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Beyond The Mental Health Community

I’m not part of the mental health movement. I don’t beg for money from the state. I don’t think the state should subsidize “mental illness”. This is an awkward position to take because I am also a psychiatric survivor, and the psychiatric survivor movement has, in a sense, become absorbed into the broader c/s/x or consumer survivor ex-patient movement.

Let me explain. Many people who call themselves psychiatric survivors are part of the mental health movement. When our movement began we were a separatist movement, that is, knowing how badly the state treated people in the psychiatric institutions it ran, we were intent on creating our own separate places where we could truly care for people who were suffering, for people who were being abused by the state. There was, in this, a call for what became known as drop-in centers.

Fast forward 20 or 30 years. These drop-in centers have evolved, in some cases, into peer support centers. What has taken place couldn’t take place without collusion or collaboration with the government at one level or another. This collaboration has essentially turned a great many former mental patients into mental health paraprofessionals. It has also made many of these places that were once alternatives to force and abuse alternatives in name only.

Many of us got into the movement, not because we wanted treatment, but because we didn’t want treatment. We received treatment regardless. It was thrust upon us against our will and wishes. We felt compelled by this force to do two things; one was look to creating the alternatives I just alluded to, and the other was to support the abolition of all forced and harmful mental health treatment.

The question then becomes, when a former mental patient becomes a mental health worker, must he or she of necessity resort to the same wrongs he or she was initially protesting. In other words, does this position have a tendency to turn psychiatric survivor former patients into turncoats, and oppressive turncoats at that, even  if this oppression is now more subtle and cleverly disguised.

Psychiatrists may be the most powerful people in the mental health profession, but corruption in the mental health field is by no means restricted to psychiatrists. The mental health system is growing, it is not stabilizing, nor is it contracting. Either “mental illness” is contagious, doctors are better at detecting it, or personal failure as a business, as other people’s success, is thriving.

Federal and state money, tax payer money, has made the mental health system even harder to escape from than it was in years past. Calling the mental patient by another name doesn’t change the mental patient role. Part of the problem is economic damage and financial dependency, and there are forces at work now that are more intent on maintaining the problem than they are at ever coming up with any solutions.

The mental health community is somehow separate from the community at large, even if it is contained within it. When we talk about the mental health community, we are mainly talking about the community that has evolved around the business of outpatient treatment, or so called community care. Perhaps a better way to refer to outpatient treatment would be to refer to it as limbo. Perhaps not.

Outpatient treatment aside, my guess is that a mental patient who was integrated into the community he or she came from would no longer be a mental patient. This seamless integration business seems to have hit a few major snags of late. This doesn’t mean that getting people back into the non-mental health community isn’t something we should be striving for. There, I think we have something we can  work on together now.

Is “mental illness” underfunded?

One way to deal with a problem is not to pay for it . In fact, it could be a solution to all sorts of problems. Problems that are subsidized tend to thrive.

The man who probably did the most to end forced psychiatric treatment in the USA in recent history was a Republican politician by the name of Ronald Reagan. I think you’ve probably all heard of him. He helped deinstitutionalize institutions, first in California, and second in the rest of the nation, by defunding them.

 A little refresher 101 might come in handy at this point. We have had a mental health movement for some time in this country. This movement is actually a “mental illness” movement. (Review the first paragraph.)

First you have moral management with the introduction of asylums, then here comes Dorothea Dix contributing her part to the asylum building boom that immediately followed. At the beginning of the 20th century, there’s Clifford Beers doing his part for mental hygiene, supporting treatment, bashing illness, if entirely theoretical illness at that.

 The mental health movement wants the government to pay for mental health treatment. The mental health movement hit pay dirt with the Kennedy administration. The Kennedy administration came up with the community mental health system idea, and passed an act to get it started.

Depopulate state mental hospitals, and what do you do with all the inhabitants then? No Clue? Well, one thing you could do is create little mini-hospitals in communities throughout the country. Another thing you could do is treat the prodigal son or daughter returning from one of these institutions like everybody else. The Kennedy admin legislation decided on the first option.

I read once that a person is “mentally ill” until the insurance runs out, and I think this statement is relatively true. If necessity is the mother of invention, as the saying goes, when one is subsidized by the tax payer, working ceases to become a necessity.

 Today there is a movement directed towards hiring patients in the mental health system as para-professional mental health workers. I have a few issues with this approach. Namely, what is the difference between a disabled person and a non-disabled person in the mental health field? Stumped. Well, I will tell you then. Employment.

Employing people in mental health is not getting them jobs in other fields, nor is it getting them very far from the problem, that problem being the mental health system. If a person enters the system against his or her will and wishes, does working for that system really represent a significant improvement?

Unfortunately, mental health insurance parity is on the horizon for which I suggest holding your nose. What was I saying about necessity? I know, There are those people with jobs in mental health care. Maybe some of them might be able to do a little bit of good.  All I can say to  them is, “When are you going to get a real job?”

An Enabling Debility

I was watching mathematician John Forbes Nash Jr. on You Tube the other day, and he made a point that I don’t think a lot of people are catching. The mental health consumer represents a failure on the part of psychiatry to restore mental patients to health. Where we used to have a mental health movement, now we have what has been referred to as a mental health consumer movement.

Nash also noted that the basic difference between a person said to be mentally ill and a person said to be mentally well was that the latter earned a living and the former didn’t earn a living. This is what the whole idea of functionality is all about, the ability to make a good wage slave on the jobs market.

Of course, now we’ve got this idea of “high functioning mental illness” where the old rules don’t apply. Seeing that “high functioning” coupled with “mental illness” is basically a contradiction in terms, how do we explain this phenomenon? A few mental patients, aka mental health consumers, have managed through “compliance” to advance in professional, often academic, careers.

I would say you have about three things going on here at once. A bright and resourceful individual. A person who has a great deal of support–legal, emotional, and social–perhaps more than people who are not so “handicapped” by impugned disease. On top of which you also have someone who would tend to be less heavily drug dose disabled than many people in treatment due to the achievement (as opposed to troubling behavior) that the person had displayed.

It must be remembered here that the idea is not to produce a better quality consumer, the idea is produce a healthy individual, a non-patient. The “high functioning mentally ill” person also suggests a failure of the system to restore that person in particular to his or her right mind. One is also left with the question, are we making “illness” in cases like these a form of “success”?

There are other people who have been fully restored to “sanity”, but there is little glory in recovering one’s mental health as long “notoriety” comes of not recovering. Anonymity may be noble, but it doesn’t pay the bills. Acclaim, in one instance, must prove as much of a disincentive to recovery as federal benefits prove in another. How much of this is a matter of our cracked actor or actress making the most of his or her crack?

Acclaim seldom comes of recovery. More often than not what you have is a mental health worker who was a former patient, and as such represents the worst of two worlds. Your prisoner has become a warder, and your penitentiary system has grown exponentially. I suppose it represents job security on his or her part, but still this means the streets have gotten a little bit meaner, and the neighborhoods have gotten a little less secure.