SAMHSA calls for a vote on “noteworthy accomplishments” in behavioral health — let’s raise our voices! 02/29/2012Posted by ALT in Mental Health Policy and Inititatives, Treatments.
Tags: antipsychotics, assisted outpatient therapy, court-ordered outpatient therapy, electroshock therapy, Mad in America, SAMHSA
As they occasionally do, SAMHSA [Substance Abuse and Mental Health Services Administration] is holding one of their “periodic stakeholder engagement” demonstrations (in the form of an online vote). They want to hear what we have to say!
Not sure what really comes from these voting sessions, exactly, as I’ve never followed one from beginning to end. I do know that most people who receive a formal invitation from SAMHSA to vote have jobs funded by SAMHSA and are obviously putting their mouths where the money is (like so; and like so).
Nevertheless, every taxpayer is a “stakeholder,” and therefore allowed to vote. So consider yourselves officially invited to answer (or vote for other people’s answers to) SAMHSA’s question:
What do you think are some of the most noteworthy accomplishments and changes in the behavioral health field over the past several years?
I was pleased to see that, so far, the winner by far of the voting is this entry from a Mad In America blogger about 10 peer support alternatives to traditional psychiatry that lead to healing and wellness. Including the harm reduction approach to decreasing medication! Love it.
Also mentioned was the Open Dialogue approach (more on that here; there’s also a lovely documentary about it). And the idea of viewing mental illness as distress rather than disease – meaning of course that distress passes, is a situational part of life, while disease is chronic and biological.
Needless to say, I voted for all of the above. I encourage you to go vote for your favorites, whatever they may be!
NOT my favorite
I was distressed, appalled, shocked to see that one of the other frontrunners was “Court-ordered Outpatient Therapy.” As a noteworthy accomplishment in the field of behavioral health.
This, of course, includes court-ordered, non-consensual electroshock therapy (like that of Elizabeth Ellis) and anti-psychotic injections (like that of Christina Walko). It constitutes a major violation of some of the most basic human rights we know.
This is an advancement?
In the description, we are informed that
Court ordered Outpatient treatment is the other option to keep people safe by giving probate judges the authority to order treatment. Any person or family member can petition the court via a downloadable affidavit as to the condition of a loved one to effect this treatment by whatever measure necessary.
- Ingrid Silvian, who contributed the “Court-ordered outpatient Therapy” item to SAMHSA’s vote
Lovely. A family member who cares can join the psychiatrists who care in making sure a loved one gets plenty of Janssen injections of long-acting antipsychotics (or whatever brand the doctor/courts order, I suppose).
I was incredibly moved by the comments of a woman named Cathy Levin in response to this. First, she shares her personal story:
I once had a court order to take medication, but I was able to leave the town and move to a big city because no one prevented me. In the big city, there was public transportation and I went back to school to study basic English writing under a scholarship from a mental health program. I worked for 12 years. Recently applied for a scholarship to study art at a prestigious art school. Had my state had IO, I would have been forced to stay in the town where the state hospital was, where I gotten court ordered medications, I would spent 9-2pm M-F at day treatment, gotten injections of meds bi-weekly at the CMHC, and slept the rest of my life away.
-Cathy Levin, in response to “Court-ordered Outpatient Therapy” in the SAMHSA stakeholder engagement vote
And next, she says something very profound (and Foucauldian!) about the treatment of the mentally ill in society:
It’s like medicating the canaries in the coal mine. When poor people keep going crazy in the streets it is a sign that something is wrong with society. These are the canaries in the coal mines who indicate life as we live it today is toxic.
Hurrah for the canaries in the coal mine! May their processes be the catalyst for a community-wide transformation, a vision of a healthier, more balanced way of being!
Tags: anatomy of an epidemic, birth, intense emotional distress, labor, Mad in America, madness, Michael Cornwall, rebirth, robert whitaker
The new* “Mad in America” website/blog/forum has seriously got it going on.
It’s got research. Resources. Recovery stories. Best of all, the “Blogs” section showcases multiple writers, representing a wide spectrum of experiences and credentials… from “providers” and “consumers” to healers, advocates, researchers — and many of these folks sit at the crossroads of these different paths.
What unites them is Robert Whitaker’s literary message (as put forth most recently in Anatomy of an Epidemic): the (mal)practice of institutionalized psychiatry in America, and his more recent efforts to bring the message into the real world, to actively practice a solutions- and positivity-based response to the evils he outlines in his works.
I can really see this site growing into the preeminent online gathering place for alternative thinkers in mental health. Our community needs a home base, a place to process our experiences and articulate the many amazing ideas for reform and recovery we’ve all got cooking in our various noggins.
Look what I found…
I found this true gem buried in the comments section of a Michael Cornwall article entitled “Initiatory Madness” (a stark and moving depiction of his own dealings with madness and abrupt loss of innocence at the age of 20).
