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Human Rights Or Patient Rights?

The government co-opted the mental patients’ liberation movement by buying it out. Now it’s primarily a mental patients’ movement.

If the mental patients’ liberation movement, also called the psychiatric survivor movement, was once a movement to liberate people from the mental patient role, and by virtue of that fact, from the mental health system itself, government funding has transformed that movement into a movement to promote the mental patient role, and to expand the mental health system. .

The mental patients’ liberation movement has been called anti-medical or anti-psychiatry. It was a movement of what might be called anti-patients, people who wanted out of the mental patient role, people who didn’t think a lifetime of so-called “mental illness” was in their best interests, nor really, in the end, entirely worthwhile. People who, in a nutshell, felt violated and abused by what passed for “mental health treatment”.

The chief difference between then and now can be found in the Brief History and Accomplishments of the Consumer/Survivor/Ex-patient (C/S/X) Movement powerpoint of Sally Zinman and Gayle Bluebird. They have slides for processes then (1970s) and now (1985 onward).

Processes (1970s)

• Autonomous groups; belief in local control
• No money from mental health system
• Separatist
• No major outreach

Processes (1985 onward)

• Mainstreaming
• Centralizing
• Money from mental health system
• Collaborations/beginning reentry

The first category may have been smaller, but it was also not incorporated into the “mental health system” itself. It was also, in theory if not in fact, not a hierarchical movement directed by a leadership elite. The revolutionary Processes have, in other words, been replaced by counterrevolutionary Processes. This change is illustrated most tellingly in the language, in jargon, once it was a mental patients’ liberation movement, now it’s a movement for consumers’ (and/or survivors’), plus some say former patients’, of mental health services.

Let’s not mince words, ‘mental health consumer’ is just another way of saying mental patient. Survivors of psychiatric oppression, by aligning themselves with ‘consumers’ of psychiatric oppression, are doing themselves no great service, or rather, they are doing themselves a great disservice. Liberation is, as it should be, at cross purposes with the marketing of subjugation, and its complementary number, oppression.

The “mental illness” rate has been growing for centuries, this is the way the mental health system expands. The “mental illness” industry is a growth industry. For this rate to decline, you’d have to be getting people out of the mental health system, and not putting more people into the mental health system. This isn’t happening because it doesn’t pay. There is much money, on top of whole careers, in the “mental illness” industry. There is no “mental health” industry. Getting people out of the mental health system, and not putting more people into it, would be more “mentally healthy”, but it doesn’t pay.

The system centers on “mental illness”, not because “mental health” is the objective, but because “mental health treatment” is the objective. “Mental health”, on a mass scale, would throw many, many mental health professionals out of work, and that’s not something a mental health professional would be keen to support.

Zinman and Bluebird also have slides on the difference in Principles between the movement in the 1970s and the movement after the government co-optation and buy out. Then is a little bit fuzzier, to them, and for obvious reasons, than since.

Principles (1970s)

All within the context of a liberation movement for people diagnosed with mental illness, the following examples were some of the principles these groups developed:
• Against forced treatment
• Against inhumane treatment—medications, lobotomy, seclusion and restraints, and ECT
• Sanism
• Anti-medical model, usually described as anti-psychiatry
• Emerging concept of consumer/survivor-run alternatives to mental health system
• Involvement in every aspect of mental health system

I’m imagining that for sanism, the mental health equivalent of racism or sexism, they actually mean opposing sanism. Involvement in every aspect of the mental health system is also somewhat problematic. If there was no forced treatment, for instance, what passes for alternative treatments today would be the rule. Also, a person’s right to reject treatment, and assume a non-compliant or anti-patient status, would be universally recognized as a civil and human right. What you’ve got are out-patient facilities with lists of rights on the wall that include Right To Treatment but absolutely no Right To Refuse Treatment. This is not choice, this is absence of choice, and thus deprivation of liberty.

Principles (1985 onward)

The same principles as the earlier days are expressed in positive rather than negative ways:
• Self determination and choice
• Rights protections
• Stigma and discrimination reduction
• Holistic services
• Self-help/peer-support programs
• Involvement in every aspect of mental health system — “Nothing About Us Without Us”
• Concept of recovery (encompassing all of the above)

The basic problem here is that if you aren’t explicitly against forced and inhumane treatment, you are for it. We could be friendly with despotic governments, too, however that doesn’t make such a positive position the kind of position one should adopt. Rejecting the “mental illness” industry, and with it the “mental illness” pandemic it has engendered, makes much more sense than promoting it. The very reasoning of these so-called advocates indicates the kind of corrupt practices that they personally have become intimately engaged in. Switching sides, from critic to consultant, doesn’t make you a better person. In fact, it can result in the reverse.

