Sunday, July 12, 2020

Comments by Will Hall, MA, DiplPW

Showing 31 of 31 comments.

  • Paula I of course agree with you 100%. The point is not the /demand/ it’s the /movement./

    By having a clear End Police Welfare Checks we are lining up with the most powerful protest movement this country has seen since the Civil Rights movement. That will massively strengthen our position around the broader demedicalization agenda you and I share.

    If you look closely at say the https://www.8toabolition.com/ demands you will see that noncoercive mental health is embedded in the sensibility of BLM. It is sadly /not/ because of the mad movement but most because of community groups and activists just thinking things through from their own perspective. People know the service nonprofit bureaucracy is corrupt. People don’t want more privatized for profit medicine. People don’t want mental health lockup. These are common sense understandings now being discussed in the BLM movement and among supporters like DSA around the country.

    The way we counter the power of Pharma and big professional mental health industries, hospitals, and the insurance system is through a /movement/. We need to be part of this movement. Right now it’s in the streets. The demands dovetail with exactly the concerns you raise, but we are not building bridges. Ending Police Welfare Checks is an obvious bridging move politically and helps build the broader coalition of BLM support. Mental health organizations with integrity, leadership with integrity, is looking for a way to channel that support that meets the challenge and urgency of the moment.

    The #defiund movement has a lot of critics from their left. Yes it can be co-oopted. In a sense that is exactly what you are raising, and I agree- these co-optation forces, especially when the Democratic Party gets hold, are strong. But this coversation is already happening and people are already anticipating what happens if #defund starts to hit cooptation. One fear of course is that you #defund the police but you fail to fund communities. We saw this with deinstitutionalization in mental health. Yeah the state hospitals were defunded alright – then the money went into the prison system and there was no real support for the community (and what support there was was just the hospital-in-the-community), and so you fuel mass incarceration and homelessness. I get it.

    The conversations about “how do we get our demands to actually be meaningful instead of coopted – how do we get to the roots of the problem” are conversations happening all over the BLM and allies communities. Those are the conversations we need to be part of.

    I don’t need people to be socialists or anarchists or anti-capitalists, but I do need people to realize that the entire society is driving people crazy and the engine is a for-profit inequality monster that is out of control. Bernie Sanders’ agenda isn’t socialist or anarchist or anti-capitalist. He himself is a democratic socialist, but his agenda is actually a mild form of FDR reformed capitalism social democracy. It just seems radical because the US is such a backwards and barbaric society (I say this as someone who loves the US and is proud of how awesome our country is). Bernie was bringing together a broad gathering of people who had enough of a shared understanding of the roots. That’s what we need.

    Joining the #defund movement by calling for an End To Welfare Checks gets us part of a broader conversation and movement that starts to resurrect the roots of the mad movement in the civil rights gay rights womens movement era, where we should be. #Defund and ending welfare checks by police is just like any demand – but it’s the demand we need right now.

    I did just learn that San Francisco Mayor Breed’s plan would essentially (if it does what it claims) end police welfare checks. I think the movement needs to think long and hard about why that demand is getting met in San Francisco in the context of Black anti-police brutality protests, not mental health advocacy. It shows us where the real change and leadership is coming from – it’s not within our movement it’s in a broader social change movement. The sooner we start to be actively part of that broader movement the faster we will actually get to a society free of psychiatric violence, a society that doesn’t drive people crazy.

  • Richard I think I basically agree with you, are you reading the Movement for Black Lives policy agenda or the 8 to Abolition response to the 8 Can’t Wait reform agenda? https://www.8toabolition.com/

    I’m a Bernie Sanders supporter and have been making the connections between our corrupt capitalist economy at the heart of our failed healthcare system pretty consistently.

    Where we may disagree is I think coalition work is imperative and you may not get leading mental health organizations on board right at this moment for a comprehensive repudiation of a profit based society I do think we can make headway with a End Police Welfare Checks demand. Movements work and make change through demands and coalitions. I would disagree with anyone who needs ideological or political purity before we can start asking for change.

