Friday, March 30, 2018

Neuroqueering Judaism: Reflections on Mad Passover

They tried to kill us off. They failed. Let’s eat. (Give or take a few minor details.) Pesach, or Passover, commemorates the biblical tale of the Jewish people fleeing from Egypt, after a pattern of slavery and persecution designed to kill our culture. Within Reform Judaism especially, it is common practice to modernize the story with comparisons to current issues. You can bet there were many this year asking their community how Donald Trump or other modern leaders are similar to Pharaoh, maybe even imploring them to “let my people go” from slavery in mainstream prisons, where about half of inmates have been branded with a psychiatric diagnosis (some organizations use this statistic to prove how violent or how sick and in need of treatment we are; I call it discrimination).

As Neurodiversity Liaison of the grassroots advocacy group Southern California Against Forced Treatment, I helped in the development and execution of a Mad Passover Seder this year. To the delight and validation of our vision in creating this event, the Seder was attended by various flavors of Jewish people as well as non-Jews who identify as Mad, neurodivergent, survivors, or allies. I introduced myself as “only technically Jewish,” a product of pro-assimilation immigrants who prioritized doing things the “American” way. Some of us learned the Passover story, some learned about Mad Pride, and some learned about neurodiversity (and some all of the above).

A plate of five symbolic foods are traditionally served at Passover, such as bitter herbs symbolizing the harshness of the slavery the Jewish people endured in Egypt. Our first act of modernization was to add a sixth symbolic item to the Seder plate: a lock and key, to represent the violence and oppression of imprisonment in psychiatric institutions and the trauma of losing one’s bodily autonomy. On this night we would celebrate our freedom from both physical incarceration in psychiatric institutions and emotional incarceration in a pathology paradigm. On a last-minute whim, I also contributed one of those new fad stim cubes (AKA “fidget widget”), to represent the neurodivergent community (stimming is most closely associated with autism, anxiety, and kinetic cognitive style). In hindsight, I should have brought kinetic sand, to symbolize the desert traversed by the Jewish people in the Passover story.
Image description: Photo of a Seder plate with the five traditional foods on it, as well as a lock, key, and stim cube.

For our Haggadah, the reading material that guides the Seder activities, we added to the biblical story with a collection of essays, poems, and personal stories from Jewish Mad people, as well as a list of the 10 modern plagues: psychiatric incarceration, forced drugging, electroshock therapy, restraint, seclusion, coercive behavior therapies, outpatient commitment, the pathology paradigm, sanism, and societal coercion to recover. We asked ourselves why we eat bread or matza on other nights, but only matza on this night — a traditional Seder question with an established answer — then we asked ourselves why we are called Mad or ill or disordered on other nights, but only Mad on this night.

In developing the Mad Haggadah, I was asked to recommend writings on neurodiversity, to complement the pieces more focused on Mad identity. The first name that came to mind was Nick Walker, a neurodivergent Jewish scholar and author of several essays considered foundational to the neurodiversity movement, including “Throw Away the Master’s Tools” and “Neurodiversity: Some Basic Terms & Definitions.” While visiting his blog to print these essays, a third one caught my eye: “Neuroqueer: An Introduction.” Neuroqueering is a concept that refers to subverting or defying various societal norms, in ways that are similar to the queer community’s subversion and defiance of gender and sexuality. For example, I neuroqueer society by producing video critiques of neurodivergent movie characters, often citing that their portrayal embodies a normative external perception rather than internal experience, and is therefore bad acting. Neuroqueer can also refer to subversion or defiance that is directly related to literally being queer in terms of gender and sexuality, in addition to neurodivergent. I neuroqueer society by existing openly as a transgender Autistic person whose subjective internal experience of gender is directly informed by being Autistic.

It was upon fulfilling this consulting request that I came to understand Mad Pride and anti-pathology as being a fundamentally neuroqueer practice. Choosing to reclaim the word “Mad” for ourselves is an act of subversion with clear parallels to how the LGBTQIA, or just “gay” community at the time, reclaimed the word queer. Anti-pathology is neuroqueer because it outright rejects the underlying assumptions of the psychiatric model, unlike say the peer support/recovery movement which merely
claims to do a better job of treating mental illnesses than a professional psychiatrist does. An example of how the Mad Pride perspective can queer a major segment of the neurodiversity community is when people say “autism is not a mental illness”, countering that with “nothing is a mental illness. Mental illness doesn’t exist.”

As a launching point for what became an hour-long discussion, we looked to the neuroqueer introduction essay for its 9 examples of what neuroqueer means, which I will interpret into plain language for the sake of a smooth read:
  1. Understanding oneself as neurodivergent (or Mad) the same way Queer Theory understands being queer. We don’t need to be “born this way” but we also don’t need a doctor’s permission for our identity. We are members of minority groups with our own natural inclinations, which lead to having our own cultures.
  2. Being both neurodivergent and queer, with some awareness of how the two interact. Queer people, especially asexual and transgender people, are no strangers to the harm inherent in being medically pathologized, nor to how much more liberating it is to free one’s identity as simply a way of being. Though most of the community has now forgotten, homosexuality was once a mental disorder too.
  3. Embodying neurodivergence/Madness in ways that queer other identities. Identities such as being Jewish. I personally queered my Jewishness by reclaiming it in the face of a culture that infected my bio-family with internalized assimilationism.
  4. Intentionally altering one’s own thoughts to diverge further from the norm. Recognizing that there’s nothing wrong with being neurodivergent/Mad is one thing; seeing it as good or preferable is even more radical.
  5. Undoing conformist conditioning to express oneself authentically as a neurodivergent/Mad person. This was the understated power of adding a stim toy to our Seder plate. It spread a semi-conscious attraction throughout the room and encouraged people to re-discover the kinds of stimulation their bodies naturally want.
  6. Adopting “neuroqueer” as an identity label because of these practices.
  7. Making art that centers the internal experiences of neurodivergent/Mad people. While the closest thing to art we made on the spot was a verbal discussion, the Haggadah supplement included Mad people’s essays, memoirs, and poetry.
  8. Critically responding to media portrayals of neurodivergent/Mad people or characters. At one point we reflected that the character of Moses, if he were alive today, would probably be considered Mad, and in this cultural climate, his contributions to the world would have been suppressed by locking him away or sedating him with drugs.
  9. Advocating for these practices to be accepted in society. By meeting as an advocacy group but for a social and cultural event, we reaffirmed our sense of community, our support for one another in the many battles ahead.
To bring the conversation full circle, we then added a 10th item to the list, explicitly a discussion question: “How do we as Jewish people neuroqueer our non-Jewish society, our own Jewish communities, and ourselves?”

