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In response to the recent post on Alternet, “7 Reasons America’s Mental Health Industry is a Threat to Our Sanity” by Bruce Levine, I’d like to offer an alternative point of view: Our mental health system acts as if it is treating an anxiety disorder when it should be addressing what I would call America’s schizophrenia.
There is a great deal of worry in the mental health system. Questions about how we are going to support people with mental illness are being confused with those about protecting ourselves from people with mental illness. We concern ourselves with finding the correct treatment, the best Evidence-Based Practice, because we don’t want to squander money on treatments that don’t work. The problem is that all of this worry forces us to rely on what is easily measured, discrete interventions over discrete periods of time to individuals and their specific mental health challenges. This is not entirely a bad thing, but it does miss the bigger point.
Many Americans feel that the mental health system has been corrupted by the pharmaceutical industry and the power of psychiatry (Dr. Levine included). Again, I don’t disagree, but I feel that the point the author succeeds in driving home may be summed up beautifully by one of our favorite sayings here at Painted Brain: in the words of Krishnamurti, “It is no measure of health to be well adjusted to a profoundly sick society.” This is, in fact, the perfect jumping off point for drawing a distinction between treating our mental health problem in America as an anxiety disorder when it is in fact more a problem of schizophrenia. Our concern with diagnosis and effective short term treatment is, at best, a mere band-aid in response to the multiple breakdowns in our society regarding mental health. Take a look at our mental health system’s response to the rampant traumatic experiences faced by our citizenry, particularly in areas impacted by poverty. Is trauma best treated by TFCBT? CPT? ACT? Seeking Safety? Sure, great, the real problem lies with the core values of our system, a system which allows the wealthiest to hoard and withhold power and privileges from the many, the fact that our value system gives rise to this very problem by promoting a paradigm that confuses wealth and power with worthiness and virtue.
I intend no harm or foul by this to the many people I love who have schizophrenia, but the problem is more like schizophrenia than like anxiety because the problem entails a breakdown in communication. In the brain, schizophrenia appears to interfere with the way different parts of the brain interact with one other. For example (and this is vastly over-simplified), the limbic system jumps the rails of its typical sensory/reactive functions, creating experiences that are perceived as real in the form of vivid hallucinations.
In America, our big city school systems are more often conduits to incarceration than to jobs or college. Our values promote individual accumulation at the expense of the common good. Our feeble welfare system leaves many of us vulnerable to low-wage flexible jobs, flexible in the sense that people may be hired and fired very easily. A weak welfare system exposes us to the worst aspects of capitalism, in that we cannot survive without work and are therefore dependent on whatever jobs are available. Where one is born has an enormous impact on a person’s prospects in this country. These systemic problems lead to identity confusion and traumatic experience, yet our mental health system treats individuals while failing to address problems arising within communities and the consequences of widespread poverty. The various parts of our social infrastructure fail to work together, and we need to view this problem as one of societal schizophrenia, requiring fundamental and comprehensive societal change. Instead, we concern ourselves with getting the greatest measurable impact from the smallest expenditure of revenue per person. Our mental health challenge causes a great deal of anxiety – and reacts with anxiety.
The very best outcomes for people living with schizophrenia occur in small third world communities like those in Zanzibar where the whole person is supported and cared for, given a place and a purpose.
This is quite the opposite of the ostracism experienced by the millions of Americans with schizophrenia. For this mental health challenge, on an individual basis, we need to deal with the whole person, not dole out assistance in single doses. To deal effectively with America’s mental health challenge, we can’t just medicate and acronym our way through, we must address the entire problem all at once.
Dave Leon LCSW is the founder/director of Painted Brain