How Would We Know If We Overthrew the Mental Health System? (Repost)

I found the below article very thought-provoking. I don’t agree with all the ideas expressed in it, but I believe it gives us a lot to think about as inclusion advocates-not only regarding how we treat people with “mental health conditions” but also how we think about things like consent, competency, and who gets to define disability.

I don’t personally agree that psychiatry is a “pseudoscience” or that it should be entirely overthrown. In a limited number of cases, particularly ones in which an individual’s behavior threatens another’s safety, a brief hospital stay may be the only feasible solution. Similarly, I imagine there are individuals who are genuinely, subjectively suffering from their symptoms, and benefit from psychiatric interventions.

However, I am troubled by the diversity of human traits and tendencies that are classified under the DSM-V as symptoms of mental illness, and the clusters of traits and tendencies that are pathologized as mental illnesses. Sometimes, I try to imagine meeting a person who has absolutely none of the symptoms of any DSM-V diagnoses. This mythical person would be in constant emotional balance with never a hint of anxiety, depression, rage, or mania. They would never exhibit any impulsivity, hyperactivity, inattention, or apathy. When I contrast this mythical individual with real people in my life (including myself, as I am definitely not free from neuroticism), I can’t help but imagine that this mythical person would also lack passion, creativity, empathy, attention to detail, and so many other uniquely human characteristics we prize. In fact, the thought experiment always leaves me feeling a little, well, depressed.

This article also raises important issues about the role of medical professionals in the disability experience. Under current policies, medical professionals have the authority to deem an adult as decisionally incompetent. Is any individual truly incompetent to make decisions regarding their own life? And if so, what criteria should be used to make that determination? Is there a magical cutoff on some assessment tool that means a person must give up their autonomy?

Furthermore, across all types of disabilities, medical professionals currently act as gatekeepers, determining who is or is not eligible to receive disability-related supports. This applies not only to income and lifesaving healthcare benefits, but also to vital educational modifications, communication aids, etc. a medically driven eligibility system not only penalizes people who don’t have the resources to access a medical proof of disability, but it also seats disability as an individual problem affecting a stigmatized few, rather than a part of the human condition that can be ameliorated in a cooperative way. I agree with the author in advocating a universal basic income in place of a medically driven disability benefits system. We must also find a way to bring down the cost of assistive technology and training so that it becomes available to all consumers who need them, without having to have that cost subsidized by a medically controlled service system.

How Would We Know If We Overthrew the Mental Health System?

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