America's mental health system may be unfixable. Fortunately, there's an alternative

The mental health system stresses individual diagnostics and drugs. What if society itself is the problem?

Published June 22, 2019 2:00PM (EDT)


The mental health system is failing us. Moreover, the way the mental health industry and our culture at large conceives of “mental illness” is designed to fail us. That’s why people are more and more engaging with alternatives to it, using peer support, community, and mutual aid.

Mutual aid is not a new thing—arguably it’s one of the oldest ideas in human history —but our conscious use of it in the context of mental health holds a radically important promise: rather than just coping with and adjusting to society through the mental health system, we can actually heal ourselves and shift the culture.

The biomedical model, which holds that all mental health concerns are the result of some brain imbalance, uses the oppressive tome of the Diagnostic and Statistical Manual (DSM) as its diagnostic touchstone. This gives mental health professionals the right to designate individuals who are suffering within categories of “disease,” which, in turn, often assigns them to a lifetime of ineffective and often harmful “treatment.” This is has become so routine that it’s hard to remember that alternatives to it exist, but people with mental health issues are starting re-imagine wellness. One alternative is the recovery model, an innovative and effective framework with the potential to genuinely heal and transform people who have experienced trauma.

Trauma is a huge category of human experience, ranging from the interpersonal to the systemically oppressive and often they overlap. Trauma manifests itself in various ways within our body-minds that result in types—and some of these types can be hazily recognized in the categories that the DSM describes. But this is not science. There is no evidence that supports the notion of “chemical imbalance” being something that a person is born with; this is speculation that supports a disease model, which reaps massive profits for the mental health and pharmaceutical industries.

This is not to say drugs can’t be one useful treatment among many when used judiciously and cautiously. But a mental health wellness plan that begins and ends with a disease model (biomedical) does not treat the whole person, or the body, where trauma is stored, and in fact, often times causes more harm than good.

The primary tenet of the Hippocratic Oath, taken by all physicians, is “do no harm.” Yet that tenet of the oath is broken over and over. These harms can include forced treatment, traumatizing hospitalizations, overmedication, and police brutality, and electroconvulsive therapy. The message of the biomedical model itself does harm to those rendered patients, and it also inhibits the personal and social transformation that could come from the recovery model and if we honored the wisdom of mutual aid.

Harm also comes from an offensive disregard for the insight and self-understanding of the person seeking professional help. There is even a word in psychiatry to denote this supposed lack of insight: anosognosia. We are thought, because of our supposedly “imbalanced” brains, to be incapable of knowing what is best for us, and thus must become compliant or “concordant” with treatment. Doctors are not a priest class, but they often act like it. Mental health professionals should be facilitators’ of each individual’s own wellness. Progress is being made in this direction, but we have a long way to go, particularly with the majority of psychiatrists. But therapists are not immune to these problems either. In addition to the growing recovery model which offers hope that people with mental and emotional struggles can and will learn not only to cope, but to heal and thrive, we need a strengths-based model that acknowledges people who experience a range of emotions and mind-states outside the realm of “normal” may actually possess unique talents and visions, or what some call “dangerous gifts.” Often this requires greater self-care. These unique perspectives we have to offer society should be cultivated and honored, not feared or stamped out.

When I couldn’t find enough healing or hope or meaning in clinics, I found peer support and mutual aid in the form of 12-step community and The Icarus Project, “a support network and education project by and for people who experience the world in ways that are often diagnosed as mental illness” The Icarus Project gave me many things, most importantly friendships, and it also gave me mad pride. I now honor and mind carefully my “dangerous gifts.” This is not to say therapy can’t be beneficial; some of it has been. And at times, it has done me harm. But mutual aid has transformed my life, has helped me heal, and at its best, can transform society. Wikipedia solidly defines mutual aid as “ a voluntary reciprocal exchange of resources and services for mutual benefit. Mutual aid, as opposed to charity, does not connote moral superiority of the giver over the receiver.” In this context, therapists and psychiatrists certainly can (but don’t always) embody a toxic “moral superiority,” whereas people freely holding space for each others’ emotional processes unlocks human potential for all involved.

When people share histories of trauma with each other, we can also share tremendous insight. Most importantly, when we create an atmosphere of mutual respect and equality that fosters wisdom and healing. In this way, mutual aid gives us something the biomedical model and the unequal power dynamics between professionals and “patients” cannot. Engaging in the very process of mutual aid itself is an antidote to the biomedical model and the flawed system it has generated.

In peer support or mutual aid, both parties look at their stuff. It seems like a no-brainer that this would promote deeper, more radical growth. It is only because we are taught not to value community that it isn’t. We all know the best intimate relationships of our lives, be it with dear friends, romantic partners, or family, can make or break us—and at best can lead to profound spiritual changes. In All About Love: New Visions bell hooks defines love as the conscious decision to aid in the spiritual development of ourselves with another human being.

When we are in a relationship of mutual respect and equality, when the connection is between two peers struggling along the same road together, working to love one another, we can become powerful and beautiful beyond measure. I believe that mutuality can transform “patients” into people and restore health beyond expectation. More than this, I also believe that as people come into wellness and self-love, society can be transformed. As Shery Mead, founder of Intentional Peer Support writes, “As peer support in mental health proliferates, we must be mindful of our intention: social change. It is not about developing more effective services, but rather about creating dialogues that have influence on all of our understandings, conversations, and relationships.”

Our healing journeys are not just about individuals. They are about transforming society and shifting the culture. The Icarus Project asks: What does it mean to be labelled “crazy” in a world gone mad? And it asks if we in fact, as “mad” people, could take that label on with pride. Maybe we shouldn’t adjust to this world. Maybe we should change it, not only to better serve our own needs; mad folks should support each other with mutual aid so we can better use our “dangerous gifts” to carry out visions of a just and safer future for us all.

Part of being radical involves being the best human you can be in a world not designed for love, in a world that trains us to be competitive, individualistic, selfish, hierarchical and discriminatory. Every act against that norm is a radical act. Mutual aid embodies those acts, and that is its simple yet revolutionary power.

# # #

L.D. Green is, along with Kelechi Ubozoh, co-editor of “We’ve Been Too Patient: Voices from Radical Mental Health.”

By LD Green

L.D. Green is, along with Kelechi Ubozoh, co-editor of “We’ve Been Too Patient: Voices from Radical Mental Health.” LD Green is a genderqueer writer, performer, college educator, and mental health advocate living in Oakland, California. LD’s work has been published on The Body is Not an Apology webzine, in Sinister WisdomFogliftersPARKLE + bLINK, on and elsewhere.  LD has featured at dozens of reading series, slams, showcases, and workshops in schools, colleges, and open mics locally and across the country. LD was on two national slam teams in 2004 and 2005. As a playwright and writer/performer, they have had their work performed at multiple local and national theater festivals including the National Queer Arts Festival three times as well as the San Francisco Fringe Festival.  LD received their BA from Vassar College and their MFA from Mills College in Creative Writing.  LD was a 2010 Lambda Literary Fellow in Fiction, attended Tin House Writers’ Workshop in 2012, and was a Catwalk Artist in Residence in 2013.  LD is Assistant Professor of English at Los Medanos College in Pittsburg, California where they teach composition, creative writing, and literature. LD was an active member of the Bay Area chapter of The Icarus Project from 2009-2011 (a support network and education project by and for people who experience the world in ways that are often diagnosed as mental illness)  and has presented with Youth in Mind and the California Mental Health Advocates for Children and Youth. LD writes poetry, plays, non-fiction and speculative fiction.  For more information, visit