There is strong pressure on people to avoid psychiatry, and the surest way they can avoid it is to do what is expected of them and keep their mouths shut. Therein lies psychiatry’s covert, or indirect, social-control function. – Leonard Roy Frank
Mass mobilizations against police terror have raised a number of demands including replacing police with social workers and therapists. While the sharp increase in pandemic-related distress seems to support this demand, it is a trap.
“Replace the cops with mental health workers!” is a really well-intentioned statement, but the current mental health system is also a white-dominated, violent, coercive, and unaccountable structure that disproportionately harms people of color.” – Morgan M. Page
It doesn’t help to replace one form of oppression with another. Like the police, the ‘mental health industry’ is saturated with institutionalized racism.
In The Protest Psychosis: How Schizophrenia Became a Black Disease (2010), psychiatrist Jonathan Metzl documents how “race gets written into the definition of mental illness” and how psychiatry treats rebellion against racism as a form of ‘insanity.’ In psychiatric institutions, as in prisons, people of color are disproportionately detained.
A 2004 survey of the medical files of 134,523 US veterans labeled ‘severely mentally ill’ found that doctors were labeling Black patients with ‘schizophrenia’ four times more often than White patients. Black patients were more frequently described as violent and prescribed higher doses of neuroleptic drugs. The researchers found no evidence that the Black veterans were any sicker or more violent than the White veterans. ‘Race’ was the only factor that accounted for the difference.
Oppression is oppression whether the uniform is a badge and gun or a white lab coat and prescription pad. Many who have experienced both prison and psychiatric hospitalizations prefer the police. Psychiatric survivors have described their forced hospitalizations as torture. Many would rather be beaten with a baton than to be forcefully injected with mind altering substances that invade one’s core internal being, a process that has been described as akin to rape. – Noel Hunter
Labeling someone with a psychiatric disorder transforms a victim of oppression into a defective individual in need of ‘mental correction.’
Psychiatric institutions are, in fact, part of the carceral state. They are part of the many systems that function to contain people, take away their locus of control, offer surveillance, isolate them from their communities, and limit their freedom. – Stefanie Lyn Kaufman-Mthimkhulu
Anyone can call the police to physically restrain and forcibly remove a distressed or distressing person to a place where they can be indefinitely confined and forcibly drugged until they are judged capable of rejoining society, assuming they survive the encounter. In the United States,
In 2015 and 2016 combined, one in four police shootings was of a person with mental illness. Nearly half the people shot by police in Maine between 2000 and 2011 had a mental illness. Almost 60 percent of people killed by police in San Francisco between 2005 and 2013 had a mental illness that “was a contributing factor in the incident.”
Anyone labeled with a psychiatric ‘disorder’ can be denied entry into the United States, even as a visitor. Thirty-eight American states authorize or require ‘mental-health’ records to be reported to the national system for checking criminal backgrounds, and police are 16 times more likely to kill people labeled ‘mentally ill.’
Those with higher social status often report good experiences with police and psychiatrists. The rest of us are not so fortunate. Regardless of the intentions of individual ‘mental health workers,’ they are locked into serving an unjust social system.
Having social workers, medicalized peer workers, psychologists, and psychiatrists respond to distress calls or community violence through the lens of getting them mental health treatment is simply replacing one racist, oppressive regime with another. They may not come in guns a-blazing or physically beating up innocent bystanders, but, as a system, they are granted the authority to psychologically manipulate your reality, beat you down with words and restraints, and drug you into submission — and insist you thank them for it afterward. – Noel Hunter
The solution is not to train ‘mental health workers’ in de-escalation techniques. While kinder, gentler therapists can be helpful, distressed people don’t need their faults and failings identified and ‘corrected.’ They need practical solutions for real-life problems.
Some argue that coercive psychiatric interventions are abuses of power in an otherwise useful and necessary service. The same is said of police. In reality, both psychiatry and the police use the same circular logic to impose control:
Police justify killing Black people on the grounds that officers fear for their safety. This explanation is ‘confirmed’ by the disproportionate killings of unarmed Black people, who (it is argued) must be dangerous or the police would not kill them.
Psychiatrists justify using drugs and electroconvulsive shock against a person’s will on the grounds that their patients do not know what is good for them. This explanation is ‘confirmed’ by the victim’s protest because (it is argued), patients who know what is good for them do not protest.
Once the legal system convicts someone, their protests of innocence are dismissed as denial. The person has been labeled guilty, so they must be guilty because the system cannot be questioned. Until they admit their guilt, they cannot be released.
Once psychiatrists label someone ‘mentally ill,’ their protests are dismissed as denial. The person has been labeled sick, so they must be sick, because the system cannot be questioned. Until they admit their sickness, they cannot be released.
Drawing a line between policing and psychiatry is increasingly difficult. By 2014, there were 10 times as many people labeled ‘severely mentally ill’ in US prisons than there were in hospitals.
The bungled response to COVID-19 has increased financial, social, and psychological distress. Labeling this distress as a ‘mental-health’ crisis hides the fact that this is a massive social crisis. Millions of people have lost their jobs, millions more are forced to work in unsafe conditions, and concern for the future has never been higher.
The individual model of depression was never meant to address a significant percentage of a population. When the diagnosis seems to apply so widely, it’s not the people or the entire medical system that’s broken, but the social context.
The solution is not to engage an army of ‘mental health workers’ to adjust individuals to the new reality. The solution is to mobilize millions to demand that everyone has sufficient social support. That is what safety means.
This pandemic has demonstrated, in the starkest possible manner, that the police and the military cannot keep us safe. Not only did these institutions prove defenseless against COVID-19, the vast sums lavished on military ‘defense’ were stolen from public health and social support institutions that could have defended us. The absurd result is police sporting the latest military gadgetry, while pandemic-battling nurses were forced to use garbage bags for protection.
Real safety is not achieved by military means but by the willingness of society to meet the needs of all its members.
The demand to abolish the police is a demand to provide what people need instead of punishing them for protesting their deprivation. This is a revolutionary demand because it cannot be achieved under capitalism.
Living standards for the majority can be raised only by reducing the wealth of the capitalist class. They vigorously resist this, and not because they can’t afford it.
In three months [of the pandemic] about 600 billionaires increased their wealth by far more than the nation’s governors say their states need in fiscal assistance to keep delivering services to 330 million residents. Their wealth increased twice as much as the federal government paid out in one-time checks to more than 150 million Americans.
The deeper problem is this: if the majority are allowed to think they deserve better, why would they limit their demands? In no sane world would a tiny elite be allowed to amass more wealth than the majority of humanity.
To maintain capitalist rule, it is necessary to cap people’s expectations for a better life by using police to criminalize dissent and psychiatrists to medicalize it.
Our priority must be to abolish the police, disband the military, dismantle all prisons (including psychiatric ones), and massively invest in social supports. This can be achieved only by replacing capitalist rule with a worker-run society that treats everyone as equally worthy and provides for everyone’s needs.
We must accept nothing less.
For more on this subject, see Rebel Minds: Class War, Mass Suffering, and the Urgent Need for Socialism