Sasha Warren - Belacqua-Syndrome: the Political Economy of Psychiatry

Year after year, everyone from major psychiatric organizations to politicians and major news outlets sounds the alarm about an apparent crisis in the American mental health care system, usually after a high-profile exposé at an institution or act of violence involving a psychiatric patient. Despite the fact that all parties seem to agree that something must be done, despite flashy new laws and expensive programs rolled out in the major cities, despite the supposed reduction in stigma faced by psychiatric service-users, nothing substantial seems to change. Those diagnosed with a serious mental illness continue to die earlier, are killed more often, many live in poverty, struggle to find work and housing, and are often isolated from their peers. A 'crisis' implies decision, a choice that makes a difference. In truth, there is at present no crisis in mental health services, but only a long, withering death rattle and an inability to change in the face of intolerable conditions. This talk will argue that the mental health system's perpetual deferment of crisis can best be explained with reference to its role within the US economy. Every psychiatric service encounter is conditional on being effectively funded. Who pays for these services and why? This talk will map out a possible answer to this question through exploring the historical relationship between mental illness and labor, the funding streams into psychiatry, psychiatry's function in the economy, and the composition of the mental health labor force.

Sasha Warren is a writer and mental health worker living in Minneapolis. He writes on psychiatric history, policy, and law on his substack Of Unsound Mind. In March, 2024, he released his first book Storming Bedlam: Madness, Utopia, and Revolt on the history of revolutionary and reactionary psychiatry with Common Notions. He is the cofounder of various projects focused on mental health: the Minnesota chapter of the International Society for Social and Psychological Approaches to Psychosis, the Network of Alternatives to Psychiatry, and Hearing Voices Twin Cities.

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Psychosis in the City is a series curated by Dr. Christopher Landry, a psychiatrist, psychoanalytic candidate at Columbia University, and a Foundation for Community Psychoanalysis Community Psychoanalysis Grant Recipient. He is the Associate Medical Director at Fountain House, a therapeutic community supporting recovery for people with Serious Mental Illness, and co-founder of the Constellation Program, a psychoanalytically-informed treatment program for young adults experiencing psychosis and extreme states.

With the Foundation for Community Psychoanalysis Chris is working on three interrelated endeavors. The Foundation supports the Constellation Program as a space for 1:1 therapy as well as group work facilitated by Isaiah Madison. Chris also organizes the Working Group for Community Mental Health Workers and he leads the speaker series Psychosis in the City, produced in collaboration with the Greene Clinic Speaker Series, hosted at the Foundation space.

Host or Publisher The Foundation for Community Psychoanalysis