A recent book edited by eminent psychologists Rogers Wright and Nicholas Cummings delivers a stunning indictment of the mental health professions. Destructive Trends in Mental Health: The Well-Intentioned Path to Harm documents and critiques the ascent of social activism over open-minded scientific inquiry and quality mental health care in the current mental health establishment. This book is a must-read for anyone who cares about mental health care in this country.
The book casts a critical eye on much of the social activism of the psychological and psychiatric professional associations over the past thirty years. However, Drs. Wright and Cummings cannot be dismissed as disgruntled conservatives. Their deeds validate their claim to be "lifelong liberal activists." For instance, while president of the American Psychological Association, Dr. Cummings supported the development of the first task force championing the mental health needs of gays, lesbians and bisexuals.
In addition to being personally involved in social activism, the authors have been keen and pragmatic observers of the mental health professions over the past 40 years. My own contact with Nick Cummings made a lasting impact on me. I first met Dr. Cummings in 1986 when American Biodyne, the first real managed behavioral health care company in
As one example, Cummings and Wright demonstrate how political support for gay activism has led to stifling of client self-determination. Consider this quote from the book regarding sexual identity therapy:
"In the current climate, it is inevitable that conflict arises among the various subgroups in the marketplace. For example, gay groups within the APA [American Psychological Association] have repeatedly tried to persuade the association to adopt ethical standards that prohibit therapists from offering psychotherapeutic services designed to ameliorate "gayness" on the basis that such efforts are unsuccessful and harmful to the consumer. Psychologists who do not agree are termed homophobic. Such efforts are especially troubling because they abrogate the patient's right to choose the therapist and determine therapeutic goals. They also deny the reality of data demonstrating that psychotherapy can be effective in changing sexual preferences in patients who have a desire to do so." (From the introduction, page xxx).
Sexual identity therapy is not the only political hot potato tackled by the authors. They demonstrate how politically correct posturing can serve to obscure research findings. For instance, co-editor Wright cites research by Cummings suggesting that positive male figures in the lives of children are significantly related to a decrease in the number of children requiring medication for behavior problems. However, he laments that such research results are frequently stifled or even dismissed because they offend feminist sensibilities.
Drs. Wright and Cummings express concern over the professional consequences of psychology’s misadventures into social activism. They paint a picture of psychologists being unable to support themselves as psychologists because the profession has become enamored with producing position statements about social change. Mental health care in
So how is the current leadership of the APA reacting to the critique of Cummings and Wright? Not well. It appears the former APA luminaries are getting a cold shoulder from the current leadership. At a recent meeting of National Association for Research and Therapy of Homosexuality, Dr. Wright noted that the APA adopted a "strategic decision not to respond" to their book to avoid giving it undue attention. Furthermore, the APA initially prohibited its member-publications from even reviewing the book. Observed Dr. Wright: "So much for diversity and open-mindedness."
In my opinion, the current APA leadership will ignore these warnings at their peril. When it comes to trends in mental health care, Nick Cummings has rarely been wrong in his predictions. I don't think he is wrong this time.