How to do mental health anti psychiatry activism

RAD BRAINS is an anti-capitalist mental health collective based in Oakland, California, United States. Our project is to use mental health as a lens for refining political analysis and bettering political practice.

When we came together in the fall of 2012 as part of the Bread and Roses Mutual Aid Network, we asked ourselves a few questions:

  • What are the needs of our communities?
  • What resources are already available in our area?
  • What can we contribute?
  • What does mutual aid for mental health struggles look like?

Being based in Oakland, near to both San Francisco and Berkeley, there are a number of mental health resources of all kinds available to us. As a result, we decided that for us mutual aid meant connecting our cohorts and comrades with these resources, bringing different spheres of mental health activism into contact with each other, and destigmatising mental health issues within our radical communities.

We don’t actually like the term “mental health” very much. While it gestures towards the psychological and emotional issues we are trying to address, the word “mental” reinforces classic philosophical assumptions of mind/body dualism and lends itself to reductive responses (how many times have we heard and will we have to hear, “Oh, it’s all in your head!”). The word “health” often acts less as a gauge for wellness than a measure of one’s ability to perform under white supremacist, patriarchal capitalism.

Instead of coming up with new terms, we decided to involve these critiques in our process. That means more questions: What does it mean to contribute in an anti-capitalist space? How can we discuss what we call mental health without the baseline assumptions of whiteness and affluence that accompany the term? How can we maintain a basic agreement about individual autonomy in making choices while critiquing both capitalism and the individualism it champions?

Our response was to be slow and intentional with our organising, to always be asking each other these questions. We make sure we have food and drink at every meeting, to check in with each other at the beginning and end of each meeting, and to constantly remind ourselves that our presence is enough. We also involve people who aren’t part of the formal group by talking with friends and care providers, and by being involved in other groups and attending events. We try to constantly recognise the roles that non-professionals (teachers, parents/family and other mentors) play in mental health.

For our events, we make sure childcare is available, as well as designated people and safe spaces for anyone who freaks out. We begin with a “good faith agreement” to acknowledge that we may not be on the same political page but to think about the structural implications of what we’re saying (i.e. “is this sexist/white supremacist/queerphobic?”), and, when someone does make a mistake, address it immediately and respond respectfully. Because talking about psychological and emotional issues can be intensely affecting for most people, we also always ask that if there is a disagreement, that the response begin with a clarifying question to encourage conversation instead of argument and to ensure that miscommunication is not part of the conflict.

Our events have included a general discussion on radical mental health, a skillshare about self defence and mental health, a facilitated conversation about mental health and its role in anti-oppression/anti-repression struggles, and a facilitated discussion at the East Bay Anarchist Bookfair.

We are currently working on a technical manual that describes both the emotional/psychological and political effects of different mental healthcare theories and practices, and a card-based role-playing game designed to encourage people to think through how people facing other conditions might respond to certain circumstances (working title: Care Wars).

If you are interested in doing mental health activism in your area, we recommend the following:

How to do mental health anti psychiatry activismFiordaliso/Getty Images

The American Psychiatric Association (APA), the largest psychiatric organization in the world, sent an email to members on the anniversary of George Floyd’s death insisting that psychiatrists incorporate “anti-racism” into their practice.

The email encouraged psychiatrists to commit themselves to practice “anti-racism” with their patients and restated its commitment to achieving “mental health equity for all.”

“The murder of George Floyd by a police officer one year ago today forced conversations about the structural racism in the very roots of our nation,” the letter reads . “The American Psychiatric Association and psychiatry were forced to confront our own past as well as to examine how racism had entwined itself into our current operations and how racism was impacting our patients on a daily basis.”

An article from the June issue of Psychiatric News was cited as reason to implement “anti-racism.” The article quoted the APA’s minority/underrepresented trustee Rahn Bailey, who claims that the only way to eradicate racism is for everyone to embrace anti-racism as a concept.

Anti-racism was popularized by Boston University professor Ibram X. Kendi following the publication of his controversial book “How to Be an Antiracist.” The ideology purports that being against racism is inadequate and the only way to rid the world of racism is to become a progressive activist.

Mental health professionals were also given suggestions for steps to “center racial equity” in their profession. The first suggestion was to “increase awareness and acknowledge that racism exists everywhere.”