Jewish history is a repetitious tale of refusing to conform. We are deviants in every nation (yes, even Israel), pressured to assimilate, to give up our cultural identity and conform to the social standards of the majority. Had we given in to this pressure, Judaism and Jewish culture would have ceased to exist. We did not. We have been defiant and we live on. Though Reform Jews often marry outside their community, they continue to pass the culture on to their children. My bio-family, where assimilation was for its own sake, is in the minority. While in antisemitic language being Jewish is not considered a medical condition to heal from as individuals, it is very much considered a blight on society whose erasure would supposedly help everyone.

Psychiatric “recovery” is a code word for conformity, for assimilation. People who are either born deviant or who later develop differently within a conformist society need to be beaten, broken, and reset so they can get back in line. Perhaps the most blatant example lies in the field of Autistic Conversion Therapy, obfuscated by psychiatrists as “Applied Behavior Analysis.” This field celebrates children becoming “recovered from autism” based on the measurement that they are now “indistinguishable from peers.” In other words, compliance training has taught them to be convincing actors, cultural outsiders successfully assimilated. If not — if someone is so far-gone in their “illness” that they cannot be trained to conform for their own good — then they need to be locked up, “out of sight, out of mind” to spare their ugliness from society.

As a Mad, neurodivergent, disabled, queer Jew, I completely reject the idea that conformity and assimilation is the “solution” to the Jewish problem or to the problem of mental illness, because I reject the assumption that either is a problem to begin with. As a psychiatric survivor, saying this places me on a radical sociological frontier, but as a Jew it is not a new thought. Regardless of how pure we are in our religious observance, from Orthodox Jews who follow the Torah and Talmud unerringly all the way to Jewish atheists, we’ve maintained our identity as a culture.

For millennia, Jewish people have neuroqueered the world simply by sticking together, refusing to give up our cultural practices, continuing to exist as Jewish people. Now is the time for Mad and neurodivergent people to do the same. They tried to kill us off. They failed. Let’s eat.

Thursday, March 15, 2018

How Would We Know If We Overthrew the Mental Health System?

The radicalness of the anti-psychiatry movement has unfortunately become one of its greatest hurdles to overcome. Even in otherwise radical spaces like prison abolition, neurodiversity, or intersectional feminism, the most common reaction to anti-psychiatry ideas is to dismiss them as so intuitively ridiculous they need not be engaged with. Sanism, behaviorism, drugs and force have permeated our culture to the point many people literally can’t imagine life without them.

On a good day, our leaders pontificate about “reforms” that would somehow fix a system whose deepest foundation is a bed of violence, oppression, and at best pseudoscience. They ask for cultural awareness training, yoga classes, art therapy, and healthier food options in psychiatric facilities, without ever questioning the confinement that made those things unavailable in the first place (let alone the coercion involved when participation in such activities becomes a condition of release).

Reform is a jail cell with pretty wallpaper. We don’t need mental health reform, we need total abolition of force and coercion. The system doesn’t just have problems, it IS the problem. So if we really fixed everything that’s wrong with the mental health system, there would be no more mental health system.

We have to be careful, of course, about rebranding. We’ve seen this happen with institutions for disabled people, renaming themselves to talk about independence, while still keeping people locked in and forcing drugs on them. Changing the name to something other than “mental health” means nothing if whatever name we replace it with offers all the same abuses. If we truly eliminated all the horrid practices that are currently committed by the mental health system, what would the world look like? What would it take to go about abolishing psychiatry and the mental health system?


What follows are 15 ways our society would need to change before we could be confident that we are free from the tyranny of the mental health system.

1. No one would be deemed incompetent.

No person would ever be declared unqualified to make decisions about their own life. Not because of a mental illness, disorder, diagnosis, health condition, disability, nor any other title. There would simply be no system in place to allow such a thing. The idea of meeting legal requirements to be conserved, confined, or made a ward of the state would become as anachronistic as the idea of meeting legal requirements to be enslaved. Everyone would be the ultimate authority on their own bodies.

Mentally ill” is a legal term which translates into plain language as “unable to make decisions.” Not biologically, but legally. Unable to decide where to live, whether to live, who to live with, what food to eat, and what drugs to take or not take. Efforts to attack the term “mentally ill” as an offensive slur haven’t done anything to combat this legal designation. All that’s changed is that people with “mental health challenges” or “psychiatric diagnoses” are deemed unable to make decisions.

The fact that such a designation exists within the law — in letter, spirit, and execution — makes the mental health system, and by extension our whole society, intrinsically unjust and oppressive, because someone will always be designated by it. Truly overthrowing the mental health system, as opposed to just forcing it to get more subtle or rebrand, would mean that any remaining systems fully support cognitive liberty: the principle that everyone can do whatever the hell they want, with restrictions only ever placed on actions that harm other people.

2. All psychiatry programs in all schools would be replaced with Mad studies and neurodivergent studies programs.

As part of a total abolition of the mental health system, it would be necessary to put a complete halt on any influx of new mental health practitioners. For students in the middle of their training, it would be unfair to pigeonhole them into finishing, with a degree in a field that no longer exists. Instead, those students would be given transfer credits and an opportunity to change programs with full scholarship.

Mad studies and neurodivergent studies would open up as new programs that these students would have the option to transfer into. These areas of study already exist in a small number of universities, but by freeing up funding from psychiatry programs, they would have the opportunity to expand.

The meaning of the prefix “psychiatric” is undefined in all fields, so the only difference between a medical drug and a psychiatric drug is that one is called a psychiatric drug. The study of these drugs would be taken up by medical doctors, who are already required to learn about drugs.

3. Mad and neurodivergent people would be managers, not “peer specialists.”

The creation of various “peer” positions has accomplished very little besides handing out a few minimum wage jobs to disabled people. A requirement of “lived experience” rather than a degree makes a vaguely defined identity group into the primary qualification.

The essential function of a “peer specialist” is to appear non-threatening, earn people’s trust, and convince them to stay on their meds. Hiring managers know that these positions only exist because others don’t, that there are far more job-seekers than jobs to fill, and thus that anyone they hire is easily replaceable. “Peer specialists” are grunt laborers with no real power to meaningfully affect the establishment that brought them in. If a radical abolitionist gets the job and conscientiously objects to their assigned duties, they just get fired like in any other job.

If a patient is prisoner to the medical facility, while their counselor has never been imprisoned and is free to leave at the end of their shift, then the counselor does not have the same lived experience and is not a peer to their client. They are just another generic white coat whose income stream depends on keeping others locked up and coercively medicated.

If the “peer specialist” has more power than the patient, then they’re not a peer, and if they have the same or less power, then they’re not needed.

Advisory committees made up of “peer advocates” are not effective either. They are a token position with no actual power. They can tell the managers what to do, but the managers have no obligation to follow their advice. In many cases all that’s accomplished is to create the appearance of listening, placating any protesters while creating no real policy change.

