On February 20th, the president of the RANZCP, Dr Elizabeth Moore, went to New Zealand to deliver an apology on behalf of the organisation. This concerned events from fifty years ago, at the child and adolescent unit at the former Lake Alice psychiatric hospital, in the North Island, about 50km from Palmerston North. I wrote about this in a post on Sept 12th last year (NB. I said I contacted the CEO of RANZCP in about 2008 but it was actually 2001).
I'd forgotten about the matter until about two years ago when the NZ Government released a report entitled: "Beautiful Children: inquiry into the Lake Alice Child and Adolescent Unit." At 425 pages, it's long and detailed. It shows how, over about seven years from 1972, a psychiatrist called Selwyn Leeks instituted and oversaw a program of grotesque mental, physical and sexual abuse of children and adolescents who had been committed to the unit. In 2020, the United Nations Committee against Torture found their prolonged mistreatment amounted to torture. That's an important decision. It establishes (yet again) that torture is what the victim says it is, not what the perpetrator claims to have had in mind: torture is as torture does (for more background, there is an article on Mad in America by Phillip Hickey, an excellent critical psychologist who, regretably, has had to stop writing due to declining health; also here and here).
The executive summary of the report starts on p34 and there is a timeline on p40 (both fairly brief). While the entire report should be compulsory reading for all workers in mental health/social welfare/prisons, etc, everybody should look at these parts at least, as they show two very important points. First, that these ghastly matters should not only take place, but they did so with strong support and enthusiasm of practically all the staff involved. I can't find how many other staff were involved but it must have been fifty or more. Second, it's not just that nobody with the power to do something about it lifted a finger, but everybody went out of their way to conceal it, at the time it was happening and for decades after. That is what the RANZCP needs to explain, and that is what the "apology" doesn't touch.
The institution of psychiatry was well aware of these matters by 1975 at the latest but carefully and discreetly understated and obfuscated them, handing the NZ police the licence they needed to continue doing nothing. From the underwhelming reaction to Dr Moore's apology, it would appear that nothing much has changed. One thing is crystal clear: the claim by the RANZCP that it couldn't act until after the egregiously sadistic psychiatrist, Selwyn Leeks, had died, is patently false. They act when it suits them, and sit on their hands when that's more convenient.
In her "apology," Dr Moore said:
We are committed to people receiving the best mental health care, guided by evidence and expertise. The barbaric abuse conducted by Leeks at Lake Alice was not psychiatry of any form. It is not and never will be condoned. That this harm occurred at all, under the guise of treatment, is a travesty.
Fine words, but why did it arise and, more important, what is there to stop something similar in the future? It arose, she intimated, because Leeks was working in isolation. Isolation like that wouldn't happen these days because psychiatrists work in teams with"ongoing training and development." Actually, he wasn't isolated. He was only 50km from Palmerston North and also went to a number of other centres and institutions. He was in sufficient contact with other psychiatrists for at least one of them to testify on his behalf, that all the complaints couldn't possibly be true and that his "treatment" was, if not entirely standard, then certainly in keeping with modern trends.
When I worked in the Kimberley Region of West Australia in 1987-93 (well before the internet), that was isolated, over 2,000km to the nearest mental hospital but, more to the point, socially isolated. In that time, not one person from the WA Health Dept or the RANZCP contacted me to conduct any sort of audit, to offer any support or advice or show any interest. If I'd been eaten by a crocodile, they would have been more inclined to ask how the crocodile was coping.
Dr Moore continued: "There are robust, safe channels for external reporting." Indeed there are, but who stands guard at the gate? That's right, the very psychiatrists whose close friends are the subject of the complaint. "Complaints," she intoned, "are not lost or ignored." Really? In February 2018, the RANZCP issued a press statement defending the rapidly rising use of antidepressants (a copy here). Psychiatrists, it said, "only ever" prescribe drugs after full discussion with the patient of the risks and benefits of medication. This was patent rubbish. Most patients report little or no discussion and learn about side effects the hard way, so I lodged a complaint alleging the RANZCP was misleading the public. It was dismissed, along with a reiteration of the offending statement; I lodged a complaint that my complaint had not been investigated; this too was dismissed. I lodged a complaint with the Queensland Medical Board who, within 24 hours (medical boards never do anything within 24hrs), dismissed my complaint on the basis that none of the psychiatrists involved lived in Queensland. I immediately complained that the person who dismissed my second complaint was the director of Mental Health in Queensland who had lived here for many years. A while later, it came back: Dismissed, no jurisdiction. I complained to something called the National Health and Privacy Ombudsman, which I didn't know existed, who dismissed my complaint on the basis that the Medical Board had dismissed it twice. Don't worry that their grounds were false, it's an Out when we call Out.
