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What is a "crisis?" The Earth is on fire, and it's not getting any better. Is it wrong to cry, scream, or want to die in such conditions? We are all lonely, sick, and nervous. Hearing violent voices or seeing visions of another world may be entirely appropriate responses to a truly uninhabitable world. Why wouldn't you lose your mind in this world? A breakdown can profoundly disrupt our or our loved ones' lives and sap our strength and energy, but they can also be opportunities for learning and growth or more. Peer support models contend that people who hear voices, see visions, or experience rapid/extreme emotional shifts are more likely to be gentle and understanding to others who do as well. We need more spaces where our strangenesses can be openly discussed and supported. Hopeless, insane, and suicidal people: let us find and validate each other, learn, and grow.

When something is labelled a "mental health crisis," a central assumption is that such a person needs a "mental health solution." Are we always so sure? Having no access to housing, money, or other resources just is distressing. Why is it deemed obvious or natural that those who appear to be in distress need therapy, medication, or incarceration? It seems just as likely such a person would need money, housing, company, or food. Rather than offering psychotropic medications to those who seem to be "insane" as a first response, why not try $1,000, lunch, or a free room?  Material support shifts the understanding of crisis to include our material conditions as inexorably tied to our physical and psychological presence without collapsing one into the other.

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"Mental health" issues are commonly treated as a purely medical problem to be dealt with by experts, but, unlike most other medical issues, the diagnosis of a mental disorder can result in incarceration, surveillance, and forced treatment. They are in equal part legal problems worked out by lawyers and judges. Patients have the right to seek out counsel or a new lawyer and push for a different treatment plan than is proposed by a psychiatrist or judge. The typical civil commitment court lasts just a few minutes, but it can decide months to years of one's life. Legal process around commitment and incompetency proves that madness is not a simple medical problem but something which involves legal/political concepts of citizenship, agency, and freedom.

Modest proposals for a mad abolitionist politic

Contest Benevolence and Niceties 

A nice prison is still a prison all the same.

Decarceration of some form is inevitable. Debt, technological innovations, and political narratives seem to be turning the tide against congregate prison settings. In its wake, subtle and precise practices of control like ankle monitors, digitally regulated antipsychotics, and "therapeutic confinement" in drug treatment centers, psych wards, for-profit psychiatric hospitals, and nursing homes are likely to become more common without widespread resistance and refusal. It is up to those of us who have experienced the violence of the state's benevolence to contest such "improvements," the result of which is to spread the logic, forms, and spaces of incarceration beyond the prison's walls. 

 

Create Shelter and Respite for All 

Somewhere to go when you can't go somewhere else. 

Respite houses or centers are spaces of refuge staffed by peers for the distressed and distraught to go relax and express their emotions and thoughts. At the moment, they are few and far between despite their simplicity and efficacy. Social groups like the Hearing Voices Network have popped up around the country offering similar zones of care and openness. Respites and social groups do not make money, and they are run by nonprofessionals who often do not ask those seeking connection and respite to change themselves, which means they will be resisted at every turn in the US. But if there is to be any radical change in mental health care in this country, respites must be opened and staffed by sympathetic peers in every city in the country. 

 

Towards a Mad Carnival

Convert the asylums into theaters, carnivals, and dining halls. 

States all across the US have long been in the process are transforming their old human warehouses into prisons, museums, or breweries. We could do so much more. What else could they be that might honor the lives spent inside? When Franca and Franco Basaglia began the process of closing down the asylums in Gorizia, patients were free to come and go, movies or performances were held in the evenings, and radicals from the Hot Autumn visited out of curiosity and made connections with residents. Some contemporaries described the scene as carnivalesque. One of the mistakes of the US antipsychiatry movement was its overemphasis on the American values like individual legal rights and "consumer choice." A mad abolitionist stance is one that emphasizes the fluidity of connection, friendship, and support over the isolated solidity of the individual or capitalist consumer. Abolition requires social space to meet and experiment together —it will be a collective process or not at all. Let us seize the asylums (or some other space) and spread the mad carnival through cities and towns across the country as a site for building power and attracting potential collaborators.

Deprofessionalization, Now.

It is not enough to be thoughtful or anti-authoritarian: the professionals must at some point actively destroy their power.

The Experts of mental health care are legion. Laborers have flocked to care-work positions in local governments, hospitals, and treatment centers and established professional mediating positions between the traditionally upper-class psychiatrists and superintendents and the historically poor and immigrant hospital nurses or group home staff. These experts are by and large more liberal minded, but have been less involved in radical projects than the nurses and paraprofessionals who, on some occasions, have joined the patients in protest against the medical institutions themselves (rather than just one aspect). Those who want to change the system cannot simply subscribe to horizontal and anarchist repudiations of power; the scales are so uneven that only a project of self-destruction could even the playing field. Those who recognize that the caring systems are broken must one day put their reputation and position aside; they must cease to be experts and professionals and throw their lot in with their "sick" and "mad" patients. 

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