The following dialogue explores the exploitation and alienation of youth within the mental health industry.
Arturo: Based on conversations we’ve had, it seems like you place a lot of value on the role of mental-health work within radical struggle. You are also a behavioral therapist. Can you describe what that job entails?
Iresha: I work for a behavioral health company in Philadelphia. My job is two fold. I’m a lead clinician in the therapeutic treatment program of a school. I work there from 8 to 3. 5 days a week. The other part is family therapy, or what is called “mobile therapy,” where I leave the school and go into the homes of the kids and their parents to work around issues that have been identified in the home. I do that after school, 4 days a week. At the school the students I work with are identified as having “behavioral problems.” The school refers the child to the company I work for. We assess the child’s behavior and recommend what level of services they need, like if they should see a psychologist. As a lead clinician, I do direct observations in class settings, group therapy, and one-on-one therapy.
Arturo: How old are your clients?
Iresha: They’re in K through 4th in the school. But in the community they’re anywhere from 5 to 18.
Arturo: That’s a big range of people. What’s the area like where you work?
Iresha: When I go to the student’s homes, they’re all in the proximity of the school. Its in the Frankford, Juniata, Kensington area of the city. It’s a very poverty stricken area. Most of all the parents of the kids I’ve worked with are single mothers, single heads of households, or there’s no parent in the household and it’s the grandmother or auntie raising the kids. I’d say that in roughly 90 percent of all the clients that I’ve had, the father is incarcerated. Or if the father is around, he is back and forth into prison. Some of the kids are going in and out of different foster homes too.
Arturo: What are some of the problems you see in your job?
Iresha: One, they refer a child for one or two incidents of what is deemed “aggressive behavior.” So if a child comes to school and throws a chair or curses out the teacher, he’s labeled as a behavioral problem. He or she could easily be labeled for ADHD or Autism, which follows the kids around for the rest of their lives—
Arturo: Like a criminal record…
Iresha: Yea. Thats fucked up. The child gets refereed to us and seen by the psychologist where a diagnosis is made. Even though there are home problems, problems from society—like a lot of my kids are displaced or homeless—the school and the company I work for doesn’t consider those factors. They just see a child having effects of trauma, some of it physical, sexual or take for instance; I have many children whose parents work all the time, so the child comes to school and engages in attention seeking behaviors. The system just sees the child as a problem. They don’t investigate what is happening to the child.
Arturo: Does money get made off the child with “behavioral problems”?
Iresha: The school actually gets money for the diagnosis. I’ve heard it’s in the thousands per child. The mental institutions that many students are sent to get money too. Those who provide the medication also get paid. So do the parents. If their child has a diagnosis, the parents can receive 700 to 800 dollars from SSI. Do I think some parents exploit this? Yes. But is that their fault? No. If I am a single mother with children, and I have no income, and SSI is telling me that they will give me 700 to 800 dollars if my child has this diagnosis, I might take it. I see it all the time. And parents will ask me if I can evaluate their other children too, and the question following this one is always, “will I get an increase in my SSI?” Its a fucked up situation, because in the end it hurts the child, but I blame the system for putting parents in that position.
Arturo: So the diagnosis and treatment of these kids is a way to make A LOT of money. I would image that the “medications” are an especially large source of capital accumulation. How does that play out?
Iresha: Besides the incentive of getting money for having a child with “behavioral problems,” there is also a lot of persuasion and manipulation going on. Medication is an option, but the way some schools talk to parents, they make it seem like its an urgent need. I’ve seen schools bullying parents into medicating their children. They call the parents to come get their kids a lot (and parents actually don’t have to get their kids if they don’t want to, but they don’t know that). Some kids might need medication in some cases, but do large amounts of children in one concentrated area need medication? No. Whats happening is that they put these children on medication, and they learn to function with it. And when the parent doesn’t give the child the medication, there is such a dependency on it that they can’t function without it and go through withdrawal. I’ve had kids act up in school and when I ask them why they are acting up, they say, “ohh I haven’t had my medication today.” So it becomes an addiction, and what I worry is that this is leading to more serious drug problems.
Arturo: So children are being singled out by the school system for “behavioral problems,” which are really socio-economic problems, and given a chemical treatment?
Iresha: Yes. When I sit in on what are called “bio-social” evaluations, the psychologists ask all these questions about home life, and the mother is crying her heart out about how they don’t have money, the father is in prison for life, or they are going through sexual trauma, and after the evaluation is done and I get it back so I can write the therapy plan, none of that is in the diagnosis. And there will just be ADHD, DBD, and all these things. And thats crazy to me. I mean you clearly heard this lady say all these things and its nowhere. One diagnosis that especially blows my mind is ODD, oppositional defiance disorder. And I’m like, I have that!
Arturo: Can you describe the symptoms of that diagnosis?
Iresha: Talking back to authority figures, not listening, not complying with directives.
Arturo: Hmm. And so kids with these “behavioral problems”are also being detained in psychiatric institutions?
Iresha: Yes. My clients that get hospitalized or refereed to partial placement—they describe it as prison. They’re isolated in these rooms all day and the only human contact they get is people handing out medication to them. Theres little social interaction. The schools are like prisons too. One day I had a child who was brought straight out of the mental hospital into the school. They didn’t bring him home or anything. And he just started flipping over desks and chairs and cursing everyone out. So the school staff puts him in an isolated room, by himself, thinking that they’re gonna cool him down and deescalate him. He went ballistic, crazy. And I’m like, does anyone think that this is traumatic to the child? No one takes into account that he was in foster care, got returned back to the family, which is homeless.
Arturo: So you’re saying that your profession doesn’t actually address or solve the kid’s problems?
Iresha: It addresses problems, but it’s only temporary. We need collective healing and therapy in our homes, community and movements. I always said my job puts band-aids on the problems to remedy them. But I think we need to overthrow capitalism to shut down all this shit. These children are living in economic isolation. Their issues are the result of a lack of resources in the community, something which people of color struggle with disproportionately. The people trying to survive go mad and need help. Its still taboo in black and brown communities to go to therapy. Because we don’t trust those people, we think we don’t need them, especially with the whole “strong black woman” thing, you can dump all this shit on our shoulders and we will rise up out of it. And thats true in some regards. We are resilient. However, I don’t think its alright.
Arturo: What role do you think behavioral therapy could play in a revolutionary struggle? Or in a revolutionary organization?
Iresha: That’s a good question. Because I think about the future. I think about all the things I’ve learned about therapy, this hands-on experience, and I think about how I can use it for the people, as opposed to working for a company that I know exploits people. I’ve also been in some radical organizations where I’ve seen people with mental issues. I don’t know, that’s something I meditate on constantly—how can we all move towards collective healing? I think in movement work, we need to be able to have those discussions about what community-care and mental health means for oppressed communities, for our people, as we survive and fight.
Arturo: Well thank you so much for sharing your thoughts. This was great.
Iresha: Thank you.