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I was away on Friday tending to inclusionary concerns in the South Bay and didn’t get to the interesting exchange on <cinmhc-bak> between Walter and Carmen and others until just now. I believe that their concerns about Network responsiveness are well-taken, but as I see it productivity demands that things need to be formulated at a higher level: We need to target the present top-down partnership policy that regulates the affairs of the California mental health community. The Network’s claim to “represent the California clients” is really quite problematical, but in any case it is the expectation of the ‘partnership’ policy that they do so, and this has tended to tie their hands. My claim is it’s better for us to challenge that policy than it is for us simply to accommodate its divisive quality, whether by blaming or by power struggle. The present mental health policy in California reflects what is called the ‘biopsychosocial model’ of madness. Which to me means that they take a little from each prominent and conflicting trend, pleasing no one but placating many, and then manage. The top-down way partnership is implemented in California today has instilled in the leaders of the families and the clients, as well as in the providers, the imperative to manage. Last week at the Partnership Conference 2000 in Santa Clara I heard Steve Mayberg emphasize that he is ‘immensely proud’ of the way that ‘controversy’ is now being handled (read: suppressed) in mental health politics here. I’m not especially comfortable with Walter’s and Carmen’s suggestions that we resolve this clinch by “breaking up the Network’s monopoly of dedicated state funding.” This seems too confrontational for me, and it seems to me that that sort of arrangement is equally susceptible of control by a variant ‘partnership management scheme’. Will we be any better off if the exclusionary practices of the Network are replaced by another process that is equally unsatisfactory, or more so? I don't think so — rather, we need ‘elbow room’: I think we need to start to do what in the 60s & 70s we called ‘challenging the medical model’. Today the dominant ‘medical model’ is ‘biopsychosocial’, and its ‘treatment regime’ includes management of providers and activists so as to avoid ‘controversy’. I hope the Network leadership will take this matter under advisement, and seek to be more and better linked to the ‘broad masses’ of clients, to be more communicant with the creative Visions that are ‘out here’. The fact is that today there are many client activists who have a relatively complex grasp of the intricacies of madness and are able to respond to it w/o getting ‘strung out’ on destructive ideological agendas when they are dealing with real people in real time. To build a healthy clients movement, I think, we are going to have to work around the prevailing ‘partnership treatment regime’ and develop a ‘new dialogue’, a kind of public space where overcoming trauma can become a major agenda, where ‘constructive controversy’ will be able to flourish. Respectfully Andrew Phelps |
