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 usual 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 Malcom X’s extended metaphor, were once field negros. Working hard to change the system. They were apart of a movement. Now, these are people just like you and I, your neighbor 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. Similar to the color of your skin and your position in society, the peer and its subservient role in the mental health systems is defined by more insidious identifiers. In this vein, depending predominantly on the indoctrination of the diagnosable people from compliance to adherence. As compliance is forced, adherence and buying into to the importance of owning the belief in treatment. 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 not only necessary, but important, the consumer becomes indoctrinated into the system of care as a professional consumer or peer. This achieves three immediate goals: 1) the patient becomes bound up by system and is limited by the same agent that empowers it, 2) the peers power and voice becomes an extension of the system, 3) 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 cant handle his client” says the agency worker without a diagnosis. Language like this is all too often thrown around in agencies utilizing 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 behaviors and our feelings, and even change the tone of the world around us while doing so. So, why don’t we, when it comes to changing this racist shift in mental health care? I suspect the reason is fear. Just as Western slave society’s (more specifically, American Slavery) feared the abolishment of slavery and contested its outlaw relentlessly, the mental health system, fears insurance companies, big pharmacy, and the regulators in local, state, and national government.
More specifically, when it comes to insurers and those in charge of the payment of care and treatment for people with a mental health diagnosis, the risk of potential danger to people (themselves, or others) is under the microscope and usually the meter stick for the levying of insurance reimbursement in hospitals, or a new law to be developed and gain traction in the community (e.g. Kendra’s Law in NY). This fear, or concern for people’s wellbeing when encountering a mentally ill person or living amongst them in society is as deep as stigma runs in a system which functions all too similarly to American Slavery.
The fact of the matter is, Peer Professional work in mental health is now monitized, 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 lie “we” is revealed as our personal responsibility and accountability to speak up and make the necessary changes in our life and our society to evolve past this evil use of social control. We must speak together, mobilize 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 wicked 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 those they 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 complete freedom from the system. Medication, therapy, and for chronic disorders, well, there is no escape from psychiatry and psychopharmacology, is there? This lie, similar to the lie hundreds of years ago told to former slaves has 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 hospitalizations and institutionalism. Today, a new neoinsitutionalism in mental health systems and powers that tell us we need to stay in treatment infefinately 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