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American Wasteland: the Most Urgent Challenge for America is Its Poorly Hidden Mental Health Crisis

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The relentless tragedy of narcotic addiction, especially of opiates, across America has overwhelmed already depleted public resources, leaving a trail of devastated communities, families and lives – threatening a new lost generation.

For millennia, opiates have been agents that wash away or deaden pain. In light of the chaos of our mental health provision, the lure of opiates (and other drugs) is an understandable, though dangerous, response to untreated mental illness.

It is ironic, however, that the default “solution” to the crisis is another range of drugs.

Substance abuse is clearly another thread in the American mental health crisis. The main arena of public intervention however remains the criminal justice system.

Hearing the phrase “mental health crisis,” one may think of the epidemic of mass shootings plaguing the country since the Reagan era. Or, images may erupt of home grown terrorist attacks or the plunge toward right-wing extremism in contemporary politics.

Yet, suicide outranks both homicides and car accidents as the number one killer of our fellow citizens. Every eighty minutes, for instance, a Veteran commits suicide, the final act of a life shattered by emotional and physical trauma.

The public health dimensions of the crisis have been studiously ignored by the neo-liberal media in its ideological refusal of any primary public role in the provision of health care.

Yet, the truth is already clear: the crisis has been an enormously profitable transition to a new order of private service provision.

From this perspective, the mental health crisis emerged with the elimination of public mental health provision in the neo-liberal project to privatize and monetize the welfare state.

Beginning with the mass eviction (“de-institutionalization”) of the mentally ill by the Reagan administration in the early 1980’s, Ken Kesey’s One Flew over the Cuckoo’s Nest was weaponized to eradicate the already quarantined. To the horror of anti-psychiatry campaigners, “care in the community” translated into death in the streets and incarceration.

The harsh transition to the dominion of privatized corporate entities has left many behind – dead, damaged and criminalized – but in this new enclosure movement, even decay has been profitable.

Simultaneous to the largest concentration of wealth in the hands of a few, moreover, the absolute reach of advertising (corporate public relations) intensifies, disseminating icons of products and services from which most citizens are locked out – whose “American dream” has become a nightmare of unfulfilled media-generated desire.

In line with French theorists Gilles Deleuze and Felix Guattari’s premonitions in Anti-Oedipus: Capitalism and Schizophrenia, unbridled capitalist social and political economic relations have generated a schizophrenic crisis, a radical dissociation between the abject singularity of exploitation and alienation and the elevated ideality of the icon.

The hyper-capitalism of the neo-liberal era has, with the elimination of the social safety net, surrendered the most vulnerable to the horrifying exteriority of the streets, medicalization, and prison. As Representative Tim Murphy (R-Pennsylvania) acknowledged, “We have replaced the hospital bed with the jail cell, the homeless shelter, and the coffin.”

We imagine we are aware of the issues of mental illness and crime, at least through our familiarity with and trust in television drama. Yet, the corporate media-generated spectacle of “crime and punishment” also remains radically dissociated from reality.

Far from friendly peace officers, strolling through our neighbourhoods, as the drama disseminates, police departments – at the front line of the mental health crisis – have become militarized, operating in communities in a para-military capacity.

The intensive “outfitting” of police forces has fuelled the atmospheric profits of weapons, ammunition, military hardware and logistics companies, as thousands of non-violent offenders are locked away in private prisons, another burgeoning industry, threatening the incarceration of thousands with serious mental health difficulties.

The deflection of the crisis by politicians and pundits is facilitated by the mantra of “crime and punishment” across corporate media. Our beloved police dramas narrate a dystopic labyrinth of irredeemable criminality, while bestowing a theatrical sense of security in the mere thought of professionals “out there looking after us”. In their homes, fearful Americans pay for added protection from private security companies.

Despite the seductive illusions of crime fiction, the most threatening aspect of the mental health crisis is the refusal of our leaders and media gatekeepers – in the real world – to challenge powerful health insurance, weapons, security, prison and pharmaceutical interests, which profit handsomely from the evolving emergency.

As blatantly compliant agents of powerful economic lobbies – of corporate power – our politicians willingly allow the cynical proliferation of a wasteland of damaged and cancelled lives – and the silent incarceration and medicalization of a generation.

In fact, other than police interdiction, there is no proactive strategy, nor is there adequate infrastructure, to cope with the proliferating mental health emergency in America.

The deterioration of the situation, moreover, has accelerated with increasing numbers of public mental health practitioners leaving their practices and therapeutic roles. One psychiatrist, who asked to remain anonymous, described the mental health system as a “shambles” and in “catastrophic meltdown.”

States – the front line of mental health care provision – have shifted, in tandem with the neo-liberal wrecking ball, mental health budgets to the matching grants of Medicaid, an underfunded system which has increasingly moved toward pharmacological solutions and sub-contracted private managed care.

In the wake of devastating cuts to already inadequate funding, the poor have been left once again to fend for themselves – Ground Zero of the crisis.

As always, the overriding criterion of corporate profits, in this instance, of “Big Pharma,” trumps the public interest and its long neglected public health concerns.

The mental health crisis is a time-bomb scenario which amplifies the longstanding calls for a comprehensive public health care system, for both physical and mental health.

In response to the crisis, there have arisen nation-wide grassroots efforts seeking to broaden our perspectives on “crime and punishment” through a re-interpretation of “raw facts” within the context of the mental health paradigm and its capacity for a humane public response.

Democratic presidential candidate Bernie Sanders’ proposal of a “Medicare for All”, for example, articulates a decisive shift toward a public health paradigm for mental illness related crime.

Communities – working to resist the lure of narcotization – are seeking proactive engagements with local, regional, and national law enforcement and government. They advocate a radical shift away from the institutional and mercenary culture of interdiction and police militarization toward a therapeutic public health context in which flexible scenarios (such as drug legalization or managed provision) are enacted to manage the crisis.

Nationwide, citizens continue to empower themselves, through organizations such as NUHW (National Union of Healthcare Workers), NAMI (National Alliance on Mental Illness), and other activist networks, such as Black Lives Matter and the Prison Radio Project, to resist the culture of demonization, criminalization, and incarceration, whether it be in penal or psychiatric systems, or in lives of despondency and despair.

We can no longer remain silent about mental illness – and its roots in our “business as usual”.

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James Luchte is a philosopher, author and activist in the United States. He is also Visiting Professor of Philosophy and Aesthetics at Shanghai University of Finance and Economics. He is the author of Marx and the Sacred Revolution. His latest book is titled “Mortal Thought: Hölderlin and Philosophy” (Bloomsbury 2016).

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