  • I think I actually agree with most of you here, but where you say

    “The question is, did they have “lawful sanction” to do this, and if the answer is yes, then it does not constitute torture.”

    You do realize that torture in many countries around the world is legally sanctioned, that the torture at Guantanamo Bay by the US was legally sanction, etc etc?

    Tyrannies torture by making it legal. The legality or illegality of torture by the standards of the local regime is irrelevant. International law does a pretty good job setting the standard but torture is at heart moral and historical.

  • Hey there anomie, we need you to give us some constructive strategies not just doompost “No, that won’t work.” You may have decided the world is hopeless and the psychiatric system wins, a lot of us disagree.

    There is already a huge movement out there with responses to the “Here is why we can’t #defund the police” objections. Let’s be part of that conversation rather than recycle talking points of the people against the BLM movement.

    Defund the police doesn’t mean “Let’s be single focused on one narrow interpretation of a demand while we abandon all other commitments to everything else we believe in so our demand just gets coopted even if we win it.” Give us some credit here we’re not stupid.

    The point is there is a global uprising right now, an uprising that is basically saying, if you look closely, “give us mental health alternatives to the police.” Now is the time we can make huge gains such as getting police out of mental health and lining up our movement with Black leadership pushing for fundamental change – but this can happen only IF mental health leadership can start adding their voice to this conversation. Do you realize that if we could make End Police Welfare Checks we could possibly get media coverage for survivor stories, for forced treatment stories and for our critique of force, and get our perspective into the broader BLM conversation in a way we haven’t ever been visible? Yes we need a broader strategy that’s why I have been urging us to endorse the policy proposals of the Movement for Black Lives.

    Right now I am convinced that if mental health leadership and organizations joined our voices together and started getting media attention to End Police Welfare Checks Now we could not only save lives but we could open up possibilities to end coercion in mental health in a way I have not seen in my entire life.

    Getting people out of the state hospitals led them to the prisons and homelessness because there were no resources to follow up. I get that and talk about it all the time. It was still the correct demand at the time — and part of broader demands never single issue — just the broader movement didn’t have enough power to push the broader needs so the liberals took it and ran with it. I feel strongly that if we want to protect mental health we need a comprehensive alternative to the neoliberal capitalist democracy-by-puchasing-votes system that gives power to the for-profit medical system in the first place. That’s actually pretty obvious to a LOT of young people these days (hello Bernie Sanders campaign) but the boomer leadership of the mental health movement (sorry folks but it’s true) is scared to connect the dots and update their politics to be more multi issue and systemic. We need to break the power of a society run by a 1% stock market driven elite controlling both the Republican and Democratic parties. To do that we need a movement in the streets. And that’s what we’ve got right now so let’s be part of it.

    That mental health organizations are basically on the sidelines except for “shows of support” and reading lists is outrageous. WMRLC and Icarus / Fireweed have been really good on this, but head on over to NAMI and you’ve got “hey let’s do so more trainings” and you even have a “if you call the police here is what you should do – not the police, you – so you don’t get killed.” The more survivor and mad movement oriented groups are not much better I am very sad to report. Yes NAMI has zero on their website no surprise, but I hate to say it and I don’t want to single any organization out and leave out others – but some of the leading orgs have zero and are not doing any real organizing for real demands. An organization I found that does have something on their homepage, well, here is what one of our leading organizations thinks is appropriate – nice words

    We support the struggle … by African Americans and other people of color. We will work to heal … traumas from the power imbalances common to all marginalized people. We will not passively watch as oppression and discrimination destroy lives. We will join together to pursue systemic change so that our common humanity is recognized, economic equality and social justice are realized, and we all can live in peace without fear and with hope and joy.”

    Sorry, that’s bullsh*t.

