WHOMHP!

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Scene: It is early evening, and a World Health Organization Mental Health Provider (WHOMHP) steps out of a United Nations helicopter just outside an indigenous community quite far from here. Community members look on as an elder steps forward, a woman highly familiar with their traditions and medicines pertaining to health and wellness, an indigenous scientist.

WHOMHP (unfurling a scroll and reading very loudly): “Mental health has been hidden behind a curtain of stigma and discrimination for too long. It is time to bring it out into the open . . . We need to enhance our investment in mental health substantially and we need to do it now.”1

“Vulnerable Group: Certain groups have an elevated risk of developing mental disorders. This vulnerability is brought about by societal factors and the environments in which they live … including:

  • Stigma and discrimination
  • Violence and abuse
  • Restrictions in exercising civil and political rights
  • Exclusion from participating fully in society
  • Reduced access to health and social services
  • Reduced access to emergency relief services
  • Lack of educational opportunities
  • Exclusion from income generation and employment opportunities
  • Increased disability and premature death.”2

Indigenous Scientist [stepping forward]: Pardon me . . . I’m glad I understand your language quite well. I’ve met with people from your august body before as have my ancestors. You must be new. Would you please explain why we are now being labeled as ‘vulnerable’ people who may be ‘mentally disordered’ because of these political factors? They sound very similar to what you call in your language ‘oppression, genocide, and cultural destruction.’

WHOMP [searching his scroll]: ‘Oppression, genocide, and cultural destruction’ are not in my list nor is the word ‘political.’ Please allow me to continue …

Indigenous Scientist: I’m sorry. Please do.

WHOMP: “[An] essential requirement is for services to be responsive to the needs of vulnerable and marginalized groups in society, including … indigenous people.”3

Indigenous Scientist: Excuse me again, I’m so sorry. What are these ‘services’ you wish to offer?

WHOMP: Services to combat the depressive, bipolar, and schizophrenic disorders you indigenous community members suffer from, of course.

Indigenous Scientist: Oppression or depression? I’m uncertain which is which.

WHOMP (searching the scroll): Nothing in here about oppression, so they must mean depression. This was put together by an Expert Work Group, and they’d know. [reading again] “Depression is currently one of the leading causes of disability in the world. The key interventions are treatment with (generic) antidepressant drugs and brief psychotherapy.”

Indigenous Scientist: Hmm, if it weren’t for oppression, genocide, and cultural destruction, I wonder if they’d see us as vulnerable, depressed, and prone to disability.

WHOMP: Well, I see nothing at all in my notes on oppression, genocide, and cultural destruction, only depressive, bipolar, and schizophrenic disorder. And what’s recommended is that we provide you with drugs and brief psychotherapy.

Indigenous Scientist: That’s the recommendation?

WHOMP: Yes. “The availability of basic medicines for mental disorders in primary health care is notably low . . . and their use restricted because of the lack of qualified health workers with the appropriate authority to prescribe medications.”5

Indigenous Scientist: I suppose you’ll be providing these drugs through expansion of our community health clinic.

WHOMP [smiling]: Absolutely! That’s the good news. [looks at scroll again] “It is surprising to find that less than 40% of countries have rehabilitation facilities and anesthetist support as a pre-requisite, given that psychiatric conditions are chronic in nature and require long-term management and rehabilitation.”6

Indigenous Scientist: When was it you spoke to us about all this? And why is an anesthetist necessary?

WHOMP: “Anesthetist support is generally considered essential for administering electroconvulsive therapies.”7

Indigenous Scientist: That doesn’t sound particularly friendly . . .

WHOMP: Our intentions are entirely benign and benevolent. “Low income countries need to increase their training resources in definite even though small steps to reach the standards generally prevalent in higher income countries.”8

Indigenous Scientist: Well, how do the standards of high income countries work out for the people living there? I’m sorry to tell you, but the resources you offer conflict with our cultural ways regarding what it means to be healthy and happy.

