Imagine-you are asked to take care of individuals who you believe are sad, pathetic, terrifying, unkempt, smelly, over-sexed, unruly and/or uncooperative. And, you have the power to sedate, challenge, control, or ridicule-in fact, that is your job description. You probably wouldn't want to do this-I don't think many sane people would seek out this job.

The type of person who agrees to a low-paying job of this sort tend to be unambitious, uneducated, and not exactly in the social mainstream. It is similar to the pool of people who might decide to be a prison guard. The only difference is that the prison guard controls individuals who are morally suspect, while the mental hospital orderly deals with individuals who are mentally suspect.

Think about the image of people who work within mental hospital in movies that portray that environment. From "One Flew Over a Cuckoo's Nest," to "Girl, Interrupted" many who work within the hospital were borderline sadists. In the first movie, we have the infamous Nurse Ratched, "a woman more a dictator than a nurse." Is there any compassion in this character, and are her actions due to being unaware of alternative and more compassionate methods? Is it just the case of a bad person in the wrong profession?

I believe, in line with Foucault's analysis of hospitals and prisons, the mental health apparatus is designed to contain and sedate the outcasts of society. With this goal in mind, compassion really has no role. Nurse Ratched can't nurse, and probably doesn't have the tools to nurse this population, even if she wanted to. The goal in a mental hospital isn't to get the patient better because it is a place which functions as a sort of emergency situation where people need to be stabilized on medication. Once that occurs, the patient might be released, or if they cannot function they will continue to be medicated and controlled. In either case, nurturing and caring for the patient on a humane level has no purpose in this context. Only medication is seen as the medical treatment-normal human connection or signs of empathy aren't not the goals of people who work in the mental hospital.

Some might argue that the overworked nature, the attempt to help so many patients, might be the reason why orderlies and nurses don't treat their patients more humanely. I think the real reason, having been in hospital environments where I saw nurses reading magazines for hours on end, has to do with the belief that the mentally ill, like any marginalized and powerless group, are not really human. It is the way most people are able to ignore the homeless, or keep out of mind the misery of victims of war or those in extreme poverty.

To empathize and care means you must be willing to put yourselves in another's place, to imagine that you could be that person. But who really wants to believe that they could be mentally ill to the point that they can't function within society, even for a brief period of time? It is easier to buy into a dehumanizing system.

In "Girl, Interrupted," the movie version, a nurse named Val is portrayed sympathetically by Whoopi Goldberg. However, even she is not purposely cruel and perhaps even tries to do what she thinks is best to help the girls within the mental hospital, the treatments she is party to involve non-nuturing, often barbaric, practices. From hydrobathes where depression is to be cured by being immersed in freezing cold water, to isolation, to forced administration of meds. Even the most neutral or positive portrayal of a mental health support worker, the nurse Val, involves the promotion of systematic practices that are inhumane in nature.

You might say, these two movies I mentioned are set in the 1960s, and things within the mental health system must be different now. In my own experience, giving meds and perhaps even ECT treatments are much more humane alternatives to prior treatments like lobotomies, however, I don't think the notion that being mentally ill is not an aberration or something to be ashamed of, or that mental health is a continuum, and often the most functional human beings can have mental health lapses, really is a foundation of our mental health system (see the episode "Broken" from recent television show House as evidence of this). The problem of mental health care is a cultural problem, and only when it is seen as such, will orderlies refuse to identify their patients as "the other."

Learn more about this author, Melissa Miles Mccarter.
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