The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
Interview with Amy Smith
EM: You work as an activist in the psychiatric survivor and mental health reform worlds. Can you tell us a little bit about that work?
AS: Nine years ago, I evolved into the role of an activist from ten years of acting in the position of a privileged, gilded industry advocate, when I titrated off psych drugs over a three year period.
I awoke from a 37-year-long psychiatric treatment-induced nightmare of complicity and compliance very angry. I was enraged that my adult life, my personal identities, my passions, and my hopes and dreams had been stripped away from me with no regard.
My talents, skills and capabilities had been crushed and I had been infantilized and institutionalized to the point where I was unable to make even the simplest adult decisions on my own. My son had been removed from my custody, raised by the state and institutionalized himself.
I was working inside the industry at the time and between my sudden blazing insight and crippling rage, I lost my employment, policy seats, credibility and standing in the community and basically was run out of town. I landed in a tiny town in northeast Colorado that is a tenth the size of the urban drop-in center I ran for years, and noticed the folks in that town have many of the same issues the members of the drop-in did: loneliness, oppressive poverty, no access to healthy food or transportation, nothing to connect them to a community or to each other.
I decided to apply what I saw as the social justice world view of these issues towards my new community and began working towards putting together a "coffee shop" that would link people together with each other in ways that support general good health and social connectedness: creative activities, skill-based workshops facilitated by town elders, community gardening, "clubs" that address the interests of the people in town.
The state of Colorado has policy plans that will vastly expand aggressive and coercive behavioral health services in NE Colorado; our plan is that this one little town will not only do much better without those services, but will thrive. I have methodology in place to collect (unseen to us!) robust and comprehensive health data on participants, and the state will be watching as our health services utilization goes down, and good health markers go up. It's both an unauthorized, peer-run societal pilot program and a manifestation of the more ethereal idea of creating the change you wish to see in the world.
EM: You contributed artwork to MindFreedom International’s Occupy American Psychiatric Association protests. How do art and advocacy go together for you?
AS: Disseminated imagery is a mainstay of any social movement throughout history, and my personal story leverages the significance of using my own imagery as much as I can. My parents were both in the advertising game in the 50's—think of a much less functional Don Draper in Denver—so I grew up contemplating whether airbrushed naked women hidden in ice cubes was an effective impulse generating strategy or a devious slippery slope we would never recover from.
Manipulation, to me, is not a bad word. I also was born with such a strong way of relating to the world around me visually that I quickly became an extremely skilled draftsperson, which of course, vaporized under the onslaught of psychiatric medications almost immediately when I was a young adult. Today, using my skills to illuminate the industry and carry forward our messages is a powerful personal political act.
An image can deliver a powerful one-two punch in the immediate and obvious, and then in the subtle, not easily seen, information that is included. Art can convey visceral, deep messages the viewer may not even know they have seen, and can instantly depict emotions and scenes that have the ability to transport the viewer to emotional lands that words have difficulty navigating. Additionally, the action of any sort of creative process generally has a healing function for the creator, and often the viewer as well. Art can touch where words can’t.
EM: What are your current and future activist efforts?
AS: I actually experienced a shattering shift in my worldview of movement work the day before this writing. For 15 years, I have been an avid policy wonk, studying the Affordable Act and the mountains of policy documents that preceded it, working hard on boards, councils and task forces to effect positive change within the industry. Time and time again, I saw my work either defeated outright, or worse, twisted in ugly manners under a shiny cloak of benevolence.
Only last month I learned that new rules in human services entities now call for all children engaged in social service interventions to be assessed with the ACE scale, adverse childhood experience makers, for potential behavioral health services. I can barely imagine anything more perverse, more opposite, of what our decade of hard work to bring trauma awareness to these entities was meant to achieve. Yesterday, after a passionate discussion with my partner regarding the work of Rat Park author Bruce K. Alexander I made the rather ego-crushing reaction to abandon all of my "fighting," change agent, transform-the-industry-activism work, in favor of building Rat Parks.
