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By Marvin Ross

This has been on my blog to do list for a few weeks and I thought how clever am I to modify the phrase military industrial complex first spoken about by Dwight D Eisenhower when he ended his presidency in 1961. It refers to the close relationship between the defence industry and the military. Then, the other day, I discovered a recent book called the Autism Industrial Complex so I’m not as creative as I thought. My consolation is what my mother always said “great minds think alike” to which she also added “but fools seldom differ”.

That book points out that “within the Autism Industrial Complex (AIC), almost anyone can capitalize on-and profit from-autism, and she (the author) also shows us how. The AIC has not always been there: it was built, conjured, created, manufactured, produced, not out of thin air, but out of ideologies, rhetoric, branding, business plans, policy lobbying, media saturation, capital investment, and the bodies of autistic people.”

One review says that “ABA (applied behavior therapy) is still widely popular with parents despite the fact that its reputation is based on a study that has never been replicated and involved the use of physical punishments on children (Broderick, 2022, p. 164). In many jurisdictions, however, ABA is the only form of treatment that is funded or insured, and this book is a strong argument as to why that has to change.  

The comment about ABA reminds me of the promotion and reliance of mental health first aid to supposedly help those with mental illness – an unproven waste as I wrote about much earlier.

What I mean about the mental illness industrial complex is the fact that there are all manner of policy researchers, policy wonks, government officials, social workers, psychologists and god knows who else, sitting around on committees and writing papers trying to develop solutions for what they call mental health. What is mental health? We all have it but some have bad mental health caused by illnesses which these people do not seem to recognize. It is like setting up committees to discuss physical health which we also all have. The plans should be for specific health problems like schizophrenia or serious and persistent mental illness rather than the vague mental health.

For serious mental illnesses, these are the problems:

1 Lack of psychiatric beds so that it is difficult to find a bed for someone who is acute but when they find one they are discharged too early because there is a backlog of people waiting to take those beds.

2. Too few psychiatrists and other dedicated staff to treat these populations

3. Little to no community programs to provide ongoing support

4. No supportive housing or affordable housing of any sort so people are discharged to shelters or to the street. Many end up in jail.

5. Insufficient funding particularly when compared to other OECD countries.

These problems have been becoming worse over the years but we have had no end of committees and task forces set up to look at them. In Ontario, which I am most familiar with, there have been 18 such groups set up since about 1989 with recommendations all being ignored. One, which I contributed to, was released in 2010 with excellent recommendations almost all ignored.

The Mental Health Commission has been around for years and has produced many reports. The Commission arose from a Senate of Canada report called Out of the Shadows. They do nothing but churn out reports and it was concluded by an independent commission in 2018 “that MHCC, in its present form and with its current orientation, is not the best instrument to achieve the objective of integrating mental health into Medicare.”

Guess what? It is still around, still generating reports and still paying people. In their last annual report, they had expenditures of around $25 million. The president and CEO earns between $272,000 and $400,000 a year. Imagine how many hospital beds could be funded for that.

Medical organizations have treatment guidelines on how to best treat people with various ailments. They know how to treat serious mental illnesses but need more money and capacity to do so but money is wasted on all these study exercises. Other groups jump in as well so Health Standards Organization which accredits hospitals and other facilities has just come out with a new set of guidelines. Their first set was lambasted because they did not think to consult with psychiatrists. If you want to read it, it will cost you $119.00.

Health Quality Ontario has also developed guidelines for community treatment that seem pretty sensible. This is one example of their recommendations “Adults with schizophrenia have a safe, affordable, stable living environment that reflects their needs and preferences.”

Necessary and laudable but where are the safe affordable supportive housing? Affordable housing is so rare that refugees from Africa recently arrived in Toronto and there was no room in the inn. They camped out on a street corner in downtown Toronto until people were so embarrassed they rallied to support them and places were found. I’m glad and don’t resent that but who has rallied to find living accommodations for the thousands of homeless Canadians many of whom have mental illnesses and substance abuse problems?

To add to the circus of so called experts feeding at the public trough of reinventing mental illness standards a new groups was set up by the Canadian Government. At the request of the Prime Minister, the Associate Minister for Mental Health and Addictions (Dr Carolyn Bennett) has commissioned the Standards Council of Canada to generate a road map on what needs to be done. The SCC “promotes efficient and effective voluntary standardization in Canada in order to advance the national economy, support sustainable development, benefit the health, safety and welfare of workers and the public, assist and protect consumers, and facilitate domestic and international trade.”

Very little is said about mental illness and that does not appear to be one of their areas of expertise so they have been bringing onboard all sorts of “experts” in the field. After almost a year of work, they still do not seem to realize that mental illness is an issue but mainly talk about mental health and addictions.

All this effort and money spent, and still no concrete plans on how to help all those who suffer and their families.

We need to end this stupidity!

We need to do what is needed!

It is going to take a long time but we have to start somewhere.

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