"When someone has cancer, they (medical professionals) don't lock the doors behind them when they show them the tests. But when someone has a mental illness, they lock the doors behind them and show them no tests. When they lock the doors behind me, I want to know why."
That was consumer activist David Gonzalez as quoted in the August 30, 2003 edition of the Washington Post. At the time, David was the only Latino participating in the "Fast for Freedom in Mental Health," a hunger strike organized by MindFreedom.org—one of several mental health advocacy organizations with Non-Governmental Organization status at the United Nations—to protest against forced mental health treatment and bio-psychiatry.
"I got involved in the fast," David states, "because I'm against forced treatment. People should have the right to take or not take medications if they choose to, or to have or not have ECT [electroshocks] if they choose to. Individuals should be empowered to make informed decisions and informed choices."
Meeting with the American Psychiatric Association
The hunger strikers eventually met with Dr. Marcia Goin, then president of the American Psychiatric Association (APA), and it was David who handed the group's letter to Dr. Goin.
"The letter," David explains, "indicated that we wanted to engage in a meaningful dialogue and have an open line of communication with the APA with the hope of improving services."
This encounter was described as "awkward" by David and "interesting" by Dr. Goin. This was a sign of the decades-old controversy regarding mainstream psychiatry's promotion of forced treatment on people with emotional disorders—which in the past included barbaric practices like lobotomies and insulin-induced comas—and the profession's current position of declaring that most emotional disorders are biologically rooted and only treatable with pharmaceutical medications.
"Ultimately," David says, "Dr. Goin was very gracious, polite and respectful, but she did not agree with the reasons why we were fasting."
David explains that this speaks of a vacuum between the APA's conception of psychiatric disorders and the role of psychiatry in society and history, and the realities of many consumers who have found wellness and recovery in non-pharmaceutical treatments.
Tackling the clinical model
"Unfortunately," David states, "the APA operates mainly within the so-called "clinical model" of treatment, and pretty much marginalizes or refuses to recognize alternative forms of treatment, which we think can often times be healthier forms of treatments."
Cross-cultural research studies conducted by the World Health Organization (WHO) support the premise that in addition to the pharmaceutical treatments proposed by the bio-psychiatry establishment, the role of family, culture and societal customs are as important and certainly effective in the treatment of emotional disorders. David Gonzalez concedes that the current bio-psychiatric model—so widely embraced in the USA today—presents a challenge for any advocate of alternative treatments, like the experience of actress Margot Kidder who has found recovery from bipolar disorder in "Orthomolecular" therapy, which supports the use of vitamins and natural nutrients instead of pharmaceutical drugs.
"Are you also in favor," I ask David, "of people who have found recovery by using pharmaceutical drugs like the newer psychotropic-atypical medications?"
"If someone feels that those medications are helping them," David states firmly, "I totally support their right and their decision to do so. However, if they don't feel that those medications are helpful to them, then likewise I totally support their right to refuse to take those medications."
Gonzalez recognized as "Emerging Leader"
This brief encounter with the APA wasn't David Gonzalez's first act in the national discussion of mental health issues. In 1999, David became the first mental health consumer to be honored with the National Paul G. Hearne Emerging Leadership Award, granted by the American Association of People with Disabilities (AAPD).
David has also been a participant and presenter in numerous statewide and national mental health conferences, and recently he traveled to the United Kingdom to do presentations on fighting stigma and on the "White Paper"—a newly released document that, with the blessing of the New York State Office of Mental Health (OMH), proposes a new and more consumer-friendly approach to the delivery of services.
10 Value & Recovery-focused Principles
"In a nutshell," David explains, "the White Paper is a list of 10 rules—which I prefer to call values and recovery-focused principles—that were created with the input of over 10,000 consumers over a three-year period. It seeks to infuse recovery-based principles into our mental health system. It proposes that, in treatment, there must be informed choice, it must be recovery-focused and person-centered, it must ‘do no harm,' there must be free access to records, there must be trust, there must be a focus on cultural values, and so forth."
David explains that for a long time "the traditional clinical-medical model was based on maintenance and custodial care as it was believed that recovery was not possible. Today we know that people with mental illness can and do recover."
The New York State Office of Mental Health has yet to make it mandatory for its providers to be educated about the rules of the White Paper. So far, some activists like David have presented the document at various mental health facilities, but mostly to consumer audiences. This "provider re-education" echoes the calling to include mandatory recovery-focused and consumer-run academic courses at all universities that train human conduct professionals, in addition to the mandatory field internships placements. This, David agrees, would "instill a new mindset in the providers—that recovery is possible—and would enlighten them about the current state and history of the peer movement. While there is a recognized history of established psychiatry and treatments, there is also a history of consumers with their contributions and their struggle to be treated as human beings."
Work: indicator of recovery & "stigma-buster"
Another of David's passions is his belief in the power of work. He is a strong believer that finding meaningful employment is one of the greatest indicators of recovery and one of the best "stigma-busters." Accordingly, he currently works as Director of the Peer Advocacy Leadership Program of Goodwill Industries, an agency with a mission to get people employed—not only people with disabilities, but also the unemployed, the underserved and the homeless.
Prior to this, David worked as an Employment Coordinator for the New York Works Research Project, which was a partnership between the Department of Labor and the Social Security Administration to help individuals with psychiatric disabilities return to work.
"Returning to work," David says, "is essential in the recovery process. For many people, treatment and recovery is actually having a job, doing something that makes them feel worthwhile, productive and gives them a good sense of self-esteem and self-confidence."
My conversation with David ends with his tireless efforts to fight the stigma of emotional disorders for which he set up an elaborate website: http://www.cinemaniastigma.com.
"The purpose of the website," David explains, "is to challenge the negative and preponderant stereotypes that consumers often have to deal with."
Countering the media's focus on violence
As an example of the contents of his website, we talk briefly about one of the most egregious attacks against mental health consumers when the New York Daily News ran a front page headline that read: "Get the Violent Crazies Off Our Streets," along with an editorial that stated, "In our new found complacency we have forgotten about a particular kind of violence to which we are still prey: the violence of the mentally ill."
This piece of journalism received the repudiation of the consumer community. The article did not even represent the actual facts: the offender was not a mental health consumer. Despite this error, the newspaper never issued a retraction. Moreover, the City of New York was not facing—and has never faced—an "epidemic" of violent acts committed by consumers. Advocates wondered whether this type of manipulation of public opinion was the result of either gross ignorance or blatant discrimination. And the headline/editorial was seen as an attempt to mislead the public into believing that consumers were dangerous and in need of being locked up in institutions—when in reality, a closer look at this problem suggested that most of the consumers who get in trouble with the law have a better prognosis of reintegration into the law-abiding community and a lower rate of recidivism than non-disabled individuals who break the law.
"I object," David says, "when [violence by consumers] is presented as the ‘norm' when it is in fact the exception."
To consumers, David has a message: "People who are labeled as ‘mentally ill' need to redefine themselves. I had to redefine myself and stop looking at myself as someone who was mentally ill, but rather as someone who had talents, skills and abilities that I could use to actualize my recovery."