Thursday, January 7, 2010

Psychiatry and national health security

The U. S. Department of Health and Human Service recently released a document presenting the first National Health Security Strategy (NHSS) pursuant to section 2802 of the Public Health Service Act. ( The strategy is intended to help minimize health consequences of "significant health incidents", defined as including, but not limited to, infectious disease outbreaks, hurricanes, earthquakes, storms, tornadoes, tsunamis, hazardous materials spills, nuclear accidents, biological and other terrorist attacks, and fires.

This is a 48-page document well worth reading. Two things struck me: 1) The document envisions bad scenarios which would threaten security sufficiently to warrant virtual martial law; 2) It is replete with statements recognizing an overarching necessity to convince the people to trust and independently cooperate with organized efforts by authorities in the amelioration of any significant health incident.

As to number 1, the only thing I might say is that high governmental authorities always have such contingent functions and powers, implicit or explicit. Although the subject is scary, it's better to have more discussion of it, not less. The planning and thought HHS has put into this is evidence they're doing their job, and not necessarily indication of any evil conspiracy.

Number 2 is much more interesting. First of all, it reminds me of the essential point in General Rupert Smith's book about the new paradigm of war among the people. (This was mentioned in my post of December 28.) The only achievable strategic victory in modern conflicts involves winning the popular will, above all else. For corresponding reasons to those which Smith explores, in less formally military contexts emergency social controls can perhaps only be effected broadly with substantial uncoerced voluntarism.

That means that ultimately, HHS can only employ health security policies which first of all secure the basic faith, confidence and consent of individual Americans.

So what of psychiatry?

I read a New York Times book review not long ago which opined that our recent love affair with modern psychiatry is a sub-prime crisis waiting to happen. I believe that. The biggest health fraud in history is psychiatric "diagnosis" and "treatment".

The ultimate security threat is a catastrophic failure of confidence in authority. Battles and wars are lost pricisely and only when one side suddenly believes it has lost. I would urge the would-be architects of any national health security plan to distance the state from psychiatry as soon and as thoroughly as possible.

Otherwise, when the government most needs the confidence and cooperation of the people, and when we all most need social cohesion in the face of disaster, we may hear the sound of something like a guillotine instead.


  1. Politicians do not need the cooperation or confidence of those who are dependent on the government for virtually all their needs. The average person today clings to the government for protection, support and explanations about every phenomenon they can't comprehend on their own. It is easy to push any sort of policy on incompetent and needy sheeple.

  2. My point is that the guys who wrote this HHS "strategy" sure seem to think, or perhaps fear, that the politicians will need cooperation and confidence. Pushing policy is different from pushing action in extreme circumstances.

  3. Viewing the Keyston Cops quality of our military's handling of the Haiti relief effort, I would think that our dear government would need all the cooperation and confidence it can get from the public were a significant health or other public "incident" to occur. The government gives no indication that it has the ability to control a tempest in a teapot, let alone a national emergency.

    I guess that cooperation and confidence would be ginned up by Cass Sunstein and his minions.

  4. Yo, Drive-By! Sunstein's teams of covert agents and pseudo-independent advocates assigned to "cognitively infiltrate" online groups and websites would be an excellent little investment in exactly that kind of open dialogue and free market exchange of ideas which has made the USA the first cultural superpower since the Roman Empire.

    The government should definitely do this, they might learn something. The fact that Sunstein himself might think influence would flow primarily in one direction rather than the other - i.e., from the smart establishment "infiltrators" to the ignorant ideological fringe dwellers - is nothing but a reflection of his arrogant and completely unrealistic elitism.

    Conversely, any fringe dwellers in the intellectual/political universe who are afraid they'll be "cognitively infiltrated" by Cass Sunstein are simply insecure about their own thought, or unwilling to engage for fear of being unable to persuade.

    I BEG Cass Sunstein and the Obama administration: PLEASE cognitively infiltrate me!

    And incidentally, I find their naivete oddly inspirational, a relief from the run-of-the-mill cynicism born of too many years, too many lives, in that old wilderness of mirrors.

    Intelligence tactics can only be undercut by true purpose, but against that rock they will always eventually founder.