Similar to the rape of slaves by their white owners in the United States and elsewhere, the forced treatment of people carrying a mental health diagnosis violently impregnated people deemed non-compliant and dangerous to the general public with toxic medications. In doing so, this vulnerable population became domesticated and docile out of fear, and its typical by-product: hate. Through institutional and systemic oppression, people with a diagnosis were once locked away forever from society in state hospitals through police and juridical court powers.
The house negro I am referring to is your typical peer specialist at any given agency. Or, even more likely, the recipient affairs in your local community mental health departments. These house negros, akin to Malcolm X’s extended metaphor, were once field negros.
Now, these are people just like you and me, your neighbour and friend. The difference is covert, instead of overt, in the case of slavery. Now, diagnosis and participation with treatment mark the professional as a peer. Like the colour of your skin and your position in society, the peer and its subservient role in the mental health systems are defined by more insidious identifiers. Depending predominantly on the indoctrination of the diagnosable people from compliance to adherence. As observation is forced, commitment, and buying into the importance of owning the treatment’s belief. Well, this is something completely different now, isn’t it? Or is it?
Let’s take a closer look. When people believe that treatment is necessary but essential, the consumer becomes indoctrinated into the care system as a professional consumer or peer. This achieves three immediate goals:
- The patient becomes bound up by the system and is limited by the same agent that empowers it.
- The peers’ power and voice become an extension of the system.
- The system defines the peer professional’s role: a source and the object to blame for scapegoating.
I’ve been it a thousand times.
‘It’s the peer’s fault, he’s crazy, and can’t handle his client,’ says the agency worker without a diagnosis. Language like this is all too often thrown around in agencies utilising peers in their workforce. In summary, the peer is to blame for everything and everything that goes wrong.
We can change our ways if we want. We can do this on a micro and macro level. If we really try, we can change our behaviours and feelings and even change the tone of the world around us. So, why don’t we, when it comes to transforming this racist shift in mental health care? I suspect the reason is fear. Just as Western slave society’s (more specifically, American slavery) feared abolishing slavery. They contested its outlaw relentlessly, the mental health system, worries insurance companies, big pharmacy, and the regulators in local, state, and national governments.
More specifically, when it comes to insurers and those in charge of payment and treatment for people with a mental health diagnosis, the risk of potential danger to people (themselves or others) is under the microscope.
Usually, the meter stick for the levying of insurance reimbursement in hospitals, or a new law to be developed and gain traction (e.g., Kendra’s Law in NY). This fear, or concern for people’s well-being when encountering a mentally ill person or living amongst them in society, is as deep as stigma runs in a system that functions similarly to American Slavery.
The fact of the matter is, Peer Professional work in mental health is now monetized, traded among agencies as commodities, and used as capital to cultivate and further a system of oppression. The willingness for peer professionals and people with lived experience to change the system will always be complicit to what’s happening until the ‘we’ is revealed as our personal responsibility and accountability to speak up. To make the necessary changes in our life and our society to evolve past this malicious use of social control. We must speak together, mobilise together, and have a shared platform of goals for the future of the mental health movement.
We are all animals in the end. I am suggesting the peer is the allegory of the American South’s mulatto in a world where animalism has supplanted reason for hate.
Fear for the evolution beyond cruel and shameless barbarism. My choice to pass over years of undoing racism is my privilege and hails me as something I never wanted to let go of because I am taught to love its legacy and fear any change that might disrupt its sovereign status. Indeed, peers are taught to love sometimes the very treatment that could potentially destroy them and serve in the mental health system. Even down to the myth of 40 acres and a mule.
Total autonomy is a lie! There is no such thing as complete freedom from the system. Medication, therapy, and chronic disorders, well, there is no escape from psychiatry and psychopharmacology, is there? This lie, similar to the lie hundreds of years ago, told former slaves that they have new meaning in the mental health system. This promise continues to go unfulfilled by the system that freed us, discharged our people from unending forced hospitalisations and institutionalism.
Today, a new neo-institutionalism in mental health systems and powers that tell us we need to stay in treatment indefinitely keeps us from questioning why we aren’t totally free from the shackles that once bound people with a diagnosis to the beds in chains.
Image credit: Freepik
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.