Joshua Landy

Proust: A very short introduction  

Caleb Smith

Thoreau's axe: Distraction and discipline in American culture

 

Today, we’re driven to distraction, our attention overwhelmed by the many demands upon it—most of which emanate from our beeping and blinking digital devices. This may seem like a decidedly twenty-first-century problem, but, as Caleb Smith shows in this elegantly written, meditative work, distraction was also a serious concern in American culture two centuries ago. In Thoreau’s Axe, Smith explores the strange, beautiful archives of the nineteenth-century attention revival—from a Protestant minister’s warning against frivolous thoughts to Thoreau’s reflections on wakefulness at Walden Pond. Smith examines how Americans came to embrace attention, mindfulness, and other ways of being “spiritual but not religious,” and how older Christian ideas about temptation and spiritual devotion endure in our modern ideas about distraction and attention.

Smith explains that nineteenth-century worries over attention developed in response to what were seen as the damaging mental effects of new technologies and economic systems. A “wandering mind,” once diagnosed, was in need of therapy or rehabilitation. Modeling his text after nineteenth-century books of devotion, Smith offers close readings of twenty-eight short passages about attention. Considering social reformers who designed moral training for the masses, religious leaders who organized Christian revivals, and spiritual seekers like Thoreau who experimented with regimens of simplified living and transcendental mysticism, Smith shows how disciplines of attention became the spiritual exercises of a distracted age.

Henry David Thoreau A Very Short Introduction Lawrence Buell

The first concise account of Thoreau's life, thought, work, and impact in more than half a century Builds upon the explosion of new scholarship on Thoreau during the decade of the bicentennial of his birth

Treats Thoreau's two most famous and influential works - Walden and "Civil Disobedience" - both as an interdependent pair and as a window into the evolution of his thought and writing as a whole

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Man-Devil: The Mind and Times of Bernard Mandeville, the Wickedest Man in Europe

John J. Callanan 

A lively and provocative account of Bernard Mandeville and the work that scandalized and appalled his contemporaries—and made him one of the most influential thinkers of the eighteenth century

In 1714, doctor, philosopher and writer Bernard Mandeville published The Fable of the Bees, a humorous tale in which a prosperous hive full of greedy and licentious bees trade their vices for virtues and immediately fall into economic and societal collapse. Outrage among the reading public followed; philosophers took up their pens to refute what they saw as the fable’s central assertion. How could it be that an immoral community thrived but the introduction of morality caused it to crash and burn? In Man-Devil, John Callanan examines Mandeville and his famous fable, showing how its contentious claim—that vice was essential to the economic flourishing of any society—formed part of Mandeville’s overall theory of human nature. Mandeville, Callanan argues, was perfectly suited to analyze and satirize the emerging phenomenon of modern society—and reveal the gap between its self-image and its reality.

Callanan shows that Mandeville’s thinking was informed by his medical training and his innovative approach to the treatment of illness with both physiological and psychological components. Through incisive and controversial analyses of sexual mores, gender inequality, economic structures, and political ideology, Mandeville sought to provide a naturalistic account of human behavior—one that put humans in close continuity with animals. Aware that his fellow human beings might find this offensive, he cloaked his theories in fables, poems, anecdotes, and humorous stories. Mandeville mastered irony precisely for the purpose of making us aware of uncomfortable aspects of our deepest natures—aspects that we still struggle to acknowledge today.

"Entertaining. . . .[Callanan] has convinced me that exposing Mandeville and his writings to a new generation of readers is indeed worthwhile."---Howard Davies, Literary Review

"John Callanan’s Man-Devil: The Mind and Times of Bernard Mandeville, the Wickedest Man in Europe (Princeton University Press) is by far the best discussion we have of this paradoxical, and immensely influential thinker, and everyone interested in the history of moral, social, or economic theorising should read it."---David Wootton, Engelsberg Ideas

"[A] superb book."---Joseph Hone, History Today

"Callanan, a philosopher at King’s College, London, has produced an engaging, expansive and effortlessly erudite study of a man who today too few people know. Man-Devil is a fascinating and welcome corrective, not least because Bernard Mandeville was amongst the first to argue that we don’t really know ourselves."---Peter West, The Critic

“Bernard Mandeville was one of the most controversial writers of early eighteenth-century England, famed for coining the paradox ‘private vices, publick benefits’ as the subtitle to his major work, The Fable of the Bees. While John Callanan never loses sight of this satirical, even mischievous, bent, he convincingly shows the reader why Mandeville became such an influential figure in eighteenth-century thought, taken up by David Hume and Adam Smith among others. Well-researched and original in its approach, his book is highly recommended.”—Malcolm Jack, historian and Mandeville scholar

“Mandeville is the first great social theorist, and everyone who comes after him—Rousseau, Smith, Marx, Hayek—is deeply in his debt. But he is slippery and paradoxical. John Callanan at last makes Mandeville’s core doctrine clear and brings out his continuing importance for understanding human beings as sociable animals. This is an important, long-needed book.”—David Wootton, author of Power, Pleasure, and Profit: Insatiable Appetites from Machiavelli to Madison

