The explicitly-stated goal is to eliminate their sense of self-power.
Methods are without limit to what the L’Hôpital has utilized in the past and even earlier
with leprosy victims: seclusion, isolation, restraint and withholding of basic needs. Save
that iron shackles are replaced with the straight-jacket, nights in a wet dungeon are
replaced with dipping in cold water, and an urban environment is replaced by a rural one.
Yet who is deemed “mad” to begin with? By 1800, madness is divided into five
categories, according to Foucault, by the preponderance of psychiatric writers of the time:
someone who thinks they are superior to everyone; someone who is raving, or in a rage;
someone who is in passions with or without delusions; someone who has too many
incoherent ideas and conflicting speeches with or without delusions; and someone who is
melancholic.6 Note that there is not yet any genetic, biological or pathological
explanations for mental illness, such as epilepsy or syphilis.
To understand our mental health system today is to understand Dr. Philippe
Pinel’s ‘moral treatment’ movement in 1801 with his famous Treatise and the
systematization of the confined and newly-distinct mentally ill from society’s other
deviants (notably criminals and addicts).
Dr. Pinel became interested in the insane after a friend died from suicide. He
visits the Hôpital frequently and takes scrupulous observations on the insane, who at the
time make up 200 of the 4000 inmates and have a separate wing where they are confined
in cells. His handbook includes instructions of how to subdue people, describing how the
supervisor must keep a certain amicable and authoritative tone while servants surround
the inmate and each grab a limb. He then goes into cures involving forced isolation and a
uniquely personalized “stripping of sovereignty” whereby punishments are increased
until there is total submission and compliance with the authority and policies of the
hospital. The hospital is encouraged to sever contact between friends and family in order
to admonish old power relationships that may interfere with gaining total control over the
patient. According to Pinel, the hospital cures through permanent visibility, absolute
authority, isolation and the insane witnessing the insanity of others.7 And these methods
are all still in use today (Remember the testimony in our opening video by the depressive
patient; and if you are interested, also refer to the addendum of personal stories with this
presentation paper.)8
Voices and Images of Present-Day
Here in the presentation we will listen to the testimony of both a patient and nurse
inside a modern-day closed unit. The nurse explains the daily routine and the nature of
the work of the staff, while the patient describes her experience from the other side of the
same process. We will also see a 2008 incident from a New York hospital where a

4. woman slumps over and proceeds to die in the presence of two guards, who watch her
passively. It is two hours later before a passing attendant from another unit sees the
woman and proceeds to act. The entire incident is filmed on a surveillance camera.
Now that you have heard both the nurse’s and patient’s testimony, and seen a
patient-attendant interaction, take careful notice of how the Hôpital-Pinel institutional
model has crystallized the leper-mentality into the mental health system. First, the nurse
is able to speak confidently of the use of restraints and seclusion, as well as forced
medications and confinement, as a logical part of the curing process. In fact, the methods
of seclude, restrain and withhold are centuries old and derive from the sequestering of an
infectious population. Ignorant of these origins, the nurse is able to use Pinelian
terminology to reason these methods into a curing process that is in essence an offshoot
of a criminal isolate-punish-subdue system. As Pinel describes, the self-sovereignty of
the patient is left entirely in the hands of the psychiatrist, who is enforced by the
supervisors and attendants who pose as servants but are actually informants. Now that
the asylum is back in the urban environment from the countryside, the attendants take on
a much more sinister role from attend-and-comply to observe-and-ignore, as is
exemplified in the death of the Jamaican patient in King’s County Hospital. Although
the electroshock therapy patient can describe her experience in frustration, her overall
attitude is still one of submissive powerlessness to an all-encompassing medical
authority, infallible to either judicial or civil law.9 There is neither a way in not a way out
to the modern-day psychiatric system. The nurse seems to have us convinced the secrecy
and security is instituted for safety. Yet the same system principles have existed for
centuries, well before the modern-day notion of “safety” came to fruition in mainstream
discourse.
