2020 was a psychologically taxing year for Black people. Not only did we contend with anxieties over the Covid 19 virus, but we also had to confront police terrorism, along with the anger and trauma it caused, which undoubtedly heightened the virus of mental illness that greatly affects our communities. In fact, according to a mental health survey conducted by the CDC last year, substance abuse increases were more common among Black respondents than White, and the percentage of Black respondents that reported suicidal ideations was double that of Whites. For me, partially as a result of isolation because of the virus, my mental health got so bad last year that I wound up in a mental hospital for a week, which was a traumatizing experience in and of itself. When I got out of the hospital and started to participate in the political uprisings in response to police terrorism, I noticed many vague demands from leftist groups along the lines of abolish the police and fund the mental healthcare system instead. The first part of these demands sounded great to me, but I had doubts about the second part. I know from experience that the American mental healthcare system has fundamental problems that additional funding can’t fix, because it was born from the same racist, capitalist, colonial empire that the police system was…, and the family resemblance shows. While I certainly believe that the mental healthcare system can help people in crisis keep it together, I also believe that we must understand its role in American society, and recognize that Black people can neither rely on it as an alternative to the police, nor as a way to entirely rid ourselves of the psychological problems that we face as a people, whether it receives additional funding or not. In order to survive the trials and tribulations that we anticipate in the future, we must find people-power based methods of coping with the traumatic effects of oppression, as we fight for the liberation of our bodies and our minds.
In order to understand the function of the mental health system in America, we first have to understand America. In his essay, Get Up For the Down Stroke, the former Crip turned Black revolutionary nationalist, Sanyika Shakur, formerly known as “Monster” Kody Scott, put it this way: “…the u.s. is an empire, under which is submerged many nations. Both internally and externally the u.s. casts its pall over the lives of millions in a neo-colonial relationship so refined and perfected that the masses themselves eagerly campaign for and work in support of their own oppression. All to the squealing delight of the bourgeoisie. And the settler citizens of the empire, who have always been loyal to their ruling class against all forms of struggle which genuinely push for real revolutionary change, are right there with them reaping the benefits of the empire.”
What Sanyika is saying here is that the United States is a capitalist empire of the racist, settler-colonial type, because it is a state that has been founded for the purpose of benefiting the class of wealthy exploiters and the descendents of white colonists from Europe, and it continues to serve this fundamental purpose. In the U.S., as well as outside of it, there are a variety of nations that America oppresses to benefit those aforementioned groups, and for Sanyika, one of those internal oppressed nations (-or colonies), is the Black African diaspora in America.
Any system based on exploitation relies on a range of institutions to prop itself up at oppressed people’s expense through both overt and covert means. It’s easy to see how the police force is one such institution because it upholds the system by overt means, (i.e. defending private property, upholding unjust laws, and terrorizing BIPOC) but a closer examination is required to see that America’s mental health system is also one of these institutions, albeit with a more subtle modus operandi.
So how does the Mental Health System help reinforce the prevailing power structure in the United States? We can turn to a theory developed by the German collective of revolutionary mental health patients known as the Socialist Patients Collective (SPK), to begin to answer this question. In his foreword to one of the SPK’s seminal works on the connection between the mental health system and capitalism, French philosopher Jean-Paul Sartre described that relationship in the following manner;
“In general, you see the same feature in capitalism that Marx understood as alienation to be illness. In that you are right. In 1845 Engels, in The Conditions of the Working Class in England wrote that through capitalist industrialization a world was created, ‘in which only a race of people can feel at home who are dehumanized, degraded, intellectually and morally debased to the level of animals, and are physically morbid.’”
The SPK recognized that capitalism puts people in a position in which they have to spend their lives working to produce wealth for the ruling class. It reduces human beings with their own minds, values, and aspirations into simple tools of a company or employer, condemned to do the same thing every day in order to make somebody else rich. To the SPK, this mindless, animal-like existence, in which one is alienated from both the product of one’s own work and other people, is illness, because the human is enslaved to an irrational process at the expense of their physical and mental health. This ain’t the end of it either, because Sartre goes on to explain that to the SPK illness is:
“ …the only possible form of life in capitalism. In fact, the psychiatrist, who is wage dependent, is a sick person like each of us. The ruling classes merely give him the power to ‘cure’ or to hospitalize. Cure – this is self-evident – can’t be understood in our system to mean the elimination of illness: it serves exclusively as the maintenance of the ability to go to work where one stays sick. In our society there are the well and the cured (two categories of unwittingly sick people who fit the norms of production), and on the other hand those recognized as sick, who are rendered incapable of performing wage work, and whom one sends to the psychiatrist. This ‘policeman’ begins by placing them outside the purview of the law by denying them the most fundamental rights. He is clearly an accomplice of the atomizing powers: he approaches individual cases as if psycho-neurotic disturbances were the personal flaw and fate of an individual.”