“Callanan sensibly and sensitively places the infamous Fable of the Bees in the wider context of Mandeville’s other writings and intellectual context and, thereby, illuminates him as a diagnostician of human self-concealment and satirist of human pride. He reveals the Dutch physician with a successful London medical practice as an original pilferer of other people’s useful ideas and with a relish for the urbane. And for those who recognize a good bargain when they are offered one, this book also instructs in the art of living, even points the way to the path of wisdom.”—Eric Schliesser, author of Adam Smith: Systematic Philosopher and Public Thinker

“John Callanan's enjoyable account of Mandeville explains clearly both why the author of The Fable of the Bees was notorious in his own day and why major figures such as Hume, Rousseau, and Smith felt the need to engage with him so closely. It tells the reader what we know about Mandeville's life, and explores the full range of Mandeville's writings. Mandeville's ideas are put in context, but are also brought to philosophical life. This is the best account in English of Mandeville’s thought as a whole.”—James Harris, University of St Andrews

“This is the book on Mandeville I’ve long hoped for, and it is even better than I could have hoped. It is beautifully and engagingly written, as befitting a book on a great, extremely funny—not a common virtue of philosophers—and often scurrilous prose stylist. The Mandeville which emerges in Callanan’s book is provocative and subtle, a humane exponent of Terence’s dictum “nothing human is alien to me” but also a sharp-witted critic of hypocrisy possessing a medical remove from which to examine our paradoxical species.”—Aaron Garrett, Boston University

“John Callanan’s Man-Devil strikes a balance between a ‘forensic’ investigation of Mandeville's engagement with reactions to his ideas in his own time and an examination of the Mandevillean tendency to cross disciplinary boundaries and enrich contemporary controversies in human and social sciences. ‘Nothing human is alien’ to Mandeville, including the human animal’s wondrous potential of being in denial about its own bottomless self-deception.”—Spyridon Tegos, University of Crete

John Callanan is reader in the history of philosophy, Department of Philosophy, at King’s College London. He is the author of Kant’s Groundwork of the Metaphysics of Morals and the coeditor of Kant and Animals.

Dan Zahavi

Phenomenology: The basics, 2nd Edition

Two footnotes to the podcast.

1. Walter Hopp's beloved Boston University course is distilled in his Phenomenology: A Contemporary Introduction (2020), an excellent companion to Zahavi's text that focuses on philosophical phenomenology. 

2. Paul Møller's Psychosis risk and experience of the self (2023) is the text mentioned in the podcast that uses phenomenological experience to predict psychosis risk. 

Description of Phenomenology: The basics, 2nd edition.

Phenomenology: The Basics is a concise and engaging introduction to one of the important philosophical movements of the twentieth century and to a subject that continues to grow and diversify. Yet it is also a challenging subject, the elements of which can be hard to grasp.

This lucid book provides an introduction to the core ideas of phenomenology and to the arguments of its principal thinkers, including Husserl, Heidegger, and Merleau-Ponty. Written by a leading expert in the field, Dan Zahavi examines and explains key questions such as:

What is a phenomenological analysis? What are the methodological foundations of phenomenology? What does phenomenology have to say about intentionality, embodiment, intersubjectivity, and the lifeworld? How do ideas from classic phenomenology relate to ongoing debates in qualitative research and the cognitive sciences?

This second edition has been thoroughly revised and expanded. It contains a new chapter on critical phenomenology and updated discussions of the application of phenomenology in psychiatry, psychology, and qualitative research.

Including a glossary of key terms and suggestions for further reading, Phenomenology: The Basics is a superb starting point for anyone seeking a concise and accessible introduction to this rich and fascinating subject.

Table of Contents

Preface to the second edition

Introduction

Part I: Foundational issues

1. The phenomena

2. Intentionality

3. Methodological considerations

4. Science and the lifeworld

5. Digging deeper: From surface to depth phenomenology

6. Merleau-Ponty’s preface to Phenomenology of Perception

Part II: Concrete analyses

7. Spatiality and embodiment

8. Intersubjectivity and sociality

9. Critical and political phenomenology

Part III: Applied phenomenology

10. Classical applications: Psychology, psychiatry, sociology

11. Current debates in qualitative research and the cognitive sciences

12. A method, an attitude, a theoretical framework

Conclusion

Glossary

References

Index

Author(s) Biography

Dan Zahavi is Professor of Philosophy at the University of Copenhagen, Denmark, and Director of the Center for Subjectivity Research in Copenhagen. His book The Phenomenological Mind (third edition, 2021), coauthored with Shaun Gallagher, is also available from Routledge.