Ayala Danzig, a fourth-year resident in the Yale University Department of Psychiatry, suggested that mental health professionals “audit” their panel of patients. Examples of an audit include checking to see if a mental health professional is disproportionately diagnosing black patients with psychotic illnesses or prescribing more substances to white patients.

“Ask yourself: What does it look like for you to center anti-racism,” said Dr. Michael Mensah.

“Does it mean introducing a sliding scale to help patients who can’t pay? Does it mean taking more Medicare and Medicaid patients than before? Does it mean taking a more active role in your local residence program to advocate for a more diverse residency class,” asked Mensah.

The mass email also linked to a resource document on “How Psychiatrists Can Talk with Patients and Their Families About Race and Racism.” The document included a slew of case vignettes including one where a hostile white person is described as being openly racist for not wanting to be treated by a black doctor. A similar case study discusses a timid black person who is kind-hearted about not wanting to be treated by a white doctor.

The scenario with the white man reads:

A 37-year-old White man is seeking treatment at a rural clinic for insomnia. He is assigned a Black psychiatrist and appears shocked to meet his new doctor. He even says “I do not want you to be my doctor. I can’t be treated by a Black person.”

The scenario with the black man reads:

A 50-year-old Black man is seeking treatment at a rural clinic for insomnia. He is assigned a White psychiatrist and is withdrawn during his assessment and shuts down after 45 minutes. The psychiatrist feels uncomfortable and uncertain why the patient has been so withdrawn and tense during the session. Suspecting discomfort with the racial dynamic in the room, the psychiatrist decides to hold off on any more questions and returns to alliance building.

The resources document also included a link to Kendi’s children’s book “Antiracist Baby,” among others.

A previous version of this article incorrectly attributed a quote to Ayala Danzig. It is attributable to Dr. Michael Mensah.

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Hey I'm a diagnosed bipolar and I've been taking antipsychotics and SSRIs for a long time. Last time I was off meds I had a manic episode and was totally delusional. I hate my meds because I have side effects like fatigue, tremors, and weight gain. And being on my meds and doing good things I still feel depressed when I can do things I want to do. So to people who don't take meds, how do you convince a psychiatrist to take you off meds and stay level without them?

Could your manic episode off the drugs with a withdrawal effect? Did you stop them fast?

Maybe read the book Anatomy of an Epidemic by Robert Whitaker.

The main use of talking to a psychiatrist about going off medication is they can sometimes write you a taper schedule. Unless you're under a legal order to take medication, getting permission to stop is not necessary.

If you want to try, but are concerned about the consequences of a manic episode, maybe try looking up and adding in some non-medication ways to manage manic episodes and then, after you've added those, try lowering your dose of antipsychotic and seeing how that goes?

Go keto for a month to see how you feel; if it makes a difference, start weaning off of meds. Keto isn’t intended to be long-term but can be therapeutic in increments. Start with 3 months first

Mind me asking why keto isn’t beneficial? I’ve just now started to taper off an ssri and I’m looking for all the help I can get to make this process smoother.

Just get off them its not like they can force you to take them .

,except if they deem an individual "a significant risk to themself or the general public" without their medication

You don’t have to have permission, you just make the choice and appreciate being sober from that point forward. IMO making health a primary thing that you want to have in your life makes it easier.

Maybe learn to cope on lower and lower doses first. Very slow is the way to go. I think the nitty-gritty specifics of what coping looks like are unique to the individual.

I’ve credit my ability to cope from hyper-analyzing the shit out of myself. Though it’s an ongoing journey, I have a very good idea of my triggers and make a plan if I can’t avoid them. Shifting my mindset away from societal expectations of what life should look like has also helped immensely.

Some psychiatrists will never budge but I think demonstrating you’ve been stable for awhile is a good way to convince them to help. Just be warned they probably won’t know how.

