The mental health system is broken – we all know this. We all preach it needs to be reformed and proclaim our ideas on how to exact meaningful change. When reflecting upon my experiences – both personal and professional – I remember this short exchange between myself and a big wig clinician-craft in the system of care: ‘You’re not easy to serve,’ the director of care management said. ‘What? What does that even mean?’ I asked the director at the agency, one of the big five mental health agencies in the county. ‘You’re different. You’re high functioning,’ she said.
There it is – I was written off. I am a consumer of mental health services (a service recipient) and I was doing well in my life. Thinking back, it’s been a long, long road. I’ve experienced mood disorder, depression, and anxiety since I was a teenager. I’ve had half a dozen experiences attempting suicide. Since then, I’ve graduated to full bloom psychosis, schizophrenia, and hospitalisation after hospitalisation, state, local, and everything in between.
I’ve experienced recovery in my terms, more education, licensure, and practice within the same system that treated me throughout my years in the system. This is a system so many activists in mental health have changed through their years of advocacy, hard work, blood, and tears. Their lives were at risk, and the fruits have been borne.
The story of my mental health disorder, and the tenure of my recovery, weren’t depicted in the psychological film One Flew Over the Cuckoo’s Nest. When I was first diagnosed as a teenager, I wrote a little synopsis of my life, and renamed as Randal McMurphy, seeing myself as some character similar to Kubrick’s depiction of the mental health system in the Cuckoo’s Nest film.
But I was young, naive, a teenager. I had no idea so many people worked so hard, so that wasn’t my experience in the system. My uncle, my aunt, their reality was different. They were in wards so deplorable Heraldo would have loved to do an expose. My ward in the state hospital. Well, let me tell you something: big screen television, computer room, we had the works! This was the state hospital. I wasn’t chained to a twin bed on a metal frame in a warehouse.
Today, I have a job, I am happy, and I am a good advocate. I am also an enemy of the mental health system – I am very much feared by the people around me. I am not talking about the system’s operants or the powers that be in the system of care. Let me tell you who I am talking about. The people I am describing serve the same folks I do as a therapist and as a peer. We even have the same goals – I hope, in the end.
My knowledge, how it was acquired, and my authenticity couldn’t be more of a threat to the powers that be in the mental health movement. As a therapist, I know I am even more of a threat. Some people may believe I bought into the system. That I signed off on a system of repression.
Well, my personal interests, careerism, or credence in this field is not in question. The fact of the matter is I have witnessed from both personal experience and professional, what works, what doesn’t, and have been a victim of a system of oppression while doing so. This dual position also means I have bold ideas. Vivid ideas of what needs to happen, what isn’t happening, and what that looks like for people like me and those I serve in the mental health system.
My perceived arrogance is really my knowledge. I am passionate about my ideas and their importance because I have seen what happens when they are put into play and given airtime. People thrive, diagnoses are understood as to what they really mean, and the system shifts for the better that much further. That director was long since fired. If not for the airing of its transcript on social media, and for the problems it signified for that agency, this director may have categorised me, stigmatised me, ‘othered‘ me, but I also knew exactly what she was doing. I knew how she did it in both clinical and non-clinical terms.
I also knew, given my knowledge, given my experiences, both personal and professional, how to disable and stop her bullshit in its tracks and do so in a manner that exacts positive change. I knew how to make meaning where meaning was at odds with the very forces that sought to destroy its potential. This potential is what I think is in crisis – the potential we prosumers have to change the system. I have talked a lot about the disjointed mental health movement. I have talked a lot about what I see needs to change and how to go about doing so. I have also seen what this can mean for people in real terms.
There are those with an agenda that I have also come across that have tried to use me, and others, in the same way so many peers and people with lived experience have been co-opted into the system of care of their benefits. Either to justify a treatment (forced) or a service, or any other gainful purpose outside the pure and platonic reason for helping and its beauty.
The implications this agenda might have for social justice and otherwise are catastrophic. I will no longer let these folks derail and pollute my vision or the purposeful steps I take to get there. I believe in bringing people lightning-speed knowledge and changing the system quickly. In doing so, relieving a piece of trauma and preventing harm to so many by the speed and savvy of my work. My promise moving forward is to be myself. To be more authentic at all times. Realise the danger to the discourse when I see this is at risk.
I question why someone’s agenda might be at odds with mine, then bring both the disparity and the similarities to the public to decide. The one thing I learned from the movement is learning the importance of choice, perspective, and doing what’s right and being allowed to do so without restriction.
This is what makes us human. This is how we bring humanity to the system and personal perspective to your individual situation and interests. This was and has always been the goal. This will continue to be what drives and defines my work going forward. I am suggesting now, in very bold terms, that we look out for those that seek to eliminate our choices and restrict our freedoms doing so.
My voice matters; our voices matter. I will no longer let the infighting, the camps, and the polarities of this movement hinder me and derail progress in its tracks. This movement is too important, and the potential to do real justice in spaces of supreme injustice and make what is so wrong, so right. In doing so, people like this director, loud and noisy naysayers in the movement, and others whose voices are now more disabling than beneficial – I promise to make you visible to all those out there as the real crisis in mental health.
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.