Critics' Reviews

"Clear, engaging and insightful, there is no better introduction to the past, present and future of phenomenological philosophy than this new edition of Zahavi's book." - Dave Ward, University of Edinburgh, UK

"Nuanced, problem-driven, and accessible, this is simply the best introduction to phenomenology. Lucidly written, it presents clear explanations of key concepts and theories while covering the breadth of the phenomenological tradition. The revised edition now also provides an introduction to Critical Phenomenology, likely the most-discussed trend in phenomenology today." - Tobias Keiling, University of Warwick, UK

Praise for the previous edition:

"For the one seeking a way into phenomenological thinking today, or a way to help others find one, it has not been obvious, in the English context, what resource should serve as the best point of entry. The first great merit of Dan Zahavi’s book, Phenomenology: The Basics, is to change this calculus for good. Offering English readers an entry point into phenomenology that is accessible, lucid, and engaging, presents key concepts and insights faithfully (but not ploddingly), along with their pertinence in multiple fields of contemporary research, and doing this without obvious error or negligence, is no small achievement." - Karl Hefty, Reading Religion

"A lucid and authoritative introduction to phenomenology including its practical applications in sociology and psychology from one of the world’s leading phenomenologists." - Dermot Moran, Boston College, USA

"Zahavi’s Phenomenology: The Basics will guide several generations of philosophers and scientists in the study of consciousness, embodiment, communality and normality." - Sara Heinämaa, University of Jyväskylä, Finland

"Dan Zahavi, one of the most prolific and insightful phenomenologists of his generation, has provided a concise, clear and intellectually stimulating introduction to the study of phenomenology."- Alessandro Duranti, University of California, Los Angeles, USA

"This lucid book gets to the core of what phenomenology is all about, and is essential reading for any students of that tradition." - Piet Hut, Institute for Advanced Study, Princeton, USA

 

https://www.routledge.com/Phenomenology-The-Basics/Zahavi/p/book/9781032396378?

 

 

Owen Flanagan

James B. Duke University Professor Emeritus of Philosophy & Professor of Neurobiology Emeritus 

What Is It Like to Be an Addict?: Understanding Substance Abuse

"A brilliant and unparalleled synthesis of the science, philosophy, and first-person phenomenology of addiction. Owen Flanagan is a distinguished philosopher who ... is also an ex-addict. This book is beyond excellent. It is wise. Everyone who wants to understand addiction must read it."  -- Hanna Pickard, Bloomberg Distinguished Professor of Philosophy and Bioethics, Johns Hopkins University   "This elegant and clear book ... deserves to be a landmark in the study of addiction."  -- Carl Erik Fisher, M.D., Assistant Professor of Clinical Psychiatry, Columbia University, author of The Urge: Our History of Addiction  

Owen Flanagan is an internationally acclaimed philosopher of mind, consciousness, ethics, and comparative philosophy and author of 12 books translated into many languages. 

A powerful and important exploration of how addiction functions on social, psychological and biological levels, integrated with the experience of being an addict, from an acclaimed philosopher and former addict.

What is addiction? Theories about what kind of thing addiction is are sharply divided between those who see it purely as a brain disorder, and those who conceive of it in psychological and social terms. Owen Flanagan, an acclaimed philosopher of mind and ethics, offers a state-of-the-art assessment of addiction science and proposes a new ecumenical model for understanding and explaining substance addiction.

Flanagan has first-hand knowledge of what it is like to be an addict. That experience, along with his wide-ranging knowledge of the philosophy of mind, psychology, neuroscience, and the ethics and politics of addiction, informs this important and novel work. He pairs the sciences that study addiction with a sophisticated view of the consciousness-brain/body relation to make his core argument: that substance addictions comprise a heterogeneous set of "psychobiosocial" behavioral disorders. He explains that substance addictions do not have one set of causes, such as self-medication or social dislocation, and they do not have one neural profile, such as a dysfunction in dopamine system. Some addictions are fun and experimentation gone awry. Flanagan reveals addiction to be a heterogeneous set of disorders, which are picked out by multifarious cultural, social, psychological, and neural features.

Flanagan explores the ways addicts sensibly insist on their own responsibility to undo addiction, as well as ways in which shame for addiction can be leveraged into healing. He insists on the collective shame we all bear for our indifference to many of the psychological and social causes of addiction and explores the implications of this new integrated paradigm for practices of harm reduction and treatment. Flanagan's powerful new book upends longstanding conventional thinking and points the way to new ways of understanding and treating addiction.

Agnes Callard

Open Socrates

"[C]harming, intelligent…Open Socrates encourages us to recognize how little we know, and to start thinking." —Jennifer Szalai, New York Times

An iconoclastic philosopher revives Socrates for our time, showing how we can answer—and, in the first place, ask—life’s most important questions.

Socrates has been hiding in plain sight. We call him the father of Western philosophy, but what exactly are his philosophical views? He is famous for his humility, but readers often find him arrogant and condescending. We parrot his claim that “the unexamined life is not worth living,” yet take no steps to live examined ones. We know that he was tried, convicted, and executed for “corrupting the youth,” but freely assign Socratic dialogues to today’s youths, to introduce them to philosophy. We’ve lost sight of what made him so dangerous. In Open Socrates, acclaimed philosopher Agnes Callard recovers the radical move at the center of Socrates’ thought, and shows why it is still the way to a good life.

Callard draws our attention to Socrates’ startling discovery that we don’t know how to ask ourselves the most important questions—about how we should live, and how we might change. Before a person even has a chance to reflect, their bodily desires or the forces of social conformity have already answered on their behalf. To ask the most important questions, we need help. Callard argues that the true ambition of the famous “Socratic method” is to reveal what one human being can be to another. You can use another person in many ways—for survival, for pleasure, for comfort—but you are engaging them to the fullest when you call on them to help answer your questions and challenge your answers.

Callard shows that Socrates’ method allows us to make progress in thinking about how to manage romantic love, how to confront one’s own death, and how to approach politics. In the process, she gives us nothing less than a new ethics to live by.

