On the call of New York's mayoral candidates to replace policing with mental health
A major theme in the New York Democratic mayoral primary, mentioned by several candidates, left and center, is to reduce the use of police power by increasing the use of 'mental health' workers.
Such a shift is probably inevitable, and it probably will reduce levels of violence and incarceration of people who could be targets of the social control activities of police and/or mental health institutions.
Unfortunately, there is a widespread failure to recognize that our 'mental health' system is deeply oppressive and it is absolutely capitalist. It enforces capitalist social norms. It also does little to really help anyone. It is more about controlling the population than about giving anyone anything they need.
At best, it declares that lots of people have a need for these kinds of services, though any very useful form of them is generally not offered. The dominant methods are: to drug patients, to give them talk 'therapy' that is designed only to make them more contented and effective workers at what are most often not very interesting jobs, and incarcerating people who present difficult cases in hospital wards where they are basically warehoused, and often treated brutally while basically being trained to minimize all expression of affect and interest in much of anything, while everything and everyone that they care about is immediately taken away from them. This latter is very central to what they do, and in some ways may be considered the main purpose.
That is, a person's manner of living is identified as so dysfunctional that they must submit to having it destroyed. In its place is put a regime of extreme boredom (nothing happens in these places) enforced by blatant threats of violence. These are places of a punishment that goes by another name, pretending to be a treatment that helps people solve their problems. Yet, how could that be, when these are also places where people are not only not given the opportunity to learn anything, but the denial of almost all opportunity for self-expression, learning, or meaningful discourse, relationships, and activities? The point is to retrain people to deal with very boring jobs. It can also be predicted that this will be more true the further down one goes in the social hierarchy.
The most effective treatment for the psychiatrically remarkable dissatisfaction we call 'mental illness' (today, this is predicated so easily, it seems to mean almost anything, and therefore nothing) is ironically the one treatment that is not about health and illness really at all: psychoanalysis. Psychoanalysis is a process of developing a certain kind of self-understanding; it changes how people think, and its criteria are really ethical and not medical or therapeutic at all. To make some kind of healing or therapy dependent on understanding, learning, and thinking is not a new idea. It was central to the aesthetics of Aristotle, reflecting on tragic theater, models taken from which were key in the development of psychoanalysis. The psychoanalytic theory of trauma holds it to be universal. The technique of psychoanalysis focuses on self-understanding in a way that, while it may have effects on a person's psychical health, if we can speak fo such a thing (which is not obviously true), does not have achieving these effects as its norm. This is why psychoanalysis loses out to cognitive and behavioral management therapies when 'evidence-based' criteria are introduced, because this subjects to business norms of achieving some result. If anything, psychoanalysis is less a form of medicine than a novel form of religion loosely modeled on Christian ideas of salvation, though it is in some ways richer than they are and more complex. Indeed, concepts like damnation and salvation, which obviously have no positive role to play in modern states and societies, are if anything more present in pseudo-medical practices that turn on fearing or believing that some people are 'damned'. 'Progressive' politics was based on such an idea, a Protestant movement to 'save' the poor from bad families and life conditions. Psychoanalysis explores the mind and in a way that may be considered as an ethical or 'spiritual' procedure or exercise, but it does not need the concept of damnation and the related notion of a saving or rescuing cure of souls.
The concept of 'mental illness' clearly is meant to replace those of 'sin' and evil in serving as a universally applicable technique of addressing what in its more consequential and problematic forms is crime. The shift from policing and prisons to psychiatry, therapy, and mental health is perhaps one that will prove salutary in comparative terms, though it is worth noting what Michel Foucault showed with respect to both forms of policing and imprisonment and practices of treating 'mental illness': every reform of these systems, however well-intentioned, brought with its success new forms of oppression, which were in only some ways better and in some ways worse.
Our contemporary politicians and political discourses normally do not recognize at all that there is anything wrong with our mental health system. Increasingly, everyone wants its benefits. Like education, we cannot easily say we don't like it and don't want any of it, though it certainly is possible to observe that many of our citizens attend, or send their kids to, really awful schools.
Our mental health system is capitalist. So is our police and prison system. And the problems with it are largely explained by their role in upholding capitalist social relations. All of the major techniques used in the system are inadequate at best:
-The idea of solving every person's problems with medications is absurd. Even if medications or drugs of whatever kind most often help people, using them to solve all personal problems will only enrich Big Pharma and the big insurance companies that support it.
