They Call Him Crazy

STEVE LISS FOR TIME
Mental patient Rodney Yoder is taking on the psychiatry establishment

(5 of 6)

The letters themselves range from terrifying to ludicrous. "I have worked out a half a dozen methods to kill someone," says a 1993 letter to a judge. "I don't want to do this. But if I must to end a lifetime of torture, I believe I can." A 1996 letter claims he had "solicited [a local woman's] murder from two Iranian nationals ... The contract is already purchased." Similar letters went to "maybe 100" people, Yoder says. He says he often wrote them with a carbon sheet underneath and sent copies to prosecutors. In 1996, Yoder even sued a prosecutor for not charging him; a judge had to remind Yoder that he "has no constitutional right to be prosecuted." He stayed at Chester.

By then, the relationship between him and the facility was poisoned and not only because Yoder never cooperated with treatment. Equip for Equality, a Chicago-based nonprofit for the disabled, has twice accused Chester of making false entries in Yoder's records; Chester staff allegedly lied in the 1999 reports by saying Yoder had called an Equip for Equality office and threatened violence. At the time, Chester director Hardy stood by the first report. He never responded to the second and now says he doesn't recall the incident.

Whatever the truth, it's doubtful that even if Yoder is sick, he could heal in such an environment. In 1998, a state commission that investigates complaints for the disabled issued a harsh report on Chester. It said the facility's treatment goals for Yoder which he must meet in order to leave were "vague and unobtainable." The commission said it "does not believe that Chester has done all that is necessary to determine if [Yoder] is appropriately placed." Hardy counters that no other hospital in the state is equipped to care for someone so dangerous. He also points out that the national organization that accredits hospitals gave Chester a 91% compliance rating in 2001.

Dr. Thomas Szasz has been the most controversial psychiatrist in the nation for years, so perhaps it's no shock that he has become Yoder's biggest defender. Born in Budapest, Szasz, 82, immigrated to the U.S. in 1938. He has been a psychiatry professor at the State University of New York for nearly 46 years. Szasz's most famous book, The Myth of Mental Illness, was published in 1961. As the Atlantic Monthly said, the book argued "that both our uses of the term 'mental illness' and the activities of the psychiatric profession are often scientifically untenable and morally indefensible." Szasz views mental illness as a metaphor for disturbing and disruptive behaviors, which he says arise from our circumstances and personality and from our own choices. Until there is incontrovertible proof that, say, paranoid personality disorder is caused by an actual lesion in the brain, Szasz will argue such a label is a mere characterization of bad behavior that shouldn't carry the force of law.

Although he once enjoyed great influence, Szasz is usually dismissed as a crank these days. His foes say he opposes all psychiatry or that he wants to free even incompetent patients who can't feed themselves. Neither is true. But at a time when psychiatry's power has grown dramatically when it seems normal to grow up taking Ritalin and then graduate to Prozac, when even shyness is treated with pharmaceuticals his views are worth revisiting. And the Yoder case offers an ideal venue in which to do so.

As academics go, psychiatrists are a lot like economists: their field is presented to the public as pure science, but there's a lot of shouting in the back office. Are drugs overused? Can treatment really work if it's involuntary? Is something like "delusional disorder" a brain disease or a behavioral problem or both? These debates are far from settled. Sometime in the past decade, it became a requirement of polite conversation to say that schizophrenia and other mental illnesses are "no different" from pneumonia. But the latest neurological research has offered only the roughest idea of the precise mechanism by which a disease such as schizophrenia arises. Scientists are decades away from being able to use a brain scan to diagnose something like Yoder's alleged personality disorders.

By the late 1990s, Yoder had immersed himself in such ideas. Because of his views, Szasz is often contacted by disgruntled patients--"there have been thousands," he sighs. But Yoder was different. "He's extraordinary in the amount of information he amassed," says Szasz. The psychiatrist was impressed that Yoder had tried to go to prison rather than Chester, since Szasz has argued for decades that it's more humane to imprison lawbreakers for a set number of years rather than forcibly treat them in a mental hospital indefinitely.