I find it hard to trace a timeline of my views on mental health. I had a phase, in my teens, in which I viewed antidepressants and the like as bad, though I’m not sure I could have explained why. I also think there was a time when I just accepted “insane asylums” as just being a necessary part of life, and assumed the people running them and working at them were there to provide the best care they could. At this point, I consider that part of modern “mental health treatment” to be a part of the prison system, at least in the United States.
Some of the change comes from reading The Day the Voices Stopped, by Ken Steele, in college. I think there’s a degree to which, because we only ever experience the world from our own perspective, growing up requires gaining a real understanding of the fact that everyone else is a person, just like we are. In some ways, I feel our society discourages that form of personal development, and actively encourages us to see other people as not fully human, when they fall outside of “normal”. This absolutely includes the politics of race and gender, whether it was pathologizing Black people’s desire for freedom as “Drapetomania”, using the diagnosis of hysteria to medicalize and control women, or declaring queer people to be mentally ill. As well-meaning as I was, in hindsight there was a degree to which I saw people with some mental illnesses as being somehow broken, or less fully human. I don’t think I ever actually supported institutionalization – I had some awareness that there were problems there – but I don’t think I would have had a real answer for people who framed mentally ill people as a “burden on society”, or other such eugenical shit. I probably would have focused instead on a somewhat condescending view of having a duty to care for them. I also think that extended into other forms of disability, but again, I find it hard to remember exactly what I used to believe on this stuff.
Reading Steele’s autobiography changed my perspective, and made it impossible for me to ignore the horrors of mental institutions. I didn’t have an alternative in mind, but I no longer had any doubt that the way things had been done was bad. That was the point at which I began to understand the need to empower people with mental disability and/or illness to make decisions in their own lives. It feels bad to say that it took me that long, but I don’t think it occurred to me that someone with schizophrenia, for example, might have valid thoughts, opinions, and requirements for their own care and lives.
I’m far less sure at what point I came to understand how mass incarceration and white supremacy intersected with psychiatry, but I do remember the point at which I realized that it was so much a part of the fabric of reality in the United States that it barely got reported on. I was having a discussion-turned-argument with acquaintances who shall remain anonymous, and we were talking about racism in the U.S. criminal justice system. I brought up a case that I’d recently heard about, and the other person insisted that if it had really happened, they would have heard about it. After all, we live in a free country, right? People don’t just get locked up for not fitting a profile, and for stating plain facts about their own identities, right? Can you even imagine? It would be a national outrage if the cops just grabbed a “sane” person, locked them up, and drugged them against their will without even checking whether their claims were true.
Well, sort of. There was some coverage of it, because it really was a sensational story. In 2014, Kam Brock was pulled over “on suspicion of driving under the influence of marijuana”. People commenting on the story at the time noted that she was a black woman driving a BMW in Harlem, and that she was really pulled over for Driving While Black. This explanation is made stronger, in my view, by the fact that while they didn’t find any drugs on her or in her car, they impounded it anyway, and when she went to pick it up the next morning, they decided she was too emotional, handcuffed and drugged her, and threw her in a mental hospital.
Next thing you know, the police held onto me, the doctor stuck me with a needle and I was knocked out… I woke up to them taking off my underwear and then went out again. I woke up the next day in a hospital robe.
She responded pretty reasonably, in my opinion. She told them who she was, and asked to be released.
For eight days.
They had the means to verify what she was saying, but instead they dismissed all of it as delusions, forced her to take powerful psychoactive drugs, and demanded that she convincingly lie about herself before she be released:
According to the New York Daily News, a treatment plan for Ms Brock at the hospital states: ‘Objective: Patient will verbalize the importance of education for employment and state that Obama is not following her on Twitter.’
This was torture. They imprisoned a person, and for nine days they told her she was insane. They forcibly drugged her, and denied her reality over, and over and over again for days. And then, one day, they gave her discharge papers, and put her out the back door of the hospital. A few days later, she got a bill for $13,000 worth of “treatment”. The idea of holding anyone criminally responsible for this nightmare was apparently never even on the table, so she went with the option left to her – she sued them.
Several jurors said that Brock was less credible than three doctors — Elisabeth Lescouflair, Zana Dobroshi and Alan Labor — and NYPD Officer Salvador Diaz, who all determined she was in need of mental health treatment.
The jurors noted that Brock did not call her father or sister to the stand. Both, according to testimony, had told Harlem Hospital staff that Brock had recently been acting erratically.
“We view this verdict as a total vindication for the defendant officer and doctors who sought to help Ms. Brock through her troubling episode. The jury rejected any notion that the actions of these officials was anything but appropriate under the circumstances,” a Law Department spokesman said.