What reformists say would be fixed by additional “peer specialists” would actually be fixed by having Mad and neurodivergent people in management positions, with actual decision-making power. This situation could be achieved legislatively, through diversity quotas, or culturally, through the understanding that Mad and neurodivergent people not only have instant added value in their wide range of lived experiences, but also can be just as skilled or more than any neurotypical.

The hierarchal structure of business means that putting good people at the top would eventually improve the immediate service at the bottom, because we understand our own needs better than someone who just needed a job.

4. Crisis hotlines would be prohibited from tracking callers or dialing law enforcement without the caller’s consent.

In today’s cultural landscape, crisis hotlines are being pushed as a way to access the mental health system quickly and without insurance. Currently, all hotlines train their staff as mandated reporters, to listen for key phrases and if the caller utters one of them, secretly send people with guns and a history of recklessly using them, directly to the caller’s location. The sole exception is Trans Lifeline, which is of course exclusively for trans people, only a fraction of everyone who might want to call a crisis hotline.

Rather than fixing these serious safety hazards, reforms to crisis hotlines include expanding hours of operation, adding text options, and starting new hotlines for identity groups like teens or LGBT. All that gets accomplished here is increasing the number of people who get tricked into putting themselves in danger, while thinking they’re getting an emotional support or referral service.

Crisis hotlines are undoubtedly part of the mental health system as long as they behave this way. So in order to overthrow the system, the hotlines would need to be more regulated. Specifically, the regulations would give hotline callers the same confidentiality rights they have with a doctor or therapist, which under this new paradigm would of course include the right not to be locked up for hearing voices or being a danger to yourself.

5. Compliance with Olmstead “community living” would mean Housing First with no strings attached.

The supreme court decision of Olmstead vs L.C. declares the right of disabled people, including those disabled by psychiatry, to live “in the community” instead of in institutions.

Unfortunately, the implementation has been a lot more fuzzy than the decision itself. Prisoners of institutions wishing to leave must first establish a place to go ahead of time, which means they must have either the money to leave on their own or a solid support network. Obviously people who have been disabled and stigmatized are not always going to have those things.

A few public supports exist, such as transitional housing for homeless people, but these all come with a heaping spoon of coercion. They may require residents to regularly see a psychiatrist, comply with drug prescriptions, eliminate their use of non-prescribed drugs, get chummy with their neighbors or attend a minimum number of religious cult meetings each week.

Some cities have implemented Housing First programs, meaning that homeless people are taken off the street and given free permanent homes, in some cases with no strings attached. These programs have been a huge success, even by dogmatic standards like increases in employment and decreased use of non-prescription illegal drugs (because they’re not so stressed by being homeless).

If you truly want to free people from institutions and homelessness, just give them homes.

6. Service providers would be trained to consider doing nothing as a valid option.

An emotional crisis or spiritual emergency doesn’t always require an intervention of any kind. Sometimes the interventions we’re told are “best practice” only make the situation worse. Sometimes the person experiencing the situation already knows their best coping strategies, and will do a much better job at implementing them than someone they have to be explained to. Sometimes their friends are already familiar with the best ways to support them. An emergency psychiatrist necessarily isn’t, and neither is a so-called peer counselor.

In a post-psychiatry world, both would be regularly, sternly reminded of their humility. Moreover, they would be taught when not to intervene, and they would not need to have basic respect packaged as just another proprietary methodology, with a sexy name like “Open Dialogue,” “Intentional Peer Support,” “Emotional CPR,” or even “Alternatives to Suicide.”

Suicide attempts aren’t always a “heat of the moment” thing. We all die. Some of us would like to decide how, and some of us would also like to decide when. Sometimes a deeply introspective, thoroughly logical contemplation reveals that suicide is the mode of death most consistent with one’s beliefs and values. An immense degree of arrogance is needed to say that this person should be required to live against their will, in a facility where all their freedoms are taken away, which could only make a reasonable person more certain that they would rather die. An even greater arrogance is needed to say that stripping a person of everything they have, emotionally and literally, would improve their health.

Whether you place the highest importance on health or liberty, using force and coercion makes no sense because doing so improves neither. It makes much more sense to think of counseling a suicidal person as end-of-life care: the professional listens, acknowledges feelings, reflects on them, and doesn’t send someone with a gun to make sure their client dies faster or goes to prison. It’s not assisted suicide; it’s just respecting another person’s beliefs and values, even if you disagree with them. You may even find that when people have the freedom to talk about their feelings without having violence committed against them, they might be more inclined to keep on living.

Knowing when not to intervene is just as important as knowing a good methodology. In many situations doing nothing is the best strategy available. To overthrow the mental health system, we must train professionals, as well as the general public, to regularly and seriously consider the option of letting people make their own decisions without trying to threaten them out of it.

7. Short-term and long-term housing would be unlocked 24/7.

Peer respites, emotional wellness centers, urban safety retreats — whatever we wind up calling the former “mental health” facilities — they are all unlocked both ways, allowing the people who stay there to come and go as they please. Common areas like kitchens and TV rooms would remain open and powered as well. Strongly worded legislation would be passed to shut down any facility that resembles an institution, such as ones that don’t pass the burrito test.

Confinement is always violence. Involuntary homelessness is always violence. Lock-ins, lock-outs and curfews cannot ever be therapeutic because they violate a person’s safety and autonomy.

Furthermore, consent is not possible any time the consenting party needs someone else’s permission to leave. Even when people technically have the legal right to refuse drugs, or not choose the “healthy” food, or abscond from group therapy, they can be coerced into doing those things because it influences someone’s opinion of how long they need to be held. Therefore, the overthrow of the mental health system is incompatible with the continued operation of locked facilities.

8. Every care unit would be funded in a way that decreases the length of stay and gives visitors the drugs they want.

It’s bad enough that anyone with a badge, a degree, or a child can create a 72-hour imprisonment with no crime, no victim, no due process, not even a charge. 72 hours can cost you your job, your home, or even your life. Yet for many, those 72 hours are only the beginning.

Most psychiatric facilities try to keep people for even more absurd lengths such as weeks or months. One reason they want people to stay longer is because medical insurance companies are willing to pay for psychiatric services. The longer the stay, the more money the facility gets. Ironically, what is otherwise considered “good insurance” paints a target on the heads of false commitment victims, whereas “bad insurance” may end up saving a person’s life.

In these environments, it’s very easy to get a forced injection of tranquilizers by acting non-compliant, yet it’s challenging to impossible to get the drugs you actually want and need, or even to continue them based on existing prescriptions.

Although we should have already banned outright cages at this point, it’s difficult to completely eliminate all coercion. Doctors and psychiatrists can be persuasive pressurers who espouse the importance of their snake oil, or they can refuse to administer legitimate life-saving services until after an arbitrary screening period.