WHOMP [pleading somewhat]: We would be very culturally sensitive in promoting them.

Indigenous Scientist: Well, are these new ideas valid and reliable?

WHOMP: They are evidence-based and empirical.

Indigenous Scientist: We also use our senses to investigate and understand our world. But that’s not really an answer, is it? Our people value truthfulness greatly. Again, as a caretaker for my people I ask, are these new ideas you wish to bring to us from your science valid and reliable?

WHOMP [blushing and searching the scroll again]: I guess I don’t see much regarding what’s valid and reliable about all this in here.

Indigenous Scientist [looking up at the fading light]: Maybe your expert scientists don’t feel all that confident in their own ways. [pointing to an early star] Do you at least see that?

WHOMP [a little put off and puffing up slightly]: Of course. Our scientists can actually measure the distance from here to that star. They go to school for many years.

Indigenous Scientist: Hmm. Very impressive. Our fishermen use that star to find their way home when bringing in food for our families. Several of them would like their children to be able to learn to read.

WHOMP [flustered]: I don’t quite get your point . . .

Indigenous Scientist: We both agree that there’s a star there, but we view its purpose very differently.

WHOMP [still flustered]: I still don’t understand . . .

Indigenous Scientist: I’ve pointed out the star, and we both see it. Now please point out this bipolar disorder you say we have.

WHOMP: It’s in your head, in your brain. We have brain-scanning machines and chemical studies to show your brain is diseased with it.

Indigenous scientist: And are those methods valid and reliable?

WHOMP [blushing and searching the scroll again]: There’s nothing written in here about that question but I’m sure . . .

Indigenous Scientist: Perhaps there is an idea of bipolar disorder stuck in your own head, and you believe it’s also stuck in ours. Your ancestors took our brains from our heads and looked at them before. Did they see this disorder inside our heads back then?

WHOMP [mildly defensive]: I wasn’t even alive! We don’t do things like that anymore. You must have people here who suffer from hearing voices in their heads.

Indigenous Scientist: Yes, we do. There are disturbances of the spirit and also visions that our healing traditions describe.

WHOMP: Well, there’s nothing spiritual about schizophrenia. It’s a brain disease.

Indigenous Scientist: I see. Another interesting idea you have. And you have located this schizophrenia reliably and validly in your peoples’ brains?

WHOMP: Uh, not exactly.

Indigenous Scientist [confused]: Well, how can you say for certain if it’s in ours? Say, in your science, do you have a division between your brain and your spirit?

WHOMP (impatient now): Yes, yes, of course, we’ve had a division between physical and metaphysical since our Enlightenment—that is, for nearly the last 500 years!

Indigenous Scientist: Hmm, well, that’s not something we have ever had in the science in our community. I think our sciences don’t agree. But ‘500 years’ sounds very familiar.

WHOMP: How so?

Indigenous Scientist: That was about the same time we first began to experience oppression, genocide, and cultural destruction around here.

WHOMP: As I mentioned, our intentions are completely benign and benevolent . . .

Indigenous Scientist [pointing to the sky]: Let’s take a look at that star again.

* * * * *

1World Health Organization, Mental Health Action Plan, 2013- 2020, p. 40

World Health Organization, Mental Health Action Plan, 2013- 2020, p. 14

World Health Organization, Investing in Mental Health Care, p. 31

4World Health Organization, Mental Health Action Plan, 2013- 2020, p. 9

5 World Health Organization, Mental Health Action Plan, 2013- 2020, p. 9

6,7,8 World Health Organization, Psychiatric Education and Training Across the World, p. 14

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29 COMMENTS

  1. David,

    Welcome to MiA.

    I spent some time on your website, and read your profile on this site:

    “David Edward Walker, Ph.D. is a Missouri Cherokee psychologist, researcher, writer, and musician. He’s consulted for many years with the 14 Confederated Tribes and Bands of Yakama Nation… ”

    I am confused with the description – “Missouri Cherokee psychologist”
    Are you part Cherokee?