-The prevalent talk therapies create a managerial and policed self. The therapist now tells you how to think. You are taught to direct the movements of your thinking in certain ways, designed to make you a more effective worker and less discontented. These therapies deny the autonomy of the self and mind, they reduce the mind to self-managing a set of tasks in lieu of more creative and critical thinking.
-Hospitalization is a form of imprisonment. People are sent there on the assumption that it will help them, yet these places have no treatment except for doctors adjusting medication in accordance with the observations of nurses that inevitably turn mainly on how compliant (and subdued and quiet) the person is. They convene discussion groups on news events or whatever they can find to ask people to talk about, and then they call that group therapy. While being giving basically no treatment at all, though being placed there on the pretense that they need intensive treatment, patients can be charged well in excess of $1,000/day. It is a bonanza for insurance companies, it enables doctors to believe that they are doing something worthwhile even when they cannot find anything useful to do that might help the person, and it gives the people who work there an opportunity to worry mainly about whether or not the patients will be violent towards them.
This is similar to the tendency of some police forces to train officers to go out to interact with poor people who might be feared to commit some crimes, and then worry primarily about violence to themselves. Let's be clear: people are trained to intervene in situations involving violence, then they are placed in situations where their presence makes violence not less but much more likely, and finally the workers who are charged with policing and preventing this violence are given to understand that their own safety against the violence that their activities make so much more likely is the primary concern. In this way, the society and its social control managers are given to understand that the potentiality for violence among the people ruled or dominated is the main social problem. It must be concluded that one of the functions of these institutions is to reproduce that very useful opinion.
Finally, there are debates about how to respond to this violence, which is really a capitalist society's obsessional fear, since the risk of violence is the flip side of property right, the one thing that it absolutely believes in, and to which all its ideas of individual liberty are tethered.
So: Given that poor blacks and other people are liable to commit crimes, which is better, inhumane policing or humane social control in padded prisons where people are subjected to a tutelage in the capitalist labor regime defined experientially by boredom? This argument will reach an unsatisfactory end because of its premises.
I confess I sometimes worry about the possibilities associated with a third institution, though its scope is much broader than that of any institution, and must be in any society that is at all democratic and at all liberal: the institutions of education. And those of our public sphere and civil society, like the internet and social media. That people are designated sick in the way that they think, or how their minds work, and then are taught -- nothing -- this is a scandal that I find very interesting to ponder, and I wish more people did.
Perhaps the root belief is that our major social problems are problems of individuals, and their deviant behaviors, and that these are psychological. We have today a relatively small college-educated professional and managerial ruling class, which is encouraged to be creative, and also have acceptable ideas about people (no prejudices, which are bad for corporations because they can generate lawsuits), and a large mass of people managed by them, largely now with reference to psychology. Like most problematic social forms, it can be defended against the supposed sole alternative of nothing in its place at all, as responding to some real referent, that can be shown to actually exist. Only it does so badly.
Certainly, learning and achieving mental health are not the same thing. The mental health paradigm excludes or marginalizes the mind conceived in subjective, rather than objective terms. That means that how you think is irrelevant. The managers only care how you behave, and, let's face it, they want to modify behaviors to suit what they think is important, and not what you do, though they will try to persuade you that you want only to be successful and happy in their very limited terms. Education cannot be understood as a correctional procedure. Those things that are, by their very character and definition, will privilege states of mind that are defined only negatively, as the absence of sick behaviors, feelings, and thoughts. This means that having effectively no thoughts of any consequence is an option in this system, and it is implicitly rewarded.
There should be an ideal of the citizen that involves life-long learning as both task and opportunity. The important role of the arts in our culture, including our 'popular culture', are a testament to the importance of that, to very many, perhaps most, of us, and its possibility. Yet, this ideal remains a marker of class privilege and it is denied to most people.
In this way we can understand the role of American business-oriented Buddhism in today's cognitive psychotherapies. Buddhism does not ask people to cultivate interesting ideas in connection with one's desires and feelings. It encourages instead an attitude that rejects all such desires and all such interest in the objects that people give their attention to. Its function and purpose is to manage people and help them manage themselves, so that they can succeed in their boring jobs and do so with enough contentment that things will not fall apart. An eventuality that is of course always blamed on individuals, and quite proactively.