Journalist Robert Whitaker and nonprofit director Sera Davidow traveled to Burlington in July for Vermont Mad Pride, where they served as the keynote speakers. Whitaker, the bestselling author of Anatomy of an Epidemic and the founder of the website Mad In America, spoke about fighting against psychiatry’s “medical model,” and Davidow, whose Wildflower Alliance opened Massachusetts’s first peer-run respite, highlighted concerns of competency and confidentiality at the 988 Suicide & Crisis Lifeline. Excerpts follow.
Robert Whitaker
The psychiatric survivor movement is a civil rights movement. And any civil rights movement is a benefit to everyone in society. And that’s what you’re doing here today.
It’s not just fighting for people labeled mad. But it’s also a fight for a better society, a more just society. …
Our society has organized itself, ever since particularly 1980, around what psychiatry calls a medical model. It’s really a disease model.
And that model is that problems arise within the head of the individual, right? So we heard about chemical imbalances. And we even hear that those things are chronic. If you have something wrong inside your head, you need to be fixed – medications or whatever it might be.
But that is a conception of human beings. It’s so out of odds with everything we know about human beings, but it is this conception that the problem arises only within the individual, and not from the individual’s environment, the environment that we create for people, the experiences.
And it gives society sort of a free pass. We don’t have to do anything to make our society better – about poverty, homelessness, good jobs, all those things – because we say if someone’s struggling with their mind, the problem is in the individual.
And the other problem with that idea is, if you say there’s people here who are mentally ill, and there’s people here who are normal, what happens? What happens with that thought? It encourages stigmatization. It encourages the erosion of civil rights. It makes people the other. …
So rather than try to fix the individual, we need an area that says, we don’t know why people are struggling, even with extreme states. We really don’t.
There’s many, many different pathways to extreme states and difficulties. Start with that humility.
And then the second thing is, what do we know about human beings? A) Human beings are responsive to their environment. B) We’re not steady-state creatures.
You know what I mean by that? If you’re depressed one day, or if you’re manic one day, or if you’re having psychotic thoughts one day, it doesn’t mean you’re going to do that for the rest of your life. …
We need to celebrate people. We need to celebrate different mind states. And we also have to recognize this: to suffer is to be human. To struggle is to be human. …
Right now, our society still is stuck with that other narrative, which is completely ahistorical. I’m not religious, but go read the Bible. Read the Old Testament. Does that sound like people that are just marching through life all nice and content? Not at all. Go read your Shakespeare. Go read those characters. …
So we run Mad In America, and I’m happy to say, Mad In America now gets about 6 million visitors a year. And here’s the most important thing now: we have 11 affiliates in 11 countries, and we’ve got four more about to be launched. …
What you will see if you come to Mad in America, the website, is a big test narrative for changing how we think about psychiatric services. I’m really proud about what I’m going to say now: the Royal College of Psychiatry had its annual meeting last week. And they named who are the people who are criticizing what we’re doing the most.
And there I was on the web. I’m on one of the slides. Which means they were recognizing that there’s a real challenge to the narrative they have.
Sera Davidow
Part of what I want to talk to you about today is this idea that the thing we most need to do with people like me is to increase access to mental health services.
When I say “people like me,” what I mean is people who have psychiatric histories and in particular some of us who sometimes still bump into those edges of our existence. Like me – sometimes I wake up in a day and I’m like, “Do I really have to brush my hair today and brush my teeth today and do that again and again and again and again?” …
And if you think about access now, what do they mean when they say increased access? What does that look like recently?
Now, I could talk to you about Mental Health First Aid. … Side note about Mental Health First Aid: they say they have all this proof. If you aren’t already aware, the vast majority of the proof they have, the evidence that it works, just says that, if you attend a Mental Health First Aid training, you leave the Mental Health First Aid training more familiar with the Mental Health First Aid training. It doesn’t actually say it works for the most part.
So bear that in mind. But what I actually want to talk to you about is 988.
So I’ve been secret-shopping 988. Some people are freaked out by that. They’re like, “You need to leave it alone so the real people who are calling for real reasons can get through.” And I’m like, I am calling for a real reason: I need to know if it’s a threat to me and my community.
I’ve done this now five times, and when I say “call,” I really mean text. I’ve done the text so far. Now, I have spoken to Sue Ann, Simone, Taylor, Gretchen, and Jen.
Sue Ann taught me something important when she took four minutes every time to reply. That’s when I learned they can text with up to ten people at a time. Simone probably shouldn’t be counted because when she asked me how I was doing and I said, “I’m feeling pretty hopeless,” the call ended.
And then there was Taylor. Taylor was actually the best of the bunch. She was pretty good. She tried really hard, and she even made me my very own safety plan based on what I said would work for me. I’m kind of condescending, but I could tell she was really, really trying. So I kind of appreciated that call.
But then we got to Gretchen. So with Gretchen, I was talking about self-injury, which I have a long history of myself. And I said I was self-injuring then, and she said, “Can we step away from the things we’re using to self-injure, so we can talk?”
And I said, “Gretchen, are you self-injuring too? You can step away, but I’m not going to.”
After that call, there was Jen. Jen was the most recent. Jen was just about a month ago. And in fairness, I pushed the limits with Jen. I did say I was self-injuring, and I also said I was suicidal. And she asked me again if I would stop self-injury.
This is actually not a helpful thing, by the way. Never in the history of time has it been helpful to me to just assume it’s bad and try to get me to stop. It’s one of the things that keeps me alive. And I tried to explain that to Jen, so she’d stop. And she sort of did. She asked me if I was bleeding and I said yes.
She said, “Do you need medical care?” I said, “No, I’m fine.” And she let it go, more or less.
And then I said I was really too tired to continue the call. And she said okay. And the last thing she said to me was, “Call back anytime. We’re here 24/7.” So I went home, and two hours later, there were three police cars outside of my house and a cop at my door knocking.
Now, let’s unpack this for just a minute. Had I actually been trying to kill myself, two hours later, I’m not sure what they would have accomplished. But I can tell you, what they did accomplish, in this situation, was really freaking out my 11-year-old. …
So this is what we’re talking about when we’re talking about increased access. It is not what we need. We know here what we need.
I’m so grateful when I hear that there’s a soteria in Vermont. I’m so sad to hear that it’s the only one. We’ve lost the California one. We’ve lost the Alaska one.
We’ve lost some of that progress, and how do we get that back? That’s the conversation I want to be having, not this idea of access.