By the Rank and Filer, November 2010
I wrote the following piece for in social work school a couple years ago for a class on psychopathology. It is a favorable account of the organizing done by RIPPD, an activist group of formerly incarcerated people living with psychiatric disabilities and their families. I don’t think my essay here is particularly remarkable, but I feel I owe a debt to these folks who took time to talk to me. In honor of their work, I share it here.
Rights for Imprisoned People with Psychiatric Disabilities (RIPPD) is a social justice community organizing and leadership development project in New York City. Through RIPPD, formerly incarcerated people living with psychiatric disabilities and families members organize aggressive campaigns to win improved mental health care for prisoners and reduce police harassment and incarceration rates, and to abolish the prison industrial complex. Their work prioritizes creating an empowering, transformative space for people with psychiatric disabilities to develop organizing skills, confident leadership, critical analysis and the ability to authentically express discontent and anger at social injustice. RIPPD sees itself as challenging a culture of mental health advocacy that prioritizes acquiescence to authority, social conformity and docility. Through RIPPD, participants have forged new narratives to understand their own mental health conditions and the social place of mental illness. Social work students of psychopathology have a great deal to learn from the organizing modalities and analyses of RIPPD.
“You have to feel the struggle deep in your bones,” began Nafis Qasim Rashed, “deep in your eyes, in your heart, in your mind. We live with mental illness our whole lives, and it drives us to struggle, to fight back, to fight for the right reasons.” Nafis is a father, a husband, and in his words, a conscious rapper. In the midst of homelessness, incarceration and time spent in addiction, Nafis had what he understands as a contact with his higher power that guided him in committing his life to ‘doing right in the world’. In 2008, he came to join Rights for Imprisoned People with Psychiatric Disabilities (RIPPD). Nafis continued, “I never felt peace before I came to RIPPD.”
Nafis’s remarkable self-narrative, seeing mental illness as a positive basis for an ongoing commitment to social justice, reflects the empowering development of critical analyses and organizing leadership at the heart of RIPPD’s work. Several elements make RIPPD an unusual organization: its commitment to leadership by a population traditionally considered hard or impossible to organize; its unusually militant presentation and organizing style; an abolitionist analysis of the prison system; and its unique positioning within the field of mental health care.
Organizing
“We were the shit on the bottom of their shoe,” explained Lisa Ortega, Lead Organizer with RIPPD, referring to the disrespect people with mental illness faced within New York’s social justice organizing and advocacy projects. “Forget about it. We are preyed upon in prison, so everyone avoids us. It was time for us to fight back.”
Lisa was hired as an organizer in 2003, starting RIPPD as a community project. Before her hire, Heather Bar had been providing legal advocacy through New York City’s Urban Justice Center to incarcerated people living with mental illness facing discrimination, abuse and mistreatment at the hands of prison officials. She quickly found that one lawyer was not enough to deal with the scale of structural and systemic abuse. Lisa had previously worked as an organizer for Mothers on the Move, a community organizing project working with public housing residents in the South Bronx. Lisa began the project with a handful of family members of imprisoned people, and formerly incarcerated people living with psychiatric disabilities. They conducted extensive outreach, eventually building a group of 25 core leaders. In 2005, RIPPD hosted Hunter College School of Social Work Intern Mary Doughtery, who was hired to help with logistical coordination in 2006.
RIPPD has since taken on a host of campaigns. In 2003 and 2004, RIPPD helped lead a successful effort to get the New York State prison system to discontinue the use of Special Housing Units (SHUs). SHUs served as segregated disciplinary housing in New York’s prison system, and were disproportionately used to house prisoners living with psychiatric disabilities. Often in solitary confinement, these prisoners were permitted to leave their cell less than one hour a day, facing “severe sensory deprivation, social isolation, and extreme boredom and idleness – conditions harmful to anyone’s mental health” (RIPPD, as quoted in in New York Association of Psychiatric Rehabilitation Services, Inc. (NYAPRS), 2003). Leah Gitter joined RIPPD early in its formation, serving as one leader in the campaign against SHUs in defense of her godson in prison. Leah reported: “There is no way to express the misery and suffering produced by confinement in SHU” (as reported NYAPRS, 2003).