The SPK realized that everyone is sick in the capitalist mode of production, but that the people who are actually called sick, are only those people who get to a place in which they can no longer serve as a useful tool for capital. In capitalism you can do mind-numbing, stressful, tiring work everyday just to make someone else rich, but you are only considered sick when your unique, complex mind does something that makes it difficult to accomplish that work. Just like capitalist society takes what is really only a set of rules that allow an economy dominated by private companies to function most optimally, and calls that law, capitalism takes the condition one needs to be in to most effectively function as a worker, and calls that “health”. Just like how the pigs label people “criminals” and put them in jail when they break the law, the mental health system labels people as “sick” and puts them in the hospital when they deviate from the mental conditions required to keep working. Of course this is a simplified explanation of the phenomena. Involuntary commitment isn’t the only way that people find their way into mental hospitals, and not everyone considered “sick” is a worker. However, the fact remains that the line of delineation between who is sick and who isn’t is socially determined, and under the hegemony of capitalism, that line is drawn in accordance with what is necessary for the continued accumulation of capital, not what is best for the human being.
The SPK’s analysis has shown us the function of the mental health system within capitalist societies in general, but the American mental health system is a product of a colonial, capitalist society. Like the SPK, the Black Marxist psychoanalyst Frantz Fanon saw mental illness as something conditioned by the structure of society, rather than a purely individual-biological phenomena. However, unlike the SPK, the main focus of Fanon’s analysis was colonial societies. In his book, The Wretched of the Earth, Fanon wrote the following:
“The colonist keeps the colonized in a state of rage, which he prevents from boiling over. The colonized are caught in a tightly knit web of colonialism. But we have seen how on the inside the colonist achieves only a pseudo-petrification. The muscular tension of the colonized periodically erupts into bloody fighting between tribes, clans, and individuals.”
What Fanon’s saying here is that the racial supremacist order of a colonial society is held up in part by a genuine effort by the colonists to keep the colonized in a permanent agitated mental state. He then goes on to explain why they do this: “…one of the ways the colonized subject releases his muscular tension is through the very real collective self-destruction of these internecine feuds. Such behavior represents a death wish in the face of danger, a suicidal conduct which reinforces the colonist’s existence and domination and reassures him that such men are not rational.”
Fanon saw the internal violence within colonized communities as suicidal behavior resulting from the intense psychological distress caused by the colonizers. For Fanon the colonizers intentionally cause said distress because the colonists interpret the resulting violence as a confirmation of the racist rationalizations they use to justify their presence. A clear example of this exists in many Black communities today. When our street tribes or “gangs”, constantly fight each other, they are really engaging in a form of suicidal behavior caused by the conditions that Black people are subjected to (poverty, poor housing, police terrorism, etc.). Settler-colonial America benefits from this because when Black folks kill each other, it registers to White America as proof of our irrationality, and thus proof that we must constantly be shepherded and dominated by White folks.
Fanon shows us where the colonial mental health system plays into this using the example of French psychiatry in colonial Algeria. He wrote:
“Since 1954 we have drawn the attention of French and international psychiatrists in scientific works to the difficulty of ‘curing’ a colonized subject correctly, in other words making him thoroughly fit into a social environment of the colonial type.”
Like the SPK, Fanon also argued that the ideal state of “good mental health” championed by the exploiters does not constitute any sort of actual liberation from mental illness. Fanon understood that the colonizer psychiatrists’ attempts to rid the Algerians of mental illness were actually an attempt to make the colonized patients into functional subjects of the colonial social order. In our case, no matter the intentions of the actual medical practitioners within the mental health system, the fundamental nature of their practice with Black people is to try to mold our psyches into a socially acceptable state, under literally sickening social conditions. In other words, their job is to make us okay with the socioeconomic conditions we’re in. When our brains start wildin’ out because of how crazy things are for us, they are there to try to put us back in line.
The synthesis of insights from Fanon and the SPK paint a clear picture of the function of America’s mental health system, which is maintaining the status quo by ensuring that people remain functional cogs in the colonial, capitalist machine. Therefore, putting more funding into the mental health system is not a valid alternative to more overt methods of social control wielded by the state. A method of social control is a method of social control, whether overt or covert, and all of these methods run contrary to the objective of human beings- to be free.