 

 

Updates 2/17.

Torture (no access to outdoors): my Human Rights Complaint

The DMH directory for January 2025 says that Jeanne Crespi is the Person in Charge for Corrigan. I emailed my Human Rights Complaint to her.  She also is not acknowledging receipt of my email. When I don't get a reply, I try someone else.  So far, the people who have received copies of the complaint include: Jose Alfonso, Maxwell I. Mayer, Startrese Sims, the DMH ombudsman, and Lawrence Weiner.  Will anything happen?  I assume nothing will happen.  Someone will, based on clearly faulty reasoning, put it in a file for things that don't get attention.  The patients will continue not to be able to access the outdoors.  C'est la vie.

Corrigan History.

It was originally called the Fall River Mental Health Center.  I believe it was opened in the 1960s. 

At one point, it had 40 beds.

There was some controversy about Brown University allegedly getting paid for research it didn't do.

There was a larger-than-life psychiatrist there, Kennard C. Kobrin, who had lots of legal charges against him (pressuring female patients for sex, medicare fraud, running a pill-mill.  I hoped to speak to him, but, unfortunately, he died in 2020.  It seems he was largely vindicated.

Another public persona who is important in the Corrigan story is David B. Sullivan who is still alive. I have reached out to him to see if he could tell us about Corrigan and his career.  The outline is that he started out as a social worker at Corrigan. He then became a state representative and in that role worked to save Corrigan when it was threatened to be axed.  After his stint on Beacon Hill, he went to work in Fall River city government. In the Housing Authority or something like that. He eventually retired from that, and I do not know what he is currently doing. I looked up some email addresses for him and asked if we could ask him about his experience.  Probably nothing will come of it though. [Sigh]

In 2010, there were attempts to shut Corrigan down for budget reasons, and he protected it.  Incidentally, in press reports, it was said that Corrigan would lose 16 beds. So the reduction to 16 beds occurred prior to 2010.

Here is a good article about the fresh air law and when it was implemented. https://www.nepsy.com/articles/leading-stories/mass-dmh-releases-fresh-air-regulations/  The "fresh air" law was passed in January 2015, and the regulations I have been referring to went into effect in July 2016.  The article mentions that MGH applied for a waiver of these rules.  Back in October 2024, when I first became alarmed about the white, white skin of some of the Corrigan patients (how they never went outside), I assumed that Corrigan had a waiver. Specifically, I assumed it had developed a Plan which would detail why they couldn't provide outdoor access.  That is exactly what I asked Larry Weiner for. And it is what I asked Public Records for. Why do they not want to present this Plan?  I have no idea.  

Currently, the DMH is trying again to make progress on getting out of the inpatient psych business.  But Corrigan MHC appears to have escaped the axe. The plan is to cut another MHC, one in Pocasset.

My best interpretation of what is going on here: the way Corrigan is run is the way DMH is run. The ethic is one of CYA.  They pick a very small number of measurable outcomes they are interested in. For example, for Corrigan, the goals are (a) don't discharge to the street or to a homeless shelter; (b) pass accreditation, (c) no elopements, and (d) no suicides on unit.  When it comes to something like providing outdoor access, it simply falls by the wayside.  Likewise, therapy.  Social workers don't spend much time at all actually talking to the patients.  The fear, I guess, is that if they pay attention to other goals such as outdoor access, they will take their eyes off the CYA goals.  For example, outdoor access could lead to elopements.

Another example of this reduction to least common denominator is the new focus on falls.  You don't want falls, because that will make you look bad.  Why provide outdoor access when it will increase the likelihood of a fall? 

Philosophically, this is the essence of modernity.  One wants to eradicate "higher" goals. (Charles Taylor, 1995).

It is the same with DMH.  I don't know enough to be able to say what their CYA goals are. Avoiding lawsuits?  Avoiding negative press?  Avoiding the closure of facilities (i.e., empire defense)?  But whatever the least-common-denominator or CYA goals are, they seem to be disciplined at ignoring all goals based on principle.  Thus, if you look at the walls of any mental hospital, it will have significant space devoted to telling people that if they have the right to file a Human Rights Complaint.  The descriptions make it sound like a big deal.  Like you are really going to be able to have your voice heard.  But in reality, the Person in Charge is just someone who works there, and the Human Rights Officer too. They are people who are not incentivized to actually listen to and treat seriously any complaints.  

Two other examples are the ombudsman and public records.  If you look at the ombudsman's page, it sounds like they are really going to listen to you.  (They say they will get back to you in 48 hours!).  In reality, this is a higher goal which gets ignored.  Or we could say iby ignoring it, they justify the law itself, but not any particular application of it.  

For public records, they say they will get back to you, but they don't.  Transparency?  They don't even acknowledge receipt of emails.  This is not a matter of individual agression. It is, I assume, strategic and organized. I don't know (because they won't talk to me) but one hypothesis is that the upper staff tell the lower staff that issue X has become a legal matter. Once it has that label, then everyone is supposed to ignore it and the attorneys will deal with it.  It serves the "don't lose in court" goal, which is a CYA goal, at the expense of "higher" goals such as transparency and accountability.  Or so I suspect.  

