discerningacall:

notbecauseofvictories:

Today we had an attorney come in to my healthcare class, who works for a major law firm dealing primarily with mental health esp. its intersection with criminal justice. Near the end of his lecture, he was talking about how a mentally ill person who is arrested can “successfully” transition through the system (i.e., released on bail with the condition they be hospitalized, receive treatment, and stabilize; or are screened for mental health at Cook County, and enter one of the mental health courts in Chicago, etc.)

When I asked what he thought the difference was between a success story and the people that the system fails, he answered: “They had that one person, just like I imagine all of you do, who saw them and helped them. Whether the judge who saw their potential, or the attorney who fought for them, or the social worker who went the extra mile, they all had people willing to help.”

I think he meant it to be inspirational, in a “you can have a profound effect on someone’s life!” sort of way. But in that moment I was so angry because the whole point of building highly-regulated systems like criminal justice and healthcare is twofold—first, to make sure that an individual doesn’t have to rely on the grace of a wonderful stranger, and second, to inform the behavior of strangers.

I mean, surely we don’t spend so much time talking about fairness and justice and equality if the basis of governance is the (ephemeral, emotional) inclination of individuals. It is the promise of a well-built system—any system!—that you do not have to hope and pray that someone will have compassion go the extra mile to get you the help you need. We built the system to get you what you need as a matter of course! Taking care of your needs has been operationalized. And if that’s not what’s happening in a system, we need to revise it into a better system, where the extra mile is the baseline, or delivery is better.

Individual self-interest is the strongest force in the world—not in a willfully malicious way, but in garden-variety, inertia-riddled ‘I’m looking out for what’s important to me’ sort of way. It manifests in a hundred different ways, apathy and doing the bare minimum, bad days and cutting corners, thinking of the bottom line. No one can be “on” all the time, especially in fields that involve heavy emotional work (social work, prison work, healthcare…anything where it is important to remember human dignity.) To rely on moments of disinterested and comprehensive compassion to make our systems work is to fight human nature. Therefore, we have to build system that will ensure every judge has to see potential, every attorney has to fight wholeheartedly, every social worker has to go the extra mile. To manifest equality in reality in the truest way.

Maybe it’s a losing battle to fight, because systems can also be abused and weakened, there can be gaping holes, problems with delivery of services. People are still people, even in a perfect system.

But this trails into the second point, which is that pretending systems do not inform how we act and move through and think about the world is ridiculous. The attorney was discussing how the number of lethal shootings of mentally ill individuals goes down if cops are given CIT training (how to approach a mentally ill individual, how to diffuse the situation instead of escalating, etc.) And that’s an example of how systemic change (specialized training, with salary incentives to become certified) can lead to shifts in individual attitudes (the cops on the ground). The medical system decided 100 years ago that “madness” was a disease of the mind, not the soul, and began treating it as such; today we talk about mental illness. The legal system decided 50 years ago that it was barbaric to take individuals and lock them away in institutions and strip them of all agency; today, it’s a civil rights violation with the precedent to back it up.

None of these ideas or things are “natural” or obvious, they are deliberate and systemic. They have rationalizations, rooted in whole systems of other ideas (civil liberties, biology.) And when we marinate in a culture of these ideas, it effects the way we think, the way we act. In order for the judge to see potential recovery in the man arrested with bipolar disorder relies on a chain of events that—yes—involves the individual judge, but also everything he carries with him into the courtroom. To shape the systems is, in large part, to shape the individual.

I know our guest lecturer wasn’t excluding the necessity of systems to improving mental health care in Chicago. But at the same time, if what separates a success story from a failure is just a stroke of good fortune, one individual happening crossing paths with another, then it is not fair, or justice, or right. It’s a failure of the system itself.

If what separates a success story from a failure is just a stroke of good fortune, one individual happening crossing paths with another, then it is not fair, or justice, or right. It’s a failure of the system itself.