Intake Laws: Universality and Jurisdiction
Most countries in the world have adopted Dr. Philippe Perlin’s ‘moral model’ and
the classic L’Hôpital-based asylum in its legal, medical and confinement model.10
Generally speaking, the intake process can be summarized as 1) public complaint; 2)
official approval for detainment and 3) coercive compliance with detainment. In the first
step, a person notifies emergency services, either medical or criminal, about the behavior
of a suspicious person. Once the emergency service arrives, they must secure the
approval of a psychiatrist or government official to confine the person in a psychiatric
unit. In the third step, when approval is granted, the person is now entirely up to the
discretion of emergency services. If it is an ambulance, for example, upon a
psychiatrist’s approval they are allowed to use strapping and forced injections for any
reason. Most ambulances use forced injection as routine procedure and it is very difficult
for a person to talk their way out of once the call has been made.11 If it is the police, than
methods used to bring in a person might include police holds and handcuffs.
A special note on step two of the process is that to acquire official approval
usually takes place in a short phone call in which emergency services relays either first-
hand observation or second-hand information to gain approval for confinement. On the
one hand, this makes ridding the area of a questionable person quick and without

5. difficulty for the medical worker or policeman. On the other hand, it proves a huge
question of human rights for the person experiencing the process from the other side.
Second-hand accounts can be exaggerated or based on miscommunications common
during psychosis or mania. First person observations are after a person has already been
confronted with police or medical personnel who have no intention on objectively
hearing their side of the story, but rather are intent on securing approval to move ahead
with the situation. Such a situation often induces aggression that police in particular are
not trained to deal with and can exacerbate an impression of aggression, which is later
passed along to psychiatric personnel.12
The police and mental health
Police are such an integral part of the intake process that in a survey administered
in the United States on confrontations with mental illness, over 75% indicated a desire for
further training on these situations.13 Another problem with police involvement is that
judgments about whether to deliver a person to psychiatric or criminal processing has to
made and is based on inconsistent criteria, such as race, age and appearance. This is a
problem known as “criminalization” of the mentally ill.
Human rights law and mental health
Dr. Thomas Sczaz writes, “There is no medical, moral or legal justification for
involuntary psychiatric interventions. They are crimes against humanity.”14 Other
psychiatrists see it as a curative model designed in the long-term interests of the patient;
although we will see statistical evidence calling the curative results of the current
psychiatric system into question. Does the 1948 UN Convention on Human Rights apply
to those exhibiting signs of mental illness?
The United Nations’ World Health Organization currently acknowledges the
problem of forced detainment for the mentally ill but has yet to reach a decision on
whether the system’s confinement and medical coercion model constitutes human rights
violations.15
PART II: STIGMA
What does a mentally ill person look like?
Now that we have a historical context in which to view present day mental illness,
who exactly are we talking about when we say, ‘the mentally ill?” Does Pinel’s
definition still apply?
Today for the purposes of this presentation, we will talk about mental illness from
the perspective of the Big Three: schizophrenia, bipolar and depression. We choose these
in our inquiry into inserting positive psychology into mental illness because they are
responsible for the majority of hospitalizations on closed psychiatric units worldwide.

6. Who gets the Big Three? The answer is, everyone and anyone. The top row of
photos are randomly selected photos of bipolar illness support group members, excluded
the man on the right who was simply photographed by a curious bystander in Norway.
Then there are prototypical “crazies” you might see in a big city environment like New
York City or Tel Aviv, exemplified by the old woman, the woman in the orange tutu, the
man in the skullcap and the man with the large Afro. Though it is impossible to say with
any rightful certainty, at first glance we might assume these to be people exhibiting the
positive symptoms of schizophrenia. Finally, we have celebrities. Celebrities of all
varieties have had major mental illness. Clockwise from left to right, Mahatma Gandhi
and Jesus can easily be said to have suffered from delusions of grandeur and delusional
psychoses associated with bipolar mania. Marilyn Monroe and Elvis Presley suffered
from major depression, while Mozart is agreed to have had bipolar disorder and Rita
Hayworth, at the end of her career, paranoid schizophrenia.
The simple truth may be that there is no such thing as crazy. Only that, in every
lifetime, there is a time and place for everything.16
Mental Illness and Violence
Perhaps some of you have been asking yourselves, Aren’t mentally ill people
violent and scary? Doesn’t society need to be protected from psychotics?
