On August 16, 2003, six individuals who had travelled from all over the country – Brooklyn; Wilmington, Delaware; Chicago; Portland – to Pasadena, California, began a Fast for Freedom, “a hunger strike to challenge international domination by biopsychiatry.” They were determined to poke their collective finger in the eye of the psychiatric establishment and to expose what they believed to be the great hoax perpetrated on the American public by the U.S. Government, by American psychiatry and allied organizations and by the pharmaceutical industry — that the causes and treatment of so-called major mental illnesses were rooted in readily verifiable scientific evidence.
I didn’t learn about the strike until 2010 when I read Bob Whitaker’s brief summary of it, which he wrote as an introduction to his last chapter in Anatomy of an Epidemic, “Blueprints for Reform.” That chapter begins with a quote from Vince Boehm, one of the hunger strikers: “I think it is time for another hunger strike.” (2009) So do I, Vince. But after speaking at some length recently to three of the strikers – David Oaks, Cat Sayama and Mickey Weinberg – and to a member of their Scientific Panel, Al Galves, I have a greater appreciation of the hard work it took, the years of planning that went into it, the fears and apprehension that it raised and that had to be addressed and the risks that people faced to bring it off. I decided to write about it because it is a significant historical event, a first for the movement to oppose psychiatric oppression – I’ll explain more below. It needs to be commemorated in a country, in a culture where it is too little known and appreciated and just as easily forgotten. It is also a model for future, similar actions, as well as an answer to the question I posed to the folks I spoke to – “why no hunger strikes since?” And finally, for me, it marks my re-connection to Mickey, my classmate at the UCLA School of Social Work, whom I hadn’t seen or spoken to since we graduated together in 1969. Pure serendipity was at work here – he saw my name listed among the MadInAmerica bloggers a few months ago and contacted me. It was Mickey who opened the door that gave me access to David, Cat and Al and to their reminiscences and lessons learned.
Back to the story.
After two years of discussion and debate about tactics, strategies and objectives, the Freedom Six, as I’ll call them, together with the panel of experts and advisors they had assembled – more on the complete cast of characters below – had decided that a hunger strike might be sufficiently dramatic to attract the media attention they needed. Bottom line, hunger strikes are medically risky endeavors. After twenty-one days of fasting from solids, an individual’s body begins to break down and the risk of serious and lasting damage, even death, goes up. Its dangerousness, in short, is what gets people to pay attention to a hunger strike and to the issues that it raises.
Hunger strikes in pursuit of justice by oppressed individuals against their oppressors are an ancient and often effective practice, appearing in the historical record in India over two thousand years ago as well as in pre-Christian Ireland. Hunger strikes were politicized and used throughout the twentieth century across many cultures and nationalities by persons as varied as Gandhi and other Indian patriots; by British and American suffragettes; by the American anarchist, Rebecca Edelsohn, jailed for protesting the 1914 Ludlow Massacre in Colorado; by Irish Republicans as late as 1981, when Bobby Sands became the first of ten IRA hunger strikers to die in Maze Prison in Northern Ireland; by Cesar Chavez and Martin Luther King. It has continued into the new century as a political weapon of seeming desperation, to witness the hunger strikes earlier this year by nearly two thousand Palestinians being held in Israeli prisons, and by a group of postal workers this past June seeking to forestall the dismantling of the U.S postal system.
The Fast for Freedom was the first hunger strike in the U.S. undertaken by a group of psychiatric survivors sponsored by an organization of psychiatric survivors and their supporters. Five of the six – Vince Boehm, Krista Erickson, David Gonzalez, David Oaks and Cat Sayama – identified themselves as psychiatric survivors; the sixth, Mickey Weinberg, a long-time activist, was the principal organizer. MindFreedom International, a major psychiatric survivor advocacy organization, which can trace its origins to 1986 and was founded by David Oaks, its executive director, and others, was the principal sponsor. The Scientific Panel, whose task would be to evaluate and respond to any scientific proofs submitted by the psychiatric establishment to substantiate its claims was comprised of fourteen mental health professionals and scholars of sterling, if controversial, reputations in the field. I know it can be off-putting to read a list of names, but I’d like to give everybody her/his due: Fred Baughman; Mary Boyle; Peter Breggin; David Cohen; Ty Colbert; Patricia Deegan; Al Galves; Thomas Greening; David Jacobs; Jay Joseph; Jonathan Leo; Bruce Levine; the late Loren Mosher; and Stuart Shipko. I’m sure that readers will recognize many of these names, notably Dr. Breggin, who founded The International Center for the Study of Psychiatry and Psychology (ICSPP); Dr. Galves, the current executive director of the ICSPP successor organization, the International Society for Ethical Psychiatry and Psychology; the late Dr. Mosher, of Soteria House renown; and Drs. Leo, Levine and Shipko, all bloggers for MadInAmerica. I certainly hope that all three of the latter group will weigh in with commentary re. their experiences with the strike and its immediate aftermath.
