Thinking Upstream: Winning Real Mental Health Reform By Joining the Anti-Corruption Movement

At the end of my talk at the American Psychiatric Association Institute on Psychiatric Services, a psychiatrist in the crowded lecture room put his hand up and posed a surprising challenge: Why was I so concerned about reforming psychiatry and ending iatrogenic harm from medications, diagnosis, and forced treatment when there are so many other issues in society to worry about?

Looking back, the answer was obvious: because psychiatry harmed me personally, and because I saw so many others harmed (including both of my parents), I was inspired to make a difference. I wanted to share what I learned so other people wouldn’t go through what I went through. Like many people who endured injustice personally, I was motivated to do something about it.

An obvious reply now, but not the reply I gave at the time.

Instead, I said to everyone off the top of my head, “I agree, I think we all should be concerned about every issue!” The room burst into laughter, and then I explained that I took his point seriously. The Madness Radio program I host has done shows on many topics including poverty, homelessness, elder care, the environment, birthing, and police, and organizations I’ve been part of, including Freedom Center and The Icarus Project, have taken multi-issue approaches. My talk at the Alternatives Conference urged us to bring issues together, including discussion of the prison industry, the war on drugs, and the harm to the Black community by our biased criminal justice system.

After all, everyone is concerned about many social problems: even psychiatrists and psychiatric survivors think about issues beyond mental health. We are not single-issue by nature. We worry about affording dental care, we worry about endless wars, about the coming generations growing up in a world of ecological extinction, about the financial system, homelessness, climate change, student debt, the disappearing middle class, and children in poverty. We all worry about these things, but we just choose to narrow our focus onto manageable areas of life where we believe can make a difference. Going smaller, going single issue, seems more realistic. Sometimes that means a career in a field, sometimes that means a role in a movement, sometimes a mixture of both.

I think we’ve got it backwards though. Going smaller and single issue isn’t the way to be effective — going small means we won’t be effective, even in our small single issue.

I was inspired to read Robert Whitaker’s latest research into psychiatry and institutional corruption because Whitaker is taking us in a direction that will inevitably lead to multi-issue organizing and away from single issue. Not by adding concerns and causes on top of concerns and causes, nor by scattering our energies where they should be focused, or just creating laundry lists of change we’d like to see. Instead, as Whitaker and Lisa Cosgrove’s new book points towards, seeing things from a multi-issue prospective is the inevitable conclusion you come to when you follow the money trail of what it will take to actually achieve the institutional reforms of mental health care that we are all reaching for. Corruption of our political system has to end if we are going to provide meaningful mental healthcare to people. Because no other effort, no matter how innovative or appealing, will succeed without the rules of the game being changed, and those rules affect all the issues.

Over 13 years I have sat in many hundreds of support groups, workshops, and events talking with many hundreds if not thousands of people who have been psychiatric patients, on medications, and in hospitals. People speak of their lives, first and foremost, as people. Mental health is about human suffering, and human suffering does not limit itself to a single issue. We may advocate for a better standard of psychiatric care, but often that narrows what someone truly needs for wellness in their whole lives. The well-documented intersections of mental health and poverty clearly illustrate this, but we should also consider the roots of mental distress in violence, isolation, and consumerism.

Most of the case managers, social workers, peer specialists and counselors that I meet with and do trainings for recognize this immediately. Aren’t most of the people we work with, I ask, really facing the problem of poverty in our society? Don’t homelessness, the criminal justice system, child abuse, lack of jobs with adequate pay, lack of funding for substance abuse programs — aren’t these the issues we see on a day-to-day basis when we talk with people diagnosed with a mental disorder? Aren’t these the “stressors” we know that turn coping day-to-day into collapse and crisis? And among those who are more middle class and privileged, isn’t there a terrible stress around lack of adequate childcare, a heavy consumer and student debt, a scramble to keep up with 60-hour work weeks, a despair about the future in a world of ecological extinction, fear of falling behind, substance problems, failure to prevent or heal child abuse, and a media-saturated and materialist world that seems to have no real space to be human?