The statistically-backed, scientifically tested answer is, Not really… sort of. In
other words, there are numerous studies on psychosis and violence, but there are as many
positive findings as negative correlations, making the overall result at best inconclusive,
and at worst, slightly negative.17 Prior to the 1990s, the conventional view held that there
is no association (e.g., Teplin, 1985) or at least no demonstrable association (Monahan,
1981/1995; Rabkin, 1979) between mental disorder and violence. A late-1990’s Danish
study found that schizophrenic men were 4.6 times more likely to commit violence and
women 22.3 times more likely to commit violence than the general population. A 1998
global study found a slight negative correlation (r=-.04) between major mental illness and
violence (Bonta et. al.) Confounding factors explaining inconclusive studies are young
age, co-morbid substance abuse, personality disorders and low socioeconomic status that
come hand-in-hand with large scale diagnosed mental illness. Some studies eliminate
significant findings when controlling for these factors and some do not, still finding an
association in the positive or negative.18
A meta-study conducted last year found overall about a 55% increase in
likelihood of violence, as an aggregate, aggressed by the mentally ill population.
However, the authors decided to include verbal remarks in their definition of violence,
and noted that the likelihood of violence upon strangers, or, in other words, persons
unknown to a mentally ill person, was equivalent to the likelihood of aggression
committed by a person who is not mentally ill.
And finally, a positive schizophrenic is 250% more likely to be attacked by
someone than to attack someone.19

7. Mental Illness and Prejudice
Perhaps one of the most endangering aspects of mental illness is the socially-
acceptable stigma against the mentally ill. ‘Stigma’ is the term afforded to describe the
effect of “coming out” with a mental illness to others and the ostracizing, ridicule and
diminished quality-of-life experienced as a result. Despite the huge numbers of people
with symptoms of mental illness, terms like “crazy,” “wacko,” “loony,” “schizoid,” and
“psycho” are used to insult and dismiss people without consideration.
First, I find it essential to highlight just how many people we are talking about.
25% adults and children will have the effects of a mental disorder within one
year. 10% of people will suffer from a disorder in their lifetime. 2-6% of adults suffer
from an MMI. Depression is the largest cause of disability and contributing factors are
alcohol dependence and dementia. Sufferers are equally male and female. 140,000
people committed suicide in highly developed countries in 2005. Northern latitudes have
more successful suicides than southern latitudes.20
A typical re-admission rate for major mental illness was confirmed in the USA
and Canada to be about 20%. A Taiwan study between 2001 and 2003 showed a rate of
30% in one month, in a causative association with length of stay and caseload per
psychiatrist. Shorter stays and higher per-psychiatrist caseloads are highly associated
with higher re-admission rates. So overall the costs of mental health, including
absenteeism from work, comes to between 6-10% of a given country’s GDP.21 That is to
say, what distracts the labor force bears high costs to productivity.
Given that major mental illness and its symptoms are so prevalent in at least a
quarter of the population’s everyday life during any given year, what is the attitude of the
general public toward the mentally ill?22
In Canada, 80% would feel very or somewhat comfortable around someone using
a wheelchair) while it is less comfortable being around persons with ‘hidden’ or ‘internal’
disabilities (i.e. 46% would feel very or somewhat comfortable around someone with
chronic depression) (Canadian Attitudes Towards Disability Issues, 2004).
In Switzerland, two-thirds of the public surveyed favored revoking drivers’
licenses of persons withmental illness (Nordt et al., 2006).
In the United Kingdom, 70% of people diagnosed with a major mental illness
reported that they or someone in their family experienced prejudice as a result of mental
illness (Mental Health Foundation, London, UK, 2000). 58% of the UK public thought
that a mentally ill person cannot work in a normal job, such as a bank clerk.
In Israel, 40% replied that they would not want a person with mental illness

8. living in their neighborhood; 88% said that they would not let a person with mental
illness take their children to school; and 50% replied that they are willing to help a person
with mental illness but are not willing to be his or her friend.