As their organizing against conditions in prisons developed, RIPPD began to see the need to keep people out of prison. In 2006, RIPPD formed a coalition advocating for expanded alternative to incarceration (ATI) programs, called Changing Minds: Mental Health Alternatives to Prisons. Changing Minds pushed for the establishment and improvement of a mental health court in Queens, called for a Community Review Board to oversee the court (Ortega, 2006). Led by RIPPD, Changing Minds continued to hold large community meetings annually until 2009.
In 2006, RIPPD also led the formation of a coalition, Community In Unity, to stop the construction of a new jail in Hunt’s Point in the Bronx. Collaborating closely with other anti-prison and South Bronx community organizations, RIPPD successfully derailed the jail construction program in March 2008 (Community In Unity, 2008). This campaign had a significant impact on RIPPD’s understanding of the prison system. While RIPPD had always been critical of prisons as a means of addressing social problems linked to mental illness and people living with mental illness, through this campaign they developed a prison abolitionist analysis.
RIPPD collaborated closely with Critical Resistance in the Community In Unity coalition. Critical Resistance was formed in 1998 as a national network of organizing projects committed to the complete abolition of the prison system. Critical Resistance popularized a concept of “the prison industrial complex” (PIC) that linked the prison system to a broader apparatus of social control, disciplinary institutions, for-profit corporations and state violence that included immigrant detention facilities, jails, police, coercive social service systems, and prison corporations. Critical Resistance saw the PIC as fueling the very problems it has been used to address: violence, poverty, racism, homelessness, drug use and social marginalization. Instead, Critical Resistance projects called for community-based, humane and transformative models of safety, justice and conflict resolution. Many Critical Resistance chapters have organized against jail and prison construction, and see it as a natural outgrowth of abolitionist politics (Samuels & Stein, 2008). Today, through the influence Critical Resistance in the struggle against the jail construction, RIPPD calls for the abolition of the PIC.
In recent years, RIPPD has been focusing on pushing the New York Police Department (NYPD) to use Crisis Intervention Teams (CITs). CITs are currently in use in many U.S. cities. “Police get a 911 call because someone has decompensated and is talking to themselves in the street,” RIPPD member Carl Van Potter explains. “They show up, and they don’t know what they are doing. A dozen undercover officers surrounding the guy, threatening him. I have seen this happen so many times! And he freaks out. He attacks a cop, or yells, or won’t do what they tell him to do. So he gets locked up – resisting arrest, assaulting an officer.” RIPPD proposes that CITs provide the first response to 911 calls concerning displays of psychiatric symptoms. Such teams could include trained peer specialists like RIPPD members, social workers, counselors or others adept at talking someone down from a serious psychotic episode or other mental health crises. Such teams would help reduce arrests and incarceration of people living with mental illness. Recently, RIPPD confronted the New York City Police Commissioner at a public conference, demanding the implementation of CITs.
RIPPD has also worked on many other issues over the years, including pushing for greater discharge planning for people with psychiatric disabilities from the city jail system, protesting specific incidents of police abuse and murder, and supporting specific prisoners.
Overall, RIPPD occupies a crucial place within New York City’s movements for prison healthcare, police accountability, community-based mental healthcare, and against the expansion of the prison industrial complex.
RIPPD is also reflective on its development as an organization. Throughout its history, RIPPD has been housed within the Urban Justice Center (UJC). UJC is an important social justice institution in New York, centered on legal advocacy for a range of issues affecting poor communities. UJC has hosted many start-up organizing and legal advocacy projects that later became independent. RIPPD is critical of UJC’s “corporate nonprofit model”, in the words of RIPPD staff Mary, and aspires to becoming fully independent as an organization.