To fix all of these problems, the end of the mental health system would have to include a revision of how care facilities are funded. Rather than getting a flat rate for each day a visitor stays, they would get a variable rate that diminishes according to the amount of time the person stays in the facility, instead of moving back into community living with proper supports.

This way, care facilities have a financial incentive to give visitors the services they asked for quickly, including drugs if desired, so that those people are satisfied enough to leave earlier.

9. All drugs would be legalized, including prescription drugs.

As said by Thomas Szasz, considered by many to be the father of anti-psychiatry, prescription drugs are illegal. You cannot waltz into a drug store and buy a prescription drug without a prescription. Prescribing to yourself is a crime. Prescribing to your friends or family is a crime. It is a crime to give someone else a drug that was prescribed to you, and it is a crime for you to take a drug that was prescribed to someone else. No other form of property is treated this way, except for illegal drugs.

Criminalization and prescription are two sides of the same coercive coin. Together, they mean that people who need or want a drug either can’t get it at all, or can only get it if they are wealthy enough, normative enough, and socially savvy enough to convince an arbitrary authority to grant permission. Restricting your choices is not on the same level as forcing a substance into your body, but it is one of the many ways the mental health system oppresses us.

Without the mental health system, there would be no such thing as a psychiatric prescription because all drugs would be legal. Supporters of the status quo often ask “how would you get the medication you need without a doctor prescribing it?” The answer is right there in the question: without a doctor prescribing it. In other words, the same way you get any other product: you go to a store and buy it.

To overthrow the mental health system, we must abolish the prescription system, and replace it with a system of informed consent. Psychiatrists would no longer be the gatekeepers who decide whether you will be allowed to take the drugs you actually want. Instead, the role of a psychiatrist would be to give recommendations and safety warnings. The paper you leave with would simply be a reminder note of what name and dosage to grab off the shelf.

Also, it would be nice if we released, pardoned, and compensated everyone who is currently in jail (including the jails that are called hospitals) on a non-violent drug charge.

10. Adverse drug effects would be independently studied, listed on the box, and discussed without taboo.

Informed consent is the only true consent. The reason is simple: if a person was not made aware of the risks and downsides, then that person did not consent to them. Abolishing prescriptions would be a major victory, but that alone would not guarantee a system of informed consent. Although banning untested drugs altogether is yet another act of paternalism, to protect you from yourself, it is nevertheless the obligation of a responsible society to protect individuals from predatory companies.

There are two parts to this change: Studying and labeling.

Trials for new drugs would be conducted by independent parties. “Independent” must mean sufficiently divorced from the manufacturer such that the people collecting data do not know the name of the drug or the company that made it. Double-blind, placebo-controlled is a good foundation for a standard, but we must also add the full human spectrum to the subject pool, including people of diverse ages, people of size, disabled people, and people who have a uterus (currently biomedical research often excludes anyone with a uterus because it would be inconvenient if they got pregnant).

As a precaution against residual paternalism from the mental health system, the results of these studies would have to be made freely accessible and open source. Once a drug goes mass market, the people who take it would be able to submit anonymous complaints (petition for redress of grievances) to an open-source government site, and a certain number of people submitting the same complaint would automatically prompt a re-investigation.

Once the drug effects are known to the elite few who understand, care about, and have time to comb through data, that knowledge must be disseminated. The most effective method is to require warning labels directly on the product. PSAs on TV, in newspapers or online all have a selection bias, word of mouth clearly hasn’t overpowered marketing money yet, and warnings in doctor’s offices would be a moot point after abolishing the prescription system. A mandatory warning on the package in the store ensures that everyone who receives the product receives the warning. Voila, informed consent.

The warning label method does have one weakness though: Many people don’t bother reading them, not because they don’t care, but because it’s so unheard of that these drugs might not be perfect. For this reason and many others, the overthrow of the mental health system would have to be not only a series of legislative victories, but a cultural shift too. Feeling like there must be something wrong with the individual, rather than the drug, is one of the insidious ways the mental health system prevents survivors from coming out, which prevents conversations about adverse effects from being normalized. More psychiatric survivors must open up about their experiences, and it must be safe for us to do so.

11. Every program that recommends drugs would also offer support for quitting drugs.

Even after the prescription system is replaced by a system of informed consent, psychiatric drug withdrawal is very real. Those who were informed and consented to the drugs may still decide to stop taking them later. Any withdrawal is a difficult process and requires support.

The lack of support for people who want to stop taking their drugs makes it difficult to have free choice over the use of mind-altering substances. Expecting people to suffer alone while they taper off the drugs or go cold turkey is essentially pressuring them to stay on the drugs. It’s a form of coercion, and thus part of the mental health system.

In a world free from the mental health system, everyone who is trained to recommend drugs would also be trained in how to help people taper off, and drug dealer facilities would also have a withdrawal unit, both for safe tapering and for maintaining a relative amount of safety while quitting all at once.

12. All psychiatric diagnoses would be recognized as bunk and removed from medical records.

Despite all the “biological brain disease” rhetoric justifying the pseudoscience of psychiatry, no so-called “diagnosis” in DSM 5 has ever been demonstrated by a biological test. In the few cases where we have discovered a biological cause, such as trisomy 21 for Down syndrome, that classification has ceased to be the domain of psychiatry.

Because these “diagnoses” are little more than pseudoscience, made up by psychiatrists to oppress people and gain money, the end of the mental health system would mean the end of the DSM. Every DSM classification would cease to be a disorder in public or professional consciousness, and they would become obsolete from medical records, because they are not medical information.

What about legitimate identities that happen to be falsely pathologized? How would they get services?

Firstly, there is no logical dependency between a group existing and that same group being classified as a mental disorder. You can have one without the other. Legitimate categories such as multiplicity, hearing voices, or Autistic would be recognized as cultural identities, similar to the way we now recognize gay as an identity, now that psychiatry finally let go of homosexual disorder to free its hands to grab transgender and asexual.

A pseudoscientific medical diagnosis is not necessary in order to get services such as communication devices, gender affirming surgery, and the anti-convulsants some people take to hear voices. The requirement of DSM classifications makes it harder to get those services, not easier. Under a system of informed consent, rather than the gatekeeping prescription model, cultural minorities would more often get the services they want and need.

13. Consent laws and consent culture would obsolete compliance.

Enough about information. What about the consent part? Atop the slain corpse of the mental health system, all procedures would require consent from the recipient. Consent must be freely given and can be revoked at any time for any reason. Patients checking into a medical facility would be able to leave whenever they want, not weeks later when the doctor finally signs the discharge papers because insurance ran out.

There could certainly still be conduct agreements, for example “no yelling in the meditation room,” but anyone who can’t or doesn’t want to abide by the rules can opt out of the entire situation.