The strikers’ basic strategy was simple and direct. They identified the three most apt surrogates for the biopsychiatry industrial complex, i.e., those entities most wedded to the biomedical model and use of psychoactive medications, and directed to them a series of demands; which, if not met, would set off the hunger strike; which, they hoped, would attract media attention to the anticipated failure of the surrogates to meet the strikers’ demands, and, consequently, publicly discredit the surrogates. Specifically, they focused on the American Psychiatric Association (APA), the National Alliance for the Mentally Ill (NAMI), and the Surgeon General of the United States (who, in 2003, was Dr. Richard Carmona). To quote from the strikers’ “Original Statement,” issued on July 28, 2003, and addressed to Dr. James Scully, the APA’s Medical Director, Dr. Rick Birkel, Executive Director of NAMI, and to Dr. Carmona, “we the undersigned ask that you produce scientifically valid evidence for the following or you publicly admit to media, government officials and the general public that you are unable to do so:
1. Evidence that clearly establishes … ‘major mental illnesses’ as biologically-based brain diseases.
2. Evidence for a physical diagnostic exam … that can reliably distinguish individuals with those diagnoses … from individuals without them.
3. Evidence for a baseline standard of a neurochemically-balanced ‘normal’ personality.
4. Evidence that any psychotropic drug can correct a ‘chemical imbalance’ attributed to a psychiatric diagnosis …
5. Evidence that any psychotropic drug can reliably decrease the likelihood of violence or suicide.
6. Evidence that psychotropic drugs do not in fact increase the overall likelihood of violence or suicide.
7. Finally, that you reveal publicly evidence … that links use of some psychiatric drugs to structural brain changes.”
The statement concludes with the admonition that “until the above demands are met to the satisfaction of an internationally respected panel of scientists and mental health professionals, we plan to drink only liquids and to refuse solid food for an indefinite period of time.” It was signed by all the strikers and members of the scientific panel.
As I noted above, the hunger strike actually began on August 16. Two of the strikers maintained their fast for twenty-one days, until September 5, when the strikers and the panel formally ended the strike. (As per Mickey Weinberg’s recollection, two of the strikers left before the strike’s conclusion for medical reasons not directly related to their fast; two others were obliged to leave early for work-related reasons.) Immediately prior to the start of the strike, on August 12, the APA’s James Scully sent a reply to the strikers’ “original statement” that was essentially patronizing, suggesting that the strikers avail themselves of certain basic “user-friendly” texts to uncover the answers they sought. Dr. Scully’s letter also referenced the response sent by Rick Birkel of NAMI, who characterized the not yet begun hunger strike as “ill-considered.” On August 22, the Scientific Panel members responded, pointedly rebuking Dr. Scully in their last and summary paragraph: “The panel members could not help but notice the contrast between the hunger strikers, who ask clear questions about the science of psychiatry … and the American Psychiatric Association, which evades revealing what actual scientific evidence justifies its authority. By not giving specific answers … you appear to be affirming the very reason for the hunger strike.”
There was another exchange of letters – from the APA on September 26, three weeks after the strike had ended, and a final response from the Panel on December 15. (If you are interested in reading these documents and seeing how the debate played out, they are archived on MFI’s website, www.mindfreedom.org.) In the former, the APA adopts an aggrieved tone and provides a “party line” answer defending the biomedical model: “It is unfortunate that in the face of this remarkable scientific and clinical progress, a small number of individuals persist in questioning the reality and clinical legitimacy of disorders that affect the mind, brain and behavior …” In return, the Panel members express continued disappointment in the APA’s response and conclude with the following: “We urge members of the public, journalists, advocates and officials reading this exchange to ask for straightforward answers to our questions from the APA. We also ask Congress to investigate the mass deception that the ‘diagnosis and treatment of mental disorders’, as promoted by … the APA and its powerful allies, represents in America today.”