I suddenly see clearly that the FDA WILL deregulate shock devices by hook or by crook; if Tim Murphy's Bill doesn't pass, the Social Security Administration will require institutional payeeships ensuring psychiatric industry treatment compliance. I abruptly became startlingly aware of the hard truth that not a thing I and others have worked on, with all our hearts and minds, at the cost of our blood, sweat and tears and often our lives, has been realized in the industry, but instead was transformed, quickly and precipitously or craftily and slowly, to the values of the juggernaut of typical western behavioral healthcare protocols and values.
And, to be fair, why not? What else is there? We MUST build Rat Parks, to show it can be done (and neatly accomplished by people living in abject poverty, mind you) and to show that it will work. People who are connected, valued, loved, busy and nurtured do not become addicts or go crazy. Crazy people and addicts who are plugged into such systems recover. My challenge will be to harness the artistic talent I was graced with to promote Rat Park values, models and ideas, while we build a working Rat Park in my little town.
EM: What are your thoughts on the current, dominant paradigm of diagnosing and treating mental disorders and the use of so-called psychiatric medication to treat mental disorders in children, teens and adults?
AS: Speaking as a policy wonk, a student of the vast ramifications of the Affordable Care Act and its accompanying policy and law, I believe the behavioral healthcare industry has made it very clear for decades what it intends to do, and is now doing it.
For the time being, the ACA essentially converts the entire nation's behavioral healthcare system into a capitated, carved-out managed care entity. While longer range plans will fold mental health treatment and substance use treatment into the physical health system, until that happens, it is not possible to sustain capitated managed care with the vast bulk of high utilizers in one funding silo.
Remember early ObamaCare ads of young skateboarders and downhill skiers? Those ads were carefully crafted to attract that demographic: capitated managed care relies on young, healthy enrollees to keep the wheels rolling. We are expensive, with our iatrogenic disease, high level of complicated treatment needs, our propensity to engage in dangerous lifestyles that harm our health (like being too impoverished to eat healthy food, for example, or live somewhere safe), our lonely Saturday nights that prompt us to call 911 over anxiety attacks because otherwise no human being would ever look at us with care and concern.
Our costs are reeling out of control, draining state resources and chafing the federal teat. Efforts to reinstitutionalize, build tighter compliance and mandatory protocols, deregulate shock (cheap as dirt), repopularize lobotomies, and generally rope us in in a manner that appears to us to reflect eugenics values, are simply fiscal remedies to address a situation that must be changed. Do I think any of these things have therapeutic benefit? Not in the least! Do I believe the industry actually creates barriers to fully realized Rat Park lifestyles? Yes, I do.
EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?
AS: The sentence, "Are you OK?" has become one of the most dangerous string of words in the English language, so for starters, I ONLY offer support if it is asked for. I run a little underground crisis bed, and try to treat people as I would like to be treated … offer a roof, good food, fun projects if desired, membership in a community of people, no defined timelines or even expectations.
I find using creative activity really helpful, but that's not for everyone … the person in question usually knows very well what helps them gather their feet underneath them themselves. I encourage the young people in my little town to know and understand their own sources of personal power, as suggested in Corinna West's work, rather than cowering in fear when they inevitably get slapped up the side of the head with a dark night of the soul or two, and running off to the doctor to "treat" a "chronic disease" that will kill them if they don't, the pervasive message delivered to our children today. I am a part of a small community of Rat Park folks that are working to make our tiny town a haven, a safe, warm creative, supportive, sustainable place to be, maybe with some municipal charters or declarations to keep behavioral mitts off our backs as time goes on, which, really, to my new eye, is the only reasonable action left to take.
Amy Smith is a long-time CSX movement activist, who lives with her partner Sarah Knutson in the tiny town of Eckley, on the northeast grasslands of Colorado. They are owned and managed by an extended dog and cat family. Amy's son Ty lives & works nearby in Denver.
Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at firstname.lastname@example.org, visit him at http://www.ericmaisel.com, and learn more about the future of mental health movement at http://www.thefutureofmentalhealth.com
To learn more about and/or to purchase The Future of Mental Health visit here
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