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Book Review
Title: Acts of Conscience: World War II, Mental Institutions and Religious Objectors, by Stephen J. Taylor, 2009
Publisher: Syracuse, N.Y. : Syracuse University Press
ISBN: 9780815609155
Price: $62.95
Description: 484 p.
This is a book I looked forward to seeing in print: in part, because it addresses a topic largely ignored by professionals and disability advocates alike in their accounts of changes in attitudes towards and services for persons with psychiatric or intellectual disabilities; and, in part, because it covers an aspect of disability history I have interest in from personal experience with some of the organizations and people involved. The book focuses on a group of young men who, as the flyleaf says, "rattled the psychiatric establishment by beaming a public spotlight the squalid conditions and brutality in... mental hospitals and trainings schools." They were among 12,000 conscientious objectors (COs) in the USA, most from historic peace churches (Mennonites, Brethren, Friends), who chose to perform civilian public service (CPS) as an alternative to fighting during World War (WW) II. It is essentially an American story, but it has resonance in other countries with similar experience.
Because WW II was widely perceived as a 'good war', the choice to seek CO status was neither lightly pursued nor easily awarded. There was broad public sentiment against allowing conscientious objection, though the government was committed to honoring agreements arrived at with the peace churches towards the conclusion of WWI. In Part I (6 chapters) of this two-part book Taylor chronicles the complex array of issues faced in negotiating CPS as an option. In short, leaders of peace churches were looking for ways their adherents could remain true to the conviction 'not to commit murder' or otherwise participate in military action, while at the same time demonstrate a willingness to give themselves to 'work of national importance under civilian direction.' For government leaders this was a test of whether the rights of a minority could be maintained in the face of significant majority feelings that COs were simply cowards, not willing to pull their weight. The government's initial impulse was to send such young men to remote forestry work camps and other similar services, out of sight from major population areas. While this option contented some COs, other voices questioned whether such work was of national significance. Two new options emerged from the discussions - to work in 'mental hospitals' or 'training schools' and to serve as subjects for medical and other research. The final agreement was that COs would receive no income for their time in CPS, and that peace churches would cover the cost of operating the CPS programs involving their men. Indeed, they ended up covering the cost of sizable numbers of COs not from peace church backgrounds.
Part II of the book, in nine chapters, examines in detail the experiences of COs in mental hospitals or training schools. This section documents the variety of contentious issues encountered, how these were addressed and their sequelae. The COs had no idea of the conditions to be encountered on entering these facilities. The widespread neglect, abuse and degradation they found shocked most, and the unwillingness or inability of the 'psychiatric establishment' to pursue changes were disheartening. With no training in human services, most coming from farms, these young men were assigned in ones or twos to supervise large wards of a hundred or more inmates. In the absence of professional advice or supervision, they had to decide whether to follow the model of using abusive controls as advocated by the few paid staff in the wards, or to try other approaches. For a significant number, this experience transformed concerns about their own situation to that of the inmates. Taylor examines in detail how different groups responded. Some (Mennonites at the fore) called on their pacifist beliefs to initiate what were innovations in personal and individualized treatment of 'patients'. Others (Quakers at the fore) initiated a national reform movement through a 'national mental health foundation' that achieved national media attention through well-documented exposes of conditions in specific institutions. Heavy emphasis is placed on examining the advocacy initiatives. From interviews, archival files and other documents Taylor draws together a compelling account of tensions that arose and were addressed between CPS groups and government, CPS groups and psychiatric establishment, as well as tensions between different of the sponsoring church groups
The only disappointment I have with the book is its concluding chapter. Where earlier chapters provide detailed, nuanced accounts of evidence on the complex variety of issues and forces at play, the conclusion is quit the opposite-- a somewhat simplistic interpretation of the cumulative evidence. The main conclusion is that the reforms initiated by the 'national foundation' (a Quaker inspired non-governmental organization) failed to have a lasting impact. This rather stark conclusion begs a variety of questions. While I understand the point that there is no 'hard' evidence the reform ideas promoted were directly 'passed down' to subsequent generations, as Taylor puts it (p. 393), such a conclusion ignores extant knowledge on the dynamics of social reform and how innovations come to be accepted by society. The implicit assumption is that social reforms emerge in a direct and linear fashion; but, social reform is not linear. Substantive reforms invariably emerge in a circuitous fashion, with similar ideas emerging at different points of time, from different and sometimes surprising sources, having many 'parents', despite a propensity in America to credit the most recent individual or group advocating an idea as 'the source'. If one looks a little deeper than the most obvious evidence, one finds traces of earlier attempts at reform present in more recent ones akin to the proverbial 'butterfly effect' in chaos theory. I would have welcomed a more substantive analysis of the ripple effect, for example, of public exposes by the foundation of conditions in mental hospitals such as published in a 1946 Life magazine article, how those contributed to shifts in public attitude or to the new policy positions promoted by the National Institute of Mental Health in the 1950s, and experimented with by States such as California that were on the forefront of mental health system change in the late1950s and '60s; or, how such exposes shaped the context in which new model programs begun by Mennonite Mental Health Services (which Taylor identifies as the 'most tangible outcome' of the CPS experience (p. 394)) and others; and, how these ideas, in turn, became some of the shoulders that subsequent mental health and developmental disability reformers stood on when developing, for example, the innovations of the early 1970s in developmental disability; and, in turn, eventually led to a 'tipping point' in public consciousness on the egregious nature of large residential institutions. Such an analysis remains to be done.
That said, I wholeheartedly commend this book. It speaks to the central role of morality in the provision of human services. More specifically, it speaks to the impact a relatively small group of people with strong ethical and moral convictions on how to treat fellow human beings can have on services systems, despite public and professional rationalizations sustaining the status quo. It provides compelling reading for everyone interested in understanding some of the forces at play in shaping public understanding that people rejected by society because of their psychiatric impairments have a human face, an understanding that only now is coming to be widely accepted.
Review by
Aldred Neufeldt, PhD
Aldred Neufeldt is Emeritus Professor of Community Rehabilitation and Disability Studies, Department of Community Health Sciences, University of Calgary; chaired Mennonite Mental Health Services in the 1970s; and, has had extensive experience with disability related reform initiatives in Canada and internationally.
Email: aneufeld@ucalgary.ca
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