In all countries surveyed, the ones to hold the highest negative views on the
mentally ill were, remarkably, psychiatrists (Caldwell & Jorm, 2001; Lauber et al., 2006;
Nordt et al., 2006). Common labels included ‘dangerous,’ ‘unpredictable,’ ‘unreliable,’
and ‘lazy.’ Psychiatrists tended to have low expectations about long-term outcomes,
display an unwillingness to interact with, live next to and form romantic relationships
with people with mental illness. Dangers of these sorts of attitudes promote
dehumanizing clinical practices, damaging the work of recovery, healing and rebuilding
lives (Angell et al., 2005; Deegan, 1997, Sartorius, 1998).
Patients’ satisfaction, although it is always surveyed, was not available on journal
databases such as PsychNet. Available surveys that I discovered consisted of three
positive accounts of outpatient clinical programs. Two other British surveys on
questionnaire-form effectiveness mentioned 66% of patients experiencing “adverse
events;” as in abuse, detainment, forced injections, strapping or isolation, and that nearly
half of mental health workers suffered from stress-related burnout from their jobs.23 24
Two-thirds of official complaints recorded in one hospital surveyed in the US in 2006
were about the hospital system and the hospital staff.
In all media worldwide, persons with mental illness are represented as violent,
dangerous, unpredictable, and criminal-like (Sartorius & Schulze, 2005; Stuart, 2006b;
Sullivan et al., 2005; Wahl, 1995). Thus, media reinforces a stigma against the well-
being of people diagnosed with mental illness, those who are appointed to heal them, and
the society expected to receive them.
Some attempt has been made to change the language by which we refer to mental
illness, such as “spiritual emergency”25 rather than “psychotic/manic episode” and other
terms sensitive to the process from a patient’s viewpoint.
I suggest that there is a dichotomous relationship between the confinement,
restraint, seclusion and forced-medication model and the ongoing stigma on mental
illness. A negative spiral ensues where mental health workers and patients are forced to
relieve cognitive dissonance by accepting false negative viewpoints more easily adopted
than a challenge to medical authority. As evidenced earlier in the presentation, the Leper
Paradigm of sequestering society’s contagious, who evolved to deviants, and then split to
prisoners and mental patients, has persisted precisely because psychiatrists have yet to
challenge Pinel’s model, which is little more than a more humanitarian treatment of the
original iron chains and damp stone cells of Paris’ L’Hôpital Général. Later on, we’ll
discuss some reasons why.

9. PART III: INSERTING POSITIVE PSYCHOLOGY
Marty Seligman and Growing-Tip Statistics
Marty Seligman, the founder of a psychological science known as “Positive
Psychology” had the notion that to study well-being, we ought to study the crème de la
crème of the phenomena we seek to explain. Rather than look at depressed people and
ask why they are unhappy, Seligman looked at happy people and asked what made them
that way.26
In this presentation, I pose the question to you of how we can apply Seligman’s
growing-tip statistic conception to the mentally ill. Who are the people who flourish in
spite of, or outside of, the formalized psychiatric mental health system? If we were to
find enough of them, what kinds of questions would we want to ask?
Practical Idealism
Positive Psychology posits that ideals can be implemented in a practical way. In
some countries, psychiatric wards are already taking on basic positive psychological
principles such as a pleasant environment (e.g. bright colors, living plants, thought-
provoking art, natural wood and soft lighting). Note the photograph of a Swedish closed
unit. How does it compare to the video footage we saw of the Jamaican patient who
collapsed and was ignored by two attendants? Can you imagine yourself inside either of
these units for a period of 44 days, the average stay for a forcibly-confined Israeli
showing symptoms for positive schizophrenia?
In particular, note the difference in costs. Colored paint is no more expensive
than white. Soft recessed lighting is possible to be made as energy-efficient as florescent
lighting. Natural sunlight reduces the need for electricity. Highly-laminate wood floors
can prevent costly injuries compared to hard linoleum. Is this really any more expensive?