In the midst of the strike, two face-to-face meetings between the strikers and Drs. Scully and Goins of the APA and Rick Birkel and others from NAMI were held, each equally unsatisfactory albeit validating for the strikers. To again quote Mickey Weinberg from his notes on the meetings: “… many of us took the measure of James Scully … as he thrashed around … annoyed and upset by the new experience of being on the receiving end of frustrating questions … On a lesser level, we experienced the ineffectual … bleating of NAMI officials trapped in their need to believe the unbelievable and defend the indefensible …”
The strike also attracted a fair amount of media attention. To quote Mickey Weinberg one more time: “We gained more media attention than our movement has had for any single event in more than twenty years and perhaps in the movement’s history – from the Pasadena Weekly to the Washington Post; from the local NPR report to CBS Radio news, to an interview on BBC Radio …” Unfortunately, the media attention was brief and somewhat uninformed. As soon as the strike was done, so were the media. The strikers I spoke with told me that more than one reporter confounded their challenge to the APA with Scientology’s anti-psychiatry beliefs, which speaks to the danger of expecting media correspondents to know in depth the story they’re covering. Further, whatever embarrassment the APA and NAMI might have suffered was fleeting – no fundamental changes anywhere in evidence. It should be remembered that the issues the strikers raised are not new but actually are the same that the APA and its DSM Task Forces have been obliged to address since the publication of DSM-III in 1980, viz., whether “major mental illnesses” are bona fide illnesses or just hypothetical constructs for which there is no evidence. As on all other occasions before and since the hunger strike, the APA failed to do so. Nonetheless, the hunger strike was the first time that the APA was challenged directly by psychiatric survivors and their supporters and found itself obliged to meet with and respond to its critics face-to-face, albeit with rote and perfunctory answers. Just to have discomfited the APA, to have publicly challenged the psychiatric establishment and to leave its representatives tongue-tied was accomplishment enough, perhaps all the strikers and their panel could have expected to achieve. They had poked the APA in the eye and lived to tell the tale.
So what lessons were learned from the strike by those who participated in it? First off, fears and anxieties get raised whenever the powers that be get confronted. Mickey Weinberg and David Oaks both recalled the fear the strikers had that many of MFI’s rank and file members might leave the organization if they came to believe that the Board’s endorsement of the strike jeopardized their access to their medications. Mr. Weinberg and Mr. Oaks reminded me that, like other psychiatric survivor advocacy organizations, many MFI members are prescribed and regularly take psychoactive medications. Many of them undoubtedly equate their improved social functioning with their compliance with their medication treatment regimen. This is, of course, a paramount consideration for any psychiatric survivor organization contemplating political protest and can only be addressed in open and honest discussion. To my knowledge, no psychiatric survivor organization supports coerced treatment of any kind; conversely, all support freedom of treatment choice, so long as it is informed. Hence, the two years of planning and discussion it took to launch the hunger strike; hence the decision not to involve MFI members en masse.
Secondly, much as with trauma victims, old memories can get stirred to the surface. Cat Sayama told me that, during the course of her three-week-long hunger strike participation, particularly at the outset, she lived with the fear that the police would burst into the building which housed the strikers and cart them all away. After all, five of the six of them had been labeled as mental patients at one point in their lives and what power did they really have to protect themselves from such an intrusion? Many of us might consider her fears irrational and groundless, particularly those of us who’ve never been victimized by the state’s police powers. But all of the strikers had or had witnessed it and stuck it out nonetheless, a testament to their commitment and courage, as well as to the bond of trust they had forged over the course of long hours of preparation and discussion. I seem to be coming back to that same theme.
What, if anything, had the strike accomplished? Panel member Al Galves emphasized that the strike actually provoked a response from the APA, which the scientific panel thoroughly refuted. Cat Sayama believed the strike “struck a blow” against the status quo and concurred with Dr. Galves that the strikers had succeeded in getting the APA to respond “in the public eye.” David Oaks pointed to the media coverage that was secured – in the Washington Post and by NPR and the BBC – as well as to the strike’s lasting impact, as evidenced in the many books that have referenced it, including Whitaker’s, in the last several years. Memories? His fondest memories are of a community of people joined together in space and time undertaking something risky and of Mickey Weinberg’s formidable organizing skills. Al Galves remembers meeting the strikers and being impressed by their courage in dealing with the uncertainty they were facing.
Finally and my main concern, I asked each of the four why nothing comparable to the hunger strike had occurred during the past nine years. Since the strike, many more psychiatric survivor-led organizations had received Federal and state government funds to provide mental health services to other peer-survivors. In short, had movement leaders been co-opted? Had potential protests and opposition to the biomedical model and psychoactive medications been bought off?
David Oaks cautioned me here, reminding me that folks who’d been stigmatized and blocked from gainful employment would jump at the opportunity to earn a decent living doing meaningful work. Many folks employed as peer program administrators and as peer counselors had lives and families that they didn’t want to put at risk and so exercised a certain caution. A greater barrier, he thought, was the inability of movement leaders to get together and uncover common ground. He was a great partisan of the experience he had undergone helping organize the hunger strike, which was the product of numerous discussions. He also recalled the retreat held at the Highlander Education Center in Tennessee, where he and thirty other movement leaders met in 2000 and drafted the Highlander Statement of Concern and Call to Action. Such an initiative now, he believed, would be a necessary first step.
