We Must Rebuild Civic Advocacy

Rising autocracy will surely lead to more psychiatric incarcerations

In response to decades of rising rates of involuntary commitment, one thing I wrote in Your Consent Is Not Required, and often say in my talks, is that more political organizing is needed. More organizations have to be publicly and explicitly advocating in defense of psychiatric patients’ rights and for alternative, non-coercive approaches to helping people in distress. However, with millions of Americans and hundreds of thousands of Canadians who’ve experienced and resisted involuntary commitments, I admit, I haven’t thought a lot about why such groups are nevertheless so rare and so difficult to create and sustain. At least, I haven’t thought about it with the kind of experiential knowledge that someone like Ralph Nader can bring to bear. And for that reason, I found a recent interview of the legendary civic advocate by investigative journalist Chris Hedges to be timely, disturbing, and enlightening.

The discussion is titled, “How the Media Walked Us into Autocracy.” At no point in the hour do the two touch on rising rates of civil psychiatric commitment—indeed, I don’t know if either have any significant knowledge about this specific issue. However, they recount the four-decade history of the gradual crushing of the voices of “unions, grassroots movements, whistleblowers, and civic organizations” etc.—and the role of high-profile news media in the crushing of these many vital voices that together help make a functional democracy.

For that alone, it’s a fascinating discussion that provides some critical lessons about how and why America has been shifting ever deeper towards autocracy for many years. But as I listened, I realized Nader and Hedges were also telling the parallel story of the undermining of psychiatric patients’ rights movements. And, for anyone concerned about turning back the tide of rising psychiatric incarceration going on, Nader’s insights are invaluable.

A brief reminder of some relevant background: Ralph Nader is a lawyer, civic activist, and author who first rose to fame in the 1960s and, for the next two decades, his name was “a household word” in North America—as well known as the names of many famous politicians, artists, and entertainers of the era. During that time, Nader spearheaded movements to raise public awareness, organize activists, engage journalists, garner the attention of politicians, and create ground-breaking legislation. His influence is all over many foundational laws in America (some of which also got adapted by Canada) for motor vehicle and traffic safety standards, anti-trust enforcement, consumer product safety, environmental protection, medication regulations, freedom of information, and much more. A retrospective in The Nation suggests Nader’s work on automobile and traffic safety alone led to millions of lives being saved. Nader also helped establish Public Citizen and developed the model for creating and funding the independent advocacy organizations, “Public Interest Research Groups,” which still exist around the U.S. (and also in Canada).

There’s much more to Nader’s legacy. But the most important part for the purpose of what I want to discuss is simply to recognize how central a figure Nader has been, for more than half a century, in what we might generally summarize as this kind of “civic advocacy.” And consequently, no one can tell the story of the rise and fall of this form of public engagement for social change better than Nader himself—because he has lived through it so intimately. When it comes to civic advocacy work, it’s not easy to find anyone with more “lived experience” than Ralph Nader.

And the basic argument Nader outlines in the interview is simple: He cannot achieve today, he tells Hedges, what he could in the 1970s. He describes a cycle of democratic public engagement that went like this:

1. He and some fellow advocates would investigate an issue, and unearth something scandalous—like cars being deliberately designed by corporations to be Unsafe at Any Speed.

2. “Nader’s Raiders” would pass the information to leading journalists at major, politically prominent news outlets like the Washington Post and New York Times, who jumped on the stories.

3. Journalists at smaller news outlets and political commentators around the country would then react, comment, do their own similar investigations, and so on. Ordinary citizens and other civil society groups would also add their voices.

4. This public attention grabbed the concern of politicians, and these politicians called open public hearings, and asked for proposals for better policies and practices. And then the politicians would pass new legislation, and gain popular public acclaim for their efforts.

5. All of this attention, and such successes, brought accolades to the civic advocates involved like Nader, and helped them garner tremendous public profile, funding, and political support to help do more organizing, investigating, protesting, and advocacy work—and the cycle started again. And continued for many years.

It was civic engagement driving important social change—the way democracy is supposed to work. And the same basic cycle, says Nader, fueled the influence of not only his work, but the work and achievements of countless civil rights movements, union activism, environmental organizations, and much more throughout the 1960s and 70s.

But then something happened to stop it all in its tracks—something at major news media.

