APA’s 'apology'?

From a Global South/Psychosocial diverse perspective, it seems to us that APA’s apology is late, scant and contradictory.  Here we explain why we find it unacceptable.


As a consequence of the massive protests and other ongoing actions carried out within the framework of the Black Lives Matter movement in the United States of America, the American Psychiatric Association (APA) published on its website an alleged apology to BIPOC communities for psychiatry’s historic support of structural racism in that country. Speaking out against racial oppression is relevant to achieve Social Justice; that is, to achieve a balance between the different sectors of society. However, to achieve these objectives it is necessary to preserve and develop fundamental rights, without barriers such as racism.

The APA apologizes for collaborating with structural racism because it recognizes that psychiatry has contributed through its practices -diagnostic labeling and 'treatment' of divergent behavior or manifestations of psychic suffering- to the situation of exclusion experienced by BIPOC people who have been labeled.

Although we welcome with empathy and sorority the hope that APA’s apology might bring to BIPOC communities and other recipients, as a regional organization which pronounces on Social Justice, we consider that without respect for human rights and freedoms for everyone -including us, Mad people-, Social Justice cannot be restored. 

From that approach, the APA's apology is unacceptable because it is not accompanied by evidence of the cessation of its practices which decontextualize the suffering of all people. Its unfortunate approach to human suffering -biomedical, mechanistic and reductionist-, continues to make psychiatry responsible for pathologizing natural and even healthy reactions, in favor of a system that destroys and depredates the ecosystem on which human beings depend.

In this vein, APA is also responsible for various discourses and devices that make trauma -childhood, transgenerational, war, abuse, systemic and structural violence- invisible. These devices have dismantled and replaced organic and traditional practices of our communities, which remain at best recognized or questioned as "alternative practices". We are not talking about an isolated incident, biological psychiatry affects millions of people and therefore perpetuates each and every one of the exclusions that intersect with the structural racism experienced by BIPOC populations; psychiatry’s current medical acts are compatible with the thinking and behavior of white/western supremacy.

Psychiatry is and has been a tool to practice the colonization of consciousness, thought and behavior all over the world. It’s servitude to capitalism is undeniable, it gets rid of the ‘obstacles’ that the human condition presents by constantly suppressing symptoms of discomfort and controlling divergent behaviors with stimulant, sedative or depressant drugs, as the case may be. With its aid, the depredatory machine of capitalism can continue to operate effectively.

Our region is no exception: all the harmful effects of psychiatry have affected us, there is proof that it was at the service of Military Dictatorships. Even in countries with democracy "Latin America style", the influence of products such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the practice of psychiatrists and general practitioners is undeniable; and it also impacts legislative decision-making.

In fact, the entire region has signed the UN Convention on the Rights of Persons with Disabilities (CRPD), but the internal legislation remains unharmonized, due to the fact that legislators and promoters of "mental health laws" guide their decisions through products of American psychiatry, such as the DSM. There is no paradigm shift. Colonialism is still in force; hence, our reply is legitimate.

The impact of APA's practices is not trivial if we remember that they come from a country where the CRPD is not implemented, these practices land in our countries where serious and broad consultation with organizations led by people of psychosocial diversity is still being postponed. 

Therefore, it is not surprising that APA's apology does not refer to a verifiable transformation plan with a calendar and objectives aimed at both professional practice, as well as university/academic training and/or industrial research. That is, a transformation that ensures compliance with articles 8, 12, 13, 14, 15, 16, 17, 18, 19 and 21 of the aforementioned CRPD, which are none other than the provisions referring to dignity, access to justice, physical and mental integrity, autonomy and fundamental freedoms, including freedom of expression.

It would seem that our lives do not matter to APA, and if they do not raise awareness about their present indifference to Human Rights, then their apology does not restore Social Justice.

Given APA's unawareness about violence to human rights in psychiatric contexts, as a regional representation of a historically discriminated group, we find it urgent that our organization follows:

-Spreading knowledge about Human Rights among our collective, rights which APA and its followers must respect.

-Discussing and commenting on the reports of international organizations on human rights and mental health.

-Promoting dialogue and decolonial reflection in the region.

-Mapping and analyzing the situation of people of psychosocial diversity in Latin America.

-Demanding transformation and compliance with human rights standards, before the Inter-American Court of Human Rights; as well as clarification and reparation for victims of psychiatric practices.

-Demanding Social Justice.

As the psychosocial diversity community, we consider that without a critical reading of said text, in a few years we will see APA apologizing for its current support and execution of torture procedures, such as lobotomies, forced sterilizations and electroshock. Or, apologies for using police brutality to operate non-voluntary internments. Not to mention to think of reparations for all the iatrogenic damage facilitated by not respecting the right to informed consent of their patients/users/clients. Even more difficult to imagine is some sort of recognition of generalized conflicts of interest in the #MentalHealth industry, promoted no less by the #PharmaceuticalIndustrialComplex.

We will wait no longer. On behalf of the Mad community in Latin America and from the pride of being who we are, we demand the total abolition of the biomedical-psychiatric model, saying to APA and its followers:

Yes: Black Lives Matter and Mad Lives (our lives) Matter too!!!

Translation: María Isabel Cantón