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 muchof 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 tobeingpersonally 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. Cummingsin 1986 when American Biodyne, the first real managed behavioral health care company in America, came to Ohio as a manager of the state employee behavioral health care program. I just started my counseling private practice in Portsmouth, Ohio, and wanted to get on board the managed care train. Biodyne did something very novel for a managed care company: all therapists in the preferred network were required to be trained by the company leaders, including the president and founder, Nick Cummings. In all my years of education, both in school and post-grad, I have never listened to a better trainer than Nick Cummings. He believed mental health therapy could be a powerful influence in a person’s life but it was never to be used to gratify the therapist or to promote a political agenda. That same theme permeates this book. Drs. Cummings and Wright believe that modern psychology has been overthrown by forces of social activism and as a consequence faces irrelevance.
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 tochoose the therapistand 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 theauthors. 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 America is adequate but barely so. Any practicing counselorknows how difficult it is to find quality services anywhere outside of the metropolitan areas of this country. Cummings and Wright predict that psychology’s preoccupation with social activism threatens to make it irrelevant as a force for quality and affordable health care for all people.
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.