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.

Do Not Feed The Monster

The difference between a mental patient and a mental health consumer is identical to the difference between a garbage person and a sanitation engineer, that is, it is a matter of words, of jargon. I say this because we have had what we call the psychiatric survivor, in former times also referred to as the mental patients’ liberation, movement. This movement has been instrumental in working to free people from the oppressive constraints of psychiatric intervention and the patient role.

Much confusion has been stirred up, of more recent date, due to the merging of that movement with what has come to be called the consumer movement, a movement that could be said to be lead by, or colluding with, the federal government. The consumer movement is not so much about liberating a person from the role of patient as it is about accommodating him or her in that role.

In part, the consumer movement has been a more or less successful attempt to subvert or co-opt the psychiatric survivor movement. It is something that can’t be completely successful, for if it was, you’d no longer have psychiatric survivors, you’d just have people stuck in the mental patient role. Funny thing, huh, when some people try to suggest that the mental patient role is an inescapable lifelong or chronic matter of “pathology”?

Colluding with the federal government is a matter of begging money from the feds, gained through taxation, to continue in the mental patient, alternately called mental health consumer, role. To further elaborate, the rallying cry of the consumer is more apt to be the right to treatment while the rallying cry of the survivor is more apt to be the right to refuse treatment.

This is a matter of accent. To further elaborate, psychiatric survivors are people who see themselves as more harmed by the mental health system  than “helped” while mental health consumers are more likely to see themselves as “helped” by the mental health system. It doesn’t end there though, there is overlap, there are survivors who feel they need “help” or “support”, and there are consumers who feel they have been harmed and oppressed by the system as well as “helped”.

I bring this up because there  are a number of rallies and marches “for mental health and dignity” in the planning stages right now. The idea behind these events is to accent mental health as a positive thing and, additionally, to focus attention on “stigma”. I imagine that the ulterior motive of these rallies and marches is a matter of rattling that tin cup before the federal government and the working public, and crying, “Nickels for your pity.”

This “positive slant” also involves ignoring the twin proverbial elephants of forced and harmful treatments in the room. Joseph Rogers and Daniel Fisher have expressed interest in getting the word out about these events. It’s–the smiley masks, this ignorance and deception–a lie that I really can’t endorse. Needless to say, I have no interest in attending such events. I would encourage others, unless they want to launch a disruption, or to conduct a counter march and rally, to do the same.

Maryland Hopes To Get The Potentially Potentially Violent Into Treatment

The U.S. government has been very successful in its effort to lay the blame for mass violence on pathology rather than individuals. The disturbed individual is no longer an individual. He or she now has a psychiatric label, whether bestowed by a doctor or a newspaper reporter, and thus belongs to a grouping of disturbed people. People with psychiatric labels aren’t their own moral agents goes the ruse.  They are adult children instead requiring full or part time professional supervision.

If violence is a matter of pathology rather than choice, fine and dandy, and this pathology is a matter of biology, alright. The thing to do is to catch violent offenders before they violently offend. When his “disease” made him (we’re talking mostly young males here) do it, after all, we’re looking at “diseases” and not individuals. Individuality is not an option. People either conform to custom and law (regardless of whether that custom and law means wearing a suit and tie or a tee-shirt, jeans and ponytail) or they are “diseased”.

The idea of pre-psychosis, although deferred from categorization as a bona fide “mental disorder” in the DSM-5, is back. The Baltimore Sun reports, New Maryland mental health initiative focuses on identifying and treating psychosis. This headline doesn’t tell you everything. Maryland is beefing up it’s mental health police state system in an effort to catch more pre-psychotic pre-killers.

Founded using a $1.2 million state appropriation approved this year, the Center for Excellence on Early Intervention for Serious Mental Illness has a goal of identifying psychosis in a fresh way: by taking notice in the earliest stages and providing support before symptoms spiral out of control.

I guess they think that by busting pre-psychotics they will be preventing psychotic mass murder in the long term. The problem I see with this plan is that you don’t have a psychotic “until symptoms spiral out of control”, and my understanding is that the majority of pre-psychotics don’t go psychotic, and so, by targeting them for treatment, one could be acting in a causative rather than a preventative fashion.

[University of Maryland child and adolescent psychiatrist, Gloria] Reeves and her colleagues say they’re working to ensure patients can live normal lives by short-circuiting the possibility of a deeper psychosis that could intensify if left untreated.

When a patient is already a patient, hey, what have you got? Shallow psychosis or pre-psychosis? In which case prevention is a matter of preventing deep, “deeper” ,or what is known in the trades as ‘full blown’, psychosis? My point is that maybe sometimes it is better to completely prevent the problem by eliminating the doctor patient relationship in its entirety first. Labeling a person “disordered” is the way you make a mental patient. Once a mental patient has been made, and is being subsidized by the state, unmaking a mental patient, unburdening the state of the financial expense, becomes a major problem in itself.

A growing body of research over the past two decades, however, has shown patients are much more responsive to treatment if they’re diagnosed early, and there are early warning signs that suggest when a person is at risk for developing psychosis.

Patients again. If we have more psychosis, but more treatment compliant psychotics, are we 1. upping the number of over all patients labeled psychotic, or 2. lessening the number of disturbed mass gunman in the nation? My feeling is that we are certainly doing # 1 while it is entirely questionable as to whether we’re getting anywhere with # 2.  Next question, do we really want a larger population of psychotics in the nation?

Before you think that the impetus for this measure is entirely medical, let it be known that the funding for this initiative was voted in by the Maryland General Assembly at the prompting of  Governor Martin O’Malley. Mental health treatment then is the state of Maryland‘s answer to massive acts of violence. Of course, this is providing that they’ve got the right suspects, uh, I mean patients, and that pre-psychosis leads to psychosis which, in turn, leads to massive acts of violence. I don’t even think that is a great theory on paper, but Maryland is not the only state that sees the answer to extreme violence in the nation as a matter of increasing the amount of oppression directed against people with psychiatric labels.