Mad in America: Rethinking Mental Health

On the podcast this week, we hear from Dr. Niall McLaren. Niall, known to many as Jock, is an Australian psychiatrist who worked for 25 years in the remote north of the country. Also an author, Jock's latest book is entitled Natural Dualism and Mental Disorder, the Biocognitive Model in Psychiatry, and it was published in December 2021. Recently retired after 47 years, Jock joined me to talk about his experiences working in psychiatry and explains why the models that purport to guide psychiatric diagnosis and treatment are not what they seem.  

Tara Thiagarajan is founder and chief scientist of Sapien Labs, a nonprofit organization that runs the Mental Health Million Project and its annual Mental State of the World Report, which uses an online survey to track mental wellbeing among internet-enabled populations around the world. The 2021 report, just published, was the project's second annual effort. Authored by Thiagarajan and lead scientist Jennifer Newson, it surveyed more than 233,000 internet users in 34 countries. The overall objective, write the authors, is to “provide an evolving global map of mental wellbeing and enable deep insights into its drivers.” Its results have considerable implications regarding mental health and the factors that contribute to it.

Dr. Bruce Cohen is an Associate Professor of Sociology at the University of Auckland. His career spans over thirty years where he has time and again used empirical research to tackle the numerous shortcomings of the psy-disciplines. With his upcoming book series, The Politics of Mental Health and Illness, he continues to expose how the psychiatric discourse “doesn’t work for us” but instead greases the wheels of a neoliberal capitalist society. In this interview he talks about how the psychiatric discourse has left the clinic and entered workplace, how the DSM has been feminized to the detriment of women, how and why the ADHD diagnosis has shifted shape, and lastly, how the global move towards “mental health” and away from “mental illness” might not be positive or benign.

Note: To find out more and to register for the 26th International Network Meeting for the Treatment of Psychosis 2022, click here. *** May is Maternal Mental Health Month, and although we tend to hear a lot about postpartum depression, as our guest today has pointed out, perinatal distress is really a spectrum of reactions. Childbirth and new parenthood are major life transitions that involve many physical, psychological, and practical changes. These changes may interfere a little or a lot in a mother’s ability to function optimally and, in turn, affect her relationship with the child and the child’s development. Today’s global crises, including climate change, the pandemic, and war, can add an additional layer of stress so normalizing the experience is more important than ever. Our guest is public health expert Jennifer Barkin, Ph.D., M.S., a Professor and Vice Chair of Community Medicine and Obstetrics and Gynecology at the Mercer University School of Medicine in Georgia. A biostatistician and psychiatric epidemiologist, Dr. Barkin was formerly an analyst at the University of Pittsburgh’s Epidemiology Data Center, where she designed the Barkin Index of Maternal Functioning (BIMF), the first patient-centered wellness assessment tool focusing on mothers’ daily lives during the first year after giving birth.  She is a peer reviewer for journals including Archives of Women’s Mental Health and serves on the Board of Directors for Postpartum Support International, Georgia Chapter.

The Visible Hands Collaborative in Pittsburgh, Pennsylvania is run by Alice Fox Thompson and Kenneth Thompson. Together, the father and daughter team is bringing a novel form of community healing developed in Brazil, called Integrative Community Therapy (ICT), to the United States for the first time. Alice Fox Thompson is currently in her fourth year of medical school at Geisinger Commonwealth School of Medicine. Before medical school, Alice worked in community organizing and advocacy. She is interested in solidarity-based approaches to community and population mental health. Kenneth Thompson is a psychiatrist trained at the Boston University School of Medicine. He has served as faculty at Yale University and the University of Pittsburgh and has been the director of many different psychiatric clinics. Ken currently serves as the Chief Medical Officer of the Pennsylvania Psychiatric Leadership Council, a unique state-level education policy and advocacy organization that he helped found. Ken’s focus as a psychiatrist has always been on social medicine and community psychiatry, having written, consulted, and lectured extensively on issues of public service, whole-person treatment, primary health services, health equity, democracy, human rights, and more. In this interview, Alice and Ken describe how they both came to Integrative Community Therapy and what they've learned in adapting it to their context in the Visible Hands Collaborative in Pittsburgh. They also discuss the connection between the emotional literacy and community support developed in their groups and broader processes for political change and social justice.

Executive Director Jahmil Roberts and Advocacy Director Yana Calou from the Trans Lifeline work towards connecting trans people to the community support and resources they need to survive and thrive. Trans Lifeline is a grassroots hotline and microgrants 501(c)(3) non-profit organization offering direct emotional and financial support to trans people in crisis – for the trans community, by the trans community. Their hotline is a peer support phone service run by trans people for trans and questioning peers and does not contact police without consent. The Cops out of Crisis initiative, which you can learn more about here, does advocacy work based on the negative impact of non-consensual law enforcement intervention and forced hospitalization on those in marginalized populations. The Trans Lifeline envisions a world where trans people have the connection, economic security, and care everyone needs and deserves – free of prisons and police. This is the third and final interview in a series of conversations being conducted around the issue of hotline tracing and intervention. The first interview was with Vanessa Green, founder of Call the Blackline and the second was with Sera Davidow from The Wildflower Peer Support Line. It is part of Mad in America’s Suicide Hotline Transparency Project, which was born out of the belief that creating transparency and public access around suicide hotline intervention and call-tracing policies should be a priority. This project includes a directory of lines that do not trace or intervene without consent, a public poll, survivor interviews, and an open call for art. Please visit the project page to find out how you can participate.