    Duane

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    • Hi Duane, Thanks for your question. My mixed-blood Cherokee roots come through my Barlow, Alexander, McKnight, and Gibson grandmothers on my father’s side who resided in southwest Missouri. Like other disenfranchised people living outside the Cherokee Nation, I’m not enrolled in a federally-recognized tribe. I also make no claims in that regard. There have been numerous efforts but no successes as of yet for Cherokee people of Missouri seeking to gain state or federal recognition. There is no such thing as ‘part-Cherokee’, in my opinion. You’re Cherokee or you’re not. I am also a licensed psychologist in the state of Washington. I’ll look over the wording of that bio again. Best regards, Dave

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      • I guess a better answer is: do you identify yourself as a Cherokee? I personally think that individual’s identity and cultural and social bonds are what makes you a member of a group not where you’re born or who your parents were.

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        • Yes, Duane, I do identify myself as Cherokee, and I appreciate and agree with what you’ve said. I say ‘Missouri Cherokee’ because that’s where my ancestors came from and that’s important to me, especially because those families became disenfranchised in various ways. I mention the family names because I’m always looking to connect with lost Cherokee relatives. Thanks again for your comment.

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  2. David , Thank you for your post . If only the “civilized” authorities and people would have dealt as real friends to the Indian Nations things would not have turned out so sadly and badly.

    About 10 years ago a friend of mine, named Jesse a Lakota Sioux woman who was also a Buddhist looking at how the authorities treat homeless people said to me ,” Now we are all the American Indian.”

    The Pharma Psychiatric government oppression combined with the generally weak response against it makes me realize that madness can can possibly come from frustration.

    Best Wishes, Fred

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    • Hi Fred, Yes, there is some resonance in what you’ve said particularly for urban American Indians (and especially those who are homeless). Another facet– American Indian and other indigenous communities who’ve continually had to defend their right to keep their homeland.

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  3. Thanks for posting this piece, David. What was most surprising to me was that so many of the WHOMP comments are, in fact, quotes from WHO literature. When I saw the footnote attributions, I went back and re-read those comments in that light.

    Talk about “lack of insight!”

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    • Thanks so much for your comment, anothervoice. Yes I purposely constructed the piece out of WHO quotes because the truth of their intentions re: mental health with indigenous communities needs to be understood as quite real, rather than approximated in my own effort at satirical parable. There was a lot more to be mined in those references regarding the global exportation of Western ‘first-world’ mental health toward an untapped market– poor people. I invite others to look closely at what’s written in those WHO documents.

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      • Welcome to MiA, David. My aunt was “part” Missouri Cherokee, too. She, and my cousins, were and are very proud of that. I was wondering if you know the relationship between the UN (whose conceded that “forced psychiatric treatment is torture”) and WHO (who apparently stands fully in support of psychiatric stigmatization and coercing people onto psychiatric drugs)? Thanks for the humor, by the way.

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        • Hi Someone Else,

          That’s a great handle, by the way. Thanks for your comment. It’d be great to have a sense of exactly what you’re referring to with regard to the UN conceding that forced psychiatric treatment is torture. It’s such a vast organization, it makes me wonder if it’s an official statement or a resolution from some division or affiliate of the UN with no binding force. In any case, WHO is the official United Nations health policy arm. There’s nothing I’ve seen within the WHO literature I surveyed (although my survey was not at all complete) to suggest WHO takes a position on forced or coerced approaches in psychiatry one way or another. I suspect they’d claim they don’t have an official position or leave questions pertaining to coercion up to the laws and ethical guidelines pertaining to the nation states in which their services are occurring. But I don’t really know and doubt there’s been much thought on the issue at WHO.

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  4. David,

    I find it outrageous that prominent, powerful and influential “leaders” in conventional psychiatry (whose expertise is supposed to be in understanding the human experience) have such little respect for the cultures and traditions of others.

