Agency (and Order) in Mental Disorder

In their introduction to Agency in Mental Disorder: Philosophical Dimensions, editors Matt King and JoshuaMay observe that people with psychiatric diagnoses have been historically and systematically marginalized, “if not entirely excluded, based on the assumption that they are incompetent or lack full autonomy” (1). One of the best documented examples of such widespread marginalization comes from the turn of the nineteenth century, when researchers in Europe and the United States were working against the backdrop of increasingly overcrowded asylums. In Following the Equator, first published in 1887, Mark Twain claimed that “the asylums can hold the sane people, but if we tried to shut up the insane we should run out of building materials.” More than two decades later Emil Kraepelin (1856–1926), widely regarded as one of the most important figures in the history of modern psychiatry, described “the rapid and continuous rise of mentally ill people who need institutional care” as “the most disturbing phenomenon of our cultural life.” There is no consensus about why people were institutionalized in such staggering numbers over this period. Academics working at the time