“Why Won’t Psychiatric Survivor Advocates Join the Fight for Single Payer?
And They’re Not the Only Ones!”
An Appeal to Solidarity – IIIa
Jack Carney, DSW, Coordinator
North Country Access to Health Care Committee
December 24, 2021
#PassNYHealth — #buildamassmovement
“Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”
Martin Luther King, Letter From a Birmingham Jail,” 1963
“The power of a bold idea uttered publicly in defiance of dominant opinion cannot be easily measured.”
Howard Zinn, You Can’t Be Neutral on a Moving Train: A Personal History of Our Times, 1994
Let me make two points at the outset. “Psychiatric survivors” didn’t make the title page because they were recalcitrant or oppositional but because I’ve spent the most time trying to find common ground with them. In two brief exchanges with several of their movement’s leaders, they convinced me that that they could never trust the current healthcare system, the site and occasion of the grave harms done to them. Further, that they would not invest any time or effort in reforming the current system, which they refer to as the Medical Industrial Complex (MIC), because they want what it can’t deliver: alternative healthcare, with no diagnoses, medications, incarcerations that rob them of who they are. They want their collective Liberation.
Secondly, ‘solidarity” sounds soothing to my ear. I marched on many a picket line singing “Solidarity forever … for the union makes us strong …” (Chaplin, 1915). I wonder, when I look at this country riven by fear and hatred, whether it’s become no more than a phantasm. Our own single-payer movement, on state and national levels, is also divided. Leaders of Medicare for All and the Campaign for NY Health and the NY Metro Chapter of Physicians for a National Health Plan (PNHP) pursue the same goal, enactment of single payer, but they don’t plan or coordinate their actions with one another. As I wrote in an earlier paper, “Cork in the Bottle” (2021), neither will succeed without the other.
All this comes at a time when single-payer healthcare has attracted a great deal of opposition. In New York City, key trade unions have declared the single-payer NY Health Act a threat to the healthcare benefits won for their members over many years of struggle and hard negotiations.
The aptly named Medical Industrial Complex (MIC) – Big Pharma, Big Insurance, Big Medicine – have let loose a horde of lobbyists in Albany, Washington and wherever else single payer is being debated, decrying the evils of single-payer, echoed on cue by the corporate-controlled media. Billions of dollars are at stake.
The Federal government has become our most determined opponent, working to privatize Medicare, the public benefit established by LBJ in 1965 with the passage of the Social Security Medicare law; neglecting, in the interim, to fund it adequately, failing to increase benefits, like dental and long-term care, pitting it against Medicare Advantage plans and the private, for-profit insurance industry. Millions of anti-single payer donor dollars come by way of the MIC and from Wall Street, which has heavily invested in the MIC.
In short, well-funded and politically powerful single payer opponents have so far overmatched the various pro-single-payer organizations active around the country, including the Campaign for NY Health, of which I’m a member, and have blocked all efforts to pass the NY Health Act in the State Legislature and Medicare for All in the Congress. Solidarity on the local and national levels has been missing. We need help.
Advocates like myself had assumed that single-payer healthcare could serve as a rallying point for individuals and organizations and provide an organizing foundation upon which to build a solidarity movement. I was quickly disabused of those notions when I decided to contact the psychiatric survivors who are Board members of Mind Freedom International, one of the largest peer advocate and survivor organizations in the world, to sound them out on single-payer.
I began by calling a friend, a Board member of Mind Freedom International (MFI), a person quite knowledgeable about neuroleptics and their consequences, who gave me the low-down: psychiatric survivors, the most ardent and militant advocates, have a deep mistrust of the US Healthcare system, the Medical Industrial Complex. It is where they are hospitalized or incarcerated, usually against their wills; it is where they are accorded diagnoses or pejorative labels that fragment their sense of self at the times they are most vulnerable. Finally, it is where they are pumped full of, again without their informed consents, medications that disrupt their brain chemistries, blunt their imaginations and increase their vulnerability to deadly diseases.
By chance, Will Hall, widely respected psychiatric survivor advocate and psychotherapist, had recently published a blog post in Medium urging psychiatric survivors not to isolate themselves but to follow the lead of Black Lives Matter, recognizing that Black Americans know more about white Americans – and the consequences of white supremacy and white privilege – than anyone else; further, that they have more experience and more audacity in successfully opposing American white supremacists; that they have developed the paradigm of opposition to oppression that all other American outsider groups seeking to secure their civil and human rights have followed (Hall, W., “Why Mental Organizations Should Endorse the Movement for Black Lives,” https://medium.com@willhall, Sept.19, 2021).