Empowerment
Following a period of homelessness, Nafis joined Howie the Harp, a job training and social service program for people living in mental illness. Through Howie the Harp, he joined in advocacy lobby trips to Albany to speak on behalf of people living with psychiatric disabilities. Nafis found, however, that Howie the Harp imposed narrow expectations of social conformity and docility on its participants, expecting them to fit into office jobs and quiet lobby meetings. Frustrated with the limitations of this advocacy, Nafis arranged an internship at Rights for Imprisoned People with Psychiatric Disabilities (RIPPD). “We have to fight the expectations the public puts on us,” Nafis explained. “They want you to wear your nice clothes and be satisfied. Give you the skills to fit into a cubicle.”
Nafis’s experience is shared by many in RIPPD. Progressive New York social service agencies, including mental health programs, have helped build an infrastructure to advocate for state policies and funding that benefits their clientele. Often, such advocacy strategies are modeled on a highly conciliatory strategy, including annual legislative advocacy meetings where little controversial or challenging is said. The author has organized many such meetings during her years organizing with both people living with HIV and AIDS and rent regulated tenants. RIPPD is one of the few New York City groups that don’t follow such a conciliatory strategy, instead openly expressing outrage at elected officials on a regular basis. While this strategy has certainly alienated many elected officials, it has also won considerable successes, as detailed in the previous section.
This commitment to authentic expression is integral to RIPPD’s model of empowerment and leadership development. “We are totally upfront,” Lisa explains. “We never hide who we are. We never mask it. We just say what we think, with complete honesty. All these community groups get money to work with the community, but they don’t do anything. If we speak up, we are called noncompliant, dangerous, out of control.”
Inseparable from authentic expression of anger at social injustice, RIPPD also prioritizes having people directly affected by incarceration and psychiatric disabilities speak entirely for themselves, without representative intermediaries. “No one else can represent you,” Nafis explained. “Only we can represent ourselves.”
Myra outlined this organizing philosophy. “RIPPD is about empowering people. We protest and demonstrate, and always people who are affected take the leadership roles.”
RIPPD is also committed to a participatory, inclusive and democratic process in making decisions. “We don’t have some directors setting the agenda, and then going around bribing consumers with a bag of lunch to go along with it,” Lisa explains, referring to a prevalent organizing and advocacy model. “We get together, and all decide it together. Our meetings can get really wild, but we give room to everybody to be a part of the process. It might seem crazy to someone walking in, but we get a lot done. We accomplish a lot in those meetings, and everyone is a part of the process.”
Mental Health
Models of understanding mental health have been subject to considerable debate. Social workers have criticized the over-medicalization of mental illness, abstracting symptomatology from social context. Other social workers, like Saleebey’s “The Diagnostic Strengths Manual?” have drawn attention to the ways dominant categories of mental illness devalue individual and communal strengths. Michel Foucault launched an even deeper critique, charging psychoanalysis, psychiatry and modern notions of mental illness evolved as systems of social control and discipline. Drawing from the work of Foucault, Thomas Szasz and R.D. Laing, the antipsychiatry movement took shape in the 1960s, charging psychiatry with systematic abuse, oppression, and imposing narrow definitions of normalcy. Later, this antipsychiatry movement developed into current organizing by mental health consumers.
Each of these respective critiques hold distinct notions on the nature of mental illness. While RIPPD has no clear organizational position on mental health diagnosis, it’s organizing reflects a sophisticated and evolving understanding of the complex politics of mental health care with significant differences from any of these frameworks.
Here is the quote in full that opened this paper, from Nafis Qasim Rashed:
You have to feel the struggle deep in your bones, deep in your eyes, in your heart, in your mind. We live with mental illness our whole lives, and it drives us to struggle, to fight back, to fight for the right reasons. We are blessed, you understand. We are blessed because we are in touch with reality. I’ve suffered a lot in my life. And my mental illness means I can’t ever forget, My mental illness means I can’t ever stop working for what is right. There are so many people out there hurting. Now our power is growing, fighting for people living with mental illness. The world looks at you like you are crazy. And the question is: what are you going to do with this title? You have to take a stand in the world. You have to fight for what’s right.