------------

Two updates since I posted this audio.  Specifically, I sent two emails to Corrigan or DMH staff.  In the first, I asked for the plan again--this time I asked two other people in addition to LW.  I also expanded the request to include prior years.  In the second, I decided to go ahead and make an official Human Rights Complaint.  You are supposed to make a complaint to the Person in Charge.  I sent it to three people who, if they aren't that person, would certainly know who was.  Needless to say, I don't expect any of them to even confirm receipt of the email!!!

 

Here are the two emails:

substantive part of first email--asking for plan

Dear Ms. H, Mr. W, and Mr. G,

  I hereby request both the current version and all available prior versions of the written plan specified and required under 104 CMR §27.13(6)(f)5 for the inpatient unit at Corrigan Mental Health Center.   I hereby also request any and all documents and records pertaining to the DMH  determination of reasonable justification referenced referenced in 104 CMR §27.13(6)(f)(5)(c)(ii).      substantive part of second email--human rights complaint  

Dear Mr. W, Dr. M, and Dr. A,

I intend this email to constitute a complaint under 104 CMR, § 32.  My complaint relates to a longstanding condition at the Acute Inpatient Unit (IPU) at Corrigan Mental Health Center ("Corrigan"). I believe this condition is either dangerous, illegal, or inhumane. 

The condition relates to all Corrigan IPU patients other than those who are young, physically fit, and relatively social (the "Youthful" patients).  For example, it relates to those patients who are catatonic, obese, elderly, or who suffer from a physical handicap or a mental disorder such as social anxiety or claustrophobia (the "Compromised" patients).

Corrigan staff represent that the patients have four times that they get to go outside. But there seems to be little or no concern or recognition that only the Youthful patients take part in these breaks.  The Compromised Patients can spend days, weeks, and even  years without ever accessing the outdoors. 

[Consider, e.g.,] patient D, who was an elderly man with significant social anxiety.  In speaking with him, his favorite moments were the times he would take walks with his sister and look at flowers.  Yet as a resident at Corrigan IPU, he was too socially anxious to go to lunch, much less to go with the group for outdoors.  [Yet if someone dedicated themself to taking him outside, he greatly enjoyed and benefited from it.]

[But for a staff member's taking it on themselves to encourage him to access the outdoors] however, he would never have gone outside.  For practical purposes, for this patient to go outside, it is not sufficient to simply post outdoors times.  Given his complex condition, and given the physical plant at Corrigan, for practical purposes, he would not have gone outside at all during his time there but for a person encouraging him and following through.

Patient P has been a resident for perhaps two years.  [Again, a special effort is required to take P outdoors, and staff is highly resentful and obstructinist when someone takes the effort.  Staff would rather use the outdoors break as their own outdoors break, without having Compromised patients interfering.  Once, it was impossible to take P down, and staff purposively blocked her participation.  Yet there were three staff outside, and only two (Youthful) patients. Nevertheless, the explanation was that P could not access the outdoors due to ... "we don't have the staff"]. 

Essentially, there is a great deal of resistance to taking [Compromised] patients outside.  [Social worker D.K. is in a position of authority but is highly resentful of any efforts to change practices.  She seems to believe that because of her managerial position, she is beholden to defend the status quo.  She does not have the experience or magnanimity for her job and appears to have been promoted too early.]

Patient L, who was catatonic, probably never accessed the outdoors [although when asked, SW D.K. blithely asserted that he gets outside often.  Just because you are management does not mean you have to lie or dissemble for the sake of the official version.]

Accessing the outdoors is a human right for all detainees.  Under Massachusetts law, access to the outdoors has to be either individual or group access.  I do not believe that Corrigan offers individual access.  Other psychiatric hospitals, such as Southcoast Behavioral, are built so that it is easy to access the outdoors.  With Corrigan, it has to be done in a group and down two dark, steep staircases.  It is a forbidding prospect [for Compromised patients].  I understand that that is a physical plant issue, but if outdoor access is not provided, it is necessary that Corrigan have a plan for why this is not possible, and that plan has to be approved by DMH.  

In October, I asked Mr. W. for a copy of this plan.  I offered to help him revisit it.  I never heard back from him, and DK provided no support for my initiative.  [She is reckless and causes significant harm to actual people in apparently supporting what she believes are "rules" but often appear to be simply what-we've-always-done. As we know from Hannah Arendt, evil is not flashy; in practice in the world, evil is banal.  And in America, served with a complacent smile.]

I hope that this Complaint will serve to alert staff to the problem of outdoors access. Not being able to access the outdoors is considered a form of torture. There are important efforts to ensure that penitentiaries provide outdoor time to their inmates.  The law--and common humanity--requires the same opportunity be provided to residents of psychiatric IPUs.

  Original post:

The first time I encountered the de facto policy that DMH employees don't respond to emails, was on Halloween 2024.  I wrote an email to the "Human Rights Officer" [LW] at Corrigan asking whether I could help by bringing a fresh eye to the facility's outdoors policy.  I received zero reply. 

I have reprinted my email below.  It refers to the CMR (Mass. code of regulations).  So let's first get oriented to that. 

That Halloween email is quoted below.  In that email, I quote some from the Massachusetts Code of Regulations (CMR).  So let's consider the CMR first.  