There are many concrete examples of problems within America’s mental health system that further illustrate the criticisms cited above. The police system/mental healthcare system relationship is one example. Here is another: When I was in the mental hospital, I roomed with a man of color who was an alcoholic. He and I were two of many POC locked up in the facility , but while I transferred there from another hospital, a very different process landed him there. Upon meeting him I quickly noticed that his glasses were broken and his face was injured. He explained to me that he was taken to the hospital by the pigs after they brutalized and arrested him for public drinking. This entirely disproportionate response to what was essentially a mental health crisis is but another example of the horrible situations that arise out of the mental health system’s reliance on police as first responders to mental health crises. Oftentimes the police end up seriously injuring or even killing people in crisis. For example, 13-year-old Linden Cameron was a neurodivergent youth who had a serious crisis that forced his mom to call emergency services for help getting him to a hospital. The police were the ones who showed up, and when they arrived, they immediately shot Linden multiple times. Other examples include Travis Jordan, a suicidal person killed by police responders and Atatiana Jefferson who was killed by police who were supposed to be performing a mental health check. Tragedies like these show that it is a major problem that armed pigs are often sent to take people in crisis to the hospital, and this can have deadly consequences.
The examples of issues with the mental health system certainly don’t end there. When one ends up in a mental hospital, whether they go voluntarily, or are taken there by cops, doctors, or therapists, they have their freedoms taken away from them or inhumanely restricted. In the place I was hospitalized, patients were locked in a section of the building and no one knew when they’d be discharged. Our schedule was strictly regimented. We were all adults, and yet we had to line up to be escorted outside of our section, and had strict bedtimes and wake-times like we were children. Some people underwent controversial treatments (like electro-convulsive therapy, which is banned in several countries) and did not seem to be the same afterward. We had no privacy; not even in our rooms. There was no door to the bathroom. And when we tried to sleep, we would sometimes be disturbed by staff members peeking in our rooms or sticking needles in our arms for an unknown reason. The staff made it clear that patients who were “really crazy” would be locked in a special section of the hospital built for difficult patients. My roommate, who had been to prison, said that the conditions in the hospital reminded him of the conditions there, and he wasn’t the first to make such a connection.
The coercive treatment methodology found in American mental hospitals can be understood as a manifestation of carceral logic. According to one study of people with psychotic disorders, regarding their first experiences of psychiatric hospitalization, researchers found that 62% of these patients reported involuntary hospitalization, 40% reported being forcibly restrained, and 37% reported being forced to take medication. To make matters worse, 69% of the patients also reported that past experiences of hospitalization had traumatized them. The results of this study are an example of how the madhouse, like the jailhouse, is often home to a variety of practices and rules that violate and traumatize the people held within it.
On top of all of that, there is, of course, the economic element. As I neared the end of my forced hospitalization, I was pressed into signing up for a partial hospitalization program that I would have to attend once I left inpatient care. It could’ve been optional, but it wasn’t presented that way. I didn’t think I needed it and couldn’t afford it, but I ended up going anyway. The amount of money that I now owe that hospital, for both inpatient hospitalization and partial hospitalization, exceeds the amount of money that I and the rest of my family have in the bank combined. I still don’t know how I will pay it off. This problem is unfortunately common. One study of the fees for psychiatric care, in approximately 400 U.S. hospitals, showed that patients were charged an average of $6,900 for about 8 days of treatment for depression, $7,593 for roughly 9 days of treatment for Bipolar Disorder, and $8,509 for around 11 days of treatment for Schizophrenia. Furthermore the study also showed that the patients were charged 2 ½ times the amount of money that the hospitals actually reported to charge for care! So on top of everything else, America’s mental health system is also a racket. People can be forced into treatment, and then forced to pay for it too! If that’s not the very definition of unfair, I don’t know what is.
So now that a few of the problems with the American mental health system have been explained , the question remains: Where do we go from here? If the mental health system helps to prop up the same power structure that makes people sick in the first place, Black people can’t rely on it for survival; not even if there was additional funding funneled into it. Instead, we must rely on ourselves. When push comes to shove, people’s power is the greatest counterbalance to the forces of oppression in any society. When people band together and work for collective solutions to collective issues, we are not only able to achieve more, but are also constructing the foundation for a new society based on our collective power within the decaying corpse of the old society. So what are some people’s power based ways of addressing the issue of mental illness? One such method is encouraging self-care in our progressive groups, movements, and in our communities. In an interview with Afropunk, the Black revolutionary Angela Davis said the following on the concept of self-care:
“I think that movement would have been very different, had we understood the importance of that kind of self care. Personally, I started practicing yoga and meditation when I was in jail. But it was more of an individual practice; later I had to recognise the importance of emphasising the collective character, of that work, on the self.”