He asks his comrades, “… [to join] with the movement for Black Liberation … Does this sound like a distraction? …
The power of the pharma and medical industry lobbies is too great: only with comprehensive political change can we ever hope to make mental health reform happen… the Movement for Black lives is a leading part in a deeper challenge … that can make real social change possible … for all of us … We will never get real mental health change without real social change … ” (W. Hall, ibid.; italics mine)
In sum, survivors can’t achieve what they intend alone, without the support of others.
I decided to contact the psych survivors who were members of Mind Freedom International and talk to MFI’s Board about the NY Health Act. I felt heartened by Mr. Hall’s appeal to his peers. I had worked 40 years in the NYC and NYS public mental health systems before I retired in 2010. Why not turn to people I knew and still kept in touch with, even if only occasionally, and whose judgment I trusted, and ask then where they stood on the issue of single-payer? From what I had personally witnessed and the facts and figures I had accumulated when I directed an Intensive Case Management program during the last 20 years of my career, I knew what happened when mental health and healthcare intersected. I assumed psych survivor advocates knew that as well, that these were issues of life and death.
I was soon to find out that is not the survivor advocates’ point of reference, their starting point for change. They are determined to devote the time and energy at their disposal to distance themselves from the institutions that caused them such harm and to look to create alternatives. As I discovered during a brief conversation with Celia Brown, President of the Board of Mind Freedom International (MFI) their starting point is Liberation, not so much their personal as their collective liberation. Indicative of their approach, they have purposefully characterized it as their “Decolonization”, a termed loaded with historical reference to the process of liberation undertaken in fits and starts over the past 75 years, or since the end of WW II, by the many nations of the world seized and colonized by European powers and the United States during the 19th and first half of the 20th Centuries. The MFI survivors have adapted it to include all marginalized Americans.
At the end of our conversation, Celia invited me to attend MFI’s Zoom meeting that night, part of MFI’s “Judi’s Room” monthly presentation series, its celebration of the life of Judi Chamberlin, revered founder of the Mad Pride Movement and author of ”On Our Own: Patient-controlled Alternatives to the Mental Health System,” (1978). Celia would moderate a four-member panel, comprised of four well-known Survivor activists, who would discuss “Decolonization: Building an Antiracist Approach With the Psychiatric Survivors Movement.”
Stokely Carmichael immediately came to mind as did the slogan “Domestic Colonialism”, which he popularized during his brief tenure as prime minister of the Black Panther Party, 1967-9. It was a term also used by many civil rights leaders, including Martin Luther King, to link the Black American civil rights struggle with the Black Liberation movements in Africa, and as a shorthand epithet to describe white supremacy and its impact on the Black community. The Black Lives Matter demonstrations earlier this year has restored its relevance.
As became readily apparent in the Judi’s Room panel discussion, “decolonization” represented the panelists’ conviction that their minds, their identities, their sense of self, had been appopriated for the self-aggrandizement of the psychiatrists who purported to help them. They had lost who they are, had managed to reclaim it and were determined to never lose it again.
As the panelists and the panel’s moderator made clear, they intended to accomplish this via an anti-racist coalition of multi-ethnic, multi-cultural psychiatric survivors. They themselves represented what such a coalition might look like, each with a long personal history of peer and survivor advocacy: one Black American woman with a family home in Ghana, president of MFI’s Board; two southeast Asian women, one a resident of the US, working to create a community that values the humanity of every person; the other, ethnic Chinese, living in Singapore, involved in legislative advocacy at the international and national levels; an Indian-American man, born in Kuwait, employed in leadership positions in several peer-led organizations; and a final panelist, pronouns they, elle, who identified themselves as indigenous American, mad liberation activist , trainer, writer, psychiatric survivor, whose life’s mission is to rewrite the narrative psychiatry has imposed on our society.
They presented in the long-standing American civil rights tradition as survivors of heartbreaking travails, willing to share their vulnerability and experiences with comrades embarked on the same journey of personal and communal liberation. I was impressed by their knowledge, wisdom and generosity with one another and the zoom participants, many of whom evidenced similar qualities. Their movement is in good hands. (Without their explicit permission, I chose not to identify them by name, save Ms. Brown, whom I’ve known for 25 years.)
Despite little evidence on the panelists’ part of interest in single-payer health care, I became determined to prevent a disconnect between MFI and the Campaign for NY Health and our allies. To pick up Will Hall’s thread, the several movements like ours, formed to help others combat and survive the oppression of an increasingly authoritarian ruling class, cannot succeed without one another. My suggestions for possible collaborations…
As I’ve written elsewhere, the Carceral State is an integral component of the MIC and presents a threat to all marginalized Americans, including psych survivors and persons of color. Pushback against its reach achieved its first success in NY when the State Legislature passed the HALT law in 2017 – Humane Alternatives to Long-term Solitary Confinement – ending the use in State Correction Facilities of solitary confinement to manage inmates who appear “out of control”. This was largely the consequence of a several-years-long lobbying campaign conducted by the NY Campaign for Alternatives to Isolated Confinement (NYCAIC).