Other cost-free initiatives in accordance with principles of Positive Psychology
would be empathy-based therapy, where meetings are designed to be centered on the
patient rather that the psychiatrist. Physical exercise and outdoor activities are also free
and a huge factor in measured well-being, particularly in depression.27
Viable Alternatives
More than any other concept you come away with in this presentation, I want you
to remember these facts on a special project that took place between 1971 and 1983 in
San Francisco, California, under the leadership of Dr. Loren Mosher.
The Soteria Project operated under the notion that perhaps it was possible to cure
the worst prognoses of mental illness in an environment cheaper, free from restraints,
forced medications and isolation, and lax on security, assuming the best of a person in

10. their capacity to be independent and well, rather than the worst. The results of the project
were astonishing to the mental health community, including Dr. Mosher himself, and
were replicated in at least two other similar projects in the United States and Switzerland.
Taking the worst cases of schizophrenia from a “normal” San Francisco
psychiatric ward, Mosher had non-medical personnel attend to them in a comfortable
home with open doors and a backyard. Patients received one-on-one attention, education,
group activities and at no time received any psychotropic medications. After two months
their rates of recovery were at 90%, on par with the hospital cases. Except after a two-
year follow-up, 90% of hospitalized patients had been re-admitted, while 90% of Soteria
patients hadn’t. Mosher had proven that acute positive schizophrenia could be treated
outside the L’Hôpital-Pinel confine-and-restrain model. He also showed that his cure
lasted beyond the psychosis and into the life of the patient, where the typical remission
rate virtually disappeared.28
PART IV: CONCLUDING REMARKS
Why hasn’t more been done?
Similar to the question of violence, you’re probably asking yourself, If this is all
true, why haven’t things changed by now?
The answer is complicated, but can be boiled down to three simple categories.
The first is history. We are still inside a leprosy-based conception of
sequestration and treatment for mental illness. Foucault pretty convincingly showed us,
before his death in 1984, that the history of mental illness is a model of confinement
meant for people with contagious, horrifying diseases. From lepers, to criminals, and
finally the mentally ill, our models are still catching up to our science. Very slowly.
But why slowly? The second category of the answer also answers this question,
which is that change is risky, and it involves big players. National government, local
government, pharmaceutical interests and insurance companies are all heavily invested in
the mental health system just the way it is now. A growth-minded capitalism doesn’t
press innovations in the population sector involving mental illness, because it overlaps
too much with public dependence. Investment in people who are chronically dependent
on others don’t matter so much to helping expand goods and services. Changing the
mental health system to a Soteria-model could change all that. But change is risky and it
will take a big push to get all those big players, stuck on the mainstream Leprosy
Paradigm, to see it.
The third is public knowledge. By their nature, psychiatric units are completely
closed and controlled. Information is intentionally barred from the public, even close
friends and family. Our only influences, then, come from movies and television, who in
turn have a commercial interest to reinforce the stigma, who in turn reinforces leprosy-
based thought-systems. But on a positive note, there is more out there than ever before in

11. the form of live testimony given by former patients on YouTube. One video I saw a girl
even had her camera in the emergency room as she was being admitted. It takes a trained
eye, however, to take the informational value away from the videos apart from the
glamour of the taboo mental hospital experience.
Okay, I see your point. But what can I do? How is it that I can help?
Think positive! There is something easy you can do, right now. First, watch Sean
Blackwell’s YouTube videos on his channel, Bipolar or Waking Up. He paints an
alternative viewing of psychosis and depression that is enlightening to any observer, in
particular someone who has any personal experience with mental illness.
You can also volunteer or visit a mental hospital. Most patients are very bored.
Anything that you can bring – whether its food, or a deck of cards – can be a welcome
help to ease the day. And seeing a friendly face when you think the whole world has
forgotten about you can also make a positive difference. Next year, my team in the New
School is starting a volunteer program in the world-famous Loewenstein Rehabilitation
Center. It will get you thinking about our hospital protocols and give you experience
working with people in sensitive points in their lives – who really need you, too.
