Left Wing Elitism And The Psychiatric Survivor Mad Pride Movement

Governmental intrusion into health care, and such issues, carries any mental health care debate beyond the exclusive domain of partisan politics. There is no health care field in which that intrusion is more flagrant than in mental health services where “treatment“ can be a matter of “law“. While I say this, most of the activists and advocates I have met are on the left liberal end of the political spectrum. They have much to gain and little to lose in systems change, and this systems change is not achieved by supporting the status quo. The left wing, on the other hand, has never been particularly accommodating towards this as yet under-acknowledged class of people.

People in the psychiatric survivor struggle for human rights often feel they take up a place almost dead last regarding their recognition as an oppressed minority. Leaders in these other populists movements are slow to recognize the legitimacy and importance of their fight. The African American struggle, the womens’ liberation struggle, the gay lesbian transgender queer pride struggle, and the disability rights struggle are more widely recognized, and have come to be seen as priority issues. The fact that the lines become blurred when you account for the large % of blacks, women, gays, and handicapped peoples shuffled off into the mental health system is all too easy to discount and ignore.

What I think is going on here is something similar to what is found in an article in Scientific American, The “Last Place Aversion” Paradox, concerning certain research, and offering a nod to the Occupy movement. This article points out that support for relative redistribution of wealth plummeted during a recession just when you’d expect it to be climaxing.

Support for redistribution, surprisingly enough, has plummeted during the recession. For years, the General Social Survey has asked individuals whether “government should reduce income differences between the rich and the poor.” Agreement with this statement dropped dramatically between 2008 and 2010, the two most recent years of data available. Other surveys have shown similar results.

We know people oppressed by psychiatry are at the end of line when it comes to receiving their slice of the collective pie. We know that this group of people are dealing with a dream, almost anywhere in the world, deferred. Most of the people who have had their lives impacted by the mental health system are not just on the bottom rung employment-wise, most of them, even many of them working within the system, are under-paid and under, if not, un-employed.

This brings us to the subject of the article in question. When you’ve got a group credited with lacking even so much as a voice with which to speak for themselves, and presumed by temperament to be weaker than their fellows, as is claimed, then you definitely don’t want to be pushed down into the human made hell hole that they’re stuck in.

Our recent research suggests that, far from being surprised that many working-class individuals would oppose redistribution, we might actually expect their opposition to rise during times of turmoil – despite the fact that redistribution appears to be in their economic interest. Our work suggests that people exhibit a fundamental loathing for being near or in last place – what we call “last place aversion.” This fear can lead people near the bottom of the income distribution to oppose redistribution because it might allow people at the very bottom to catch up with them or even leapfrog past them.

There are limits to people’s altruism where self-interest is concerned, Eastern and Western religions aside. Martyrdom and self-sacrifise are not always the most desireable goals on peoples’ checklists. Even people within the mental health system aren’t crazy about any personal martyrdom or self-sacrifise that they may have to endure.

We’ve also found evidence of last place aversion in laboratory experiments. In one, we created an artificial income distribution by endowing individuals with different sums of money and showing them their “rank”– with each rank separated by $1. We then gave them an additional $2, which they had to give to either the person directly below or directly above them in the distribution. In this income distribution, of course, giving $2 to the person below you means he will jump ahead of you in rank. In our experiments, most people still give to the person below them – after all, the alternative is to give $2 to a person who already has more money than you. People in second-to-last place, however, who would fall to last place when giving the money to the person below them, are the least likely to do so: so strong is their desire to avoid last place that they choose to give the money to a wealthier person (the person above them) nearly half the time. If Americans behave like people in our experiments, then it could be challenging to unite those in the bottom of the income distribution to support redistribution.

The conclusion of this Scientific American article is that maybe the Occupy Wall Street movement has developed a strategy, implicit in the slogan, We’re the 99 %, for overcoming this challenge to more equalitarian ways of thinking and behaving. I hope so, and I hope that this strategy can be more inclusive of human difference rather than less so. The social pariah, the eccentric, and the non-conformist are more likely to be found among the 99 % of the people who are not filthy rich than they are within the 1 % of people that are, believe me! These same people, due to such “misbehaviors”, are also more likely to be found in mental institutions.

