Abstract
The authors conducted a qualitative analysis of thirty-seven issues of The DDU Review, a newsletter produced by residents of the Dual Diagnosis Unit, a residential unit for people who had diagnoses of developmental disability and serious mental illness in the Central State Hospital (Indiana, USA). The analysis of the newsletters produced between September 1988 and June 1992 revealed three major themes: 1) the mundane; 2) good behavior; and 3) advocacy. Contrary to the authors’ expectations, the discourse of medicalization—such as relations with physicians, diagnoses, and medications—receive little attention. Instead, the patient-journalists focus on prosaic aspects of institutional life. The patients used their writing as a form self-definition and advocacy. The authors argue that even though it is tempting to consider the patients’ emphasis on good behavior as evidence of institutional control, internalized discipline, and medicalization, a more nuanced interpretation, which focuses on how the patients’ understood their own experiences, is warranted. Researchers must also recognize the ways in which The DDU Review reveals the patient-journalists’ experience of an institutional life that includes non-medical staff (attendants, secretaries, and therapists), varied social relationships among patients, and negotiated freedoms.
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References
Bacopoulos-Viau, A. and A. Fauvel. 2016. “The Patient’s Turn: Roy Porter and Psychiatry’s Tales, Thirty Years On.” Medical History 60 (1):1–18.
Barker, P., P. Campbell, and B. Davidson, eds. 1999. From the Ashes of Experience: Reflections on Madness, Survival and Growth. London: Whurr Publishers.
Brian, K.M. 2011. “The Reclamation of Anna Agnew: Violence, Victimhood, and the Uses of ‘Cure.’” Journal of Literary and Cultural Disability Studies 5 (3): 279–302.
Brody, H. 2003. Stories of Sickness. Oxford and New York: Oxford University Press.
Centers for Medicare and Medicaid Services. “Intermediate Care Facilities for Individuals with Intellectual Disabilities.” 2020. https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/Intermediate-Care-Facilities-for-Individuals-with-Intellectual-Disabilities-ICF-IID. Accessed 13 May 2020.
Central State Hospital.1989. 142nd Annual Report. Indianapolis: State of Indiana.
C., Sam. 1988a. “The Hay Ride.” The DDU Review. October.
----. 1988b. “Ward 34 News.” The DDU Review. September.
DDU Review. 1988. “Reporter of the Month: Up Close and Personal.” November.
DDU Review. 1992. “Special Feature.” March-April.
Duwe, Terry. 1988. “Speak Easy.” The DDU Review. September.
Duwe, Terry, Lisa Freeman, and Bonnie O’Connor. 2016. Personal communications. August and November.
Dwyer, E. 1983. “Mental Health Care in Early Twentieth Century Indiana and the Limits of Reform.” Indiana Medical History Quarterly 9:23–27.
----. 2019. “The Final Years of Central State Hospital.” Journal of the History of Medicine and Allied Sciences 74 (1): 107–126.
E., Tracy. 1990a. “Safe Sex.” The DDU Review, June.
----. 1990b. “Ward 35 Gets a Homestyle Breakfast.” The DDU Review. August.
Flores, Mike. n.d. “Employment Narrative: Central State Hospital.” Personal Files. In the authors’ possession.
Foucault, M. 1988. Technologies of the Self: A Seminar with Michel Foucault. Edited by L. H. Martin, H. Gutman, and P. H. Hutton. Amherst: University of Massachusetts Press.
G., Tim. 1991. “Taking Walks.” The DDU Review. July.
Giacomini M.K. and D. J. Cook. 2000. “Users' Guides to the Medical Literature: XXIII. Qualitative Research in Health Care A. Are the Results of the Study Valid? Evidence-Based Medicine Working Group.” Journal of the American Medical Association 284:357–362.
Gibson, B. E, F. A. Carnevale, and G. King. 2012 “‘This is my way’: Reimagining Disability, In/dependence and Interconnectedness of Persons and Assistive Technologies.” Disability and Rehabilitation 34 (22): 1894-1899.