A larger and larger mental patient population doesn’t make for a healthier nation. Duh. The “mental illness” industry is its own critique. Were people thrust into the mental patient role, to reject that role, and to opt for a more anti-patient stance instead, we would be making progress. Embracing the mental patient role, on the other hand, and with it, government subsidies, is a way of producing career mental patients. A career mental patient is a person said to have a “chronic mental illness”. Such a career choice may be good for the “mental illness” industry, perhaps, but it is bad for the world as a whole. Certainly there is better work to be found in the world than that of career mental patient. Ditto, career mental patient manufacturer.

Remake of the Last Horror Asylum

movieproj “The road to hell is paved with good intentions”, or so a certain saying goes, and nowhere is the gist of this saying more apparent than in the realm of mental health treatment.

The problem we have here may be summed up with a word, and that word is paternalism. Just what do we mean by paternalism? According to Wikipedia:

Paternalism (or parentalism) is behavior, by a person, organization or state, which limits some person or group’s liberty or autonomy for that person’s or group’s own good. Paternalism can also imply that the behavior is against or regardless of the will of a person, or also that the behavior expresses an attitude of superiority.

I think the Oxford Dictionary definition a little more precise.

The policy or practice on the part of people in positions of authority of restricting the freedom and responsibilities of those subordinate to them in the subordinates’ supposed best interest.

No question about it, suppressing insubordination can only serve the status quo. Of course, sooner or later the status quo grows old and boring, not to mention oppressive.

I bring this up because of the usual piece of propaganda I ran into the other day bearing the headline, Ohio has a ‘critical’ shortage of psychiatric hospital beds. Of course, Ohio can’t be said to have a ‘critical’ shortage of psychiatric hospital beds for those who think Ohio could use fewer psychiatric hospital beds.

Kinda like deja vu, don’t you think? Good thing for us the likes of Dorothea Dix are no longer around to stir a big problem very much bigger. We know psychiatric hospitals for the prisons and warehouses that they actually are rather than the hospitals that they, in fact, never were. No, instead we have the likes of Hannah Poturalski of Journal-News to aggravate matters. Do we really need to rediscover our reasons for closing big asylums in the first place? Certainly, it’s always possible to do so the hard way, by ignoring history and, thus, repeating it.

Among the typical misinformational drivel you get out of this kind of thing is the following tidbit.

In the U.S., one in four adults has a severe mental health need, but only a third of the affected population seeks out treatment.

Alright. When you’re looking for money, and you need a big problem, that means big numbers. Now if 25 % of the people in the continental USA are in need of medical treatment that is news. On the other hand, if you’re just inflating figures in order to drum up funding, that isn’t news. Sometimes the line between “severe” and non-existent is blurred to the max, that is, sheer fabrication. What, after all, is a “severe mental health need”? Oh, I know. It is whatever some hired “expert” says it is.

If 2/3s of 1/4 are not seeking treatment, what is the problem!? The problem is that said “expert” would impose treatment on the 2/3s not seeking treatment regardless of whether they want it or not. Do we, the question then becomes, achieve better “mental health” by forcing treatment on people who don’t want it? The next question is, are we really going to achieve better “mental health” in the country by not leaving well enough alone? I rather doubt that that’s the way it works.

Something to think about, 1/3 of 25 % is about 8 %. 8 % is a much more manageable figure. 8 % is, in fact, much closer to the 6 or 7 % estimation of people in the USA given serious “mental illness” labels. If you are going to conflate figures in such an exaggerated fashion, it is more than likely that Ohio, and any other state in a similar “crisis”, would do better to seek fewer beds rather than more. Yes, fewer beds and fewer patients to fill them.

Doctor Thomas Szasz: Antiquated Relic Or Continuing Influence

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Not that long ago, Michael Fontaine, an Associate Professor in Classics at Cornell University, published a post on the Mad In America website, On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz. In this piece he compared the ancient Greek philosopher Epicurus with the recently deceased libertarian psychiatrist, Thomas S. Szasz. The piece itself evolved out of a presentation he gave at the American Psychiatric Association convention in New York City. Far be it from me to suggest that any APA meeting would have a grand reception for the ideas of Szasz. The idea of burying him, and with him them, on the other hand, now that might go over pretty well indeed there.

