Leaving the Cuckoo’s Nest: Challenging Incarceration in Psychiatric Hospitals

Since the nineteenth century, state governments in the U.S. wielded the power to involuntarily commit citizens based on their medical diagnosis of insanity. While patients challenged this practice at various points over the years, it was not until the decades between 1960 and 1990 that a movement to protect the rights of institutionalized people successfully coalesced to over-turn the laws that allowed for involuntary confinement based on mental health disabilities.

This paper examines the movement against medical incarceration in Pennsylvania by closely studying events at the state's Farview State Hospital for the Criminally Insane. In the late 1960s, patients at Farview, aided by civil rights attorneys, filed a lawsuit charging that the state had illegally committed them to the hospital after they had finished their prison terms. These plantiffs, who were disproportionately working-class and African American men, eventually won the case and their victory echoed far beyond the walls of Farview. In 1971, the Pennsylvania Legislature overhauled the mental health commitment laws, leading to the release of over 14,000 people from psychiatric hospitals across the state.

The legal victory for the patients at Farview illuminates how the movement to protect psychiatric patients’ rights intersected with prisoners’ rights activism. Patient-prisoners in states such as New York similarly filed lawsuits against incarceration based on medical authority, hastening deinstitutionalization around the country. These efforts to protect the rights of people in state custody diminished the state practices of confining people based on their mental health disabilities. However, the law and order politics of the 1980s and the call to increased policing enabled the imprisonment of people with mental health disabilities based on their criminal behavior. As a result, the connections between prisoners and patients weakened, causing scholars to overlook the vital links between the struggles of these two groups of people today.