Nafis’s understanding of his own mental illness is remarkable and rich. For him, mental illness is a motivation towards social justice ingrained deeply in one’s body. Mental illness, the suffering it entails, necessitates participation in social justice movement and struggle. This experience is profoundly corporeal, inescapable, and lends transformative value to the experience of psychiatric disabilities. In this sense mental illness is a “blessing”, an access to move pass denial and acquiescence into reality – a reality defined by violence, suffering, and the possibility for transformation and justice.
This perspective on mental health, while Nafis’s own, is reflected in many aspects of RIPPD’s organizing. RIPPD values the leadership and participation of people living with serious mental illness, seeing this leadership as fundamentally integral to building viable movements for social change and the reform of police and prisons. Here mental illness, while a disability linked to a variety of difficulties in a person’s life, is also a bridge in collective participation in social justice struggle. Motivation for reforming public policy is not just abstract interest, but is embedded deeply in how each member lives their lives, lives with their bodies and minds.
RIPPD has launched a sustained challenge to models of mental health care that centrally locate state violence, police and prisons as means of dealing with people living with psychiatric illness. Prisons serve the primary mental health provider in the United States, but are rarely taken seriously within curriculum for mental health providers. While few social workers would condone the mass incarceration of people living with mental illness, the author can personally attest to the absence of any curriculum on prisons and incarceration in her three semesters of Human Behavior in the Social Environment within a Masters of Social Work program. For RIPPD, the entire system of prisons, jails and police are ongoing sources of social violence for people living with mental illness, and should be entirely replaced with more effective and humane care.
In this sense, RIPPD strongly defends and advocates for community-based mental health care. Even here, however, RIPPD is not entirely uncritical. They readily detail criticisms of specific mental health service providers, as enforcing models of social conformity that are disempowering to people with mental illness. Lisa and Nafis’s critique of Howie the Harp, for example, challenge the ways the service provider pushes people with mental illness into dull office jobs with little social value. Nafis further draws a parallel between prisons and mental health hospitals: “We have to fight for the people inside prison, and fight for the people in the hospitals, which are just like prisons.”
RIPPD does not, however, express much interest in challenging mental health diagnosis or medicalization per se. For RIPPD’s members, accurate diagnosis and access to respectful care can be integrally valuable to developing adequate supports in living with mental illness. The form, organization and social conditions of care systems are of far greater importance than potential negative implications of diagnositic systems.
RIPPD’s organizing suggests a transformative and radical understanding of the role of people living with psychiatric disabilities in society. Their work calls for care systems rooted in dignity, empowerment, and a respect for the diversity of human expression among people living with psychiatric disabilities. They recognize people living with mental illness as core agents of social change and leaders in a broader social movement to abolish prisons and police violence. RIPPD continues to evolve ways of understanding mental illness and mental health care that recognize the complexity of members’ experiences and value their unique social contributions.
Implications for Social Work Students
Social work students would have a great deal to learn from RIPPD. While our curriculum on psychopathology largely limits critiques of psychiatric care to a need to examine social context, the actually existing social context of state violence in the lives of people with mental illness is rarely considered. RIPPD draws attention to the preponderance of policy violence and mass incarceration as a central experience for people living with mental illness. RIPPD offers a bridge between studies of human behavior, psychopathology, community organizing, agency administration and public policy. Their critique of the state is far more sophisticated and radical than often shared by social workers. Further, their understanding of the specific value and form of empowerment could be appropriately incorporated into a wide variety of service settings.
Special thanks to the members and staff of RIPPD, whose generous sharing of their time, experiences and vision made this paper possible.
Unless otherwise noted, all quotes are from a November 17, 2010 personal interview with RIPPD staff and leaders, including (in alphabetical order) M. Dougherty, L. Gitter, M. Hutchinson, L. Ortega, C. Van Potter, N. Qasim Rashed, and J. Sunshine. All participants agreed to have their names included.
The author is grateful to have had the opportunity to organize in coalition with RIPPD on prison healthcare issues during her time in HIV/AIDS services advocating for improved prison care.
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