A few weeks ago, I wrote how the new editor of the main college journal had published his own, very long editorial on an idea he liked. It was pure pseudoscience; my commentary pointing this out was rejected with no reasons given. I could give lots more examples but there is a critically important point here: Complaints are accepted and investigated entirely on the whim of the tight little group whose members are the subjects of the complaints. That was absolutely true of the Lake Alice disaster, where the victims' complaints were dismissed because they were naughty children complaining about the lovely doctor, and it is true everywhere. We see this in the UN Security Council at present, where the US has repeatedly vetoed resolutions condemning Israel's disproportionate violence in Gaza. There can be no oversight when the complaints process is stacked with people who have a lot to lose if the complaint is investigated properly.
So back to the crucial questions: Why did it arise, and what is there to stop it happening again? It arose at Lake Alice because of the same old combination of circumstances: a sadistic person with total legal control over a group of defenceless young people in an isolated setting, with unsophisticated staff who were easily intimidated and/or happy to join in the fun. It's the same in any institutional setting. Most staff are reasonable human beings but a small number aren't, and they soon wriggle their way into positions of power where they can intimidate or terrorise everybody just because power excites them. Remember the Milgram experiment from the early 1960s, where students were encouraged to deliver painful shocks to the "subjects" - and they did as they were told. There was also the Stanford prison experiment in 1971, where a psychologist got one group of students to act as prisoners and the other as guards. The experiment had to be stopped early as it was too successful: the guards eagerly slipped into their role and began mistreating the "prisoners." Yes, there were methodological problems with each of them but the take-home message remains as Milgram said:
Ordinary people, simply doing their jobs, and without any particular hostility on their part, can become agents in a terrible destructive process. Moreover, even when the destructive effects of their work become patently clear, and they are asked to carry out actions incompatible with fundamental standards of morality, relatively few people have the resources needed to resist authority.
That is, the tendency toward intimidation and brutalisation of defenceless people is inherent in humankind. We are a species that enjoys the thrill of dominating others, it's the game that never bores. Pretending our motives are pure, that we don't get off on power, is dangerous. Thus, wherever there is any sort of hierarchy, it is essential to have foolproof restraints in place before those at the bottom are rendered helpless, and to protect people who, as they say, blow the whistle on misconduct. That isn't the case now. Silencing whistleblowers has become the must-join sport that unites the entire political class.
What is there to stop another Lake Alice? In one word, nothing. The institution of psychiatry has convinced itself that the problem was a single rotten apple and there was nothing wrong with their barrel. Moore said: "The barbaric abuse conducted by Leeks at Lake Alice was not psychiatry of any form." But that, as she well knew, is absolutely false. It is the very institution of psychiatry that lends itself to these and so many other abuses. As everybody who has been on the receiving end of "psychiatric treatment" knows, the legal machinery is in place and there is nothing to restrain it: the prison has been built so that nobody can see inside, so don't pretend to be shocked when bad things happen. I suggest that particular evasion was what so angered the audience at her carefully-stage little "apology."
She continued: "There must never be a repeat of Lake Alice." But it will happen again, and again and again, perhaps not so crude as sticking an electric jigger on teenage boys' nuts but human ingenuity has no limits. It will happen again for exactly the same reason that the "barbaric abuse" (Dr Moore's expression) called psychosurgery happened, that the Deep Sleep and Ward 10B (Townsville, Qld; no link) scandals and so many others happened, just because psychiatry has no theory of mind or model of mental disorder to say "This is the limit. Go no further down that path." To pretend otherwise, as the President and Board of the RANZCP did, goes beyond mere hypocrisy into the realm of fantasy, if not frank deception. I have used this quote by Nobel Laureate Peter Medawar before but it's apposite:
(The) author can be excused of dishonesty only on the grounds that, before deceiving others, he has taken great pains to deceive himself.
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