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14 Responses

  1. IMO, reform of the mental health system will one-day come from a place where it is least-exptected…

    From Constitutional conservatives, and those with libertarian tendencies…

    Because, at the end of the day, it’s about freedom, not more intrusion –

    http://discoverandrecover.wordpress.com/mental-health-freedom-and-recovery-act/

    Duane

    • I wouldn’t see it as least-expected. Senator Chuck Grassley is a Republican, and maybe he is a Constitional conservative, too. I don’t know. Ron Paul is libertarian, and he supports a parental rights act. Liberal Senator Ted Kennedy was notorious for his opposition to a similar law.

      Columbia University psychiatry professor emeritus Thomas Szasz is known for his libertarian views.

      Libertarian can be too often equated with the right wing libertarianism of the present Libertarian Party. Not every libertarian is a right wing proponant of lessez-faire completely unregulated economic *madness (*for lack of a better term.)

      There are places where the right and the radical left have been in agreement, and in disagreement with moderates and liberals. Dissident psychologist Bruce Levine has suggested a coalition of the right and left forces to take on excessive government and corporate imperialism. I could see that kind of thing developing, at least, among people who have the same vested interest in systemic change that some of us do.

      I know that there is much constitional basis for reform. Violating people’s human rights in the name of mental health treatment flies in the face of those rights guaranteed by The Bill of Rights in that same Constition.

      Even the left can’t ignore the reality of this situation forever, or so I would like to think.

  2. I think it’s fair to say that we are largely in agreement…

    Not sure what you mean by “corporate imperialism”… It seems to me that the problem is “crony capitalism”… the drug makers are in cahoots with the FDA, NIH, NIMH, etc.. They have been for years… Hardly a free market model, especially when you take a look at the amt of drugs purchased through the states’ Medicaid systems, along with Medicare, VA, etc…

    Forced outpatient treatment, “parity” (forcing people to pay for psychotropics in private plans) are not ideas that come from libertarian minds… and a massive, federal, bureaucratic health care system is not what people who believe in limited government think is a good idea… These are the resuls of “liberal” thought.

    Duane

    • Crony capitalism as corporate imperialism, sure, that works, but we’re really going beyond the matter of drug companies and the mental health system. You’re also talking about bankrolling banks and auto-companies while bankrupting Mom & Pops, and throwing the neighbors out on the streets. It all ties in together. We used to have effective ‘anti-trust’ laws. We don’t seem to have such effective ‘anti-trust’ laws any more. “Monopoly” is not a game that, as a rule, allows folks to prosper. We need a market that permits real competition, not just “corporate takeovers”. When individuals are valued at $40,000,000,000, those individuals are way over valued. The McDonaldification of the world is not a great improvement over whatever came before, to say the least.

      Liberalism in the spendthrift sense is not something I’d want to encourage. I don’t think we should throw money away on ineffective programs either once they have been proven to be ineffective. Insurance parity is a big problem in the sense that it encourages relatively intact people to opt for disability rather than seeking honest employment.

  3. To clarify, I’m all for liberal thought.

    I do not see the progressive movement and the left wing as “liberal”..
    They are, far-too-often creating a “Nanny state”… Having little faith in people’s ability to make their own decisions, and live their lives as they see fit.

    And it shows in mental health care as well… Where taking care of the “mentally ill” is seen as a good thing to do… with taxpayer money, by force if necessary… Afterall, the “mentally ill” do not know what’s in their best interest, and the Nanny-state can provide cradle-to-grave “treatment”.

    Duane

    • We differ here. I see liberalism as doing what you credit the progressive movement with doing. The problem, as I see it, is with leaders in this progressive movement who have bought into medical model psychiatry, and thus, the liberal line.

      Ralph Nadar, flirting with the Treatment Advocacy Center, and Noam Chomsky’s faith in conventional psychiatry, I see as concessions to liberalism. I’m against this form of liberalism. I equate liberalism with Nanny Statism. A radical stance, itself, is not a liberal stance, and may in fact share many qualities associated with the right.

      More fundamentally, the problem is one of prejudice and intolerance. Nobody flirts with the TAC, or converts to the church of biological psychiatry, who is not prejudiced against human beings oppressed by mental health law and the mental health system. This prejudice makes our struggle, like the struggles of black people, women, gays, and handicapped people, progressive, and a matter of struggling for human and civil rights.

