not to make this about “this mental illness versus that mental illness” because it’s really not about the diagnoses or the identities themselves. but I feel like materially, those of us who have been through situations (personally or with a loved one) involving some kind of psychosis/mania/severe dissociation/another stigmatized mental health crisis that necessitated immediate crisis response, we know- without/before reading the theory- what it means to be anti-psychiatry or psych-critical, at least somewhat.
we get it on some deep-set level even if we’ve had an uncomfortable knee-jerk response to those terms before, because of ways we’ve had to rely on existing psych systems for personal safety in the past.
I can’t tell you how many people get angry and say things like “my abusive mother was hospitalized during mania and it saved my life, how dare you suggest we dismantle psychiatry, you’re obviously unipolar & privileged”, or, “without my medication I would be in a scary situation, the word anti-psychiatry makes me feel like you’re trying to take away my medication” or something like that.
but then if I take away the words that trigger that response (“anti-psych”) and explain it in terms of its core ideas/sentiments/concerns, those people often end up agreeing in part or whole with what I’m saying.
because it’s not about wanting an end to skilled or trained crisis interventions, it’s about wanting them out of the hands of state or corporate institutions that rob people of their dignity and autonomy. which is the current reality of psychiatry and the impact of the ways medical, psychiatric and pharmaceutical institutions hold and use societal power.
it’s about watching yourself (or someone close to you) be handed over to those institutions for the sake of your/their/others’ safety, knowing that there’s no alternative in place in your community, and having that powerless feeling of “isn’t there some other way”.
there are other ways, and all of us have to put serious thought into them and constructing them rather than falling complacent whenever the conversation turns to mental health professionals and simply normalizing the current system as the way it has to be.
it’s like the prison/police abolition conversation: just because we have a hard time picturing another way out because of everything we’ve always been surrounded by and taught, doesn’t absolve us of doing that work.
psych-critical activists are not suggesting making the need for “people who respond to [problem]” obsolete. we are 1) having a larger conversation about the causes and exacerbating factors for that problem, and how solutions must go beyond individual pathology/diagnosis/treatment, and 2) challenging the current “professional” role that has been constructed (whether it be police, psychiatrists, etc), and the entrenchment of that role in capitalism and white supremacy and patriarchy and other systems of oppression.
“I don’t trust psychiatrists or even therapists” doesn’t mean “I’ve given up on training people specifically in mental health crisis intervention.” it means “the structures these figures are embedded in are committing and maintaining violence, ensuring that anyone who adopts these roles is easily complicit in that violence and forced to enter into those power dynamics, and we can’t settle for that”.
it also involves considering- especially in a society where we could approach labor and roles in a community differently- that responding to mental health involves all manner of collective care and mutual aid. and rejecting the psychiatric thesis that every mentally ill person has an inherent disease, when it has been shown to be much more complex and deeply involve the surrounding environment and conditions someone lives in.
this means mental health care must center housing and feeding people. educating them in a way that isn’t alienating or oppressive. structuring labor differently. it means that the community must be prepared to respond to instances of abuse or just conflict in general, and do so with justice and dignity. that gendered and sexual violence are addressed in the community. that racism is thoroughly dismantled.
meds can be important. counseling and therapy of various kinds can be important. but those things in isolation, especially the way they currently exist (behind a paywall, dismissive of patient autonomy, a mechanism of regulation and control, focused on pathologizing the individual rather than addressing the surrounding environment and context) are not an acceptable picture of care.
I literally want to be a trained responder/counselor to mental health crises and I’m psych-critical + opposed to existing psych institutions, and that’s something I’m going to grapple with my whole life as I move through educational institutions and then try to build my life work around it. it’s not something that should scare me away from my interest and investment in organizing and participating in crisis response or counseling in my community, it’s just something I am cognizant of and should never neglect to make central to my practices and whatever I publish, whatever projects I work on, and where & how I choose to work in those capacities.
edit from months later: through doing street outreach and peer counseling at a syringe exchange/overall harm reduction center (as a person who has, and continues to, receive resources myself through that space) I’ve now seen more than ever how powerful it is to have a team of mutual-aid oriented community members- who’ve received thorough training but lack a draconian power imbalance with the person they’re helping- come together to help someone access resources and engage in healing practices.
I am less conflicted about the reasons for, and application of, my training. I am confident that I do not want to undertake a mainstream social work or therapy role. I want to use my training and Professional Credentials to glean resources from the system at times, and make myself heard through my research, writing, and voice. but overall, I plan to work within groups doing community-based collective care work, grounded in harm reduction.