Mental health is one of a handful of industries, along with education and government, where the person paying for the service, in effect the employer, is expected to complete arbitrary rigors and assessments, or else face inescapable consequences decided by their employee. Without the mental health framework, expecting compliance with doctor’s orders would no longer make sense, because the doctor-patient relationship can be terminated at any time. Instead, the professional would be expected to comply with the wishes of the person requesting their service, or else be fired and replaced.

14. Social Security would be replaced with Universal Basic Income.

Wait, what does welfare have to do with mental health? Well, the legal definition of a disability is still pretty stuck in the medical model — the idea that people are disabled by medical conditions, rather than by access barriers like stairs and strobe lights. Therefore, one must get a “diagnosis” from a doctor to qualify for any disability-based government program.

Aside from the inherent dangers in handing over your recorded history of madness to multiple corporations and the government, the current bureaucracy creates a problem within the mental health system itself: imbalance of power. Those who are unable to work due to systemic hiring discrimination rely on welfare programs, which require you to convince a doctor to say you’re unable to work. If you’re magical and manage to convince them that you’re a victim of discrimination, that doesn’t count.

If your survival within a capitalist system depends on you qualifying as legally disabled, and a doctor wields the power to decide whether you’re legally disabled, then the relationship you have with that doctor is inherently coercive. The doctor can let you die if they feel that your madness is too weird, or that you smell bad, or you didn’t say “please” enough.

Keeping doctors the gatekeepers of disability benefits is no better than keeping them the gatekeepers of drugs. You can’t revoke your consent to the doctor-patient relationship because the doctor holds something you need and can’t get without them. That is the definition of coercion. In order for patients to have the power to revoke the relationship with their doctor, they must not require a doctor’s permission to get the services they need, including income. In order to revoke the power of coercion from doctors, we would have to revoke the power of their signature in disability benefits.

15. Any use of force in a psychiatric context would be illegal.

In case it wasn’t clear, freeing ourselves from psychiatric tyranny requires the complete and total abolition of all interventions that lack the consent of the person whose life is being intervened in. Not reduction, not higher standards of proof, not “last resort” policies, total abolition.

Anything less than total abolition is playing within the system, using the master’s tools to ask for minor cosmetic changes and lip service. If nine hundred people were force-drugged this year instead of last year’s thousand, we still have a problem.

The master’s tools will never dismantle the master’s house. Create a list of criteria so the cops can’t just lock up anyone for any reason, and they’ll use those criteria to shop around for people who meet them. Make force a “last resort” and the first resort will be to halfheartedly skim through a checklist. Add a “peer specialist” to the team and they’ll hire someone who’s up to their eyeballs in the medical model and a paradigm of health first, liberty never.

We are not free from the mental health system as long as one person is under threat of legalized force. All the other changes on this list are ways to keep laws enforced or to reduce manipulation and coercion. But first and foremost, we need far-reaching legislation, with broad definitions, that makes every use of psychiatric force automatically a crime.

Sunday, November 19, 2017

Baby’s First Madness: A Newcomer Perspective on the Hearing Voices Congress and Alternatives

This past year was home to many firsts for me, including my first arrest, my first forced injection, and my first time attending the Hearing Voices Congress and Alternatives. For at least three years I’ve been doing similar work in the neurodiversity movement, which is all about framing mental differences as ordinary variations of human experience, without adding a value judgment. Someone who hears voices is no better or worse than someone who doesn’t. This paradigm is theoretically incompatible with the diagnosis and treatment of mental disorders, also known as psychiatry; yet when I talk about being “anti-psychiatry" in those spaces, the responses range from confusion to outrage. Needing a space to talk about my lived experience, I began to call myself a psychiatric survivor (and not long after that a Mad person) much more often than neurodivergent. There are too many different names, but if there’s one thing that unites this community (which there may not be at all, but bear with me), it’s that we don’t want anyone locked down, literally or chemically, for the crime of acting strange. Understanding this as the community I’m talking about, how has the introduction been? A warm welcome for an eager activist, or a colossal barrier to entry that will bleed the movement into obscurity?

Hearing Voices kicked off with keynote speeches by Gogo Ekhaya, Akiko Hart, and Marty Hadge. While the Day 2 speakers were also notable (I especially liked David Walker’s research on the “asylum for insane Indians”), these first three exemplified the themes of both their own conference and Alternatives. Gogo spoke on spirituality, Akiko on systems change, Marty on community and identity.

The Spirituality Scam: Feeling Good at the Expense of Thinking Critically


Throughout the Hearing Voices Congress, spirituality was discussed from a critical perspective on European imperialism. That is, the notion that experiences are not “real” until they are demonstrated within a uniquely European idea of what is scientific. One example that came up repeatedly was aggressive enforcement of the gender binary, scrubbing out awareness of the Indian Hijra, the six Jewish genders named in the Torah, and the various two-spirit identities of North America.

In some Hearing Voices workshops, and then more frequently in Alternatives, presenters thanked God for their healing, with no apparent awareness that not all religions, let alone all spiritual practices, use the word God as a name or even have a god at all. The definition of “spiritual” shifted to “Christians who only go to church on Christmas and Easter.” At this point, I was thankful to have a Humanist/Rationalist caucus to go to. Not out of disgust or annoyance, but just to take a break. There are plenty of religious and spiritual ideas I don’t miss, and would rather see criticized as potentially exceptions in the imperative to accept all perspectives. The concept of demonic possession, for instance, has been tremendously harmful to those we now call voice hearers, Autistic people, and multiple systems. On the other hand, we haven’t really socially evolved away from it. Most people don’t use the words demon or possess any more, but we talk about an external “mental illness” exerting control upon the “real” person locked inside it. No scientific study in any country has ever hypothesized (much less proven) that “mental illness” is separate from the person, has possessive power, or even exists at all, yet most of us accept the idea as true because the “science” classes we grew up with only taught us how to memorize distilled fact lists, not to think critically.

Back onto the first hand, the humanist/rationalist/atheist/“skeptic”/“free-thinker” community also does a great disservice to Mad people when reactionaries see religious rejection of science, and so embrace psychiatry because its proponents are good at dressing their propaganda in sciencey language. I feel compelled to tow the line here, as an explicit atheist who also finds great value in mindfulness practices such as meditation, acting, and psychedelics— though I hesitate to call them spiritual. I think science is cool and awesome (though we definitely need to be more critical and not just worship it as another religion) but I don’t need to wait for scientists to admit that my internal experiences are real and meaningful and not a disorder.