The first five sections of the CMR are:

101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES 102 CMR - OFFICE OF CHILD CARE SERVICES 103 CMR - DEPARTMENT OF CORRECTION 104 CMR - DEPARTMENT OF MENTAL HEALTH 105 CMR - DEPARTMENT OF PUBLIC HEALTH

We are interested in 104.  Within 104, the first five sections are: 

104 CMR 25.00 - Authority, Mission, And Definitions (§ 25.01 to 25.04) 104 CMR 26.00 - Organizational Structure and Citizen Participation (§ 26.01 to 26.03) 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES (Subpart A to D) 104 CMR 28.00 - Licensing and Operational Standards for Community Services (§ 28.01) 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals (§ 29.01 to 29.16)

We are interested in 27.  Within 27, there are four subparts: 

SUBPART A: SCOPE AND DEFINITIONS SUBPART B: LICENSING SUBPART C: OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES SUBPART D: OPERATIONAL STANDARDS FOR SUBSTANCE USE DISORDER TREATMENT FACILITIES

We are interested in Subpart C, which has 13 subsections, including:

§ 27.11 - Periodic Review § 27.13 - Human Rights § 27.14 - Human Rights Officer; Human Rights Committee § 27.15 - Absence without Authorization

We'll be looking here at 27.13 and specifically sub-section (6)(f) which states: "A patient of a facility ... shall have reasonable daily access to the outdoors."" 

There are six subsections to § 27.13(6)(f) which elaborate on this reasonable daily access.  Three are relevant here (sub sections 1, 2, and 5). 

Sub section 1 says what is meant by "reasonable daily access." We are told it means "supervised or unsupervised daily access to the outdoors, individually or in groups." The word "individually" piqued my interest because Corrigan does not provide individual access.  In addition, this section says that facilities can establish designated times for access, "as long as each patient has a reasonable opportunity to access the outdoors on a daily basis ... during one or more of" those schedule times.

Subsection 2 is about how to construe "outdoors." Specifically, "outdoors" means "a space or area outside of a building, which may include a porch, courtyard, roof deck or open space surrounded by a building." Subsection 5 is about how the facility needs to have a plan. 

My Halloween email to LW was pretty tame.  I simply noted that it doesn't seem like the Corrigan IPU patients have access to the outdoors.  And I asked to see the plan.  I assumed that would answer all my questions.  Here is the email:

 

---Beginning of Halloween 2024 email to Human Rights Officer LW regarding outside air and outside light.----------------

"I am writing to ask if I could help assist you / your office in conducting a fresh-eyed review of Corrigan Inpatient's compliance under 104 CMR, §27.13(6)(f) (reasonable daily access to the outdoors). 

Although Corrigan Inpatient does schedule Recreation breaks (at 8am, 1pm, 4pm, and 8pm), it is my understanding and belief that some patients, especially elderly patients or largely bedridden patients, do not in fact take advantage of these breaks.  ... 

On three occasions, I prompted elderly patients to go to on one of these outside breaks. On two of those occasions, my efforts were successful, and I believe the patients greatly benefited.  [Yet to my understanding, this trip outside was rare for these individuals,] causing me to wonder whether some patients would *like* to take advantage of the outside but are intimidated by the current structures of these breaks.  

For example, note that under 104 CMR, §27.13(6)(f)(1), "reasonable daily access ... mean[s] daily access to the outdoors, individually or in groups" [my emphasis].  I do not believe that Corrigan Inpatient offers individual access. Yet, for many IPU patients [e.g., those with paranoia, social anxiety, obesity, or catatonia], the only way they could reasonably be expected to access the outdoors would be via individual access]. 

Admittedly, it may not be possible or feasible to offer individual access, but my aim is to help assist you and Corrigan Inpatient in taking a fresh look at this issue. ...

To start, could you please provide to me (or point me towards) the written plan described in 104 CMR 27.13(6)(f)5?  That may answer all my questions.  I look forward to working with you on this important issue.  

The Association for the Prevention of Torture, for example, recommends a minimum of one hour outdoor exercise for any detainee [https://www.apt.ch/knowledge-hub/dfd/outdoor-exercise].  The benefits of exercise and sunlight for mental health are very well established. 

I would be happy to discuss these issues in person at at any point.  

-------End of Halloween email

No response. Zip.  Not even acknoweldgment of receipt.  I did, however, re-send this email to LW yesterday (February 7, 2025).  Note that despite being significantly over-staffed, the answer to the question, "Why don't you provide individual access?" will probably be: "we don't have the staff for that."

It will also be pointed out that the building is old, and it is not feasible to provide secure access: partly due to the unreliable elevators and partly due to the fact that to access the outdoors from the unit, it is necessary to walk down a long and narrow stairway.  That is certainly understandable. 

Nevertheless, the CMR specifies that if the facility cannot provide access, they simply need to document it in the plan. Here is the code regarding that plan.  Section c is the part saying that if staffing or the physical plant preclude satisfying the requirements, then you simply add that to the plan.