The right to refuse treatment is the most controversial of the rights of mental patients, and usually polarizes the movement for mental health reform between providers of care and external activist reformers. A broad alliance supported earlier struggles for recognition of patients’ rights, but most professionals oppose recognizing this most extreme right of treatment refusal. Professional opposition to treatment refusal is not based on a wide extent of actual refusal; rather it derives from a defense against challenges to professional and institutional autonomy, an opposition to legal interference, and a belief that the community as well as the patient must be protected. These three reasons for opposition are examined by reviewing studies of attitudes toward patients’ rights, knowledge about patients’ rights, and implementation of patients’ rights. Finally, the implications of these studies for future directions in the movement for patients’ rights are examined.

KIE: Advocacy of the right of mental patients to refuse treatment has tended to polarize the movement for mental health reform because mental health professionals and institutions see this right as a threat to their own autonomy. The author analyzes why the right to refuse treatment is viewed differently from other patients’ rights, reviews studies of attitudes toward patients’ rights and how such rights have been implemented, and considers the future of the mental patients’ rights movement as a reform strategy.

RebPsych Conference 2018—Rebellious Psychiatry: Where Mental Health Meets Social Justice

September 28, 2018

Harkness Auditorium, Yale School of Medicine, 333 Cedar St.

Multiple Justices

In its inaugural year, the Rebellious Psychiatry conference brought together activists, artists, consumers, mental health professionals, and students to form a strong, interdisciplinary coalition for social justice. Our conversations at RebPsych2017 helped us understand that there are multiple forms of justice that operate in the field of mental health. This year we build upon that foundation, seeking to explore and unite these “multiple justices.” For example, two paradigms of justice emerged last year: one seeks to expand access to care and address mental health disparities, and another critiques the history and the very practice of mental health care. RebPsych2018 will interrogate the various, and sometimes conflicting, conceptions of justice. What forms of justice are currently mobilized and supported within the field of mental health and by mental health institutions? What forms of justice are excluded? How could these multiple justices inform each other in a more integrated manner? How do mental health care providers act as a credible force in advancing justice? When it comes to activism, is there a boundary between the professional and the political, and if so, when and how was this boundary conceived?

For this year’s conference, we solicited proposals from a diverse array of people, including health professionals, activists, community organizers, scholars, patients, artists, students, and writers. The resulting program includes a rich variety of traditional academic papers, panels, discussions of activist work, and artistic projects. As always, we hope to foster dialogue, partnerships, and sharing of ideas that will continue long after the conference is over. We look forward to seeing you on September 28!

T he New York Times recently led with a front-page splash about psychiatry’s propensity to prescribe pills, “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy”. That news is already widely known in the mental health field, but it has vast ramifications for Americans trying to maintain their sanity in our market-driven and medical system for delivering mental healthcare.

What does the turn to drug therapy mean for the mass of Americans?

Mental illness has not decreased with the change from talk therapy to drugs. In fact, as Robert Whitaker’s book diagnoses, mental illness in America has become an established epidemic. So-called miracle drugs like Prozac are taken by 11% of the population – and Prozac is only one of the 30 available antidepressants on the market. Antidepressants are accompanied by anti-anxiety and anti-psychotic drugs. Xanax, America’s leading anti-anxiety medication, is so ubiquitous that Xanax generates more revenue than Tide detergent, reports Charles Barber in his Comfortably Numb.

Anti-psychotics drugs alone net the pharmaceutical industry at least $14.6bn dollars a year. Psycho-pharmaceuticals are the most profitable sector of the industry, which makes it one of the most profitable business sectors in the world. Americans are less than 5% of the world’s population, yet they consume 66% of the world’s psychological medications.

Do these psycho pharmaceuticals work to restore mental health? Actually, the evidence is overwhelming that they fail. Antidepressants, the most popular psycho-pharmaceuticals, work no better than placebos. They work 25% of the time and stop working when the user stops taking them. In addition, they may actually harm patients in the long run. They disrupt brain neurotransmitters and may usurp the brain’s organic soothing functions.

Psycho-pharmaceuticals are less effective in the long run than talk therapy. Talk therapy, like drugs, does change brain and body chemistry; unlike drugs, though, talk therapy has no side-effects. Instead, talk therapy gives a patient tools that usually help to solve future problems. The latest research is most clearly expressed in both Irving Kirsch’s Antidepressants: The Emperors New Drugs and Gary Greenberg’s, Manufacturing Depression, both published last year. Kirsch is one of the world’s leading psychiatrists; Greenberg is one of the world’s most prestigious psychologists. Their views are echoed by many voices in the field of mental health. Why is prestigious and extensive research so widely ignored by doctors and patients alike? Our market-driven healthcare system gives us clues.

