Political abuse of psychiatry, also known as punitive psychiatry, refers to the misuse of psychiatric diagnosis, detention, and treatment to suppress individual or group human rights in society. This abuse involves the deliberate psychiatric diagnosis of individuals who require neither psychiatric restraint nor treatment, often for political purposes.
Psychiatrists have been implicated in human rights abuses worldwide, particularly in states where diagnostic criteria for mental illness are expanded to include political disobedience. Scholars have long observed that government and medical institutions tend to label threats to authority as mentally ill during periods of political unrest. In many countries, political prisoners are confined and abused in psychiatric hospitals.
Psychiatry is uniquely vulnerable to being used for abusive purposes compared to other specialties of medicine. The power to diagnose mental illness allows the state to detain individuals against their will and administer unnecessary treatments under the guise of serving both individual and societal interests. This can be exploited to circumvent standard legal procedures for determining guilt or innocence, effectively incarcerating political dissidents while avoiding public scrutiny.
The use of psychiatric hospitals instead of prisons also prevents the victims from receiving legal aid, makes indefinite incarceration possible, and discredits the individual and their ideas. This allows authorities to avoid open trials when deemed undesirable.
The political abuse of medical power, particularly in psychiatry, has a long history, including notable examples during the Nazi era and Soviet rule, where religious and political dissenters were labeled "mentally ill" and subjected to inhumane "treatments". From the 1960s to 1986, systematic psychiatric abuse for political and ideological purposes was reported in the Soviet Union, with occasional occurrences in other Eastern European countries like Romania, Hungary, Czechoslovakia, and Yugoslavia.
The practice of incarcerating religious and political dissidents in psychiatric hospitals in the Eastern Bloc and the former USSR severely damaged the credibility of psychiatric practice in these states and drew strong condemnation from the international community. Similar abuses have been reported in the People's Republic of China. Psychiatric diagnoses, such as "sluggish schizophrenia" in the USSR, were specifically developed and used for political purposes. In the United States, psychiatry was used to control African-American slaves, a practice that some argue continues to this day.
By country
Canada
The Duplessis Orphans were several thousand orphaned children that were falsely certified as mentally ill by the government of the province of Quebec, Canada, and confined to psychiatric institutions. The institutionalization occurred between 1935 and 1964.
Donald Ewen Cameron's operation was running from what is today known as the Allen Memorial Institute (AMI), part of the Royal Victoria Hospital, and not to be confused with the non-governmental organization based in Montreal, AMI-Québec Agir contre la maladie mentale.
China
In 2002, Human Rights Watch published the book Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era written by Robin Munro and based on the documents obtained by him. (Google Books) (HTML) The British researcher Robin Munro, a sinologist who was writing his dissertation in London after a long sojourn in China, had traveled to China several times to survey libraries in provincial towns and while he was there, he had gathered a large amount of literature which bore the stamp 'secret' but at the same time, it was openly available. This literature even included historical analyses which were published during the Cultural Revolution and it concerned articles and reports on the number of people who were taken to mental hospitals because they complained about a series of issues. It was found, according to Munro, that the involuntary confinement of religious groups, political dissidents, and whistleblowers had a long history in China. The abuses began in the 1950s and 1960s, and they became extremely widespread throughout the Cultural Revolution. During the period of the Cultural Revolution, from 1966 to 1976, the political abuse of psychiatry reached its apogee in China, which was then under the rule of Mao Zedong and the Gang of Four, who established a very repressive and harsh regime. No deviance or opposition was tolerated, either in thought or in practice.
The documents described the massive abuses of psychiatry that were committed for political purposes during the rule of Mao Zedong, when millions of people were declared mentally sick. In the 1980s, according to official documents, fifteen percent of all forensic psychiatric cases had political connotations. In the early 1990s, the number of such cases had dropped to five percent, but with the beginning of the campaign against Falun Gong, the percentage of such cases increased quite rapidly.
Official Chinese psychiatric literature distinctly testifies that the Chinese Communist Party's notion of 'political dangerousness' was institutionally engrafted as the main concept in the diagnostic armory of China's psychiatry for a long time and its most important tool for suppressing opposition was the concept of psychiatric dangerousness.
Despite international criticism, China seems to be continuing its political abuse of psychiatry. Political abuse of psychiatry in China is high on the agenda and it has produced recurring disputes in the international psychiatric community. The abuses there appear to be even more widespread than they were in the Soviet Union in the 1970s and 1980s and they involve the incarceration of 'petitioners', human rights workers, trade union activists, members of the Falun Gong movement, and people who complain about injustices that have been committed against them by local authorities.