While at the hospital, Brock was injected three times with powerful anti-psychotics. The experience, she said, left her traumatized. She frequently broke down during the six-day trial.
Jurors deliberated for three days before reaching a verdict. At the beginning of deliberations three were in Brock’s favor and five were against, Rella said.
Brock began sobbing as the verdict was read.
“It’s reasonable for them to diagnose me with bipolar even though I’m telling the truth?” Brock said through tears.
“What am I supposed to do? I’m crazy because of this verdict.”
In the United States of America, it is apparently legal for police to decide that you’re “in need of medical treatment”, restrain, drug, and imprison you, and for doctors to keep you prisoner, keep you drugged, and demand that you deny reality because they said so. Not only is it legal, it’s apparently barely newsworthy. I could only find two articles online that followed up on Kam Brock’s story, and I needed a VPN to read them because they’re geo-restricted to the U.S., like so much other “local news” that’s not considered worth a larger platform. How can this be?
Well, I suspect that, aside from the ever-present white supremacy in our law enforcement system, it’s because it’s considered perfectly acceptable to do all of that to “crazy” people. Solitary confinement, assault, sexual assault, some of the most powerful psychoactive drugs available – all are just routine parts of how our society deals with mental illness, to the point where all of this can happen, triggered by some cop deciding to hassle the black woman in the expensive car, and it’s barely newsworthy that a court, as Brock said, ruled that she was “crazy”.
It’s even more horrifying when you consider what this means for the rest of Brock’s life. It’s now a legal fact that she’s “crazy”. The torture inflicted on her was ruled by the courts to be just fine. That means that if this, or something like this happens again, there is legal precedent that it’s OK to imprison and torture this woman. Any legal dispute she’s in in the future will have this hanging over it. Any time she has a negligent or vindictive landlord, or a dispute with a neighbor, or is wrongfully fired, it could make that nightmare happen again. Crying seems like a pretty reasonable response.
Remember how we saw, over the last few years, the way white women have been able to weaponize white supremacy to sic cops on black people? Brock now has to deal with that, plus the legal declaration that she’s crazy. Practically anyone has the power to get her locked up at any time, for any reason, because some cop decided to pull her over. That doesn’t mean it will happen, but the fact that it can says very bad things about what sort of “freedom” people in the United States really have.
It’s made worse by the fact that, as I mentioned earlier, mental health has always had a political dimension to it, and just as white supremacy didn’t end when the Civil Rights Act was passed, the politicization of sanity and the stigma against people with mental illness – sanism – is also very much alive and well within the systems that govern the people of the United States.
All of this is worth talking about in its own right, but I also wanted it to set the scene a little. Our society dehumanizes people with mental illness, portraying them as anything from pitiable to demonic, so long as it’s not fully human. I think this is one of those prejudices that exists within all of us, at least a little, because of the society in which we live. It doesn’t help that the way the world is set up can make life extremely difficult for some neurotypes, making them into disorders or disabilities by context. This is very similar to how non-white races are often treated, and I think that establishing that connection, and giving the example of Kam Brock, is useful in going into this next story:
Rights groups are sharply condemning New York City Mayor Eric Adams’ Tuesday directive requiring local law enforcement and emergency medical workers to respond to the intertwined mental health and homelessness crises with involuntary hospitalizations.
“If the circumstances support an objectively reasonable basis to conclude that the person appears to have a mental illness and cannot support their basic human needs to an extent that causes them harm, they may be removed for an evaluation,” states a city document.
I don’t know how useful evil is, as a concept, but I’m finding it hard to think of a better description for this. Our society routinely and deliberately denies people access to their basic human needs, for money. An economic advisor who is respected in the U.S. government actually said that they should try to increase unemployment to curb “inflation” that seems to be mostly caused by outright greed. This is the context in which law enforcement and mental hospitals will be judging whether people who have been forced to live on the streets are mentally well enough to be allowed any say over their lives. “Evil” seems about right.
There are efforts to push back against this, but it often feels like the governing philosophy in the U.S., when it comes to those at the bottom, amounts to “the beatings will continue until morale improves”. The notion – put forward by Mayor Adams – that this is about helping people would be laughable if it weren’t so cruel. Being forcibly committed, drugged against your will, and “treated” by people who will call you delusional for telling the truth, won’t make anyone’s health better, mental or otherwise. Part of me feels like that shouldn’t need to be said, but I know that I used to think it was at least somewhat OK.