    “Systemic change?’ Really? What “systemic change” exactly? I have an idea for systemic change you can get behind – how about End Police Welfare Checks Now. That would actually really make an impact.

    Not passively watch? Sure you are marching in the streets and maybe you donated /personally/ but what bout using your power as an organization, your leadership, and actually do something substantial?

    If you have a vision of the “recovery model” that you thinks includes police doing welfare checks (killing people routinely, then covering it up), then you have lost all moral authority to be an activist in this movement, much less a leader.

    Mental Health organizations could have a real impact, right now — maybe //directly// save lives of people who would be murdered by police and then covered up by police — if they’d drop the bs words and actually take a common sense stand: “No Police Wellness Checks.”

    Maybe some of us on this comment thread should stop barking at the choir and instead send some emails and make some phone calls to get our mental health leadership and organizations behind actually doing something – now when the movement is strong – and come out against police welfare checks, gather endorsers and sign-ons and make a coalition, and do some press releases.

    Or maybe they need to double check with their donors first?

    It’s amazing to me how many BLM emails I get around #defund the police that if you read them they are endorsing peer and community controlled non-coercive mental health as alternatives MUCH more strongly that mental health organizations. The leadership of the BLM movement is not stupid they know pills aren’t the answer (they’re also skeptical of being hijacked by ant-meds fanatics, but that’s another story. I spent a lot of time working locally in Portland and hey, guess what, the mad survivor movement actually has a lot to learn from community organizations instead of just yelling at people about how bad pills and labels are. I was on the Board of the Mental Health Association of Portland because of the excellent anti-police violence work they did, and what it got me was harassment from other mad movement so called leaders who didn’t like the disease model language some of the other Board members and the Association’s projects. Ideological purity is the sign of fanaticism people, you might think about that).

    What is deeply wrong is how there is little visibility of any mental health leadership joining these demands. It reminds me of how the War on Drugs and prison abolition movements have been addressing mental health issues much much better than the so-called mental health organizations, for decades. I spoke about this at an Alternatives keynote. Freedom Center really was doing things differently by connecting these issues, and Portland Hearing Voices as well (just speaking from my own experience here, there are lots of awesome people doing awesome work out there I’m overlooking I’m sure, but you get my basic point). I see this as just doing what the survivor movement was doing from the beginning being deeply connected to the broader civil rights, gay liberation, and women’s movements. I’m glad to see the WMRLC carrying things forward and Icarus/Fireweed is too, as well as other organizations and individuals, but the problem looks to me like the donors / grant signers are gatekeeping common sense connect-the-dots because they are themselves not on board with actual real change in society – many of the leading organizations get state county federal contracts, and, well, you can’t fund a movement with money from the system you are building a movement against, it doesn’t work. The other problem is the Szaszian libertarian wing (full disclosure: I love Szasz but also hate him) and the single issue people who never get challenged on their broader politics (ban electroshock, stop forced drugging, promote Open Dialogue, but no Medicare for All or a living wage, as if mental health stops at psychiatry when the whole society is what drives you crazy, read some R.D. Laing people. Etc.)

    Instead, I keep getting emails from mental health organizations with nice words with no real substance asking for more money.

  • I have had a chance to discuss with few police officers at some conferences and different settings I’ve been in. Every single one I have spoke with says they don’t want to be in the business of mental health, or being a taxi to the hospital, or trying to defuse domestic violence.

    Now, at the time I didn’t also talk to them about abolishing police unions…

  • Hi Ivana, thanks for your comment. I understand your point – we need a simple clear message. I just disagree that coming off medications can be made so simple. It’s just not like exercising and eating right.

    Especially with complicated topics like coming off medications, the role of doctors is to provide useful, complete, and honest information to empower patients. Oversimplifying can imply patients are incapable of thinking for themselves.

    I often emphasize very strongly the importance of gradual withdrawal in my workshops and talks, and I try to make things as simple as possible, but I don’t think we can get around really educating people.

