Doctors’ Orders: The Mentally Disordered in Prison

Abstract

It has become a truism to state that prison is no place for the mentally disordered. It is equally true that since the seventeenth century, when the practice of confining the mentally disordered became widespread, there has developed close identification between this group and other socially challenging citizens. Foucault (1965) highlights the founding in 1656 of l’Hôpital Général in Paris as heralding what he terms the ‘Age of Great Confinement’. Harmless madmen who had previously wandered freely were now housed alongside criminals, prostitutes and beggars, in an institution more akin to a pauper prison than a hospital; treatment, such as it existed in l’Hôpital Général, had strong moral overtones. Thus, ‘whatever therapy was administered to the internees was often intertwined with rites of purification and exorcism of sin; the distinction between sin, disease and violation of social norms was absent’ (Cousins and Hussain, 1984). The connection forged between mental disorder, criminality and failings of morality became firmly established in l’Hôpital Général and its sister institutions, and the mentally disordered became an expected feature of prison populations.

As a result of this new restraint, a whole army of technicians took over from the executioner, the immediate anatomist of pain: warders, doctors, chaplains, psychiatrists, psychologists, educationalists; by their very presence near the prisoner, they sing the praises that the law needs. (Foucault, 1977)