When we sit and listen to people we find a society in crisis from multiple issues, a crisis that is affecting everyone. The enormous popularity of the short-lived Occupy movement showed that ordinary people in the US are deeply affected by the decline of the middle class and growing economic insecurity. Many of us watched our pensions and retirement savings suddenly shrink in the 2008 economic crisis. And if you talk with people, all this plays directly into mental health diagnosis and recovery.

What will it take to establish a new standard of care in mental health? A standard of care that serves recovery, avoids iatrogenic harm, keeps people off disability payments, saves money, embodies humanistic values, is preventive, and responds to consumer needs? And what will it take to actually lift people above the suffering that drives mental health crisis? To actually create a society that not only responds to crisis well downstream, but prevents the causes of crisis upstream?

So when we look deeply at people with psych diagnoses facing mental health problems, we find human beings living in a society that has problems that are multi-issue. But then of course we say, “Well we can’t address everything, so let’s at least try to focus on the outrageous harm from psychiatry itself, and at least make a difference on that specific area of our lives.”  It’s manageable. We can’t tackle everything. We have lived experience or professional training that makes us experts in this single issue. And, especially since we’ve now got some momentum – there is more credence to non-medication approaches, the influence of pharma corruption is under greater scrutiny, and the faulty science is finally coming to greater light – some alternatives are being funded (sort of). We can’t address everything, so go more single-issue around mental health, and keep it smaller.

But, it turns out, as Whitaker, Cosgrove, and others (including Lawrence Lessig — who wrote the preface to the new Whitaker book — and his colleagues in the growing “anti-corruption movement”) are now starting to suggest, not only do we discover multiple issues behind peoples’ mental distress when we listen deeply, but when we look deeply at psychiatry itself we find that the very solution to the “single issue” of mental health reform necessarily brings in all the social issues.

Just follow the money.

As Whitaker is pointing out, psychiatry harms people despite being dedicated to helping people, because economies of influence create incentives for psychiatry to act in a way antithetical to psychiatry’s public mission. If you want to reform psychiatry, you have to change those economies of influence. And you have to change the rules of the money game that are creating those incentives. Pharma creates payoffs for psychiatrists to embrace a disease model that markets drugs, and in turn enhances the marketing power of the doctors who prescribe the drugs. When problems are framed as diseases to be cured with pills then more consumers will turn to the prescribers. Sickness becomes a commodity and the more illness the more incentive.

This corrupt economy of influence means money will flow into science to twist it to back the model that serves pharmaceutical and professional interests, even at the expense of honest research. Marcia Angell, former Editor-In-Chief of the prestigious New England Journal of Medicine, writes what is now widely known:

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”

The entire industry takes in money for its mutual enrichment, and the public trust of science and human needs is broken. As Whitaker notes, this economy of influence — and the rules of the game it plays by — is properly named “institutional corruption.” Not “backroom payoffs to bad apples, breaking-the-rules” kind of corruption (though that happens, too, and just results in court battles and fines that Pharma covers as a cost of doing business), but out-in-the-open corruption — legal corruption:  funding through lobbyists, research money, payoffs to researchers, bribery of leading advocacy and lobby groups like NAMI and MHA, a revolving door of legislators, regulators and the industries they should be overseeing. A corrupt — but legal — economy of influence.

And why, we ask, was pharma allowed to corrupt the public trust of mental health care and science so thoroughly? Where is the regulatory apparatus that protects the public from such corruption? Where is congress? Where was oversight as this unfolded? And the answer is very clear – the governmental regulatory apparatus that should be overseeing the public trust and that could be counted on to curb these social harms is part of the same system of corrupted economy of influence. The democratic bodies of accountability that might have stepped in and prevented the moneymaking incentives for psychiatry’s social harms have themselves come under the influence of the same moneymaking influence. Both parties, Democrat and Republican — just follow the money. The founding fathers of the US democracy said that government shall be accountable to the people, yet that accountability no longer exists today. Government is accountable to money.

