The lady that wrote the article above has been nominated by Donald Trump to be head of SAMSHA. She says that Donald Trump is good news for the severely mentally ill. He, she says, know what they need.
Aside from the inevitable jokes about Trump knowing what the severely mentally ill need what else needs to be said as at least a start to the conversation.
Quite a lot.
1. Donald Trump is not good news for anyone and understands little about what people need. I would love to have someone who believes in the good news of Trump explains his willingness to destroy basically the entire social safety net of anybody in need and how that shows his understanding of their needs.
2. Trumps comments about tragic shootings in this country certainly show his “insight” into the needs of the “severely mentally ill.” Trump just does what Trump always does. Tell people who to fear, who to blame for the things that trouble them and then assure them he can put them in their place. And a “scientist” that tells you Donald Trump is good news for “science”? If the American Psychiatric Association is going to sell itself to Donald Trump to maintain its sense of ownership over the mental health system then it has given up any claim to moral integrity or scientific standing.
3. I would hope that in her confirmation hearings someone would ask her what impact she sees the dismantling of the social safety net programs across a wide variety of areas as having on “the severely mentally ill.”
4. When she talks about the need for psychiatric control of the mental health system she is really talking about three things : psychiatric hospitals, medications, and AOT.
5. Psychiatric hospitals have three small problems. They hurt people who go there. They traumatized, demoralize, and discourage already vulnerable people and try to get people to internalize an identity that makes them more dependent on psychiatric care. Secondly there is no evidence I am aware of they work. People keep coming back. In an era of evidence based practices they aren’t. Finally they are economically unsustainable. Insurance companies won’t pay for them. They are tremendous cash cows that eat state mental budgets alive and divert money from other resources that might be more effective and serve more people.
6. I am sure that Donald Trump will find considerable support from pharmacy companies, psychiatrists looking for proof that what they do is essential and irreplaceable, and the people who make money off psychiatric hospitals for making the widespread use of psychiatric medication the unquestioned and official policy of the United States government. Psychiatrists like control. Trump likes control. And the pharmacy companies will be happy to oblige. None of that is likely to make much of a difference for the people it is prescribed for who find it’s side effects intolerable, it’s threat to their health and life as dangerous and it’s lack of positive effect as appalling. As a policy it gives power to those that prescribe and makes money for those that provide.
7. AOT. There is an inherent contradiction to the call for AOT I have never heard anybody who supports AOT address. They normally deride and dismiss the mental health system as insufficient to meet the needs of the “severely mentally ill” and then turn around and tell you that the needs of these people they so passionately defend can best be met by their forced participation in a system they say sucks. Makes no sense……
8. Their real issue is not the content or lack of content of any service. It is the issue of force, of coercion. They see coercion as being an integral part of the mental health system and want to marginalize and dismiss the opinion of anyone who doesn’t.
9. This approach supports a certain political stance. In a country beset by social issues it tells us that the demand for justice that so many people are making is a symptom of an underlying problem. It medicalizes social unrest. In unscrupulous hands it means that personal problems are dismissed as a defiency in psychiatric hospitalization. It makes control and not change the answer to our problems.
10. Trump remains true. He appoints people who are fundamentally opposed to the mission of a program to be in charge of the program.
11. I don’t know what her odds of approval are. Powerful forces will be in support of her and I am not sure the survivor/consumer movement has the appetite for another fight. I hope so but genuinely don’t know.
12. Sadly I think Trump’s appointees may end up having more long term effect on our country that he himself will ever have. Very scary.
These are just some of my thoughts on hearing the news last night. Murphy is very much alive and now locked and loaded.