“Pills and Prayer” is how I describe a certain strain of public mental health, geared to treating large numbers of people as cheaply as possible.

Let’s say you come into a free clinic and you say you’re anxious about something. You’ll most likely get an intake and a prescription for either benzodiazepine or a phenothiazine, or perhaps, fluoxetine or an atypical: a synthetic that behaves like two of the above. You’ll then spend some months “getting the prescription right”. You might talk about your life, but that’s neither here nor there: that’s just a facade, they tell you, once your condition is adequately addressed, everything will turn out just fine.

Well, now you’re probably taking more than one psychiatric drug, and a few to counter the side effects you’re probably beginning to experience, and a friend might offer you something to help. Or the benzos are getting the better of you. And you get some under the counter.

No problem, you’ll hear from your more conventional gateway for drugs: we’ve got some people you might want to meet. And so you’ll enter the wonderful world of the 12 steps, that will tell you that your problem is not a moral failing, but a spiritual unease (with a few ‘defects of character’ — but those aren’t moral, as such). You’ll be a lot better off if you join a church.

Well, if you’re mostly ground level, the churches that cater to the poor tend to be evangelical, and might have some mighty peculiar notions of what constitutes reality, when viewed by bougie folks like therapists. So when you come in and talk about how you’re afraid that your once and future Democratic Representative Rosa Delauro, is probably sipping baby blood with Killary in Satanic day spas, they’re bound to add the entry “Schizophreniform ideation” or suchlike, and up your prescription.

At which point, you’ll probably have lost whatever job you’ve gotten because you’re too slow, you can’t handle whatever duties you have because of the drugs, and you don’t have a place to live. And there’s a waiting list of at least a year and a half for the inhouse treatment facility.

And you’re supposed to wait until you get better before you get a roof over your head?

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