(We see the same pattern in the financial crisis that nearly toppled the world economy and led to an unprecedented bailout of banks, a return to business-as-usual, and zero prosecution of any of those responsible. The financial sector dismantled regulation, created financial high-risk super profit products that cause social harm and destabilized global markets in a speculative bubble, and finally threw the entire system into crisis — and the financial sector had already captured the regulators that might step in and fix things.)

Pharma spent $2.6 billion on lobbying activities from 1998 through 2012. Oil and gas companies spent $1.4 billion lobbying Congress over the same time frame while the defense and aerospace industry spent $662 million. Yes, an industry with that much influence will shape the whole society in its image. That is why so many people are on psych drugs today. When the rules of the game allow it to, pharma has every rational economic reason to seek maximum profit by turning the entire society into a prescription pad, which it has effectively done over the past thirty years. That is the reason psychiatry continues its social harm: there is clear financial incentive for the government to play along with rigging the rules of the game against fairness and honesty. If you want to understand politics, you just need to follow the money.

The power of lobbying and the power of money in politics. The revolving door. The fact that if you want to predict who will win any election just look at who raises the most money. The secret donors swaying election results. The obscene Koch brothers’ legal bribery that is just the tip of the iceberg of political process sold to monied interests, with Citizens United only the latest excess. We are all aware of this to some degree.

But we’ve sort of stepped to the side of it all, in the name of focusing on our manageable, smaller single issue. And now here we find it — at the very center of our concern for mental health reform.

We even have stories of bright examples in the past — Soteria for example, or the promise of the early “recovery” and now “peer” movements — being co-opted and twisted when they are up against the power of this institutional corruption. And so, this is the key: the corrupt economy of influence that drives psychiatry’s social harms is a normative economy of influence for every policy issue in the US today, because the entire US policymaking system is based on corrupt economies of influence. Psychiatry’s corruption is just a single example of the standard operating incentive structure of every aspect of our national politics.

As I write this I am becoming emotional. My compassion goes out to everyone that I meet and work with, everyone I listen to and learn from. Each of us is suffering and struggling with the large social issues of our time. I am not talking about left or right here, Democrat or Republic, tea party or anarchist, I am talking about human suffering. I am talking about how hard it is to get childcare, how working families are under extraordinary stress, how it is hard to look at a child today and feel joy when you know the world they are growing into will be a post-mass-extinction world. My deepest passion is to meet human suffering in the most ethical and honest way that I can, and my focus on mental health has been a way to use my own personal experience for the social good.

And now I see clearly that if we truly care about each other as suffering human beings — which is what “mental health” is really about— we have to challenge the broader institutional corruption of our society as a whole. I have always sought to bring issues together, and always spoken out for a multi-issue perspective. Now the “anti-corruption” framework of “get money out of politics” articulates a clear imperative. And Whitaker’s new book points to the same inevitable conclusion. Not to add issue on top of issue, but to recognize that no meaningful and widespread mental health reform can ever be achieved as long as the broader corruption remains, broader corruption which affects all issues.

And I struggle to make this clear, to convey it succinctly, and convincingly. I can’t summarize or persuade you of the pressing social issues of our time: child poverty, climate change, species extinction, homelessness, violence, the prison system, the disappearing middle class, endless war, financial giveaways to those responsible for financial crisis. But I want to say that those on the right, Republicans and tea party activists, share a human need to have our social concerns addressed, and that is just as impossible for the right as it is for the left under the corrupt political economy of influence in the US today. Right-wing thinkers are waking up the corrupting influence of moneyed special interests in our democracy as well.

