Basic urban problems and “mental health”
It is reported that roughly three people in Toronto die each week because of homelessness and addiction problems (although Toronto has passed resolutions this week which may seriously attempt to deal with those problems). There have been numerous studies over the past four decades about what causes urban unrest in our area, along with specific proposals to solve those problems. They have been largely ignored or hobbled. I know from my work on many advisory committees in my regional municipality and from conversations with many front-line service providers, that all too often new programs get only short-term funding. Staff routinely are hired and let go at six-month intervals, making consistent delivery of services nearly impossible. Such shallow approaches have existed since the 1990s to my own knowledge, but perhaps much longer. We have a long history of avoiding engaging these problems — discrimination of several kinds, inadequate housing, and drug-related criminal violence, warrant peoples’ attention (other than increasing police responsibilities) only when they culminate in unsafe transit. But then we blame mental health issues.
Cybernetics includes the study of how people fit into processes and systems and is a useful approach. But satellite imagery was not going to provide solutions to mental health problems. I’m not sure what would: Healing: Our Path from Mental Illness to Mental Health, by a former director of the National Institute of Mental Health Dr. Thomas Insel, says that how to heal mental health problems has not been discovered. I’m not quite so pessimistic. My own training progressed from my undergraduate thesis on “Moral Responsibility in the Ideas of Freud and Jung,” through Piaget, psychotropic medicine, milieu therapy, conjoint family therapy, transactional analysis, psychotherapy, mental health farms, community mental health programs, and the contributions of neurology. So I know that many people get effective help to some extent. But not enough people get enough help, soon enough.
I have been a mental health chaplain in the U.S., as well as a parish minister in downtown urban areas, rural areas, and suburban places in Canada. In all locations I have worked with the poor, hungry, mentally ill, people who haven’t the place or funds to attend to their hygiene, (including feminine hygiene), and homeless. I know about these matters.
Anyone who is without reliable income, food, medication, hygiene, shelter, warmth in winter and coolness in extreme summer temperatures, may lose any sense of control over their lives. They adopt whatever behaviour helps them get through the day and the night. The inadequate income provided to our poor and our disabled not only does not provide their basic needs, it is constructed to deliberately limit what they can achieve on their own, and then make them feel badly about themselves for being poor. Yes, we provide free (to some extent) medical care and hospitalization, but once you return “to the community”, that disappears. If your eyesight is not corrected because, being homeless, you have difficulty keeping your glasses; when on the streets or in crowded shelters; if your hearing is degrading but you can’t get the kind of hearing aid you need; or if you can’t afford the medications or over-the-counter pharmacy support, hygiene products, cane (let alone walker or wheelchair), or assistance for blindness, or mask, what then? It’s very difficult to get on with life, although I have seen, daily, evidence that it is not impossible – for a while. Mental illness is not necessarily the cause of these people living on transit. But it may be the result of what drives them to live on transit What I saw riding the 505 Dundas streetcar in Toronto – The Globe and Mail.
People who are homeless are not necessarily that way because they are mentally ill, but homelessness may bring on mental health problems.
Whose “mental health”?
The world around us is not mentally healthy** any more than physically healthy. Sometimes the “mental health” problems are really under-resourced peoples’ responses to impossible situations. The unhealthy society causes its members to be unhealthy. Gabor Maté’s book The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, demonstrates (along with his years of articles in the Globe and Mail while he was working with drug addicts in Vancouver’s lower east side) that trauma, whether emotional trauma in childhood or physical trauma at any time, messes us up. Trauma affects memories (including ”embodied memory”) and damages a person and make it difficult to cope with all the stresses of modern life. We musn’t ignore the consequences of these abuses of people caused by society at large and by individuals up close. Our concern must be with not only “mental health” in the form of psychiatric treatment of individuals; it must be (perhaps first) how each of us treats the next person, and how our social, political, and economic systems make life harder than it should be.
I support space exploration and cybernetics and all that, but we do not need to go look there, to understand and deal with urban problems here. We need to be caring, attentive, thinking individuals who form supportive communities. We need to be here, not there, to solve here’s problems.