Listening to Nader talk, I thought of paralleling events related to resistance against involuntary commitment in the 1960s and 70s: The rise of patients’ rights movements with leaders like Judi Chamberlin; the fame and media coverage of critics of psychiatry like RD Laing, Thomas Szasz, Ivan Illich, and many more; the narrowing of involuntary commitment criteria; the closure of asylums; the legislated plan for supporting independent living in community-based settings; the federal establishment of state Protection & Advocacy organizations to defend the rights of people labeled with disabilities, and so on.

But then Nader recounts to Hedges how, in the 80s and 90s, this vital cycle got fatally interrupted—at step 2. Nader pins the dates and names the names, and explains the key policy decisions at the New York Times and other prominent news outlets. Essentially, the biggest news publishers started to pursue corporate advertising dollars more aggressively—and, at the corporations’ behest, started to ignore voices like Nader’s that were frequently critical of corporate malfeasance and corporate interests. One damning tidbit Nader reveals: the editor-in-chief of the New York Times began explicitly instructing journalists that, if a corporation targeted by Nader declined to provide a response to his allegations, then the whole story would be killed. “Well, you know,” comments Nader, “that doesn't take long for corporations to find that out. And so they didn't respond.”

This, in turn, dramatically reduced most coverage, reactions, and discussion in secondary news outlets, too. And that left most politicians uninterested in Nader’s concerns, and ultimately gutted public awareness and funding for his and many other groups engaged in civic advocacy work of all kinds that threatened corporate interests.

The situation worsened still further, says Nader, as both the Republican and Democratic parties became obsessively focused on raising corporate dollars as well.

In the wake of these changes, news media, social media, and the political actors that now get most of the media traction are usually preoccupied with inflammatory ideological debates that don’t seriously threaten major corporate interests either way.

And as a direct consequence, says Nader, there’s been a corresponding devastating decline in the public profile, numbers, funding, power, and influence of independent, grassroots civil society leaders and groups—the kind of folks that work in communities helping diverse, ordinary people of all political persuasions on issues that affect everyone where they live, such as clean air and water, living wages, child poverty, safe, affordable housing, running small businesses etc. Nader says:

We should always remember that when it comes down to where people live, work, and raise their children, there are not the kind of polarizations that the rulers try to inculcate on the public. Divide and rule goes back over 2,000 years as a tactic. Most of the necessities of life are supported by an overwhelming number of Americans, regardless of the labels they put on themselves—conservative, liberal, or whatever.

And the people and organizations that work on these issues, says Nader, don’t carry such prejudices, either:

…the civic groups are groups that know how to talk to people at the grassroots… They don't differentiate between conservative workers and liberal workers for health and safety or conservative patients and liberal patients for health and safety, or consumers, they don't do that. They talk to all people and they know the language, they know the strategies and the tactics.

But instead of a place where we’re all strategically collaborating through civic engagement, Nader describes our society as a “decaying democracy” sliding ever deeper into a corporate “oligarchy”—highly centralized governance in service of corporate interests that has increasingly dominated decades of both Democratic and Republican leadership and reached its latest apotheosis in the Trump/Musk administration.

And, although Nader and Hedges don’t discuss this, the key, expanding role of policing and incarceration in these circumstances is clear. A continuing breakdown in the basic functions of civil society, responsive government, and democratic processes means that ever more people will suffer and become more disenfranchised and impoverished in service to the needs of the corporate sector and ever-more-centralized wealth. In turn, autocratic rule becomes increasingly reliant on heavy-handed policing to control those whose basic rights and needs are getting trampled.

As I listened to and considered all of this, I realized in a new way that psychiatric patients’ rights movements are truly not unique. They’ve been victimized by many of the exact same social-political forces that have been undermining other civil society organizations. And major news media continue to play a major role in that oppression—largely ignoring critical views, organizations, and books, and hewing close to the corporate psychiatric industry and carceral-model narratives.

But this also means psychiatric patients’ rights movements are not alone, not as isolated as it seems, when they’re more tapped into their communities instead of into what the media is saying. And patients’ rights movements can learn from and join in what people like Nader and others are starting to do to try to get more traction. Hedges asks Nader for a summary of some of his best tips, and Nader mentions his latest books and begins, “Well, there's a lot that has to be done in order to create the brooks that feed the streams that feed the tributaries, that feed the Mississippi River...” But then in classic Nader fashion, he breaks down some of his proposed strategies into specific numbers of people contributing specific numbers of hours per month of volunteering and raising money for specific efforts to manifest specific types of politicians engaged around specific issues… I found it to be an inspiring listen, but ultimately Nader’s core message is that, if we want to make governments more responsive and our society more democratic for everyone again, then more of us need to become “active engaged citizens” again, too.

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