I am not pitching a mental health reform movement that just joins a broader left. This is very significant, because the “left-right,” Democrat/Republican, Red-state/Blue-state divide in our country is an image of the corruption itself. The Democrats are just as much a part of this problem – they thrive on it as well. Talk of the Red-state/Blue-State divide obscures the many common concerns and interests that people have when you look at public opinion polls – commonalities that are obscured by the corrupt economies of influence that capture both sides of the political aisle.

Public opinion polls show broad and overwhelming support for the framework of “get money out of politics” and “end institutional corruption” regardless of political orientation. According to the Pew Research Center, public trust in government — from the left and the right — is at near-record lows; shockingly, 50 percent lower than immediately after Watergate. Another poll shows about 81 percent of people surveyed said the current campaign spending rules are “bad for democracy.’ 81 percent — Red-state/Blue-state. Yet like other broadly supported issues, that doesn’t translate into policy — because of the corrupt economy of influence.

So, please take this essay as an invitation to think and research and discover. I don’t have the answers, I don’t have a grand strategy or solution. But I do know this: We have to start talking about getting money out of politics — not just to win real reforms of psychiatry, but for all social concerns. We may not know exactly how to do that, but no real mental health reform will be possible when the political system is sold to monied interests invested in preventing reform. It just is not going to happen. Some of us continue to push for our single issue, but where are those who are asking for a winning strategy? I personally am not interesting in pushing for change, calling for change, advocating for change. I want the change to actually happen.

Getting money out of politics is the only way to end the corrupt economies of influence driving the social harm of psychiatry. When I talk with people involved in mental health advocacy, they are inspired. Then we talk about corruption of politics by money and how that creates a real bottleneck for true change. They become despairing, cynical, fatalistic. That won’t change. So we have to focus on our single issue area. But, if we are honest, we see that this is no longer viable — our single issue will never succeed without the larger upstream problem being addressed.

We tend to separate reforming the standard of care for mental health from the problems with the health care system as a whole for example. But seen from the standpoint of institutional corruption, they are the same. As are the issues of climate change, a living wage, a financial sector that won’t keep blowing up, a fair and just police and prison system. How many times have we heard that the US delivers terrible healthcare for the highest cost? How many times have we been told there is not enough money, or no insurance reimbursement, for alternatives? Follow the money and the same picture emerges.

The story of Medicare Part D is just one example. In 2006 US political leadership under heavy pharmaceutical lobbying and campaign contribution influence — under the corrupt economy of incentives that is standard — passed a Medicare law that prohibited the government from negotiating drug prices. (Bear with me here, because I realize some of you may be saying, “We don’t want cheaper psychiatric drugs.” I hope this broader discussion will show the pointlessness of narrow single-issue downstream thinking when the upstream cause is what is important.)

The Veterans Administration has already set a precedent for negotiating prices, but Medicare now cannot. Pharma profits rose 33%! From a single legislative act! And the congressperson who wrote Part D went to work as a lobbyist for pharma, with a $2 million salary. Obama campaigned strongly against this giveaway to the pill companies, and it was estimated his proposal to reform Medicare Part D could save the country $137 billion over 10 years. But Obama, too, operates under the rules of the corrupt economies of influence, and so $69.6 million in Pharma lobbying meant that Obama broke his promise to end Medicare Part D. Publicly broke a promise at the center of his flagship issue, healthcare reform.

That is how much power the rigged rules of the game have: they routinely overwhelm even explicit campaign promises and commitments at the highest levels. No vision of humane, honest mental health treatment can stand up to that kind of corruption. It just won’t happen.

Currently our strategies look like this: speak out and change public opinion. Engage, as Jim Gottstein has written about, in strategic litigation, and build viable alternatives such as peer respites and medication alternatives to point the way to the future.

None of that will succeed unless the more upstream issue of institutional corruption is addressed. The Medicare Part D issue is instructive: it was at the top of so many people’s agendas, and makes perfect logical sense. It was under huge public scrutiny. And it was a corruption of healthcare priorities pure and simple. And still, reform was not effective because the incentive structure of corruption was too powerful.