According to Angela Davis, the practice of self-care must become a vital aspect of the Black Liberation Movement. Two methods of self-care that Davis describes, yoga and meditation, are so accessible that anyone, even prisoners, can use them. Later in the interview, Angela Davis goes on to emphasize the fact that we must practice “collective self-care”, because the fact is, the illness that is generated by racial capitalism in America affects Black people as a community, and so it is necessary for Black people to start practicing self-care as a community in order to combat said illness.
We could also establish alternative mental health institutions for our people that are based on people’s power and a revolutionary program. One example of this is the Lincoln Detox program, which was founded by the now captured Black revolutionary Dr. Mutulu Shakur and his comrades. The program was established after several radical community organizations took over a part of a hospital and carried out an investigation of the community’s health needs. The community organizations realized that the masses were unsatisfied with the way that the hospital handled addiction, and so the organizations decided to establish a community detox center in the occupied space. According to the Lincoln Detox Program’s essay, Dope is Death , the program was designed to aid addicts in the detoxification process and educate them about the addiction epidemic in their community. Through this methodology, the program was able to help over 1,000 people become drug free at no cost while simultaneously helping to raise their patient’s consciousness of the social issues at the root of their illnesses.
People in our communities could also organize into formations in which they can address the mental illness issue as a collective. The SPK provides a great example of this in practice. The SPK engaged in practices ranging from “group agitation” discussions in which patients collectively drew connections between their problems and the society that conditioned them, to practices similar to social work, in which the patients would help each other solve domestic or familial crises, raise money to help their financially struggling comrades, or even tutor the comrades who were experiencing distress due to the capitalist educational system, all to the collective benefit of the patients involved.
That said, while there are methods of survival in our sick society that we must pursue, the fact remains that there is only one way for all of us to truly heal. In his essay, Revolutionary Suicide, Huey P. Newton, the late leader of the Black Panther Party for Self Defense, spelled it out for us:
“I do not think that life will change for the better without an assault on the Establishment, which goes on exploiting the wretched of the earth. This belief lies at the heart of the concept of revolutionary suicide. Thus it is better to oppose the forces that would drive me to self-murder than to endure them. Although I risk the likelihood of death, there is at least the possibility, if not the probability, of changing intolerable conditions. This possibility is important, because much in human existence is based upon hope without any real understanding of the odds. Indeed, we are all—Black and white alike—ill in the same way, mortally ill. But before we die, how shall we live? I say with hope and dignity; and if premature death is the result, that death has a meaning reactionary suicide can never have. It is the price of self-respect.”
If you want to dig up a plant, you have to start from the roots. We’ve established that not only the police system, but the mental health system, and even the deep psychological sickness that plagues us, all have the same roots, which are white supremacy, capitalism, and colonialism. The mental health system as it is cannot save us from that sickness, just like the police can not protect us from the injustices in our society, because all of those things come from the same roots. The only way to get rid of them in their entirety is for the people to grab those roots and tear them out, so that the whole system that has grown from them can be cast away. To do this, we have to accept that we are sick, and understand why that is. Only then can we reclaim our dignity as human beings, and realize our right to life through revolutionary struggle for a new society.
When I got out of the hospital for the first time, I felt broken and defeated. The “spark” inside of me, my passion for life, had been snuffed out. But when police terrorism forced our people to rise up in the wake of the shooting of George Floyd, I knew what I had to do. Out on the streets of Atlanta I was immersed in the largest assembly of Black people in protest that I had ever seen in my life. As I chanted and shouted for the recognition of my humanity, in the midst of the great multitude, I felt the fire within me ignite once again . At that moment, when I stood up alongside my people to exclaim, “Enough!”, my dignity as a human being was restored, and my right to life was reaffirmed. Thus, it was through participation in the popular struggle, and not involuntary mental hospitalization , that I pushed back against sickness. It was there, in the sea of the rising people, and not in any hospital, that my healing process began. The South African revolutionary Steve Biko said “The greatest weapon in the hands of the oppressor, is the minds of the oppressed.” Thus, when we fight back against our oppression, we are fighting for our minds too.