  4. I think we are saying much of the same thing.

    I’m for real progression. Key word “real”.
    The rights of people who’ve been diagnosed with “mental illness” have been trounced for decades (centuries, actually).

    I’m also against the use of force by the TAC and Ralph Nader’s group… any group, from either the “left” or “right”…. IMO, this is addressed in the Constition in the 14th amenment (6th amendment as it applies to the feds).

    And I do think the thoughts of Bruce Levine makes good sense.

    Duane

  5. I read your discussion with interest and I am glad to hear of Bruce Levine. I am surprised to hear of Chomsky’s views on psychiatry; I would have thought he would have more sense.

    My understanding of the due process bestowed by the 6th and 14th amendments is that this should be accorded to all. There is clearly a shortfall in the due process afforded to those taken into custody on psychiatric grounds. Can you tell me if there is anything in the Constitution that applies directly to psychiatric circumstances?
    If there is nothing there, do you think there is the potential for a legal challenge?

    • Legendary advocate Judi Chamberlin tried to talk to Noam Chromsky about our (consumer, survivor, and ex-patient) issues once, and he was dismissive, seeing it all as a medical matter.

      There are a number of amendments in the constitution that speak directly to the matter of discrimination and undue force. Freedom of religion has been used successfully to leave a hospital on the grounds that treatment there violated a person’s Christian Scientist principles. The 2nd amendment that guarantees our right to bear arms is being violated in a number of cases where states pass treatment information onto the federal government. The 5th amendment would prevent people from testifying against themselves, and still treatment records are used to besmirch character. The 6th amendment is about making sure people receive a fair trial, and still people facing civil commitment generally get nothing more than a hearing with a court appointed attorney (who doesn’t even mount a vigorious defense), a magistrate, and a psychiatrist. In short, civil commitment hearings are an example of Kangaroo “justice”. The 14th amendment would protect people from being deprived of life, liberty, and property unduly by the state. The 8th amendment would protect people from cruel and unusual punishment. I’d also like to point out that there is no presumption of “wellness” until proven “sick” by a jury of one’s peers ‘beyond a reasonable doubt’. A psychiatrist’s expert opinion would have a much tougher time if it had to weather potential conflict with any one of the opinions of 12 jurors. People in the mental health system have fewer rights than people in the criminal justice system, and this injustice translates into second class citizenship, financially and operatively.

      Jim Gottstein, the director of the Law Project for Psychiatric Rights, out of Anchorage Alaska, is an attorney who is always looking for constitutional grounds with which to launch a test case to challenge forced treatment. You might check out his website, and see what you think.

    • Gottstein’s had some success with the Alaska State Supreme Court…
      From Duke Law Review –

      http://www.law.duke.edu/shell/cite.pl?25+Alaska+L.+Rev.+51

      Duane

  6. Thank you both for the information and resources. I am going to have a good look before commenting.

  7. In Canada with our health and welfare system. The drug companies are making a bundle. It is impossible to get any alternative therapy other than mindnumbing psychotropic drugs. When you, because of your Mental “Illness” are classified as “disabled’ by either the Federal or Provincial Government the drugs are provided free. Of course if you are committed you have NO choice they are forced on you by law.

    • Very much like the situation in the United States.We’ve got Medicare, Medicaid, and now the government’s own health insurance solution. The government had to pal with big pharma to get that one through. We’ve also got “insurance parity” which boils down, where mental health is concerned, to one big disincentive to working.

      On the positive side, I’m more impressed by the consumer or consumer/survivor movement in this country than I was a few years ago. I think there is a growing understanding among mental health consumers and ex-patients that choice is important, and that psychiatric drugs aren’t the wonder drugs they are often cracked up to be. They also see the need for creating more consumer/survivor run alternatives. Although I say this, many people in this movement feel that things are getting worse for people in the mental health system as a whole. Some deinstitutionalization has occurred, but at the same time, you’ve got this great flood of people seeking solutions to their problems in living. We’ve got these human-made epidemics to contend with. You’ve also got Involuntary Outpatient Commitment laws, group homes, assisted living facilities, a widening mortality gap, and an expanding institution without walls. There is also the matter of impoverishment and dimenished opportunity, or what is referred to as the mental health ghetto. Prejudice can and does keep good people down.

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