You can also help me with my Section 12 project! This is an initiative to make a
mandatory reading of rights to anyone being forcibly confined through an emergency
services process. When someone is arrested they are automatically read their rights
according to the “Miranda Law.” Yet no such mandatory reading exists for the mentally
ill. It is my hypothesis that much of the observed aggression coming to the psych unit is
a direct consequence of patients not knowing what’s going on – not to mention being
forcibly strapped and injected in the ambulance on the way to the unit, or taken down and
handcuffed by the police without having committed a crime.
Finally, educate, inform and circulate truth! The more voices know the truth, the
less power the stigma can carry against the mentally ill. Remember, the Big Three are
not a person’s choice. No brain is condemned from birth; it is our duty as a society to
help these people come to feel loved, welcome and happy in their own skin.
“Where there is coercion and disrespect, there is no medicine.”
Grace Nichols, 3rd June, 2010.29

12. 1
Greenwood et. al. Satisfaction with In-Patient Psychiatric Services. (1999). The
British Journal of Psychiatry, 174. 159-163.
Haw, Camilla et. al. Patients’ Complaints at a Large Psychiatric Hospital. (2010).
International Journal of Health Care Quality Assurance, (23), 4. 400-409.
2
Szasz, Thomas S., MD. (1974). The Myth of Mental Illness. New York: Harper
Perennial.
3
Foucault, Michel. Madness and Civilization. (1961). London and New York:
Routledge Publishing.
4
Ibid.
5
Foucault, Michel. Psychiatric Power. (2003). London: Palgrave MacMillan.
6
Ibid.
7
Ibid.
8
First Person Stories of Forced Intervention and Being Deprived of Legal Capacity.
(2007). World Health Organization.
9
Davidson, Larry. (2003). Living Outside Mental Illness. New York and London: New
York University Press.
10
Horton, Richard. The Lancet Series on General Mental Health. (2007). The Lancet:
DOI:10.1016/S0140-6736(07)61245-8. www.thelancet.com.
11
Kallert, Thomas W. et. al. Differences of Legal Regulations Concerning Voluntary
Psychiatric Hospitalization in Twelve European Countries: Implications for Clinical
Practice. (2007.) International Journal of Forensic Mental Health, (6), 2. 197-207.
12
Lamb, H. Richard et. al. The Police and Mental Health. (2002). Psychiatric
Service Online, (20), 3. www.psychservices.psychiatryonline.org.
13
Ibid.
14
Szasz, Thomas S., MD. The Myth of Mental Illness.
15
Horton, Richard. The Lancet Series on General Mental Health.
16
Willinger, Michal and Feld, Gabriel. (2009). Boston: Back Bay Yoga.
17
Douglas, Kevin S. et. al. Psychosis as a Risk Factor for Violence toward Others: A
Meta-Analysis. (2009). Psychological Bulletin, (135), 5. 679-706.
18
Ibid.
19
Abnormal Psychology Lecture, Spring 2008. Psychology Department: Columbia
University, New York, USA.
20
De Looper, Michael et. al. Mental Health in OECD Countries. (2008).
Organization of Economic Cooperation and Development Policy Brief
(November). www.sourceoecd.org.
21
Ibid.
22
All statistics on stigma taken from Tal, Amir et. al. Mental Illness Stigma in the Israeli
Context: Deliberations and Suggestions. (2007). International Journal of Social
Psychiatry: 1-17. Citations given to referenced studies within Amir et. al’s report as
needed.
23
Greenwood et. al. Satisfaction with In-Patient Psychiatric Services. (1999). The
British Journal of Psychiatry, 174. 159-163.
24
Evans, Sherrill et. al. Mental Health, Burnout and Job Among Mental Health
Workers. (2006). The British Journal of Psychiatry, (188). 75-80.
25
Blackwell, Sean. Bipolar or Waking Up?. (2010). www.youtube.com.
26
Ben-Shahar, Tal. (2010). Positive Psychology; Lectures 1-3. IDC RRIS New School
of Psychology: Herzliya, Israel.
27
Ibid., Lectures 6-8.
28
Mosher, Loren R. Soteria and Other Alternatives to Acute Psychiatric

13. Hospitalization. (1999). The Journal of Nervous and Mental Disease, 187. 142-
149.
29
First Person Stories of Forced Intervention and Being Deprived of Legal Capacity.