I think it may even be that a majority of people still take the view that “sometimes it’s necessary”, but who decides what’s necessary? Why is mental illness – a category that we know has been, and continues to be politicized – something that can remove someone’s right to autonomy? If someone is a danger to others, then sure, the community can take steps to defend itself, but if they’re incapable of not being that way, then what’s the point of punishing them? And if they are capable of change, why the fuck would we think that incarceration and torture would help?
This new policy in NYC is horrific, and the more you know about the history and practices of the system carrying it out, the worse it looks. These are people. People who’ve been forced into about the worst situation it’s possible to be in, by a society that treats poverty as a moral failing. These are people who are routinely discussed as sub-human monsters. These are people who are routinely treated as sub-human, and this law is making that worse.
Yesterday, I talked about how each step on the path I want us to take involves making life better for humanity in the short term. This is an example of that. We’ve been taking the punitive/carceral approach to mental illness for centuries, and it has not worked. Likewise, relying on the grinding misery of poverty to get people to “do better” has never worked. A housing first policy, on the other hand, treats people as people, focuses on meeting needs, not demanding that people prove themselves worthy of existence, and it works.
Housing First Improves Lives
Study participants who were housed through HFCM showed substantial improvements across multiple dimensions of their lives:
High Housing Retention. Housing Retention was high overall (73%), but highest for those in housing first permanent supportive housing (HF PSH) (80%). HF PSH secures housing through a permanent subsidy and builds stability through the ongoing availability of wrap-around services.
Better Quality of Life. Quality of life scores improved 30% after housing.
Fewer Mental Illness and Trauma Symptoms. Mental health symptoms decreased 35% and trauma-related symptoms decreased 26% after housing.
Reduced Substance Use. Housing first does not require sobriety or abstinence. However, after housing, the percent of housed participants that used any drugs fell 37%; and the number of days in the last month that housed participants used alcohol to the point of intoxication fell an average of 3 days more than it did for unhoused participants. Other substance use measures did not change, challenging criticism that housing first and harm reduction encourage substance use.
Making this approach the default in the U.S. would not solve all of our problems, but unless you view the maintenance of this hierarchy, complete with those being crushed at the bottom, as a good in its own right, then this is an obvious step to take. This isn’t some kind of “too good to be true” con, it’s just a way to do things that is, quite simply, better. Would it cost more money, when you account for all the long-term impacts of the policy? Who the fuck cares?
It’s not like we’re short on resources. Congress just increased the Pentagon’s budget again, and we’re going to pass one trillion dollars per year soon, not even including the less direct ways money is funneled into the military-industrial complex. Elon Musk is currently burning billions of dollars in an apparent effort to prove the meritocracy wrong, Bezos is trying to get infrastructure rebuilt to fit his “super-yacht”, and Bill Gates screwed with the education system because the arrogant jackass thought he knew better than people who study education.
We are not short on money. We are not short on resources. We know how to make the world better, it’s just that the people in power don’t want it to get better. Not if it threatens their power. Why should we care how cost-effective it is to meet people’s basic needs? Why is that treated as a valid question, in the face of society as it exists, not to mention the money that will be spent kidnapping, assaulting, and drugging unhoused people in NYC?
But, since it’s relevant in the world as it is, I’ll also mention that there’s evidence that a policy of doing the right thing also happens to be “economically sound”, in that it won’t cost rich people anything.
I’m angry about this, in case you couldn’t tell. Everywhere you turn, there’s another way in which the world is set up to cause immense suffering for no damned reason, other than the shitty ideas of shitty people. There are folks fighting back, of course, mostly through local organizing. Sometimes it’s standing up to the cops to stop them from “sweeping” an encampment, sometimes it’s feeding people, but a key part is listening to the people in question, not making decisions for them.
The current political momentum in our world is pushing us towards a future that is both much worse than our present, and also much worse than it needs to be. Policies like this are, of course, an attack on both unhoused people, and mentally ill people, but it’s more than that. It will also almost certainly hurt black people more than other groups, and non-white people more than white. It will be weaponized against trans people, who are more likely to be unhoused because of bigotry that cops tend to share. It will be used, to justify horrific abuse of anyone the cops don’t like, just as they’ve done with every other tool, weapon, and policy they’ve been handed. It seems designed to “solve homelessness” by warehousing people, and using drugs to make it easier.
I wouldn’t call the Democratic Party fascist, the way I do the GOP, but bipartisan U.S. policy around houseless people has always leaned towards eugenics (when not just going there outright). Combine that with the current fascist movement, and this feels similar to the detention immigrant detention facilities that were set up under the Obama administration, and expanded and made worse under Trump. This new policy is bad, but it can get much, much worse, and instead of trying to avoid that, Democrats like Eric Adams seem to be trying to move things farther in that direction.
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