What “black lives matter” has to do with mental health reform 

What “black lives matter”  has tried to say about the killing of black people by the police is that it is more than the actions of a few bad cops,  that it is built into the fabric of the way that we do policing.   It is in their view an institutional problem that requires more than sending a few bad apples to jail.   The problem is not that it is an aberration.   The problem is that it is not.  Public pronouncements from political figures from a variety of viewpoints indicates that at least in a small way the point is finally being heard and received. 

Many mental health advocates have tried to make a similar argument. According to them, the mental health system within the normal parameters of its operation too frequently hurts,  injures,  and traumatizes the people it serves,  the people it is trying to help.

 It is dominated by a pharmaceutical industry whose bottom line is based on their ability to market the medicalization of human distress as scientific fact and a psychiatric community whose role and power is based on the success of this effort. 

According to advocates many of its basic truths are neither basic or true.  Medication prescribed is not specific to any “ailment.”   It is the prescribers best guess and is often more descriptive of the training, the experience,  and philosophy of the prescriber rather than the needs of their patients.   Many of the medicines have little documented histories of success and long documented histories of adverse side effects,  effects often life altering and sometimes life threatening. 

The system is based on the power of those who do mental health over those it is done to and that power based system has negative consequences.  People are regularly coerced either formally or informally to accept treatments they either don’t understand or disagree with. Their wishes,  their values,  their knowledge of themselves is characteristically either ignored or minimized.  They are told if they have questions or doubts that their motivation to “really”  want to change is suspect. 

The system in many ways,  both spoken and unspoken,  affects the identity of the people it serves. It tends to reduce people to the labels it places on them and often explains behaviors,  thoughts,  and feelings as symptoms of those labels.   It tells people that their troubles are chronic and lifelong and that they face a life time of dependency on the system. 

Advocates also claim that having a mental health diagnosis had real and damaging consequences in the real world.   It makes people the target of very real prejudice and discrimination in all areas of their life.   And while black people understand that every encounter with the police is possibly dangerous those labeled as “mentally ill” understand the same thing. 

The problem is that the narrative of the way we do mental health as being intrinsically problematic has little currency and basically no credibility other than among a relatively small population.   422-2 the most recent vote in the house tells it all.   No one got it.   I don’t see how it is possible to misunderstand that. 

Someone who I had this discussion with told me they thought I was against mental health reform.   They talked about the recently passed Murphy Bill and carefully explained to me how virtually everyone of the poison pills in the original Murphy Bill had been substantially neutralized.   I  told her I understood that and wasn’t t arguing otherwise.   I told her that I  thought mental health reform was about more than treating “mental illness”  well.   It was about treating people well and until people realized that was a problem I wasn’t  sure anything else was going to make a  difference. 

We need to find a way to speak in a language that engages and has traction with those that we speak with.   We need to talk about strategies that make a difference.   422-2.  It is not about trying harder.   We tried hard.   I doubt know what the answers are but something must change if we want a change. 

I think part of it is saying our lives must matter too.  That, at least in part,  is part of the task ahead. 


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