As an old community organizer, Mickey Weinberg had a slightly different take. He wasn’t deterred by the differing perspectives, interests and goals of movement leaders. In any organizing effort, it was to be expected that such differences would exist, and it was the principal task of the organizer to help the organization’s members recognize those differences, surmount them and decide on an action or a program that all could live with. He lamented the fact that there didn’t seem to anyone wiling to do that hard, onerous work – such as he had done when he helped organize the hunger strike.
So what’s next? Is it time for another hunger strike? It appears to me that an issue that invites immediate consensus and collaboration is involuntary outpatient commitment. All psychiatric survivors and survivor-led organizations have a visceral opposition to it. New York State, which has had Kendra’s Law or Assisted Out-Patient Treatment on the books since 1999, is shaping up as the next battleground state. Unlike the forty-five other states – staggering number – that have already passed involuntary outpatient treatment legislation, New York’s law is not permanent but subject to review by the State Legislature every five years. The current law sunsets or expires in 2015 and the opposing sides are already lining up. Just earlier this year, Harvey Rosenthal and NYAPRS and its allies beat back an effort to add further restrictive conditions to AOT orders after several violent altercations between New York police officers and persons presumed to be psychotic resulted in injuries to the police officers and the death of a woman they were seeking to restrain. One can only assume that the issue will continue heating up until a major confrontation ensues in 2015. A victory in overturning AOT in New York could possibly lead to a rollback of other States’ laws. I’ve already suggested to Harvey Rosenthal that he send out a call to all interested stakeholders and kickstart a series of discussions aimed at organizing an AOT rollback effort in New York. Hope someone’s listening. As always, don’t mourn, organize. And remember, we’re all prisoners of hope! My sincere thanks to Al Galves, David Oaks and MFI, Cat Sayama and Mickey Weinberg and all your Fast for Freedom comrades for the legacy you have left us.
Upcoming Events: For those of you who’d like to meet some of the strikers and panel members and/or learn about MFI and participate in some of its upcoming events on the east coast …
Dr. Al Galves, executive director of ISEPP, is involved in promoting ISEPP’s annual conference, which is scheduled to be held in Philadelphia on November 2nd and 3rd. Vince Boehm, a long-time ISEPP member, will be in attendance. Dr. Galves is also a believer in “discussion, discussion, discussion,” and is enthused by the appearance at the conference of Dr. Bill Anthony, Director of Boston University’s Center for Psychiatric Rehabilitation, who is scheduled to lead a three-hour-long program development workshop. Dr. Galves believes the workshop should provide participants with ample opportunities to network and share ideas with one another. He is also heartened by the financial involvement in the conference of Excellence in Mental Health Care, the foundation located in Portland that Bob Whitaker helped establish, which is funding Dr. Anthony’s appearance. Additional information about the conference and registration materials can be found at ISEPP’s website, www.psychintegrity.org.
Please note that on November 1st in the very same venue as the ISEPP conference, the Philadelphia Airport Marriott, MFI is sponsoring a one-day conference entitled “Creative Revolution: Mobilizing Our Healing Resources.” Those persons interested can obtain information about and register for the conference at http://www.madmarket.org.
More immediately, MFI is co-sponsoring with several like-minded organizations a “Human Rights Rally & March” on Saturday, October 6, in New York City. The rally will be held at 12 Noon on 1st Avenue, opposite the entrance to the U.N. building. It will be followed by a march to 53rd Street and 7th Avenue, the site of an APA conference on community-based treatment. Additional information can be obtained from Dan Hazen of Voices of the Heart at 518-932-3137 or [email protected]
Hope to see you at all of the above.
Beresford, D., Ten Men Dead, Atlantic Press, New York, 1987
Huffington Post, “Postal Workers Launch Hunger Strike to Save Agency,” June 6, 2012, www.huffingtonpost.com
Khoury, J., “Palestinian Prisoners Continue Hunger Strike,” May 12, 2012,
“Mahatma Gandhi and India,” http://www.historylearning site.co.uk
MindFreedom International, “Fast for Freedom in Mental Health,” archived materials, www.mindfreedom.org
Moran J., “Hunger Striking in America: Rebecca Edelsohn and the Anarchist Response to Social Unrest,” Fall, 2004, http://userwww.sfsu.edu
Weinberg, M., “Notes on the Fast for Freedom, 2003,” private collection
Whitaker, B., Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental illness in America, Crown Publishers, New York, 2010
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.