Godderis, B. 2006. “Food for Thought: An Analysis of Power and Identity in Prison Food Narratives.” Berkeley Journal of Sociology 50:61–75.
H., Barbara. 1989. “APS Workshop Gets a Water Container.” The DDU Review. June.
----. 1992. “The Dirty, Nasty Gym and Bathrooms.” The DDU Review. February.
H., Jason. 1989. “Somebody Dieded.” The DDU Review. November.
Higgins, Will. 2015. “The Unusual, Unforgettable Way Indy Buried Ryan White.” IndyStar.com. April 9. Accessed 24 September 2019. https://www.indystar.com/story/life/2015/04/09/buried-ryan-white/25424315/.
J., Charles. 1989a. “Charles J. is Mr. Cool.” The DDU Review. June.
----. 1989b. “I’ll Go CRAZY Without My MOUNTAIN DEW!!!” The DDU Review. October.
----. 1989c. “It’s Too Hot in This Building.” The DDU Review. May
J., Charles and John L. 1989. “Attendant’s Appreciation.” The DDU Review. June.
J., Jimmy. 1990. “No Roller Skating.” The DDU Review. April 1990.
Kelly, B.D. 2016. “Searching for the Patient’s Voice in the Irish Asylums.” Medical Humanities 42:87-91.
Kröger, T. 2009. “Care Research and Disability Studies: Nothing in Common?” Critical Social Policy 29 (3): 398-420.
LeFrançois, B.A., R. J. Menzies, and G. Reaume, eds. 2013. Mad Matters: A Critical Reader in Canadian Mad Studies. Toronto: Canadian Scholars’ Press.
Leftridge, B. 1988. “Rehab Rap.” The DDU Review. December.
Lewis, B. 2009. “Madness Studies.” Literature and Medicine 28:152–171.
M., Tommy. 1988. “Choking.” The DDU Review. December.
Majerus, B. 2016. “Making Sense of the ‘Chemical Revolution’: Patients’ Voices on the Introduction of Neuroleptics in the 1950s.” Medical History 60:54–66.
McDonel, E.C., L. Meyer, and R. Deliberty. 1996. “Implementing State-Level Mental Health Policy Reforms in Indiana: Closing a State-Operated Psychiatric Hospital and Passing Major Mental Health Reform Legislation.” International Journal of Law and Psychiatry 19 (3/4): 239–264.
Morse, J.M. and P.A. Field. 1995. Qualitative Methods for Health Professionals. 2nd ed. Thousand Oaks : Sage.
Murat, L. 2011. L’homme qui se prenait pour Napoléon. Pour une histoire politique de la folie. Paris: Gallimard.
N. Vincent. 1989. “Smoking Rules.” The DDU Review. October.
Porter, R. 1985. “The Patient’s View: Doing Medical History from Below.” Theory and Society 14:175–198.
Read, J. and J. Reynolds, editors. 1996. Speaking Our Minds: An Anthology of Personal Experiences of Mental Distress and its Consequences. Houndmills: Macmillan.
Reiss, B. 2004. “Letters from Asylumia: The Opal and the Cultural Work of the Lunatic Asylum, 1851–1860.” American Literary History 16 (1): 1-28.
Ripa, Y. 1990. Women and Madness. The Incarceration of Women in Nineteenth-Century France. Cambridge: Polity Press.
S., Jeffrey. 1988. “Steps on the Ward.” The DDU Review. October.
S., Kenneth. 1989. “Ward Officers on Ward 34.” The DDU Review. November.
S., Linda. 1988a. “My Best Friend Pat Buford.” The DDU Review. October.
S., Linda. 1988b. “My Communication Class.” The DDU Review. September.
Shipp, E. R. 1992. “Tyson Found Guilty on 3 Counts as Indianapolis Rape Trial Ends.” New York Times. February 11. Accessed 10 March 2020. https://archive.nytimes.com/query.nytimes.com/gst/fullpage-9F0CE0DB133DF932A25751C0A964958260.html
Strauss, A. and J. Corbin. 1998. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 2nd ed. Thousand Oaks: Sage.
