All Commentary
Wednesday, May 3, 2017

Trump’s Troubling Pick to Head Mental Health

Giving the state authority over mental illnesses is a dangerous threat to civil liberties.

So far, Donald Trump’s appointments have been a mixed bag. From Jeff Sessions, who wants to ramp up the misguided and counterproductive war on drugs, to Ajit Pai, who is bringing a badly needed respect for liberty to the FCC. One appointment I’m particularly concerned about, though, is Ellie McCance-Katz for Assistant Secretary of the Substance Abuse and Mental Health Services Administration. 

McCance-Katz has the support of the psychiatric community because she ascribes to the industry orthodoxy on mental illness; namely that it is the result of brain malfunction and should be treated with psychotropic drugs, irrespective of the wishes of the patients.

“Settled” Science

In a piece she wrote for the Psychiatric Times, she lambasted the agency she is about to join:

“There is a perceptible hostility toward psychiatric medicine: a resistance to addressing the treatment needs of those with serious mental illness and a questioning by some at SAMHSA as to whether mental disorders even exist—for example, is psychosis just a ‘different way of thinking for some experiencing stress?'”

But wait a minute, aren’t these the questions we should be asking? Isn’t the goal of science and medicine to seek truth and question authority? There’s an uncomfortable “settled science” element to her remarks that is reminiscent of the Climate Change movement. Any skepticism of official dogma is dismissed as heresy. 

The goal of psychiatry should be to continue to advance our understanding of the mind.As recently as the 1970s, psychiatric orthodoxy held that homosexuality was a mental disorder to be corrected. Now it is regarded as a legitimate sexual preference. Might not the same mistake have been made for other forms of supposed-disorder?

It seems to me that the goal of psychiatry should be to continue to advance our understanding of the mind, not to purge anyone who questions the current state of knowledge.

Healthy Skepticism

It is fashionable in psychiatric circles to brand any skepticism with the loaded term “anti-psychiatry,” a movement with ties to Scientology. But this is basically ad hominem thinking, attempting to delegitimize the person as opposed to the idea.

There are plenty of reasons to be skeptical of psychiatry’s current practices, without buying into the tenets of antipsychiatry.

For example, psychiatry holds that mental illness is like any other illness, that a disease of the mind is really a disease of the brain. But is there any conclusive evidence that gambling addiction is a brain disease? Is there any evidence that Obsessive Compulsive Disorder stems from a sick brain?

In fact, there isn’t. Excessive gambling and compulsive actions are observed behaviors, not medical pathologies.

Involuntary commitment is indistinguishable from kidnapping.

Yet, the psychiatric profession bristles whenever anyone suggests that these behaviors may not be “an illness like any other” and insists that drugging patients is the proper course of treatment even when there is no chemical rationale for why a drug would help.

Dangerous Minds

McCance-Katz condescendingly mischaracterizes the opinions of the people she wants to replace, saying that they think “it’s abusive to impose our constructs of normal mental and emotional functioning even on seriously mentally ill people.”

In fact, what psychiatric skeptics define as abuse are those things which, without a doctor’s signature, would be unambiguous criminal activities.

Anyone concerned about liberty should be alarmed at the amount of power these laws give the state.

Involuntary commitment is indistinguishable from kidnapping apart from the legitimacy given to it by doctors and judges. Mandatory drugging is indistinguishable from assault apart from the fact that it has been made legal in certain cases.

The fact that these people, defined as the mentally ill not by themselves, but by others, are made to suffer such ignominious indignities, merely on the basis of a professional opinion should be worrying to anyone concerned with individual liberty.

Last year, SAMHSA opposed legislation that gave family members greater control over their relatives, to the point of violating their medical privacy and making decisions for them, even potentially having them committed, on the basis of some doctor deciding whether they are competent.

McCance-Katz worked at the agency at the time, and has not commented specifically on the law, but her comments in the Psychiatric Times indicate that she is unhappy with the way the agency has been run, and has expressed no concern for the potential rights violations the law creates.

Anyone concerned about liberty should be alarmed at the amount of power laws like these place in the hands of the state.

I’m not saying the status quo at the SAMHSA is a good thing; I am worried by any effort on the part of the federal government to meddle in the lives of people who have committed no crime.

But McCance-Katz’s approach to the treatment of mental illness is worrying in that she appears little concerned with individual rights, and unwilling to tolerate any diversity of thought.

To the extent that these offices should do anything, a question which is very much in doubt, they should focus on helping people who actually want help, and who ask for it, and not forcing drugs on those who do not want them.

  • Logan Albright is the Director of Research at Free the People. Logan was the Senior Research Analyst at FreedomWorks, and was responsible for producing a wide variety of written content, research for staff media appearances, and scripts for video production. Logan also managed the research and interviews with congressional candidates used for endorsements by FreedomWorks PAC. He received his Master’s degree in economics from Georgia State University in 2011, before promptly setting out for DC to fight for liberty.