I happen to disagree with what seems to be the major premise of the post Michael Fontaine submitted, and that is that Thomas Szasz was somehow a failure because there is no school of psychiatry operating today that could be said to be Szaszian. As Thomas Szasz himself put it, the type of psychiatry he advanced could not be practiced in the USA today because it would be such an exception to what passes for standard practice that litigation would not permit it. I think Thomas Szasz did have an enormous influence on one group of people, and so big an influence that a Szaszian school could be said to exist today.

Recently, just last year, there was held at Wagner College in New York City a symposium on R.D. Laing. On the internet The Society for Laingian Studies has a website. R. D. Laing, by no means an atheist, when it served him, equated madness with religious experience. R. D. Laing had a large following, and despite losing his license to practice medicine late in life, he continues to have such a following. Laing with Szasz have been associated with the term “anti-psychiatry”, a term both of them came to disavow. “Anti-psychiatry” was coined by a colleague of Laing’s David Cooper. David Cooper’s “anti-psychiatry”, at the time, was essentially meant to be a movement of people supporting approaches to psychiatry that weren’t heavily biologically biased.

During the 1970’s the mental patients liberation movement, a movement that came to be described as the psychiatric survivor movement, and later still the mad, or mad pride, movement was developing. The initial “anti-psychiatrists”, if by “anti-psychiatrists” you mean associates of R. D. Laing, stopped short of supporting the abolition of coercive psychiatric practices. Thomas Szasz, on the other hand, did see forced psychiatry for the social control mechanism that it was, and he sought to see it abolished. It is my contention that, as far as this movement was concerned, at least initially, Szasz had more of an influence than Laing.

There were two missions of this movement in the beginning. One was to provide for people victimized by psychiatry, in a way that the state did not, that is, to create alternatives to forced treatment for people at risk for it, and abused by it. The other was to see the end of coercive mental health treatment, or what in actual fact was state sanctioned abduction, torture, assault, imprisonment, and poisoning. This second aim has not vanished. People are still being oppressed, abused, tortured, and even killed by the psychiatric system in the name of “treating” diseases that can’t, in fact, be proven to exist…not in any physical sense anyway.

What would have called itself “anti-psychiatry” at one time, now describes itself as “critical psychiatry”. “Anti-psychiatry” has grown to take such a bad rap in the mental health professions, and in the corporate media, that any professional using the term could find him or herself at risk of a major career change. Of course, this is not the case with patients and ex-patients, and many of them have gone on to embrace the idea of an anti-psychiatry movement. Psychiatry itself as a profession grew out of the coercive mistreatment of certain individuals by medical specialists, and so, we have no problem implicating the entire profession in the mess it has had a major hand in making.

Over time, and as would be expected, alternatives to conventional psychiatry create their own conventions. Some of these alternatives lose sight of their origins, and begin to resemble the very thing they arose to counter. For this reason, the abolition of coercive psychiatry need not be contingent upon the development of alternatives, even if one supports such as options. The mental health movement, in which alternatives often play a substantial part, is all about mental illness industry expansion. The anti-psychiatry movement, on the other hand, is opposed to this mental illness industry expansion. Mental illness industry expansion means more and more people bearing psychiatric labels and, as such, coercively mistreated

I don’t think the religion of psycho-babble any more palatable than that of rational analysis in the long run. Nor do I think the Laing-Epicurean Szaszian-extinction comparison, and divide, really follows. As I see it Szasz has had a great deal of influence on a lot of people, and that influence is not going to fade into obscurity anytime soon. I would hope that out of this discussion more people discover the works of Dr. Szasz, and that they come to see, as many of us have, the need to abolish coercive mistreatment. As far as it goes, with a great many psychiatric survivors, Szasz still represents a major influence, one might say school of thought, and by no means does his legacy come close to approaching the dismal failure that some of his detractors might be hoping for.

Shrink Crazy

Some headlines step over the line. This is our Weird Headline For The Day:

Research shows that there needs to be a new psychiatry diagnostic added to their manual…fear of having a cell phone that does not work.

Somebody should tell these dimwits that there are almost 400 diagnostic labels in the current DSM, the DSM-5, already. (DSM: short for Diagnostic and Statistical Manual of Mental Disorders; AKA shrinks’ bible; AKA Field Guide to Looney Birds.) Some people even go so far as to call these diagnostic “mental disorder” tags,  cataloged in the DSM,  “diseases”.

Believe it or not, this is not satire. Technobabble, yes. Satire, no. It should be satire, really, so let’s call it “found satire”.