All 30 of the available antidepressants have suffered lawsuits within five years of their appearance on the market. These suits are often settled with large payments and gag clauses. The new generation of anti-psychotics are the latest case in point. Anti-psychotics were the single biggest targets of the False Claims Act. Every major company selling anti-psychotics – Bristol Meyers Squibb, Eli Lilly, Pfizer, Johnson and Johnson and AstraZeneca – has either settled investigations for healthcare fraud or is currently being investigated for it. Two recent settlements involving charges of illegal marketing set records for the largest criminal fines ever imposed on corporations. Their corporate logic is expressed in the words of Dr Jerome Avorn, a medical professor and researcher at Harvard: “When you are selling a billion a year or more of a drug, it’s very tempting for a company to just ignore the traffic ticket and keep speeding.”

There is also the widespread practice of paying physicians and psychiatrists heavy subsidies to recommend psycho-pharmaceuticals to their colleagues in small meetings at which a drug company representative is present. If doubt or criticism of the discussed drug is expressed, the doctor’s stipend stops. Another legally acceptable tool is to publish praise of a company’s drug in a scholarly article, which is often written by drug company personnel and simply tweaked by the physician whose name appears on the article. The physician is paid handsomely for such a service.

Under the pressure of legal settlements and embarrassing disclosures, eight pharmaceutical companies began posting doctors’ names and compensation on the web. ProPublica compiled these disclosures, totaling $320m, into a single database that allows patients to search for their doctor. Receiving payments for publishing articles written by drug companies is not illegal.

Two doctors, Dr Joseph Biederman and Dr Timothy Wilens of Harvard University Medical School, illustrate the close and cozy relationship between medical “scholarship” and drug companies. Drs Biederman and Wilens netted $1.6m each from drug companies for their work in recommending powerful anti-psychotic drugs for children. Biederman, Wilens and other extremely well-rewarded child psychiatrists are in part responsible for giving children the diagnosis of paediatric bipolar disorder for which anti-psychotic drugs like Risperidal and Zyprexa are used.

Experts agree that there is no long-term improvement in children’s lives from taking anti-psychotic drugs. In fact, these drugs have a substantiated pattern of metabolic problems and rapid weight gain that often leads to diabetes. The use of bipolar diagnoses and bipolar medications is one small example of how market-driven mental healthcare works in the United States. It illustrates the transformation of US healthcare into a system dominated by some of the richest corporations in the world.

Caring about profit is first, and that is why psychiatry has turned to drug therapy.

Documenting Psychiatrists Behaving Badly Of all professions, psychiatrists seem to get into the most trouble. I have been collecting stories about psychiatric screwups for a while. Sadly, it has been disgustingly easy to do. We post stories with links to the original sources. We couldn’t make this stuff up if we wanted to. My Name is Sickmind Fraud.

Saturday, November 22, 2014

How do I file a complaint against a mental health care facility/professional?

Complaints about an individual physician/psychiatrist:

If the physician/psychiatrist works for a hospital or agency, you may contact the doctor’s supervisor. You can also file a complaint with the state medical board or the American Psychiatric Association (APA) (some psychiatrists are members, some are not). The APA might also refer you to its APA District Branch or state psychiatric society.

Complaints about other mental health professionals:

If employed by a hospital or agency, you may file complaints with the therapist’s supervisor, the hospital ombudsman or the administrator. Therapists are regulated by their licensing boards (e.g. the state board of health and mental hygiene, counseling or other licensing board). They may also be members of their professional associations (such as the National Association of Social Workers, the American Psychological Association, etc.). Your NAMI State Organization may have the appropriate number and listing.

Abuse or neglect in an institutional setting:

Protection and Advocacy Agencies advocate on behalf of individuals with mental illness who are in institutional settings (such as jails, correctional facilities or state psychiatric hospitals); allegations of abuse or neglect are one of their top priorities.

Complaints of abuse, neglect or mistreatment in the hospital setting:

As mentioned above, you may file a complaint directly to the hospital ombudsman or administrator.