It also seems that, China had no known high security forensic institutions until 1989. However, since then, the Chinese authorities have constructed an entire network of special forensic mental hospitals which are called Ankang which means 'Peace and Health' in Chinese. By that time, China had 20 Ankang institutions and their staff was employed by the Ministry of State Security (MSS). The psychiatrists who worked there wore uniforms under their white coats.
The political abuse of psychiatry in China only seems to take place in the institutions which are under the authority of the police and the MSS but it does not take place in those institutions which belong to other governmental sectors. Psychiatric care in China falls into four sectors which are hardly connected with each other. These are the Ankang institutions of the MSS; those which belong to the police; those which fall under the authority of the Ministry of Social Affairs; those which belong to the Ministry of Health. The sectors which belong to the police and the MSS are all closed to the public, and, consequently, information about them hardly ever leaks out. In the hospitals which belong to the Ministry of Health, psychiatrists do not have any contact with the Ankang institutions, and they have no idea of what occurred there, which means they can sincerely state that they were not informed about the political abuse of psychiatry in China.
In China, the structure of forensic psychiatry was to a great extent identical to that which existed in the Soviet Union. On its own, it is not so strange, since psychiatrists from the Moscow Serbsky Institute visited Beijing in 1957 in order to help their Chinese 'brethren', the same psychiatrists who promoted the system of political abuse of psychiatry in the Soviet Union. As a consequence, diagnostics in China were not much different than those which were made in the Soviet Union. The only difference was that the Soviet Union preferred "sluggish schizophrenia" as a diagnosis, and that China generally cleaved to the diagnosis of "paranoia" or "paranoid schizophrenia". However, the results were the same: long hospitalizations in mental hospitals, involuntary treatments with neuroleptics, torture, abuse, all of which were aimed at breaking the victim's will.
In accordance with Chinese law which contains the concept of "political harm to society" and the similar phrase dangerous mentally ill behavior, police take "political maniacs into mental hospitals, those who are defined as persons who write reactionary letters, make anti-government speeches, or "express opinions on important domestic and international affairs". Psychiatrists are frequently caught involved in such cases, unable and unwilling to challenge the police, according to psychiatry professor at the Peking University Yu Xin. As Liu's database suggests, today's most frequent victims of psychiatric abuse are political dissidents, petitioners, and Falun Gong members. In the beginning of the 2000s, Human Rights Watch accused China of locking up Falun Gong members and dissidents in a number of Chinese mental hospitals managed by the Public Security Bureau. Access to the hospitals was requested by the World Psychiatric Association (WPA), but denied by China, and the controversy subsided.
The WPA attempted to confine the problem by presenting it as Falun Gong issue and, at the same time, make the impression that the members of the movement were likely not mentally sound, that it was a sect which likely brainwashed its members, etc. There was even a diagnosis of 'qigong syndrome' which was used reflecting on the exercises practiced by Falun Gong. It was the unfair game aiming to avoid the political abuse of psychiatry from dominating the WPA agenda.
In August 2002, the General Assembly was to take place during the next WPA World Congress in Yokohama. The issue of Chinese political abuse of psychiatry had been placed as one of the final items on the agenda of the General Assembly. When the issue was broached during the General Assembly, the exact nature of compromise came to light. In order to investigate the political abuse of psychiatry, the WPA would send an investigative mission to China. The visit was projected for the spring of 2003 in order to assure that one could present a report during the annual meeting of the British Royal College of Psychiatrists in June/July of that year and the Annual Meeting of the American Psychiatric Association in May of the same year. After the 2002 World Congress, the WPA Executive Committee's half-hearted attitude in Yokohama came to light: it was an omen of a longstanding policy of diversion and postponement. The 2003 investigative mission never took place, and when finally a visit to China did take place, this visit was more of scientific exchange. In the meantime, the political abuse of psychiatry persisted unabatedly, nevertheless the WPA did not seem to care.
In August 2022, Safeguard Defenders issued an 85-page report on forced hospitalization in psychiatric hospitals between 2015 and 2021. Based on information from 144 cases, the report identifies 109 hospitals from 21 provinces in China, and documents repeated hospitalization of up to more than five times for victims. Some have spent around ten or more years inside. According to the report, victims are mostly petitioners and activists.
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