The Peer Support Scam: Growing In Number at the Expense of Our Values


In the United Kingdom, some people in the business of locking up humans, including both psychiatric facilities and mainstream prisons, are actively reaching out to the Hearing Voices Network to create internal support groups for people who aren’t allowed to leave. The fact of such mainstream awareness, not of the “signs of schizophrenia” but of the support network, is something to celebrate. While reform can often be a threat to the goal of total abolition, we still have to seriously consider each opportunity to make living conditions less horrible. In the same speech in which Akiko shared this, she also expressed a concern, a certain uneasiness, about the fact that a Hearing Voices support group apparently doesn’t cause immense discomfort to the criminal and psychiatric systems. Our ethos should be a force that fundamentally undermines the power of such a system. Is it getting lost in translation, or intentionally distorted?

I wrote “Acceptance Must Not Become a Buzzword” as a call to action for Autism Acceptance Month, warning that community’s activists that convincing the public to use the word acceptance instead of the word awareness won’t mean anything if the change in language doesn’t cause a change in paradigm. A more broadly applicable example is when we convinced a critical mass that “mental illness” is a stigmatizing term, and mainstream organizations were ready to swoop in and say you’re right, we totally agree, we should be fighting stigma by saying “mental health challenge” instead. Let’s all make sure people with “mental health challenges” are locked up and drugged against their will because they’re far too “challenged” to make their own decisions.

The Alternatives conference featured a mess of conflicting ideologies. Once upon a time, the conference represented alternatives to drugs and lock-ups. For some people that’s 12-step groups. Others find 12-step to be the oppressive part of the system and need an alternative to that. Others still find the concept of a support group to be fundamentally flawed. Thus the calling shrunk to simply “Alternatives” so everyone can apply their own meaning.

While the Healing Voices Congress made space for a variety of personal experiences, Alternatives went a step further and made space for a variety of political stances, including the ones that say those personal experiences are bad and wrong and should be punished. The fact that some participants felt entirely comfortable walking about in NAMI attire illustrates what happens when someone decides that survivors, people who have been abused and tortured by the psychiatric system, need to ally with people who love the psychiatric system and think it’s great and we need more of it.

It’s the worst of both worlds: By allowing all identities, including ideological ones, we wind up NOT accepting certain identities because hostile ideologies push them out. Insisting that every Mad or neurodivergent person intrinsically has something to “recover from” is a form of hatred that pushes away Mad and neurodivergent people. Defining “danger to self” as a jailable offense; restricting when and how people can eat or use the bathroom; making the assumption that everyone is a “consumer” and happy about it— all forms of hatred. If we want government services to be as good as our peer groups, we aren’t going to get there by compromising. We must reject the hatred.

The Identity Scam: Collecting Bodies at the Expense of Diversity


In the middle of Alternatives, the city of Boston made national news thanks to a hate speech rally, attended by about forty Nazis and forty thousand protesters. Many conference-goers including myself ducked out of the event they paid for to join the protest. With forty thousand different perspectives represented, there were sure to be many who believed that victims of psychiatric diagnosis should have fewer rights as a result. Signs labeled Donald Trump “mentally ill”, screaming mouths called the Nazis “virgins”, and pussy hats reminded us that the women’s movement was only upset that a cis woman lost. Yet a dozen transgender psychiatric survivors grouped up and joined the protest anyway, because on this one issue, that we want Nazis to feel unwelcome, we all agreed.

However, this backlash against modern Nazis comes only from a narrow, liberal definition of intolerance. They’re bad because they’re racist and racism is bad. The original German Nazis didn’t just hate Jews, they loved eugenics— an idea they got from American psychiatrists. What nearly all historical and modern atrocities have in common, including those committed in the name of “mental health”, is an ideological imperative to reduce the amount of diversity in the world.

The theme of Marty’s speech was that we need to validate (and maybe even celebrate) diverse experiences. “It’s really important to not just switch from saying that these things are a medical illness, to saying it’s all about trauma.” When you take a one-size-fits-all approach, you are always inevitably telling some people that you know them better than they know themselves. Diverse doesn’t just mean there are racial minorities here; there is also diversity of creed, gender, sexuality, disability, age, size, language, culture, personality and worldview. All of these matter, and all have value. Many in the Mad community are resistant to the neurodiversity model because of negative associations between the neuro prefix and the “chemical imbalance” brand of psychiatry. The rest of the world, however, has no problem with that but hisses furiously at the “diversity” part.

Is the diversity of the human species one of the most wonderful and beautiful things about us, or is it nice, but not really necessary? Based on the attitudes at these two conferences, I came to understand the majority answer as “it’s a useful tool if it supports MY group, but I’ll throw anyone under the bus at a moment’s notice.” The liberal checklist approach works very much like the checklist methods of psychiatry, just listing positives instead of negatives. Gay rights are so 2016, so now we’re going to check the “trans” box and make those the new hip, cool people. Of course, if we skip a checkbox on the “types of people we like” list, that means we don’t like those people. If a certain kind of people doesn’t even have a box to skip, we really don’t like them. Therein lies the problem with neurodiversity: Pushing all of those horrible scary “mental illnesses” onto society’s diversity checklist.

White supremacy wasn’t the only anti-diversity force in Boston that week. Controversy also erupted within Alternatives, in response to a very vocally transphobic person getting a platform to speak in the workshop schedule. While an informal trans contingent quickly came together, got a Trans Justice Panel added to the workshop list, went to Boston Common as a group, and made plans roughly two steps less civilly disobedient than obstructing access to a workshop room, I felt conflicted.

The actual topic of the workshop was not gender, but instead efforts to abolish forced treatment of disabled people. Abolitionists and disability rights activists are both underrepresented at Alternatives and in the community at large. No attention was paid to the zombie-like mass of consumers, chanting “recovery” with no awareness of societal oppression; because there’s no checked box for Mad and neurodivergent people who don’t want to recover.

And yet, just as I went along with the anti-racism protest, with thousands of people who probably wouldn’t hesitate to grab a cop and report me for suicidality or voice hearing, I went along with the anti-transphobia squad, with a dozen people who probably wouldn’t show the same solidarity for disabled people, to a presentation about disability.

By the time we got there, to the workshop that started the whole debacle, it didn’t matter to me what the presenter was actually going to say. Between the trans and non-conforming keynotes at the Hearing Voices Congress, a roundtable where I learned about trans multiples, a group of anti-Nazi protesters, and a Trans Justice Panel, I was in a community and would go wherever they went.

More importantly, the connections with these people weren’t limited to the workshop time. They were also the people I tracked down in the hallways and sat with at lunch. The most valuable and transformative parts of both conferences were not the speeches, presentations, or workshops, but the time spent with people in the breaks in-between.

Two weeks after Alternatives, I flew across the country again to attend Trans Health in Philadelphia, where I got to join a group of more Autistic people than I had met at any autism conference, and bear witness to one of the biggest gatherings of multiples in history: about 150 people in 30 bodies. That is what good conferences are about: Building intersectional communities.