Or, you may contact The Joint Commission (formerly known as JCAHO, the Joint Commission on Accreditation of Healthcare Organizations) online or call their toll-free Compliant Hotline at (800) 994-6610 to share concerns regarding quality of care. The Joint Commission accredits hospitals, home health agencies, nursing homes, outpatient clinics, behavioral health care programs and managed care plans among others. Complaints should be related to patient rights, quality of care, safety, infection control, medication use and/or security. They are unable to assist with billing, insurance or payment disputes.

Complaints about a CMHC (community mental health center):

6 comments:

I filed 5 complaints to the Michigan state license board bureau of health professions. They refused all complaints stating that no violations were made. Don't expect their board reviewers to do anything about their own peers. There is no accountability in mental health which is why there is so much fraud. When you research the state laws for record's release you will find that mental health has special privileges within the state and through HIPAA. Even the patient may be barred from getting their own records. In 2007 the attorney general could not get session notes from a psychologist during a billing fraud investigation. Mental health licensees have no one to answer to and the Bureau of Health violates its own code of ethics which in part reads "[p]rotect the health, safety, and welfare"] of the general public. Contact your legislators if you want that to change; otherwise you can keep paying for mental health to commit fraud. jlr

I agree. I had the same experience. Tather than properly training healthcare professionals in appropriate patient care and family interaction they train them to cover their tracks and lie for each other at the patients expense. The Joint Commission was absolutely no help. They didn't even contact me personally about my complaint

My wife has battled depression on and off for most of her life. 9 days ago she attempted suicide. She is doing good now and I spent 7 days at her bed side in ICU. 8 days prior to this incident she went to our family doctor and he prescribed her Zoloft. She begged him to try something different because Zoloft has not worked for her in the past. The doctor insisted that she try it again and this was the result.

The initial hospital transferred her straight from ICU to Signature Psychiatric in North Kansas City against our wishes stating they had liability issues. She went straight to Signature and received no medical treatment for almost 16 hours. She spent most of the first day in her room without anyone even checking on her. She left her door closed the entire time and no one ever opened it. When I asked the D.O.N. she insisted that she had been checked on every 15 minutes since her arrival. She didn't receive any new medication until the afternoon of the second day (after I called the D.O.N and complained).

I went in yesterday evening and told them I wanted her transferred to another facility of I wanted to sign her out to seek our own treatment options. I was told that they would immediately place a 96 Hour hold on her if I did that. They even acknowledged that she's no longer suicidal and has shown them no concerns. A employee told her that he knew she was coerced into signing in voluntarily and a second employee told her that he sat in on a meeting where they said they would release her on day 5 when the insurance expired. They also told me that they would place the 96 hour hold themselves and don't need a judges signature.

I'm in the process of filing complaints with every agency I can. Since I complained they are now harassing and targeting my wife.

DO NOT LET YOUR FAMILY MEMBERS GO TO Signature Psychiatric in the Kansas City area.

I am still going to try–I expect the same results. 19 years—-nineteen years of my life –my reputation ruined in so many ways. I have to try—knowing that of all the Good Ol' Boy networks –medicine will be the worst. State of GA has been exposed for its substandard mental healthcare. Emory–it is run by doctors trained at Emory—and chances are good that this is a very difficult challenge to have. Criminal–I have been humiliated, tormented by officials affiliated with the substandard mental health agency and it might be better to contact the media–I can do that, yes–I can.

My pysch stopped my valium because I missed 2 appointments and now I'm going through the worst withdrawals ever. What should I do? Please help

I am desperate to report the hospital i was 'treated' by this week but do not even know where to start. I appreciate your repost, if you find it compelling.

A new article explores Mahi a Atua, an affirming, indigenous Māori healing practice which stands in contrast to the Western psychiatric methods typically promoted by the Movement for Global Mental Health.

An article published in Transcultural Psychiatry introduces readers to Mahi a Atua, a Māori approach to addressing emotional distress and mental health difficulties. Mahi a Atua uses traditional Māori customs to facilitate clients’ healing in the context of the family (whānau) and community (iwi). The practice was developed by Māori psychiatrist Diana Maree Kopua and Māori art and culture expert (Tohunga) Mark A Kopua, who are co-authors of the article with critical psychiatrist Pat Bracken. The authors suggest that Mahi a Atua provides a much-needed alternative to the Western pharmaco- and psycho-therapeutic interventions championed by the Movement for Global Mental Health (MGMH), which has been criticized for extending neo-colonial practices.