[We must understand] the necessity for our waiting on madness to continue its often pain-filled birthing process in the sanctuary of our heartfelt compassion. Our first impulse when a loved one is in intense emotional distress and pain is to give them anything to relieve their hellish pain. It appears grossly irresponsible, if not cruel, to withhold medicine that would quickly numb the emotional suffering of a person in the throes of madness. But what the paradoxical evidence shows, is that if …any young person in their initial experiences of madness is not allowed to go through their purposive madness in the requisite healing crucible of a heart center sanctuary, then a huge majority of us would be stuck, trapped in a laboring process that can go on our whole lives. Birthing is painful but it accomplishes its task of bringing new life forward. But being suspended in the birth canal indefinitely, emotionally numbed out of fear of the raw emotions of transformative, life-renewing madness, is a tragic waste of our birthright.
- Michael Cornwall, PhD; in the comments section of his article “Initiatory Madness“
- the parallel he draws between madness/the emergence of a new, awakened consciousness and labor/the emergence of a new human life
- the fact that both of these experiences, in all their terrible power, are our birthright!
Labor is a (sometimes) painful opening. A birthing woman is truly exposed in a way she may never again be in her life. Emotions raw, body and mind experiencing something fundamentally new and perhaps even frightening, she needs support, comfort, and reassurance to pass through to the other side. But despite the difficulties, remember that labor is a natural process, one for which she is designed by nature. She was made to do this! And it is her right, as a woman, to do it in the way that she sees fit.
Now our modern, institutionalized, corporate medical structures would have us believe that birth is a medical emergency (perhaps even pathological!) requiring numerous invasive techniques and expensive procedures to deliver mother and baby from death’s door.
Cesarean rates in the US are skyrocketing (the national rate rose by 53% between 1996 and 2007), and as a sometimes direct result so is the maternal death rate. No amount of fuzzy math (don’t think they haven’t tried it!)** can hide this alarming trend.
But here’s the thing… women have been giving birth at home, without doctors, for literally thousands of years! And the majority of women around the world are still doing it. And doing just fine. How did we survive so long without these “life-saving” doctors and their “miraculous” procedures?
We don’t need them. We are strong enough to do it with only the support and love of a few who care for us… and be the better for the experience! By coming that close to our spiritual origin and our mortality as well, we are people with a new, heightened knowledge of our humanity. We are people who know a deeper kind of love: visceral, unconditional, of the soul. And by doing it together, we share this experience with our loved ones, we build community, we further cement the bonds of humanity.
Michael is right on… all of the above applies to madness as well. In madness, we are opened to a new, deeper experience of reality. This can be terrifying, and we will probably need some serious support and love to get through it safely.
But we can do it! Without coercion, or unwanted chemical intervention. We wouldn’t have survived for thousands of years on this planet if we couldn’t.
Taking the birth metaphor a little further…
Labor is divided into three stages: opening (first stage), expulsion (second stage), and placental (third stage).
Between the first and second stages is a period called “transition.”
In transition, the woman is fully dilated and the head (usually) of the baby must pass through the opening and into the birth canal. It is widely considered to be the most difficult part of giving birth. Luckily it is also the shortest; usually just 15 minutes or so.
At this point, almost universally, women have a psychological crisis. A mother previously handling birth well may go entirely to pieces. “I can’t do this,” many mothers at this stage of labor have said.
Labor support people (doulas, midwives, etc.) are trained to recognize and perhaps even warn the mother about transition. A mother who feels she can’t go on at this point may need nothing more than some strong encouragement from her supporters to move beyond the crisis.
Unfortunately, the purveyors of birth medications are also trained to recognize transition, and most women who had not planned on a medicated birth accept medication during this period (which is rather unfortunate, as the period is often over before the medication can take effect and the mother is subsequently numbed, unable to follow her body’s cues as her baby descends the birth canal).
Back to madness
I can’t help but think that the well-known crisis of faith in oneself at “transition” has some parallels in the experience of madness. If only professionals were trained to recognize the crisis (which sometimes takes a suicidal bent), and coach the person through it – seeing it as a phase of the process, rather than a medical emergency requiring immediate incapacitation – perhaps more people would be allowed to transition into later stages of their journey.
What Michael is saying is that many psychiatric patients are frozen (by medication) in early stages of their journey, never being allowed to follow their path. They are “laboring” their whole life long, their bodies and minds prohibited from opening, their souls unable to heal. A transition to wellness and rebirth never takes place.
Their birthing processes halted, their strength and resources untested, resolution and rest an impossibility—it is a senseless waste. And, in this consuming culture, I think we’ve all seen enough of senseless waste to last a lifetime.
*Well, it may not be brand, spanking “new”… I have been out of the loop for a couple of months. But I’m happy to report I’ve gotten myself a little part-time office job, so I find myself suddenly blessed with plenty of free time for mental health blogging. Which means: ALT is back in the game!
** In 1998, the CDC reported that the US maternal death rate could be as much as three times higher than the officially reported number (which is bad enough!), because maternal death reporting is a.) not standardized and b.) optional. Every other developed nation has a standardized, mandatory, national system for counting maternal deaths and makes that data available to the public. For example, the UK issues one of these — a comprehensive report containing data on all maternal deaths that occurred during the period spanned by the journal – every 2 years.