Policing Mental Health
Critiques of the involvement of police imply that the problem of violence perpetrated against the mad could be stemmed or at least reduced by sending "experts" instead of armed officers. It should be made clear that left-leaning activists are virtually alone in calling for this. The APA, NAMI, the TAC and other psychiatric or advocacy organizations are overwhelmingly conservative in their visions and take it for granted that the municipal police will continue have the most interface with the mad. At most, they are lobbying for more training or for increasing crisis-response teams budgets to work with the police. This push for expert jurisdiction ultimately lets the psy-police off the hook for their own role in surveilling, detaining, or forcing treatments on patients (for instance in eugenics projects), framing them as the relatively innocent and intelligent foil to the brutish police's senseless brutality. To create "non-police" psychiatric teams would conceal that fact that psychiatry is at present fully embedded within a coercive civil and criminal legal system, the violence of which would continue unabated behind the scenes in psych wards, the courts, locked residencies, and treatment centers.
Much of what has been deemed "community" psychiatric care has taken the form of preventative measures that closer resemble policing than treatment. Among these are included risk-assessment metrics, drug tests, welfare checks, involuntary out-patient therapy sessions, digitally monitored medications, and placements in halfway houses and group homes. This web of surveillance mechanisms, outfitted with agents ready for intervention at the sight of danger, could be considered illustrative of what Rachel Jane Liebert has recently termed "psycurity." Anti-stigma educational campaigns around mental illness train the general public to look out for "signs" of mental disorder, much as they were trained to "say something" if they "saw something" in the wake of 9/11. The goal is to capture as many deviants and pre-deviants in a web of visibility and containment as possible. The growth of the business of adolescent psychiatry as a whole is a part of this trend: younger and younger children are being identified as mentally ill while their torture via shock or doping is being legitimated in the name of prevention and security. To this day, the US can refuse entry to the "mentally unfit" seeking citizenship. The half often left out of the conversation around the anti-Black origins of policing is the anti-Black origins of psychiatric diagnostics: Black people in particular are more likely to be criminalized, but are also more likely to be psychiatrized, considered insane, and feared as such.
In the current debate around police violence, it is often said that the police should not be involved in mental health crises. "Leave it to the experts" is the slogan of the reformist wing of the defund the police movement. The first thing that must be acknowledged is that psychiatry legally legitimates its capacity to coercively treat or incarcerate through 1. the parens patriae (the power of guardianship) and 2. the police power. The first power defends “incompetent” people from themselves, and the latter protects society from “dangerous” people. Such debates, then, are not really about whether we ought to police the mad, but who should do the policing, how, and with what means. What lies behind this desire to police? And what exactly is "it" that must be left to the mental health experts? What is this problem we commonly refer to in short hand as "mental health crises" they should solve? Loudness? Weirdness? Aggression? Each such crisis seems to be entirely unique, so what are we referring to when we use this phrase?
Why has the conversation around abolishing or defunding the police returned again and again to the question of "mental health crises?" The police, for their part, have long incorporated psychiatric methods and knowledge when it serves to improve their methods and mechanisms of the management of public space; doing so has done little to stem the violence associated with them. Eras in which police interaction with the mad was less likely were violent in a different way. Fewer people were executed in the streets, but more were disappeared into filthy environs and medicated shoulder-to-shoulder in the hopes they would live out their remaining years without bothering anyone. The psychiatric profession having barely changed (relying still on the same or similar methods and frameworks they have for a century), we have no reason to believe now would be much different. The entire debate serves to conceal the essential: madness and distress are essentially related to the material conditions of the world. Replacing the foot soldiers of the social order with nurses will not change the fact that climate change is forever changing the planet for the worse, that our economic system and nation is built on slave labor, or that the land we stand on was stolen with unrelenting force.