In Foucault’s chapter on “Confinement”, he traces the history of the large hospitals in Europe, which, in the 1600s and beyond, were used to treat various different issues, including homelessness, substance abuse, and mental illness.
Foucault is clearly against such “confinement”. He would have been pleased, I suppose, with the current mode of mental health treatment, which is to establish the independence of the patient. Higher functioning schizophrenics and others who suffer are often encouraged to rent apartments for themselves, buy their own groceries, and so forth.
There was an interesting quote in Madness And Civilization: “It is not immaterial that madmen were included in the proscription of idleness. From its origin, they would have their place beside the poor, deserving or not, and the idle, voluntary or not. Like them, they would be subject to the rules of forced labor.” (Madness And Civilization, 58)
This quote interests me in two ways. First of all, it suggests a connection between poverty and mental illness. Back in the 1600s, patients occupied the hospital alongside people who had to beg for money.
Poverty in the mentally ill community is a real and current issue. It’s not hard to understand why this is the case– if a person is unable (or unwilling) to work, and has to rely on government stipends, money is bound to be lacking.
The hospitals of the 1600s resolved this issue, in part, by putting the mentally ill to work. They subjected them to “forced labor”. This moved to resolve the issue of the patients’ idleness– helping to rehabilitate them physically, mentally and in other ways. It did not help with poverty issues, as laboring schizophrenics and other “madmen” were not reimbursed for their work.
I have mentioned the “Ticket To Work” program. This program was key to my rehabilitation. Living independently was a positive, both for me, my family, and my community. Sitting idle all day, however, did not provide my with the impetus to transform myself into a contributing member of society.
Ticket To Work allows patients to gradually come off of their disability benefits, while trying to obtain and keep jobs. Because they get to stay on their benefits for a period of time, it is not as challenging as taking them off of the checks completely and forcing them to rely on work as their main and only income source.
The work that patients do in today’s society may be difficult and stressful at times, but unlike 400 years ago, patients are financially reimbursed for their labor. By providing them with goals, discipline and direction, the world of work gives mentally ill people a chance to improve their skills and situation(s).
Using labor for rehabilitative means can be easily abused. Forcing anyone to work without compensation is immoral, and akin to slavery. However, work can be a helpful element in a patients’ healing, and becomes a quality of life issue. The early hospitals weren’t wrong to think that labor might benefit patients– only wrong not to compensate them for their efforts.