After Bergh's death
A blanket of silence descended after Bergh's death; his books and legal battles were scarcely mentioned. Several patients are discussed in the book Norsk psykiatri gjennom tidene (Norwegian psychiatry through the ages), including Carl Halvorsen Paulshus (1871–1955) and Arnold Juklerød (1925–1996), who, like Bergh, spent much of their lives critically examining psychiatry (28). Bergh, however, is not mentioned (28, 29).
The history of psychiatry has traditionally been written from the viewpoint of doctors and institutions, with little heed paid to the patient's perspective (30. 15). Many autobiographical accounts exist, particularly regarding involuntary admissions, but these often remain purely personal and rarely frame individual experiences within a broader context. Among the exceptions are Haaken Bergh and Stella Danner, the pseudonym of Merete Wiger (1921–2015) (31). Our article contributes to this 'history of psychiatry from below'.
During his lifetime, Bergh attracted a great deal of attention. His books, lectures, court battles and campaign for ex-gratia compensation were widely reported, and he was even granted an audience with the King of Norway (32). He proposed mental health care reforms, and his books offer a rare glimpse into what it was like to undergo psychiatric treatment in that era. His radical views attracted attention but were met with a wall of silence from the medical establishment.
Bergh's criticism was directed, in part, at the Insanity Act of 1848, which was not replaced until the Mental Health Act of 1961 (33, 34). In its day, the 1848 Act represented major progress and led to improved conditions for the mentally ill. Over time, however, its effectiveness waned, and the asylums were increasingly characterised by large wards and limited treatment options (30, pp. 113, 493). In practice, they served as custodial care facilities for the poor – including Dikemark, which was established in 1905. By the time Bergh was admitted, it was effectively a psychiatric nursing home (35).
Many of Bergh's criticisms were regarded as justified: the threshold for involuntary admission was too low, staff competence was insufficient (30, pp. 50, 102) and oversight of the asylums was inadequate. These issues have been the subject of debate ever since involuntary admission was enshrined in law (33, 34).
Other aspects of his critique undermined his credibility, such as his proposals to bar women from supervisory boards (1. XVI) and to reintroduce corporal punishment (2. 23). His rhetoric was often vitriolic, branding Norway a country of fools (1, pp. XVII, 86), rife with fakery, hypocrisy, injustice, incompetence, stupidity, coercion and falsehoods (2, pp. 5–6).
Bergh always acted alone. There is little evidence that he sought alliances or participated in broader medical or political debates. His engagement was primarily rooted in his own experiences, which he used as a basis to expose the flaws in contemporary psychiatry.
Ultimately, however, the sheer scope of his criticism, and doubts regarding his lack of insight into his illness and the circumstances surrounding his admissions, likely contributed to the limited impact of his views.