“Indigenous approaches to mental health offer not just an adjunct to, but a real alternative to, the interventions of Western psychiatry,” the authors write.

How to do mental health anti psychiatry activism Sculpture by Rewete Arapere

The Movement for Global Mental Health (MGMH) is a decade-old initiative aimed at addressing mental health problems around the world, primarily through the dissemination of Western, “evidence-based” psychiatric and psychological treatments such as pharmacotherapy and cognitive behavioral therapy (CBT). As Kopua, Kopua, and Bracken explain, a burgeoning “counter-discourse” to this movement warns of the potential harms of such wholesale expansion of Western psychiatry.

Critics have expressed concern that Western psychiatric approaches are often culturally incongruent and inattentive to sociopolitical causes of illness and distress such as historical trauma in the countries to which they are exported and that they do damage to local “healing systems.” This threat of lost traditional healing knowledge is reminiscent of the destruction of indigenous healing infrastructure that occurred in the wake of colonial legislation outlawing traditional Māori medicine in New Zealand in the early 1900s.

“The highly individualized idiom of psychiatry fails to capture the ways in which whole communities are struggling and can serve to obscure the social, cultural, and economic dynamics that lead to such suffering,” the authors write.

The consequences of colonially rooted historical trauma and communal suffering are visible in Māori health measures and markedly different experiences in New Zealand’s mental health system. For example, approximately 51% of Māori “develop a mental health disorder” in their lifetime; Māori have higher rates of suicide attempts than the general New Zealand population, and Māori receive compulsory mental health treatment 3.5 times more often than non-Māori in New Zealand.

Given these factors and broader concerns about the impact of MGMH on indigenous communities, the authors argue that there is a crucial need for the development and implementation of Māori indigenous approaches to mental health. The authors add:

“There is a need to develop ways of discussing states of madness, dislocation, and distress in indigenous societies without automatically invoking the idiom, language, and assumptions of Western psychiatry.”

Māori practitioners have responded to this call by exploring and creating indigenous models for understanding and repairing mental health. These include Māori psychiatrist Mason Durie’s Māori mental health plan, which prioritizes economic empowerment and the “promotion of a strong and positive identity for Māori people,” and Melissa Taitimu’s study of Māori conceptualizations of “schizophrenia” and “psychosis.” Mahi a Atua continues this lineage. The authors explain that Mahi a Atua is “not a therapy or a new set of techniques,” but instead is a:

“Process whereby Māori creation stories, or pūrākau, are explored and used to provide a set of words, ideas, images, and narratives that can help provide a matrix through which communal family, and individual challenges can be met without recourse to a ‘psychologized’ and ‘psychiatrized’ vocabulary.”

Key to this process is the Māori concept of wānanga, which although not easily translated into English, may be described as “a process involving meeting, discussing learning, and the passing on of wisdom.”

The authors detail a case history in which Mahi a Atua was used to support a young woman who was engaging in challenging behaviors, such as bullying, at school. The Mahi a Atua practitioner shared Māori creation stories (pūrākau) with the client and her family (whānau), inviting them to reflect on which character they most connected with and explore the meaning of these identifications. Through this process, the client was able to make sense of her experience in a non-pathologizing way, by seeing the links between her frustration about communication with her mother and a Māori god known for his anger in the face of injustice. She was also able to begin to find ways to change her behavior, develop a positive sense of Māori identity, and share what she had learned with friends and other school community members.

The authors explain that Mahi a Atua is representative of a broader Māori “renaissance” in research, psychology, and community advancement, which is itself a part of a global indigenous movement to “reassert positive identity in the wake of colonial oppression and genocide.”

“The technological assumptions of Western psychiatry make it singularly ill-suited to help with the psychological and social problems that emerge in indigenous societies in the post-colonial period.” The authors conclude. “In the wider debate about ‘global mental health,’ we argue for a ‘scaling down’ of Western psychiatry and a ‘scaling up’ of indigenous approaches like [Mahi a Atua].”