To the Editor:
The Counterpoint book review of Vermont for the Vermonters in its winter issue captured Mercedes de Guardiola’s effort at pulling back the curtains on the eugenics movement in Vermont.
The review observed how the author, Mercedes de Guardiola, exposed the major role that discrimination against psychiatric disabilities played in mass incarceration in state institutions long before sterilization became an added tool for eugenic policies. What the book review failed to observe, however, was the extent to which the author exposed her own implicit bias in the ways she compared those events to the status of the mental health system of today.
The tricky thing about implicit bias is that if you know it’s there, it is no longer implicit. It is explicit.
The tricky thing about systemic discrimination is that it is usually hidden within implicit bias. We don’t fight it because we don’t recognize it.
While de Guardiola condemns the abuses of the past and condemns the lack of funding for community services now, in the same breath she criticizes current law that requires that care be provided in the “least restrictive environment” and be limited to those at danger to self and others. That’s because, she says, it “protects individual rights [but] can also lead to a lack of solely needed ongoing treatment.”
She fails to even wrestle with the question over whether forced treatment being imposed today is any different from that imposed 100 years ago, as well as whether its roots are the same bias of deeming those with disabilities less worthy.
She’s not denying it; she is completely failing to see it, subject as she is to ongoing systemic discrimination against us. A great deal of de Guardiola’s book is editorialized, which plays a large role in enabling implicit bias to take hold.
She takes a string of facts and draws conclusions without providing evidence for the conclusions themselves. We might draw the same conclusions, but they are also based upon our own opinion, not on objective historical evidence.
One example (among many) is the accusation that the state hospital in Waterbury used patient labor for the purpose of saving money to pay for food, heat and so forth. That was most certainly a desirable outcome of having patients chop the wood for the furnace and grow crops and run a dairy herd.
But in that day, it was a point of huge progress to not simply lock up insane people in basements. She acknowledges that the concept argued by the institutions was that fresh air and hard work was therapeutic, but her editorial tone dismisses those rationales altogether.
Thinking of forced labor as being a well-intentioned effort at promoting better health – in the context of the time – is not irrational. It is likely that both motives were at play: good for patients and good for the financial bottom line.
And de Guardiola’s research is neither of the depth nor of quality one might want. At the basic level, she repeatedly calls the Vermont State Hospital,” the “Waterbury Hospital,” based on asserting it was better known by that name. In everyday parlance, Vermonters actually said “the state hospital” or simply “Waterbury.”
De Guardiola does not even adapt language to person-first standards, referring to current people with disabilities as “the severely mentally ill and disabled.” She also misses some of the more critical early quotations from VSH reports showing early support for eugenics as the means to address the growing number of the insane.
She cites only “private statements” that tied VSH leaders to eugenic policies prior to 1912, ignoring the 1898 Biennial Report to the governor and legislature, which stated that laws referring to support of “the State insane and dotards” needed to radically change to avoid steady increases in “defective wards being committed to state care.” The decreases in infant mortality “tends to the survival of the unfit, and consequently the number of defective individuals will probably increase,” the three hospital trustees wrote.
Although de Guardiola quotes those references earlier in the book, she ignores them in the chapter discussing actual connections between state hospital leadership and eugenics. (In a staggering statement, the trustees added that, “The people [inmates], themselves, also, are learning to appreciate the advantages of the modern mental hospital.”)
Based upon the involuntary servitude discussion, de Guardiola later concludes that many institutions ultimately began to close down after a 1966 federal act banned exploitative unpaid labor, seemingly evidence that the only purpose had been to make locking people up economically feasible.
In fact, de Guardiola also cites the federal refusal to fund large psychiatric institutions (the “IMD” rule) as discrimination that strapped state governments for funding, while in reality, it is based upon a refusal to fund large standalone treatment facilities in lieu of integrated inpatient hospitals.
More complete research would point to a huge number of factors that led to the downsizing of state institutions.
Vermont’s early history included leading the first major study of successful community living by those with so-called severe and chronic illness who had been deinstitutionalized. De Guardiola ignores that critical and groundbreaking early work, which found high rates of improvement or recovery in a long-term follow-up of those discharged to strong community supports in the 1950s (The Vermont longitudinal study of persons with severe mental illness, pubmed.ncbi.nlm.nih.gov/3591992/).
The public has likewise forgotten that research in Vermont when, instead of looking at inadequate funding, they assert that community-based care is a failure and has resulted in those who were once in state hospitals now being institutionalized in our prison systems. Some use it as an argument to rebuild and expand state hospitals, and it’s an active discussion among some Vermonters.
Vermont is now moving to open a new “forensic treatment facility” to incarcerate those individuals in a forced treatment setting. The mantra often appears to be, “Take these poor folks out of prison and lock them up in hospitals instead, where we can inject them with drugs to keep them [us] safe.”
De Guardiola recounts with dismay that efforts to add hospital beds in Vermont in recent years have been stymied and asserts there are an insufficient number of beds and overly-short stays.
This underscores that the very systemic discrimination that she is attempting to expose is actually very alive in her own work and implicit biases.
These arguments defy the effort to learn from eugenics. Those with mental health trauma or disabilities aren’t defective. With support, those of us who face life struggles can be active participants in a holistically-based and inclusive society.
It calls to mind a recent meme: “Education is not about memorizing that Hitler killed 6 million Jews. Education is about understanding how millions of ordinary Germans were convinced that it was required. Education is learning how to spot the signs of history repeating itself.”
We, too, were targets of Hitler, and we were among the forerunners victimized by the thinking behind eugenics that led to Hitler’s final solution.
That sense of needing to spot the signs of embedded past history feels about where we are right now. As the marginalized group whose voice is most easily dismissed in today’s supposedly “woke” world, we are often at greatest risk of movements to repeat the myths that underlies eugenics.
John Kennedy said, “The great enemy of truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive, and unrealistic.”
Persuasive myths of genetic defectiveness made eugenics possible yesterday. Those myths stay alive today through the ongoing forces of implicit bias and discrimination.
ANNE DONAHUE, Northfield