The reality is that we rely on changing public opinion to make change. That is the assumption — get the word out, wake people up, get people on our side. Publicize research showing that alternatives to the medical model work. Convince through great investigative journalism. Appeal to conscience by speaking from lived experience. Reach people. A pluralist assumption: change opinion, and it changes policy. Attitudes will shift and there will be a gradual change of society. Right? Sadly, no. That assumes that public opinion and attitudes drive political policy in the US, that the views of ordinary people shape social issues. But people don’t. Money does. There is no pluralist democracy in the US. Activism and education on the assumption of pluralist democracy will fail.

This has been demonstrated again and again, if you look beyond the “wedge issues” that distract us so often from real issues and have become the spectator sports of election time. This is clear if you go beyond the single issue, lesser-evil logic that leads so many to vote single-issue and mocks the very concept of democracy expressing the will of the people. Opinion polls consistently show wide support for issues that never get support on the policy legislative level. While a clear majority of the 1% super-rich favor cuts in Medicare, education, and highways to reduce budget deficits, only about a quarter of the rest of the population agree. Eighty-seven percent of the general population agree that “government should spend what is necessary to ensure all children have good public schools,” while only 35 percent of the super-rich share that sentiment.

And 53 percent of regular people believe that “government should provide jobs to everyone who can’t find one in the private sector,” while only eight percent of the super-rich agree. By overwhelming margins, Americans favor raising the minimum wage, reducing wealth and income inequality, stopping any more NAFTA-style trade agreements, breaking up giant banks, investing in infrastructure, taking measures to avert catastrophic climate change, protecting and expanding Social Security and Medicare. Those are strong public sentiments for humane policies — despite a barrage of media messages pushing these views out of the realm of the thinkable.

But this public opinion doesn’t translate into public policy — money does.

In fact, Princeton researchers Martin Gilens and Benjamin I. Page did a careful study (“Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens,” in Perspectives on Politics) looking at whose opinions actually shape government policy. Using careful analysis of data that showed that it is money, not people, who run our democracy, they looked at 1,800 different policy initiatives from 1981 to 2002 and concluded that

“The central point that emerges from our research is that economic elites and organized groups representing business interests have substantial independent impacts on U.S. government policy while mass-based interest groups and average citizens have little or no independent influence.”

They found that when controlling for the power of economic elites and organized interest groups, the influence of ordinary Americans registers at a “non-significant, near-zero level.”

Average citizens — the ones we hope to change the opinions of — have little or no independent influence on government policy. Non-significant. Near-zero.

Personally I have not voted in every election. Voter turnout in the US is very low (in 2014, only 36% of eligible voters turned out for the midterm elections… 36 percent!) . But when you look at the facts — that ordinary people’s votes don’t really make a difference, it is money that makes a difference — who is more “apathetic”? Someone who votes in a system they won’t actually influence, or someone who votes with their feet against that system by not voting? And many of those non-voters do know, if you ask them, that the game is rigged.

I’m not arguing against voting. But Lawrence Lessig summed it up. There are two elections. The first election is by money. The 1% sets the agenda for this election. Then you and I step in with our vote — once the real election has happened. It is a modern form of what Lessig calls “Tweedism” after the New York corrupt politician Boss Tweed. Tweed said, “I don’t care who does the electing, so long as I get to do the nominating.”

It’s a time-honored racket to keep democracy out of the hands of the people, and it continues today. In the Jim Crow south a similar corruption kept racism in place: the “white primary” where only whites did the nominating of candidates, then the general election where Blacks were (nominally) included. Today we have the same – a “money primary” where all the issues and candidates are determined, and then they vote for the rest of us. Isn’t that why, again and again, there is no real candidate supporting an alternative to the medical model of mental illness – despite huge public support for holistic healthcare, and huge skepticism of pharmaceutical companies and psychiatrists? Isn’t that why we are reduced to ridiculous “lesser evil” calculations for our votes that go nowhere? It is because pharma already did the nominating — ensuring that both sides of the aisle were pro-pharma.

