Norah Vincent, "Voluntary Madness" (2008)

Vincent undertook to understand the treatment of mental illness by 'immersing' herself in three different American treatment centres: one a public urban institution, one a private rural institution, and one a private 'progressive' institution in the US mid-west. Not purely a 'tourist' or 'poseur', Vincent believes that she may indeed have some form of mental illness, but her problems are not so debilitating as to render her incapable of researching and writing a book.

Her narrative of time spent in these institutions is believable. She captures details of scenery and thought that those who have spent time in psychiatric wards and asylums, particularly as patients, will recognize. In this regard, the work provides excellent insight, something like the affirmation of experiential commonality that an addict finds in a twelve-step program. She offers the kind of insights that "One Flew Over the Cuckoo's Nest" can't, and yet affirms in many respects that the situation in America's psychiatric institutions has not greatly improved or even changed.

Her desire to understand mental illness, to document its treatment and challenge some of the premises under which treatment is premised, was not convincing, however. Her capacity to stand back (or willingness to believe that she was) from her own mental illness, and to achieve some kind of overarching or privileged critical position, is unconvincing. The very reality that someone was putting up thousands of dollars for her to enter and stay in these institutions separates her experience from that of many people who find themselves in them - particularly when entry is not voluntary, but as incarceration by court order. I would expect that forced membership in the asylum not only alters the experience, it alters the perception of the experience. While Vincent is critical of many of her peers in the 'system', she particularly directs attention to persons incarcerated in the final institution (the nicest of the three) who do not seem to 'want to get better'. Of course they don't want to get better! They were sent there by court order. A system for caring for mental patients based on force by its very nature is likely going to be much different than one based on a preventative healthcare model.

You can read a short excerpt at Smith Magazine.

The Guardian offers a very prescient review.