  • Hi Darby, I’m with you 100% that “that the message that going cold turkey is perfectly OK in general is problematic.” I would never agree with that. The point of my post is that by calling the whole process “tapering” and not coming up with a better term, we miss instances where abrupt withdrawal can work.

    Yes abrupt withdrawal may be like russian roulette, the problem is that staying on the drugs may be like russian roulette too.

    I have read Breggin’s new book and it is an extremely useful contribution to everyone’s learning. I agree we need more prescribers who can guide people in the process, I just think we also need to learn from people who did it without — or despite — their prescribers.

    – Will

  • Thanks for the thoughtful reply to my post. I am with you completely about the importance of getting the message out about gradual vs. abrupt withdrawal. It is a cornerstone of my educational work (I was just at a psychology class at Portland State University and I told the students that this, along with the role of sleep deprivation in psychosis, was the most important message I wanted to get across).

    If you read what I say here, and in my Harm Reduction Guide to Coming Off Psychiatric Drugs, I think you’ll find I agree with you. The problem I see it is that by calling the whole process “tapering” people are misunderstanding the complex and diverse nature of coming off.

    I work with many people who have prolonged difficulty with medications, and have close friends living the horror stories of medication damage. I work with people all the time who got into trouble with abrupt withdrawal. I always, always warn people around abrupt withdrawal.

    And I know firsthand exactly about abrupt withdrawal. I was abrupt withdrawn from both Zooloft and from Navane and had very bad experiences both times. A suicide attempt and hospitalization took place after a Zooloft and benzo abrupt withdrawal and I wonder if the withdrawal played a role. So I wish I had been withdrawn gradually.

    I also watched my roommate almost die from Lamictal poisoning. If she hadn’t been withdrawn abruptly, cold turkey, she could have died. What if she went to websites that said “never withdraw abruptly from medications”? Would she be dead now? What if she wanted to come off the Lamictal on instict but decided to stay on to wait until she could withdrawal gradually? Might she have had that poisoning reaction and ended up dying?

    Yes people do get into problems after abrupt withdrawal and some of them really regret the process because of the problems it can create. But I have to disagree with your certainty around this. Some people go too slowly or wait to get off meds, or don’t trust their desire to go off, and then staying on the drugs creates problems.

    Your point about abrupt withdrawal and then not being able to get relief by going back on is a good one. There are people like this, and you point to an extremely important area for research. But at the same time that doesn’t encompass everyone – others find improvement by going back on or trying different drugs. Again, one group’s experience can’t be generalized to a firm rule.

    You say “…yes if you are having a life-threatening reaction then you need to stop straightaway.” The problem here is, When do you know you are going to have a life threatening reaction soon? Getting off quickly is a personal choice and I don’t want to claim I know people are making the wrong choice when there are so many unknowns.

    I have a very close friend who was on Lithium for 15 years before coming off. She had a strong instinct she was too damaged to become pregnant, but her holistic doctors, being ignorant, encouraged her to go ahead with the pregnancy. It turned out that her thyroid had been so injured by the lithium that the hormone and thyroid changes in pregnancy almost gave her cardiac arrest, and she had to terminate the pregnancy. People often have very good instincts and intuitions about their bodies and drugs. If someone feels coming off abruptly is the way to go, I simply don’t have the certainty to tell them it is the wrong decision.

    Published accounts of withdrawal and the internet forums and email lists tend to omit the stories of people who withdraw successfully and then just leave the whole system — survivors and peers included — behind. I do often meet people who come off medications abruptly and succeed. That’s just honest. We need to recognize they are out there.

    Part of the confusion is that there is such a wide diversity of medication experiences. Like I said, 2 weeks into an Effexor prescription is different than 20 years of anti-psychotic and benzo polypharmacy. Again a general principle but not a firm rule: sometimes people are so beaten down and powerless that the desire to come off abruptly, even with bad consequences, is part of an impulse to empowerment and liberation. I don’t want to judge that as wrong.