I am all for alternatives and for hopeful initiatives. I love to see reforms moving forward. I do them myself. But philanthropy is no solution to the economy of influence; it is moneyed influence in its purest form. I am inspired by the rise of large-scale philanthropy around mental health reform that Whitaker’s research (and the failure of the mainstream standard of care) has helped inspire, and I’m excited to see small changes and more open minds among wealthy patrons, leading to good causes getting funded. But if we are honest, rather than just career reformers content with endlessly calling for change, none of it will succeed if the upstream issue of corruption of our political system remains unresolved. Philanthropy isn’t just explicitly anti-democratic, it is a reversion to monarchy.

A few philanthropists are joining the movement against corruption and the upstream problems, including some in the tech sector who have been following Lessig’s work, and this is good. But philanthropy, because it is pure influence by money, becomes the very gatekeeper that is the problem within the economy of influence itself. We are now beholden to our rich funders rather than county and state contracts, but we are still beholden, and the result is the same: we are now driven to remain single issue, and now this issue becomes the focus and not that one (notice how medications, not trauma and forced treatment, are more and more at the fore in our movement?). We can go and talk so far, but not too far; mental health innovations but not multi-issue thinking; downstream focus but not upstream solutions.

Who is talking about preventing child abuse in the first place? Isn’t that a way to deal with mental distress – by preventing it? Why is that issue not part of the broader mental health reform agenda? Do gatekeepers keep the issues separate despite common sense bringing them all together?

Again and again I see this when I give talks and trainings. People working in publicly-funded agencies are the same as people working in philanthropically-funded organizations. If you talk with them individually they embrace a multi-issue view and agree with getting money out of politics. They get it. I get cheers and applause at my talks. But the work they do publicly? It’s beholden to the language of their funders and contracts, and limited to narrow agendas. They are held back by the same gatekeeping dynamic of the corrupt economies of influence as a whole. Lessig calls this “dependency corruption” — you don’t go against the implicit agenda of your funders or whoever gives you access. You don’t bite the hand that feeds you, or the patrons that open doors for you. So, as much as I respect the good small single-issue work of my colleagues — and I do this work myself — it is a dead end. Just follow the money and ask yourself: what is truly needed to make real mental health reform happen in the US? Real change that will really help people? Reforms are impossible without reforming the rules of the game itself.

There is currently no established mental health advocacy organization that is actually addressing what it will take to get not only meaningful mental health reform but any social policy reform. There is no established mental health advocacy organization that is raising the question of corruption of our democratic policy-making system by monied interests. There is no mental health advocacy group that is joining with other organizations in the society and addressing the upstream issue of political corruption. None. And that needs to change

The only organization I can think of that comes close is The Icarus Project, where I was co-coordinator for many years. At Icarus political reform discussions are routinely woven into discussions of mental health reform and mental health activism is woven with social justice activism in general. But the corruption issue is broader than the left, and Occupy burned itself out on failure to focus. We need a clear focus people can relate to across the false Red-state/Blue-state spectacle that falsely divides us.

Charlotte Hill of the anti-corruption group Represent.US writes

“The one-sided nature of many past ‘money out of politics’ campaigns left them vulnerable to opposition attacks painting them as pet projects of liberals intent on shutting down their opponent’s financial support. If we want to avoid a similar fate, we need to call out corrupt behavior regardless of party affiliation, and make it clear that we believe it should be illegal for anyone to use money to purchase political influence.”

I’ve been writing and speaking about multi-issue advocacy for many years, and have begun writing and speaking about institutional corruption of the democratic system and the comprehensive reforms needed to get money out of politics. When I’ve made speeches and shared info about the prison industrial system or Lessig’s work, the response from movement leadership has often been that I am changing the subject, or going off-topic, or they are personally glad to hear it but won’t bring it into their daily work agendas. It hasn’t been picked up. But I think this is changing. Whitaker’s new book asks the right questions and points in the right direction.