The real problem with presenters who are bigoted against a specific kind of people isn’t that they’re problematic. It’s when they aggressively exclude those people from their network, creating a ripple of drama where other community builders have to choose between bigots and the targets of their bigotry. As said by the Redwoods, the system who organized that Philadelphia gathering, “when you carve out a niche, the knife always cuts through someone.” I may learn a lot of useful information by hearing a problematic presenter speak, but at the end of it I won’t have made a new friend.

Humanity is diverse because every single person has a completely unique experience and worldview. I’m not here, in this community, as an activist, because I think we should take pity on minorities until someone figures out how to do eugenics right. I’m here because I genuinely want to live in a diverse world. I love diversity, sincerely, irrevocably. What kind of world do you want to live in?

Sunday, November 12, 2017

Models of Pride 2017: Psychiatrization Of Queer Minds

One of the two workshops I led at the 25th Models of Pride in Los Angeles, California.

Captioned with manual transcription but automated timing. Parts of the video are blurred because not all attendees signed consent to photography.

Summary in the MOP program:
Did you know that homosexuality was once a mental illness? That the American Psychiatric Association STILL describes being asexual or transgender the same way? Come to this workshop to learn about the historical role of psychiatry in defining queer identities, and how to be an ally to those who are still getting pathologized.



The video from my second workshop, "Conversion Therapy: History and Reality" were unfortunately lost prior to backup due my phone being stolen. However, you can view the slides for the presentation at TinyURL.com/mop2017slides

Models of Pride is a queer youth conference held every year at the University of Southern California (USC). Visit ModelsOfPride.org to learn more.

Sunday, October 15, 2017

Everything Wrong With The Good Doctor (Autism Sins)

5 years after House, the head writer seems to have regressed. Now the autism is explicit, and made of DSM criteria instead of actual personality. Lots of ethics laws are broken, but with no acknowledgement that law-breaking is what's happening. All this and more in just the pilot episode!



Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins.

To see more of my videos, visit my YouTube channel.

For the original Sinners, visit youtube.com/user/CinemaSins or cinemasins.com

Wednesday, September 27, 2017

NO 911, Suicide Awareness, and 13 Reasons Why

What does "suicide prevention" mean when the causes of suicide are oppression, trauma, and a world not worth living in?

Speech by yours truly at the Garden Church's "Suicide Prevention & Healing Ceremony" in San Pedro, California.



Please excuse and disregard the "danger to self or others" line. This was totally unscripted, I took a chance with a half-formed thought, and it turned out to be less than half-formed.

This video features closed captions in English. Other than that, there was no editing.

Tuesday, September 26, 2017

Everything Wrong With Atypical, Episode Three (Autism Sins)

This episode features a competition between two parents and a therapist, to see who can be the biggest abusive asshole. No need for a spoiler warning, because obviously the mom wins.



Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins.

To see more of my videos, visit my YouTube channel.

For the original Sinners, visit youtube.com/user/CinemaSins or cinemasins.com

Thursday, September 7, 2017

Everything Wrong With Atypical, Episode Two (Autism Sins)

The sinner is back for more of the train-wreck that is Atypical! Since the first 30-minute episode already taught us everything there is to know about autism, we can now move on to the important stuff: Parents whining over how hard it is to raise us.



Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins.

To see more of my videos, visit my YouTube channel.

For the original Sinners, visit youtube.com/user/CinemaSins or cinemasins.com

Thursday, August 31, 2017

Everything Wrong With Atypical, Episode One (Autism Sins)

The new Netflix series "Atypical" kicks off with a script so cringey, it practically sins itself. Today's drinking game is a shot every time a character is likeable; I promise you'll stay completely sober.



Autism Sins is a snarky, sometimes satirical series, where I review media portrayals of autism in a rip off- er, I mean, an homage to the format of CinemaSins.

To see more of my videos, visit my YouTube channel.

For the original Sinners, visit youtube.com/user/CinemaSins or cinemasins.com

Monday, May 1, 2017

13 Reasons "Mental Health" Advocates Need to Watch 13 Reasons Why

Controversy erupted quickly around the release of 13 Reasons Why, a Netflix series based on the 2007 novel of the same name. This comes as no surprise, considering the story revolves around suicide. Not only that, the show (and the novel, but those don't get nearly as much attention in pop culture) disrupts the standard expected narrative in which suicide is typically portrayed.

The premise of the story is that a high school student, Hannah Baker, killed herself, but first left a series of audio tapes for and about all the people who contributed to her suicidality. The idea of a dead person leaving messages behind isn't new, but what does stand out is that a person who attempted suicide, and succeeded, still gets to tell her story. This premise allowed the script to offer a perspective that isn't found in other suicide narratives, and is much closer to reality.

The objections to the show seem to mostly fall into two categories: 1) People who have actually had suicidal thoughts or even attempted suicide, who understandably refuse to watch the show for fear of being triggered or re-traumatized. 2) People who advocate for "mental health awareness" and are very offended that suicidality is portrayed as a natural life experience and not a chemical imbalance. Where these two groups overlap, the label for that section of the Venn diagram is "internalized ableism". Here's an example (WARNING: auto-playing music) which seems to be the most popular "don't watch it!" post floating around multiple social media sites, and the inspiration for this rebuttal.

Evidence on comforting the afflicted is inconclusive, but 13 Reasons Why definitely brings affliction to the comfortable. "Mental health" advocates need to see this show. No, it's not for "everyone" - it's highly triggering (for example the act of suicide is shown on screen, as well as multiple sexual assaults) and more than a little problematic. As said most elegantly by my colleague Leila Yoder, there are definitely aspects of the script to be critical of, but "it's not pathology paradigm enough" isn't one of them.

13 Reasons Why is an important cultural commentary that more people should see. Here are 13 reasons why:


1. Bad consultants were mostly ignored.

The creators of the show consulted with the American Foundation for Suicide Prevention, an organization which advocates in favor of force and coercion, including locking people up in psychiatric prisons and pacifying them with medication. Can you guess how the Foundation justifies this? All human rights violations are a necessary means to the exalted end of recovering people from their mental illnesses. What a unique and original thought. While it's impossible to know whether the final script was molded by ethics, marketing, or storytelling, it's clear to me is that the screenwriter had a chat with a very bad organization, then went directly against most of their bad advice.

2. The dead girl tells us what didn't work.

In real life, we can't ask someone what went wrong after a successful suicide attempt. Therefore we don't know how realistic Hannah's perspective is. Nevertheless, it disrupts the standard narrative: Suicide attempt survivors, both real and fictional, get paraded as tokens by "mental health" advocates to talk about how great the "treatment", usually being locked up and medicated, worked for them. This narrative is not scientifically justified. In fact, it's propaganda.

The most well-known example of this problem was recognized during World War 2, when the U.S. Navy studied returning planes and reinforced the most damaged parts in the next design. The mistake was that those were the parts which could get heavily damaged and still return. The parts that never return damaged are the ones that bring the plane crashing down, never to be studied. In psychology, this cognitive error is literally called survivor bias.