    Where you say “I have spent years on the various Internet withdrawal forums and it is unquestionably the case that the people who suffer the most and for the longest are those who come off their drugs too rapidly.” I would have to say yes absolutely, that is also my experience as well. And also, there are lots of people who stay on the medications too long and that also causes huge problems. One of the problems with the “only gradually” message is the same problem with the “only with a doctor” message: it potentially puts up an obstacle to people and it denies the reality of people who’ve had other experiences. So I think we put a little too much fear into the meds and can inadvertently give them a little too much power. Sometimes movements tend to start to look like what they are opposing.

    I think, in our efforts to alert the world about the dangers of psych drugs, we sometimes overstate the case. Psychiatry has erred for so long in favor of meds, we shouldn’t make the opposite mistake by exaggerating the dangers of drugs. That is not to deny that people are killed and seriously damaged by medications, but if we express only these accounts we are distorting a complicated picture.

    What I am seeing these days is some people and families read Bob’s work and then think that getting off meds is the solution in and of itself. Often it is, like a magic bullet in reverse. Sometimes it’s not. I fear if we just promote coming off meds as the solution then we are setting up a backlash just like promoting taking meds as the solution creates a backlash. Maybe a smaller backlash, and maybe the overarching message is better, but I’d rather be honest at the outset.

    One of the principles of my work is giving people accurate information that matches my experience, so I often get into quite a lot of hot water when I take unpopular positions. That I guess (maybe it’s because I’m an Aquarius) is my role in the world, I’m always going to not quite go along with the majority view wherever I find myself. My position that medication withdrawal is not always best under the guidance of a doctor is one of the reasons I was shut out of the Alternatives conference for so many years and why some people doubted the value of my coming off guide. I think I was right on that, and eventually the culture caught up with me: today peers are more open to getting involved with coming off.

    I think we’re going to learn that the reality is that gradual reduction is usually best and a very wise general guideline. But the limited research literature that documents people going off abruptly does not state that 100% had problems and couldn’t withdraw; it just documents a trend that supports the general principle of gradual withdrawal. At the same time it’s definitely not a firm rule, and to treat it like that is dangerous.

    Another principle I work with is to accept the ambiguity and uncertainty of life. “Don’t ever go off meds abruptly” is an easy short cut to thinking, but doesn’t get at the diversity of medication experiences out there. I think my principle puts faith in individual relationships, learning, dialogue, and people figuring things out on their own, and that’s my bias about how to contribute to human liberation. I’m just not into programs and monologues about what’s right.

    Obviously I am hugely concerned with abrupt withdrawal. I probably would not have written this blog post unless I also had written in greater detail in my Harm Reduction Guide. But I am committed to following my experience and learning with integrity, which is why I am encouraging us to try to use a different term than “medication tapering.”

    I am with you that “withdrawal” may not be the best term for coming off medications. I use “a harm reduction approach” because I want to emphasize flexibility of outcome, as the diversity is what we need to be emphasizing here, not a program in advance.

    Also your post helps me to understand that, though ‘psychiatric drugs’ is a useful umbrella and the principles of withdrawal do apply in general, there are specific drug classes — like the benzodiazepines — that have very specific profiles around long term addiction. We need more research and education around these differences. I would be much more cautious on abrupt withdrawal in a discussion about benzos for example because of the widely documented sudden death risk and the long term physical risks of abrupt withdrawal. So your information and experience here are really important.

    Again thanks for a thoughtful reply.

  • Thanks Chris. I emphasize that drugs are helpful for many people in the context of telling horror stories of when they are not helpful – including how I was harmed. I stay consistent with the research, which has medications playing all kinds of roles in people’s lives and recovery.