I’ve already made a personal commitment that I will no longer be speaking as a mental health advocate without also speaking as an anti-corruption advocate. It’s just not honest – calling for something that’s impossible without bigger, upstream reforms. Not as a way of “adding on” new issues. Not as a way of pushing a liberal or left agenda against the right. But as a way of being realistic about what it will take to achieve mental health reform itself: it won’t happen unless the rules of the game are changed.

I am a learner and I am a researcher about this. I’m expanding my thinking and broadening the scope of my awareness. I have begun to find organizations, writers, campaigns and projects that form the broader anti-corruption movement in the US and abroad.  Because, yes, many of our international colleagues are coming to the same conclusions — most much faster than we in the US, especially after devastating economic crisis in Greece and Spain make it impossible to think of any reform without rules of the game reform.

I’m not beholden to any specific organization and I am not writing a grant proposal to go solicit funds for some new project. This is about what my heart says needs to happen for us as a society. What I am doing is reading books like Lessig’s Republic, Lost, and his other writing, joining some of the efforts of mayday.us and represent.us, checking out the Sunlight Foundation and Public Citizen, signing up on sites like MoneyOutVotersIn.org, speaking out about the Citizens United ruling, and learning about the American Anti-Corruption Act. I don’t know that these are ultimate solutions, and my thinking is evolving, but I do believe these are in the direction we need to go. Organizations are always interested in self-preservation, and many of these campaigns have a “we’re doing great work, support us” emphasis where I prefer coalitions and broad discussion communities.

So perhaps my direction will shift as I learn more about the issues and find out more about organizations and individuals working on them. But I do know that we as a society — and as a species even — are facing extraordinary social crisis rooted in an out-of-control political system corrupted by money. We need a fully human response. We need to think upstream. And above all, we need action that has a real chance of winning, not single-issue action that fails to address the corrupt economies of influence that have sold our politics in the US and around the world.

Deep electoral system reform is possible. In the 19^th century most balloting was public, which led to massive corruption and bribery of voters. That was changed to secret ballots as the result of state by state reform movements in the 1890s. The New Deal dramatically reformed our economic system.

The American Anti-Corruption Act is one possible direction of reform to deal with bribery of candidates: it would make it illegal for politicians to fundraise from interests they regulate, ban lobbyists from offering elected officials lucrative jobs after they leave office, and create a system of citizen-funded elections to make it possible to run for office without selling out. The Act would also provide for public campaign financing that would put ideas and people, not bribery, at the center of candidacies.

New York City, for example, has public electoral campaign funding, and a much more diverse political spectrum to vote from. In Maine the Clean Elections Act dramatically increased accountability and reduced corruption, and could lead other states to head in the same direction (the Act is under challenge by a pushback from the courts, leading proponents to mount a defense to get it re-established). Efforts are growing against the Citizen United ruling, and to make visible the 90% of campaign donations that are “dark money” — money that is unclear about where it came from, hiding the influence of monied interests.

Does this seem like changing the subject and “adding on” new issues that will just distract us from the narrower agendas we should be focusing on? Or do we need to join efforts to end political corruption and get money out of politics or else we will never achieve the mental health reforms we are calling for?

Just follow the money.

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Some possible links for further learning and action, an incomplete and imperfect list:

http://time.com/3529924/larry-lessig-reclaim-democracy/

https://represent.us/action/theproblem-4/

http://www.huffingtonpost.com/lawrence-lessig/we-should-be-protesting-too_b_5917486.html),

www.mayday.us

www.represent.us

https://represent.us/action/private-prisons-1/

Sunlight Foundation

www.99rise.org

www.MoneyOutVotersIn.org

https://www.citizen.org/

http://anticorruptionact.org