--------BEGIN EXCERPT FROM CODE REGARDING THE PLAN THE FACILITY MUST KEEP-----------

a. The plan shall include the following: i. procedures, including staffing and other safety requirements, to allow for access to nonsecure outdoor space for patients who have been assessed as clinically appropriate and safe to exercise this option; and ii. procedures, including staffing and other safety requirements, to allow for access to secure outdoor space, if available, for patients who have been assessed as clinically appropriate and safe to exercise this option.

b. Reasonable efforts to safely provide access to outdoor space may include, but shall not be limited to: i. reasonable capital expenditures to develop, construct or otherwise acquire outdoor space; ii. reasonable modifications of staffing patterns to permit staff escorts; or iii. reasonable modificationsto building access policies to permit patient access to common areas of the facility or proximate to the facility not normally dedicated as patient areas.

c. If the facility determines that it cannot safely provide secure outdoor access due to staffing or physical plant limitations, it shall: i. identify and document such limitations in the plan; and ii. identify what actions the facility will take to address these limitations and the time frame for the actions. If the facility determines that the limitations cannot be reasonably remedied, the facility shall identify the reasons for such determination. Such reasons shall be documented with sufficient detail to enable the Department to determine whether they constitute reasonable justification.

d. Upon request of the Department, but no less frequently than in its application for licensure or license renewal, the facility shall demonstrate to the Department’s satisfaction that its plan is current and that it has identified, considered and implemented all reasonable actions to safely provide access to outdoor space.

--------END EXCERPT FROM CODE REGARDING THE PLAN THE FACILITY MUST KEEP ------------

That was 27.13.  The next section is also relevant. It's about how the Human Rights (including the right of access to the outdoors) is (supposedly) enforced.  It doesn't look promising, but here it is:

27.14: Human Rights Officer; Human Rights Committee

(1) Human Rights Officer. Each facility shall have a person or person employed by or affiliated with the facility appointed to serve as the human rights officer and to undertake the following responsibilities: (a) To participate in training programs for human rights officers offered by the Department; (b) To inform, train and assist patients in the exercise of their rights; (c) To assist patients in obtaining legal information, advice and representation through appropriate means, including referral to attorneys or legal advocates when appropriate; and (d) In the case of Department facilities, to serve as staff to the facility’s human rights committee. The human rights officer must have no day-to-day duties that are in conflict with his or her responsibilities as a human rights officer, including carrying out fact-finding activities under 104 CMR 32.00: Investigation and Reporting Responsibilities.

2) Human Rights Committee. For each facility operated by, or under contract to the Department, the Commissioner or designee shall establish, impanel and empower a human rights committee in accordance with the provisions of 104 CMR 27.14. Such a human rights committee may be established jointly with other programs in an Area; provided however, that the number, geographical separateness or programmatic diversity of the programs is not so great as to limit the effectiveness of the committee in meeting the requirements of 104 CMR 27.14. (3) The majority of members of each human rights committee shall be current or former consumers of mental health services, family members of consumers, or advocates; provided however, that a member who has any direct or indirect financial or administrative interest in the facility or the Department shall notify the facility director or Commissioner, as applicable, in writing. (4) The general responsibility of each such human rights committee shall be to monitor the activities of the facility with regard to the human rights of the patients in the facility. The specific duties of the committee shall include: (a) Reviewing and making inquiry into complaints and allegations of patient mistreatment, harm or violation of patient’s rights and referral of such complaints for investigation in accordance with the requirements of 104 CMR 32.00: Investigation and Reporting Responsibilities; (b) Reviewing and monitoring the use of restraint, seclusion and other physical limitations on movement; (c) Reviewing and monitoring the methods utilized by the facility to inform patients and staff of the patient’s rights, to train patients served by the program in the exercise of their rights, and to provide patients with opportunities to exercise their rights to the fullest extent of their capabilities and interests; (d) Making recommendations to the facility to improve the degree to which the human rights of patients served by the facility are understood and enforced; and (e) Visiting the facility with prior notice or without prior notice provided good cause exists.

(5) Each such human rights committee shall meet as often as necessary upon call of the chairpersons, or upon request of any two members, but no less often than quarterly. Minutes of all committee meetings shall be kept and shall be available for inspection by the Department upon request. The committee shall develop operating rules and procedures, as necessary.

 

 

 

The American Bar Association, the U.N. Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules), and the Association for the Prevention of Torture all recommend a minimum of one hour outdoors daily, weather permitting, as part of minimum humane standards for detention and incarceration.

-------------------------------------

This is a 2nd podcast about the IPU (inpatient unit) at Corrigan Mental Health Center.  There are many other things going on at Corrigan MHC besides the IPU.  For example, there is a great program for helping families in which there is a young person who may be experiences the early stages of psychosis.  The people there are excellent. This podcast is only about the IPU.

In brief, the IPU itself is a valuable entity for the community.  If you did not consider the taxpayer perspective, there would be little to find fault with.  Once, however, you do consider the taxpayer perspective, you start to see Corrigan IPU in a very different light.  On the surface, it looks like a place to treat people who are a danger to themselves or others, albeit one that is substantially overstaffed.  From the taxpayer perspective, however, we look at the underlying reality: where is the cash going?  Who is receiving the cash?

