“There is nothing so shocking as madness in the cabin of the Irish peasant…when a strong man or woman gets the complaint, the only way they have to manage is by making a hole in the floor of the cabin, not high enough for the person to stand up in, with a crib over it to prevent his getting up. This hole is about five feet deep, and they give this wretched being his food there and there he generally dies”
Report of an Irish member of parliament c 1800
A couple of months ago my office neighbor Dr. Vivienne Rowan pointed out an article in the New York Times titled The Chains of Mental Illness in West Africa (click to view). It is very powerful and well worth reading.
At a point in life when many of us are taking up bridge and golf Vivienne, a psychologist, is volunteering with Doctors Without Borders/Médecins Sans Frontières (MSF). She shared with me the picture below, which she’d taken while in Aceh province Indonesia on a MSF assignment. The man had a psychotic illness. Family had previously been able to pay for psychiatric treatment but had run out of resources. With no other option the family caged him. While there Vivienne helped arrange for the man to get an injectable antipsychotic and he could then be unchained.
ACT clinicians should remember what many of our client’s lives would have been like in the not too distant past. Even with all the challenges posed by severe and persistent mental illness, addictions, poverty and the myriad of other problems clients face, it’s a big step up from what conditions were, and still are for some.