Whyde, K. 1988. “Capturing Pride in Print.” The Indianapolis Star. April 9: 37. Accessed on 12 March 2020. https://www.newspapers.com/clip/4861344/capturing-pride-in-print-indianapolis/.
Wilson, S. 2010. Voices from the Asylum: Four French Women Writers, 1850-1920. Oxford: Oxford University Press.
Acknowledgements
The authors would like to thank the journal editors and the anonymous reviewer for their astute and helpful critique.
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Dr. Emily Beckman declares that she has no conflict of interest.
Dr. Elizabeth Nelson declares that she has no conflict of interest.
Dr. Modupe Labode declares that she has no conflict of interest.
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This article does not contain any studies with animals performed by any of the authors.
Statement on Human Rights
This article is based on publicly available archival materials and as such, falls outside of the purview of the authors’ Institutional Review Board. The authors have not been able to trace the patients who wrote articles for The DDU Review. To preserve the anonymity of writers while also acknowledging the importance of each individual’s production, the authors have referred to the individual authors by their first name and the initial of their surname (for example, Linda S.).
Endnotes
1 The Indiana Medical History Museum’s collection of Central State Hospital newsletters also includes The Central Observer (1970-1971) and The Local Bahr (1991–1993). The DDU Review holdings include forty-two issues published from September 1988 until September 1993. The earliest issues (dating from October 1986-August 1988, along with January 1991–June 1991 and July–August 1992) have not been located.
2 As Reiss (2004, 23, f.n. 5) notes: “Erving Goffman wrote that ‘house organs’—newsletters written by patients—are little more than vehicles for patients to voice ‘the institutional line’ on issues affecting their lives (96). Jann Matlock, writing about a nineteenth-century woman’s surreptitious asylum journal, arrives at an equally sweeping but precisely opposite conclusion: ‘Writing in the asylum is always transgression. It is always an attempt to get beyond the asylum, to make sense out of being locked up, to reclaim an identity other than the one conferred by the system, to procure an inviolable space’ (168–69).” Reiss is referencing Erving Goffman (1961) Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (New York: Doubleday) and Jann Matlock (1991) “Doubling Out of the Crazy House: Gender, Autobiography, and the Insane Asylum System in Nineteenth-Century France,” Representations 34 (1991):166-195.
3See, for example, Kathleen Brian’s elegant examination of the appropriation of medical discourse—in this case, the nascent language of eugenics—in Anna Agnew’s institutional memoir From Under the Cloud, or Personal Reminscences of Insanity (1886), a text also created by a patient at Central State, then called the Indiana Hospital for the Insane.
4 Indeed, psychiatric hospitals in particular have incorporated rehabilitative techniques that exceed the purely biomedical since the advent of the “moral treatment” in the mid-nineteenth century.
5 As of 2010, these facilities are called Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
6 Today, Bonnie Leftridge is known as Bonnie O’Connor.
7 The authors have not been able to trace the patients who wrote articles for The DDU Review. To preserve the anonymity of writers while also acknowledging the importance of each individual’s production, the authors have referred to the individual authors by their first name and the initial of their surname (for example, Linda S.).
8 Ryan White (1971-1990) used his experience of living with HIV/AIDS to fight discrimination and stigma against people with HIV/AIDS. Many celebrities who supported his activism attended his funeral in Indianapolis. In 1992, heavyweight boxing champion Mike Tyson was convicted of raping an eighteen-year-old woman. The trial was held in Indianapolis, where the crime occurred in July 1991. The national media extensively covered both events.
9 Having “full grounds” was the hospital’s term for a level of privilege in which the resident was permitted having the privilege to move freely throughout the entire hospital grounds on their own.
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Beckman, E., Nelson, E. & Labode, M. Voices from the Newspaper Club: Patient Life at a State Psychiatric Hospital (1988-1992). J Med Humanit 43, 179–195 (2022). https://doi.org/10.1007/s10912-020-09617-7
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DOI: https://doi.org/10.1007/s10912-020-09617-7