    From E. Fuller Torrey, MD:

    “The Cheyenne River Sioux tribe in South Dakota, for example, receives $249,540 per year for what they call the “Restoring the Balance Project” to implement mental health services that take into consideration the “unique history and culture of the Cheyenne River Sioux tribe.” How a Sioux child with a serious mental illness differs from other American children with these diseases is unclear… ”

    In the rest of the article, Dr. Torrey exercises an equal opportunity assault on anyone he doesn’t understand or appreciate:

    http://www.washingtonmonthly.com/features/2001/0204.torrey.html

    It’s an uphill climb, to say the least. Not only for indigenous people, but for anyone who does not fit into the box psychiatry has determined to be “normal” – culturally mainstream.

    Best,

    Duane

    “Kindness is a language which the deaf can hear and the blind can see.” – Mark Twain

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    • “How a Sioux child with a serious mental illness differs from other American children with these diseases is unclear… ”
      First of all he should know that calling Lakota tribes people Sioux may be considered offensive and maybe if he wants to speak for those people he should use the proper names:
      “The name “Sioux” is an abbreviated form of Nadouessioux borrowed into Canadian French from Nadoüessioüak from the early Odawa exonym: naadowesiwag “Sioux”.[3] Jean Nicolet recorded the use in 1640.[4] The Proto-Algonquian form *na·towe·wa, meaning “Northern Iroquoian”, has reflexes in several daughter languages that refer to a small rattlesnake (massasauga, Sistrurus).[5] This information was interpreted by some that the Odawa borrowing was an insult. However, this Proto-Algonquian term most likely was ultimately derived from a form *-a·towe·, meaning simply “to speak a foreign language”,[3] which would make it similar to the etymology of the Greek “Barbarian”. Later this was extended in meaning in some Algonquian languages to refer to the massasauga. Thus, contrary to many accounts, the old Odawa word naadowesiwag did not equate the Sioux with snakes. This is not confirmed though, since usage over the previous decades has led to this term having negative connotations to those tribes to which it refers. This would explain why many tribes have rejected this term as an exonym. One source states that the name “Sioux” derives from a Chippewa word meaning “little snake”;[6] Chippewa, or Ojibwa, is a dialectic variant of Odawa.” from Wikipedia

      But I’m pretty sure Mr Torrey has no interest in the history, culture and ethnic divisions of Lakota tribes he’s outwardly so concerned about. Arrogance at its worst.

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    • Duane,

      I am unaware of a “normal” “box” within the DSM. Is there one? I think it’s impossible to go to a mental “health” professional and not be labeled as “mentally ill.” Am I incorrect?

      I like your Mark Twain quote; because the biggest compliment I’ve ever had, IMO, was when a blind man told me I was beautiful.

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  5. Thanks for sharing this quote, Duane. It’s deeply concerning to me and I’ve sent it out to some other folks. I am aware of Torrey, his biopsychiatric hyperbole, and his influence. I didn’t know he was a former Indian Health Service psychiatrist in Alaska. It saddens me he worked with indigenous people and didn’t notice anything important about their culture(s). I’ll take a look at the article, although not on a full stomach.

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  6. So great to read this. In the World Network of Users and Survivors of Psychiatry (www.wnusp.net) we have members in the Global South who similarly identify psychiatry as a colonial imposition. In one of our submissions to the UN we talked about psychiatry as a harmful cultural practice originating in the west and being harmful to people everywhere. That didn’t get much traction at the time but we will keep mentioning it in addition to the other advocacy points.

    It was great connecting with you at NARPA, and I’m posting this on Facebook to share with global friends who might want to connect with you as well.