    My aim is to express an experience we don’t hear enough about, while not marginalizing the diversity of other experiences. In a heated, either/or political culture this is often a real challenge, but when we can hold all these voices in the same room and discuss things openly together then real learning and change can take place. – Will

  • I want to thank everyone who is criticizing me when I say psychiatric drugs are sometimes helpful. Being attacked not only at the American Psychiatric Association but also on Mad In America just improves my credibility.
    🙂

    Do psych drugs help people sometimes? Bob’s books aren’t anti-medication, and the research supports the experience of many people who are helped. There are huge risks that often outweigh benefits, and what seems like help might not actually turn out to be, but we have to be honest about the complexity of this issue rather than forcing the facts into either/or thinking.

    I hope you can set aside your own bias and join me in listening without judgment to the broad diversity of roles psychiatric medications play in people’s lives. Do you really want to be like many psychiatrists, diagnosing people as lacking insight when they don’t agree with you?

    I’ve written in detail about psych drugs in my Guide to Coming off Medications, and if you have any suggestions on how to improve it please email me through my website. – Will

  • I am one of the people Bob thanks in the acknowledgements of Anatomy of an Epidemic so yes I’ve read it.

    🙂

    The book is not anti-psychiatric drugs; if you read carefully it is full of research confirming the experience of many people who are helped by their medications. Bob’s journalism is honest, which is why he’s successful and why I work with him. Being clear you are not “anti-medication” is a first step to really being able to talk with people. If they think you just have an axe to grind it doesn’t go very far.

  • I was also forced into the hospital and coerced to take drugs that harmed me. I’m with you 100%.

    Calling psychiatric drugs “medications” does as you suggest confuse and obscure what they actually do to the body, and promote inaccurate disease and medical models. You’re absolutely right here, and that’s why I used the word “drug” in my coming off guide rather than ‘medications.’ I am in the rare position of someone on an internet forum who not only says “Yes, you are right, I agree,” but actually can point to a publication they’ve written where they demonstrate that their agreement has real practical substance in their behavior.

    Professional and common use of language isn’t so simple though – prescription medications can also be for pain, for example, and people do do often understand that their ‘medication’ is also a ‘drug.’ In Oregon we have “medical marijuana” and I also think people understand that a substance can be used medicinally because of its effects, not necessarily in the presence of a disease. For me doing yoga, and drinking skullcap tea, are medicine.

    But I really do agree with your point, and at the heart of my educational work is breaking down the distinction between recreational and psychiatric drugs and emphasizing, as Joanna Moncrieff and David Cohen do, that they all fall under the category of psychoactives and must be understood as such.

    Thanks for your comment – Will

  • I used the word ‘drugs’ in my coming off guide rather than ‘medication,’ but I don’t think purity in language accomplishes much when trying to talk to professionals.

    I meet people all the time who are helped by psych drugs, and I don’t take a fundamentalist, anti-drug stance like the Scientologists. I think we need to be honest.

  • Hi there, I discuss the issue of doctor approval at length in my Harm Reduction Guide To Coming Off Psychiatric Drugs: I’ve been outspoken about choice and the importance of coming off without doctor support for many people. And while it is true that sometimes coming off can be quite straightforward as you suggest, sometimes it is not. For example, many pills are designed in a way that they can’t just be cut with a pill cutter, and even small reductions can sometimes have large withdrawal and be part of altered states. It’s important to treat this topic with the careful consideration it demands, or else we risk becoming as shortsighted as the medical professionals we are challenging. Thanks for your comment and please do add to my survey.
    — Will

  • Hi Maria, this is important information and thanks for writing. While no laboratory tests can demonstrate the existence of bipolar or schizophrenia, yes many tests point to the role of physical factors that could be driving psychotic symptoms then diagnosed as bipolar or schizophrenia. When I learned I was gluten and caffeine sensitive for example, removing these from my diet reduced by experiences that would be diagnosed as psychotic, and I frequently work with people who unearth the role of medication side effects such as from steroids in driving their crisis.