How to organize our efforts here?
Let us reconsider some more of the past.
Gal Beckerman (The Quiet Before: on the Unexpected Origins of Radical Ideas) examines what was going on (conversations, meetings, rallies) before major revolutions. He examines movements from the beginning of the twentieth century on, into very recent years, e.g. Black Lives Matter, Black Identity, Dream Defenders, in reaction to assaults on Blacks in the U.S. and the resultant calls for defunding the police in Milwaukee. The Soviet-era prisoners’ Samizdat communicated by hand-written and hand- delivered small pieces of paper, and BLM and others tended to use social media, but all can be described by an analogy he borrows from Hanna Arendt, “the table”. He says that some of us need a table of our own, away from the main tables at which sit the powerful and important majority. A table where we can sit and talk with a few. He recounts how some groups got away from Twitter and the other large tables, and use smaller, secure apps for more limited communications. Some of these apps even inhibit immediate responses to a post, affording some time to contemplate. Some are so restrictive that it’s like writing a letter to someone, giving them time to read the entire message, taking some time to think, and then writing a letter back. (I don’t know why gmail isn’t considered sufficient to this task, but there you are.) Slow communication, both low- and high-tech, has had some profound effects.
These benefits of slow, quiet communication leads me to another book, The Republic of Letters, by Marc Fumaroli, an account of certain people in Europe in the 15th through 18th centuries. They felt the need to communicate with their peers (intellectuals, well-to-do businesses, academics, scientists) to preserve and share knowledge; keep discussion and dialogue going, and carry out cooperative efforts (such as viewing the same part of the sky at the same hour and reporting findings to help establish longitude), through the fog of never-ending European wars. This book has great detail about the format and courtesies involved in these correspondences. I urge readers to examine this book themselves. **** (The book is part of Yale University Press’ efforts to disseminate translations of many books to enable scholars and others to be aware of thought in other parts of the world.) As we see in this and in Beckerman’s book, the table analogy is very helpful and should be kept in mind.
Conclusions
Not all technology over there is as useful here as it claims. Just as Toronto had to walk away from Sidewalk because the information gathered would benefit Google but not necessarily the community; just as U.S. cities returned to normal air mapping and turned away from satellite mapping; so some recent revolutionary thinkers needed to turn away from mass media to communicate around a table of their own, and the correspondents in the republic of letters needed to stay at their own table to keep civilized thought going.
So do we. But there must be a time to join the big tables here. Join the big tables. Don’t throw them out with some sort of revolution. Bring your attention from over there to here.
** I have had much experience in the area of mental health and physical community. In the 1970s when Detroit was the murder capital of America, I was the “community chaplain” provided by the Michigan Dept. of Health to the Detroit Psychiatric Institute, as well as to the 24/7 emergency psychiatry clinic at Detroit General Hospital (no longer extant, I hear), and also to 130 room-and-board and nursing homes in Detroit and three counties. The department I worked for had a heavy emphasis on statistics, so I learned that the usual newcomer to the Detroit General facility landed there in roughly a week after arriving in the city from the rural American South. The culture clash was too much, and they simply lost their place anywhere. Because the Detroit Psychiatric Institute was one of the few buildings still standing after the riots of 1967, and because most of the community facilities I visited regularly were in slum areas, I learned quickly the relationship between physical and social environment, and mental health. I studied the plans for urban redevelopment centering around the Renaissance Centre, sponsored primarily by the Ford Motor Company. I preached at Black Presbyterian churches in the city and talked with people there, and tied to help the “community leave” patients find spiritual support and care at nearby churches. Talking with my patients and their families, the pastors, the home administrators, and community activists, and the hospital staff, I learned a great deal about how physical and social environments affect mental health, and how mental health difficulties influence perceptions of the social and physical environments.
***Are we really going to do just the minimum? – Upon reconsidering…
We have built our society on the wrong principles and values. – Upon reconsidering…
****I regret that this blog is not the same level of discussion as did the Republic of Letters, but who knows? Perhaps ore of my readers will decide to pick up a virtual pen and express their views to others as well as to myself.
Upon reconsidering... 