Nicholas Haslam is a Professor of Psychology at the University of Melbourne. He is a prolific writer with nine books and around 270 articles to his name and is well-renowned for his work on dehumanization and concept creep. He received his PhD at the University of Pennsylvania and taught at the New School for Social Research in New York City before returning to Australia. His books include Psychology in the Bathroom, Introduction to Personality and Intelligence, Yearning to Breathe Free: Seeking Asylum in Australia, and Introduction to the Taxometric Method. In addition to his academic writing, Nick regularly contributes to The Conversation, Inside Story, and Australian Book Review. He has also written for TIME, The Monthly, The Guardian, The Washington Post, The Australian, and two Best Australian Science Writing anthologies. Nick is a Fellow of the Academy of the Social Sciences in Australia, the Society for Personality and Social Psychology, and the Association for Psychological Science. In this interview, he discusses inflating concepts around harm and their effects on ourselves, our experience, and society at large. He also talks about his work on stigma and biogenetic explanations of mental disorders, calling it a mixed blessing.

In this interview, MIA speaks with Allan Horwitz and Sarah Fay about the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and its impact on our society and our personal lives. Allan Horwitz is an Emeritus Professor of Sociology at Rutgers University. He is the author or co-author of 11 books, a number of which have focused on the DSM and how the successive iterations of that manual have shaped societal thinking about mental disorders. His most recent book is DSM: A History of Psychiatry’s Bible. Sarah Fay is a writer whose essays and articles have been published in the New York Times, the Atlantic and numerous other national publications. Her memoir, Pathological: The True Story of Six Misdiagnoses was published in March. She is also the founder of Pathological: The Movement, a public awareness campaign “devoted to making people aware of the unreliability and invalidity of DSM diagnoses, and the dangers of identifying with an unproven mental illness.”

Sera Davidow is a filmmaker, activist, advocate, author, and mother of two very busy kids. As a survivor of physical, sexual, and emotional abuse as a child and relationship violence as an adult, Sera has faced many challenges throughout her own healing process, including many ups and downs with suicidal thoughts, and self-injury. At present, she spends much of her time working as Director of the Wildflower Alliance (formerly known as the Western Mass Recovery Learning Community), which includes Afiya Peer Respite, recently recognized by the World Health Organization (WHO) as one of about two dozen exemplary, rights-based programs operating across the world. She also serves on several boards including the Massachusetts Disability Law Center (DLC) Board of Directors, the DLC’s Council Against Institutional and Psychiatric Abuse (CAIPA), as an advisory board member for the National Center on Domestic Violence, Trauma, and Mental Health (NCDVTM), and as a founding Board member of Hearing Voices USA. You can learn more about Sera and her work in an April, 2018 article in Sun Magazine.

Lynne Layton is a psychoanalyst in Cambridge, Massachusetts, and part-time assistant clinical professor of psychology at Harvard Medical School. Holding a Ph.D. in clinical psychology as well as comparative literature, she has taught courses on gender, popular culture, and psychoanalysis for Harvard’s Committee on Degrees in Women’s Studies and Social Studies. Currently, she teaches and supervises at the Massachusetts Institute for Psychoanalysis. She recently published a book called Towards a Social Psychoanalysis: Culture, Character, and Normative Unconscious Processes and is the author of Who’s That Girl? Who’s That Boy? Clinical Practice Meets Postmodern Gender Theory(2004). She was also the co-editor of the books Narcissism and the Text: Studies in Literature and the Psychology of Self, Bringing the Plague: Toward a Postmodern Psychoanalysis, and Psychoanalysis, Class and Politics: Encounters in the Clinical Setting. Her involvement in editing peer-reviewed journals includes being the associate editor of the journal Psychoanalytic Dialogues and the former co-editor of the journal Psychoanalysis, Culture & Society. She is the past president of Section IX, Division 39 of the American Psychological Association, Psychoanalysis for Social Responsibility, and co-founder of the Boston Psychosocial Work Group and Reflective Spaces/Material Places-Boston, a group of psychodynamic therapists committed to community mental health and social justice. She is also on the organizing committee for Grassroots Reparations Campaign, an organization working towards building a culture of repair. In this interview, Layton discusses social psychoanalysis. She explores how her construct of "normative unconscious processes" can illuminate how oppressive systems are continually internalized and reproduced, both inside and outside the clinic.