Ashes of Policy

For more than two centuries, the institutions built to protect people living with schizophrenia have, with quiet regularity, become instruments of harm. From the overcrowded moral treatment asylums of the nineteenth century — where containment replaced care — to the deinstitutionalization movements of the 1960s and 1970s, policy after policy promised relief but delivered neglect. The passage of the Lanterman-Petris-Short Act in California, born from an unlikely alliance between fiscal conservatism and civil libertarian idealism, fractured the already fragile architecture of psychiatric care and ushered in an era of transinstitutionalization. Jails and prisons filled where hospitals had emptied. In the Soviet Union, the diagnosis of schizophrenia was weaponized entirely — repurposed to silence political dissidents under the invented classification of "sluggishly progressing schizophrenia," condemned by the World Psychiatric Association in 1977. In Nazi Germany, those diagnosed with schizophrenia were among the first targets of compulsory sterilization laws in 1933, later progressing toward systematic killing. These were not aberrations. They were policy.