In a society where every suicidal person is forced, coerced, or at least pressured into some kind of "treatment" program, you either never get identified as suicidal and never get hit with a psychiatric intervention, or you get identified and you get an intervention. There is no identified-but-not-intervened control group to verify that the "treatment" should actually get the credit. We do on the other hand have research suggesting that locked facilities make people more suicidal, not less.


3. Hannah was killed by other people.


Another part of the standard narrative is that suicidality, without a verbal acknowledgement, is undetectable. Therefore it's no one's fault when someone dies. 13 Reasons Why straight-up says no to this narrative, instead placing the blame firmly on those who hurt Hannah and those who failed to reach out. The show demonstrates the simple causal link between suicide and traumatic events such as bullying and sexual assault. The other main character, Clay, wasn't a direct assailant but has to come to terms with his complicity.

4. Hannah is neurotypical.

 

You can't deflect the blame to a "mental illness" or "chemical imbalance" either. Not for the character any more than for real people, unless being gay also causes a "chemical imbalance" the same way excessive melanin in the skin exerts a gravitational force on police bullets.

Hannah is portrayed as a normal, mentally healthy person (at least until she racks up a few traumas), not as a list of diagnostic criteria or LOL RANDOM CRAZY. It was her experiences that caused her to become suicidal, not spontaneously manifested brain chemicals.

This is a breath of fresh air for people who have been falsely labeled as mentally ill... which is everyone who's been labeled as mentally ill...

5. Hannah is able-bodied.

 

Though I'm rarely thankful for this, disability is not represented at all. Hannah does not have one. She does not kill herself because it's so tragic and burdensome to exist in the world as a disabled person. Another break from one of cinema's most offensive and harmful clich├ęs.

6. It's not just a choice.

I usually go out for vanilla ice cream on the weekends, but this time I think I'll try rocky road to see if I like it. And I usually enjoy being alive but I think I'll try killing myself today. That's what has to be going through the heads of people who say suicide is just "a choice".

Suicide is what people are driven to when they're pushed past their breaking point. This reality is reflected in the portrayal of Hannah Baker. She is bullied and abused and injured and broken, until eventually she can't think of any other option. If seeing the truth makes people uncomfortable, good.

7. Reaching out backfires.

When Hannah tries to reach out to other characters - friends, parents, school counselor, they are at best unhelpful and unsupportive, if not making the situation even worse. This is realistic, if perhaps a bit relentless in its cynicism. "Don't reach out" may be a dangerous message, but so is "reach out to anyone and everyone." Some people will invalidate, re-traumatize, or even call the cops. This warning creates the appropriate balance, supporting the reasonable message to be selective.

8. Self-harm gets a spotlight too.

One of the characters (not Hannah) explains her self-harm by saying "it's what you do instead of killing yourself." This isn't the true reason for everybody who self-harms, but it is for some. In a non-coercive way, this line offers an alternative to suicide. Because the rationale is so difficult to argue with, it also helps to de-stigmatize self-harm, and yes, self-harm absolutely does need to be de-stigmatized. Not the "treatments" for it, but the act itself.

Self-harm and suicidality are both natural parts of the human experience. Turning them into taboo subjects does no good for the people experiencing them. In fact, it often creates shame, which makes both of them more attractive. 13 Reasons Why has got people talking.

9. Hotlines are not the answer.

 

Another major complaint against the show is that it doesn't offer resources. For example, there is not a list of phone numbers for suicide hotlines in each episode's end credits.

I don't believe that this was an oversight. I believe it was a deliberate choice, because promoting suicide hotlines would undermine the central message of the show.

The real reason people get uncomfortable with the lack of resources is not moral outrage at irresponsible triggering, it's because they are yet again trying to find a way to make suicide the sole responsibility of the suicidal person and not anyone else. If calling a stranger on the phone is a magic pill to cure suicide, then every death is the fault of the dead person for not reaching out. By not inviting this supposed solution into the show, it was not invited into the conversation. The focus is kept instead on other people's responsibility in causation or prevention.

10. Medication is not the answer.

 

Medication actually does come up in the show, not for Hannah but for Clay. His incompetent mother can't think of any other way to relate to him, because she's internalized the idea that his grief over a dead friend is a mental health condition, and the way you deal with those is by taking drugs, not, you know, being human together.

Hannah does not take any medication, because that would give the audience freedom to rationalize however they see fit: Either the medication caused the suicide so it's not other people's fault, or it was the wrong medication for her mental illness so it's not other people's fault. Clay explores medication but doesn't get any benefit from it, which is also the most common outcome in real life.

11. Prison is not the answer.

 

None of the characters, least of all Hannah herself, ever suggest that what she really needed was to be locked up in a psychiatric prison where she can be somehow healed by additional violence against her. Not only would such a statement have been patently untrue, it would have once again undermined the apparently controversial message that people are responsible for each other's well-being. If suicide prevention is the responsibility of some professional psychologist in some hidden facility, then it doesn't have to be yours. You have permission to ship people off and wash your hands of it. Out of sight, out of mind.

12. Permanence is powerful.

 

If Hannah really wanted to send a message, why didn't she power through and tell her story while still alive? Isn't that more powerful? No. It isn't. Sticking around gives other people the chance to apologize, to offer help, to give lip service and feel good about themselves, without doing anything to actually improve the victim's quality of life.
13 Reasons Why is not a warning to suicidal people not to kill themselves. That was never the intent. It's a warning to friends and family of suicidal people, that if you fuck up, if you're not present and caring and supportive, that's it. They're dead. You don't get a second chance. You don't get closure.

13. Suicide awareness can kiss this show's ass.

I have a confession to make: I have never been suicidal. And I don't think I ever will.

Yet suicide awareness campaigns still affect me personally, and my community. I won't soon forget the inherent dehumanization in habitually cutting the strings off my shorts, because I'm expected like all other interchangeable mental patients to somehow kill myself with them while pinned down on a four-point restraint bed. I haven't forgotten that suicide was the big justification no one wanted to challenge, when we first decided that you could detain people in so-called "hospitals" instead of mainstream jails. Every time I see a therapist, I'm reminded that if I so much as express a thought about killing myself, that she not only has the option to legally commit violence against me, she's expected to and can get in trouble if she doesn't.

As someone who has been subjected to traumatic and abusive human rights violations in the name of misguided attempts at suicide prevention, and who knows the stories of other people who can say the same, I am thankful that an item of cultural influence promotes a different message. Even if I believe for a second that the point of 13 Reasons Why is to "glorify suicide", I'll take that over awareness.

Image description: Promotional photo of the characters Clay and Hannah, with additional text around the title so that the image says "There are thirteen reasons why I killed myself and not a single one of them is a chemical imbalance."