Psych survivor advocates, as early as 2013, had pushed the US Senate to ratify the UN Convention for Disability Rights, which the Senate refused to do. Their testimony before the UN Commission on Human Rights led the UN’s Rapporteur to declare involuntary hospitalization torture, a transgression of the rights of persons with disabilities. Two years later, the Mandela Rules, the UN’s “Standard Minimum Rules for the Treatment of Prisoners,” were updated to declare the solitary confinement of inmates that exceeded 22 uninterrupted hours a form of psychological torture.
The HALT Law conforms to these standards and promises to protect those inmates most likely to be driven mad by such confinement. Its implementation is currently being blocked in NYS prisons by a lawsuit filed by the Correction Officers Union; NYCAIC is now lobbying the NYC Council to enact a version of the bill that can be implemented in Rikers Island jails. In my estimation, this represents an opportunity for MFI to apply its Decolonization declaration to a struggle far from over, pertinent to it and of great benefit to thousands of New Yorkers incarcerated in the State’s prisons and jails. It would also lend impetus to Will Hall’s call for solidarity with like-minded movements and organizations, viz., the NY Campaign for Alternatives to Incarceration. An introduction to the issue and the NYCAIC could be provided by a long-time peer leader, Harvey Rosenthal, Executive Director of the NY Association for Psychosocial Rehabilitation Services (NYAPRS), who has lent his organization’s support for passage of HALT from the very beginning. Just a suggestion.
Secondly, despite MFI’s – and actually NYAPRS’s as well — expressed disinterest in single-payer, I’d like to suggest that MFI seek a meeting with Assemblyman Gottfried and Senator Rivera, principal sponsors of the NY Health Act. Safe to say, they probably know little of psychiatric survivors’ concerns, interests, needs. It’s also unlikely they would refuse to meet with survivors – it’s not their style and they’re eager to secure as much support for the NYHA as they can. Even if they prove unreceptive, survivors would still have their voice, their issues, on the record. A relationship with them, the Legislature’s healthcare activists, might also prove useful at a future time. Gottfried is retiring from the Assembly at the end of the 2022 Legislative term and a meeting with him now would be timely. I can help arrange such a meeting.
Finally, there are changes coming down the pike, most significantly the accelerating privatization of Medicare, i.e., awarding private for-profit insurance companies with the responsibility of managing enrollees’ Medicare accounts, single-payer’s poison pill, which will doom single-payer healthcare and jeopardize vulnerable individuals’ access to healthcare. I’m thinking here of the many thousands of persons whose Medicare eligibility depends on a government-recognized and -categorized disability – like a psychiatric disability. Many MFI members’ lives will take a turn for the worse should the Center for Medicare and Medicaid Services’ (CMS) most draconian initiative, Direct Contracting Entities (DCE’s), ever take effect. (I’ve described much of what I just mentioned in the three papers that preceded this one, referenced below in Suggested Readings.) Should DCE’s introduction appear imminent, and I’m afraid we’re approaching that point, we will all need one another’s help. Nationwide, Physicians for a National Health Plan and its NYC Metro Chapter have taken the lead in opposing DCE’s and will prove welcoming allies.
In closing and taking Will Hall at his word, I invite him and all psych survivor advocates and peers, particularly my fellow members in Mind Freedom International, one of the oldest and largest peer advocacy organizations in the world, to join us in what promises to be a series of all-encompassing struggles. Bring along with you whoever else is willing. And remember …
“If solidarity is unity of purpose or togetherness, how to span this great divide of inequality, privilege, universal rights, political agency, and even our seeing things completely differently …?”
Zapatista Spring: Anatomy of a Rebel Water Project & the Lessons of International Solidarity, Ramor Ryan, 2011
We begin In the here and now. Having seen our fear, we will not be afraid.
In solidarity, Jack Carney, December 23, 2021.
“Stokely Carmichael: From Black Power to Pan Africanism,” March, 1971,
Bulhan, HA, Franz Fanon and the Psychology of Oppression, 2004
Bulhan, HA, Stages of Colonialism in Africa: From Occupation of Land to Occupation of Being, 2015
Fanon, Franz, The Wretched of the Earth, 1961
On my website: www.paddlingupstream.org-northcountryforum –
“The Cork in the Bottle: The Road to Single-Payer Health Care Goes Through New York, Revised,” August 11, 2012
“Will Single Payer and Mental Health Advocates Ever Join Forces? – I – revised
Facts and Figures for Policy Wonks, September 25 – November 29, 2021
“Will Single Payer and Mental Health Advocates Ever Join Forces? – II – revised
A Summary in Two Parts: – An Appeal to Solidarity;
- Out From Under the Carceral State, November 29, 2021