    Tina

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    • Hi Tina, Sorry to get to your comment so late. I was honored to meet you and know what you and your members are doing. There are other cross-currents at the UN right now pertaining to indigenous issues that are generating controversy in lacking an inclusive voice. We may need to compare notes…

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  7. Hi Dave, I’m just getting started on your work, previewing your multimedia website and Academia.edu. I don’t see anything not to like. But then nothing will stay altogether casual about your productions for me either. I moved out to dullsville that didn’t know it from St. Louis area about six or seven years getting pegged for a major troublemaker whose happy days were over by a miserable Jewish doctor I thought could help me learn something during a short stint in Portland. Oregon, not Maine. Anyway, my grandfather was married into the family from Illinois German coalminer’s stock and on my mother’s side there back two generations you see something pretty wrong. Indians darker than Ghandi could get, none with any of their stuff. Up here in PA more recently, returning to Penn State in rented and wrecked condition after suffering a ludicrous forced intervention that I did nothing to precipitate, I got busy with elective assignment work in folk class and tried to work out the registry game rules for our tribe through the Harrisburg office. That very teacher was by coincidence Jewish himself and riidiculously discriminatory toward me. I am not implying it was all that knowingly about anything but showing my meds, but in addition to worsening my classtime he also wouldn’t sign off on my English credits from Vassar. Pretty funny, huh? I know I shouldn’t relate it to the ethnicity of the two of them, but they were both self-styled liberal types offered up by the Academy, and I can’t see how that didn’t count to the both of them in a way not thought of for me. I mean that their game to put authority, power, and respectability in my face and pretend to see envy in my regard for it was impossibly interconnected to them enjoying their race game to themselves, no matter my being solid white in every way they could know. I don’t mean that to signify or justify any crude prejudices despite the pointed references. My aim just is to carry on seeing people make things count while behavioral scince looks to define it differently and not square up with their independent human source material about the end results. At any rate it stands aside of what I was just meaning to report about my distant relations, that we were Garrett’s on my mother’s mother’s side, and telling you that is as far as I’ve got or as close as come to getting my given name registered with Cherokee authorities in this country. The documentation, wasn’t it? Couldn’t find it at the time. Here looking at your work that very nearly works to remind me that I might as well not have been born in this country, for what history it demands that I keep up with and answer to about my thoughts and desires and what ones it would never help me keep up with. And of course the wonderful rules for keeping you thinking how not to work it out for yourself. I disbelieve the good will enshrined in the liberal cultural program here, inside and out and will hate the fact of its hypocrisy and betrayal of libertarian ideals and native rights as they count for better ideals until I die.

    On a lighter note , I naturally wonder if you knew Bill Moon. Besides his first book a few times, The Red Couch was the only other thing I’ve read of his front to back, just having dipped into River Horse and “Prairie Earth”. I recently picked up a nice used hardcopy of Mankiller’s biography, and tangentially I have enticed my son into reading Lewis and Clark and now have a running start on a pleasant little history of the LaClede’s. Only other choice thing really related to your personal discussion of roots would be the old novel Wakonta, about the Osage–you probably know. The dynamics of my upbringing and understanding due to it, literally baffle the establishment mental health operations and administrations types all over this place, to the point that it cannot be broght into apposition with anything they could tell me or require me to show them about my attitudes toward life. Sometimes they literally are deliberate murderers of the spirit and of historical truth without knowing how they made up their mind about, aren’t they? The liberal agenda is to reduce the whole issue to not at all or not ver intentionally and not in any way by design. But what you get and don’t get to lay claim to both constitute who you will be. Our conversation on race itself seemed halted rather pathetically after the Civil Rights era became normalized–I think, to the detriment of the token “underachievers allowed already allowed specially by law”. Such doubletalk as forces us to talk about the aesthetics of doubletalk as the liberal establishment forces us into doing can’t proceed to cover many specifics of dislocation or alienation as it means your lineage, and in its place mukticulturalism points back as obliquely and ineffectively as humanly possible to how race as the issue here is grouded in tribal rights. It’s just the way you said. I haven’t read this thread since first seeing the article when you put it up. Nice to have it here. Thanks.

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