And the answer is that from this perspective, Corrigan IPU is a benefit program where labor-market subsidies are suppled to a group of white, middle-class professionals.  For a population of at most 15 or 16 patients at a time, we have a staff of 30? 40? middle-class white professionals  working for whom Corrigan IPU provides employment safe from labor market presures.  The IPU may also effectively provide a private IPU for the patients of providers working there. 

I wanted to get some data or records to confirm or deny my understanding.  I wanted to know how did we end up with such a small unit with so many professionals working there?  So I first tried to make a public records request.  The folklore was that it was a patient suicide which caused the dramatic downsizing (but not the elimination) of the unit.  I wanted to find out when that suicide had occurred. The public records request put me in touch with a very nice young person who referred me then to the Director of Communications (DOC).  They may have the data I need at their fingertips.  I expanded my request and sent it to the DOC.  

That was mid January. By early February, I had received nothing back. Not even an acknowledgement of receipt of the email. So on Feb. 3, I left two voicemails and re-sent the original email.  As of February 7, today, still I have received nothing.

This was my experience also when I wrote the Human Rights Director originally to ask how Corrigan IPU justified its practically minimal provision of outside air and outside light to patients. (Effectively, on information and belief, only about 1/4 to 1/3 of the patients there receive daily outdoor air and light.  None are provided with individual access to the outdoors).  When I wrote the HRD, I received nothing, zip back.

There are laws and then there is what happens. My guess would be that DMH employees face incentives which make it inadvisable for them to reply to non-fluff inquiries.  It seems like it will only lead to frustration to keep communicating with the DOC.  So all I do, below, is provide the email chain with DMH.

1. At first, I was simply interested in trying to verify the folklore, viz., that the unit's bed count was cut dramatically following a patient suicide.  I wanted to know the date of that suicide, so I sent this request on January 11: 

I request all documents related to any patient suicides at Corrigan Mental Health Center in Fall River, from 1990 to the present.

2, They replied: 

Thank you for your email.  Kindly let me know when you have a moment to speak about your request over the phone this week. Our office hours are M-F 9 am to 5 pm.

3, We spoke on the phone, and I was diverted via this email: 

Thank you for your conversation today, where we went over your request and concluded that you were looking for information and not records regarding capacity at CMHC. Given this, we agreed to withdraw your request and to connect you with our Director of Communications, [GH] to go over your inquiry about that information and how it is reported. I have copied her contact information below.

[GH]

617-626-8150

4, I then called the Director of Communications (DOC), and I got the sense from the outgoing message that the phone number was more of a voice message collection device. (It was doubtful would ever be actually answered). The outgoing message also indicated people should email the DOC.  I expanded my request and sent the following email to the DOC on Friday January 17th:

  Hi.  I am planning to do a series of podcasts about the Acute Inpatient Unit Corrigan Mental Health Center in Fall River ("Corrigan IPU).  (If you are interested, the first of these podcasts is here: https://philosophypodcasts.org/pork, but you don't of course need to listen to that.  I merely provide it in case you are interested. )  I wrote a records request (below), but Mr. [G] steered me instead towards you, suggesting you may be in the best position to answer my questions.  The major puzzle I have is the following: It seems that the Corrigan IPU has only 16 beds.  Despite the fact that these are non-violent, non-medically compromised patients, there are more professional staff than patients.  On information and belief, the Corrigan IPU once served a much larger caseload.  (Specifically, at one time, it held 40 patients).     Questions 1) Is it correct that the the Corrigan IPU only has 16 beds 2) Is it correct that the Corrigan IPU employs many more than 16 professionals (specifically, is it correct that Corrigan IPU employs over 10 nurses (including two in administrative positions--i.e., who do not interact with patients, but merely serve as administrators of the staff), 1 nurse practitioner, 1 MD, 3 full-time social workers, 2 full-time occupational therapists, a dietician and a peer-support specialist?   3) Is it correct that all of these professionals are white (i.e., caucasian) 4)  Is it also correct that the Corrigan IPU also employs at least 12 mental-health workers?  5)  Is it correct that all of the higher-level (level 3 or 4) mental health workers are white?  6) Is it correct that Corrigan IPU also employs a doctor-on-call around the clock? 7)  Including all staff, what are the annual labor costs for operating the Corrigan IPU? 8)  Is it also correct that Corrigan IPU does not track whether its patients access the outdoors?   9) Is it correct that patients do not have the opportunity to access the outdoors individually? 10) Is it correct that the patients can only access the outdoors in groups, and only by traversing staircases that are daunting for older patients? 11 Is it correct that the Corrigan staff does not require or even encourage patients to access the outdoors? 12) Does the Massachusetts DMH agree that not being able to access the outdoors is a form of torture?

5. After a couple of weeks of not hearing anything, I decided to attempt contact again. On February 3rd, I left a voicemail message with the DOC asking if she had received my email and asking if she could call me or email me at least to confirm receipt.  I also sent them an email forwarding the Feb. 17 email.  

Dear [DOC],

I hope you are well.  Could you please confirm that you received this message?  I just want to make sure it didn't slip through the cracks!   Thank you so much.   As of Feb. 7 2025, I have received neither a phone call nor an email in reply.  

 

 

Wouter Kusters

A Philosophy of Madness: The Experience of Psychotic Thinking

MIT Press: https://mitpress.mit.edu/9780262044288/a-philosophy-of-madness/