The Great Need For Systemic Change In Mental Health Care

Failure and success are manufactured by people. This is part of the problem with the mental health system. On the one side you have the success stories, these are the people described as mental health providers. They make a considerable amount of money, live in enviable conditions, and support lifestyles to match. On the other side you have the failure stories, these are the people described as mental patients or mental health consumers. They tend to be chronically un or under employed, live in conditions of squalor, and seem to be doomed to repetitive cycles of failure that come of lamentable and impoverished circumstances.

Somehow advantage and privilege are built into a system that doesn’t serve it’s recipients so much. Instead you’ve got a self-perpetuating public service system that serves it’s service providers while crippling and impoverishing it’s service recipients. One career option, mental health professional, determines the role of the other, mental patient or mental health consumer. Trouble is the first, middle, and last name of the service recipient while the service providers official name is Help. The service provider is there to Help with the person in Trouble, the recipient, and the process continues. Should Trouble ever find an acceptable role in life Help is out of luck and out of a job.

Given that the provider’s lot is substantially above that of the recipient as a rule, this maintenance of Trouble is not such a tall order. The provider is paid to fail the recipient in his or her endeavors. The provider is essentially in the superior, more predatory, role and position. To draw a parallel from the animal kingdom, you always need more prey in relation to predators and, likewise, recipients must outnumber providers because the provider draws his or her sustenance from the recipients. Were the recipient not in a weaker position, the provider would not be in a stronger position vis-a-vis the recipient. Of course, this structural arrangement requires much collaboration from the community at large in order to persist.

Obviously if we haven’t got a sickness in the first place this isn’t about finding a cure. The cure to a bad situation is a better situation. Problem: if this be the case, you can’t cure the recipient without sickening the provider. When we’re dealing with essentially the lost causes of the survival game, no problem. The provider’s role is to survive by perpetuating the lost cause mythology of the recipient. The recipient’s role is to be the lost cause that supports the provider’s continued existence. Survival is more important to the providers than it is to the recipients in that the recipient’s role is fundamentally not to survive, but rather to be victimized. We don’t have an interdependence of equals, instead we have the relative independence and interdependence of superiors based upon the dependence of inferiors.

There is no way to label and treat people without making these more or less arbitrary value judgments regarding the relative merit of human beings. A wannabe is not a star attraction, but both wannabes and star attractions  are interchangeable. It is the audience that makes the wannabe a wannabe and the star a star, or further, the wannabe a star and the star a has-been. We’ve got more than enough overblown mediocre talents who make megabucks to go around. There is a world of worth beyond the dependency system that I have been critiquing that needs to be mined. This is a matter of rather than expanding mental health care services unto perpetuity, of contracting them. This is a matter of  creating a door crack  into the world at large rather than warehousing certain individuals in the world’s invalidated parenthetical doppelganger, that is, in a would be rehabilitation zone that rehabilitates no one.

The system needs changing. The system needs to lead to that which is not system. A self-perpetuating system of facility and debilitation is what we don’t need. While this system has been very good at convincing recipients of their debility,  it has been very bad at convincing them of their ability. This is because the recipients are not the only people in this system that need treating. The privilege and authority of the providers needs treating as well. They are all too often “sick” with their own sense of self-worth and power.  This conceit has blinded them to the assets of their clients. The providers need another role besides that of benevolent paternalistic dictator. The recipients need another role besides that of victim. The other side of the recipient’s misfortune is the provider’s fortune.  They just aren’t sharing enough of it yet, and this situation needs to change if some people are ever to achieve a better station in life.