The APA should be ashamed of itself

The mental health field is one of the most challenging and important medical specialties, with some 20 percent of the population experiencing symptoms of mental health conditions in any given year. Sometimes these issues are transient, while in other cases, they are part of long-term mental illness. We put tremendous trust in mental health providers, and rely on them to be careful and responsible stewards of our health and safety — they, in turn, are required to be cautious with their patients, and to consider the latest available information about mental health when working with people who need therapy, medication, and other treatments.

Professional organizations like the American Psychological Organization are a critical part of the mental health system, providing governance and guidance to their members to ensure a high standard of care. The key function of such organizations is to support evidence-based supportive treatment, and to create very clear mechanisms for researching and implementing mental health care. Without this kind of guidance, the field would suffer, with individuals relying on their own training and no supervisory element to promote continuing education, culturally competent treatment, and high ethical standards.

Which is why failings on the part of such organisations represent such a tremendous betrayal. Substantial evidence indicates that the Bush administration used psychologists in the administration as well as justification of torture, relying on extensive mental health training to exploit vulnerable prisoners of war and other targets in the name of anti-terrorism. The participation of mental health professionals was critical, as it became the grounds around which legal defenses revolved, because the Department of Justice determined that the torture was legally justifiable as long as medical professionals were present — much as we consider the death penalty legal with an attending doctor to supervise and ensure that state-sponsored murder is conducted ‘humanely.’

Had these mental health professionals refused to participate, torture would most definitely have occurred anyway, without a doubt. Members of the torture programme weren’t limited by the presence or lack thereof of mental health professionals — though psychologists may well have provided additional tools for torturers to use, and that’s something they’re going to have to live with, hopefully painfully, for the rest of their lives.

However, the programme might have come to light earlier, or been delegitimised, had they not participated. Without the smokescreen of ‘professionals’ allegedly preventing long-term psychological harm, the administration would have had a much more difficult time justifying systemic torture of targets; and despite claims that torture yields results, most significant studies on the subject indicate that this is not the case. Torture, if anything, reveals false positives, and it is opposed by most Western governments, a number of those in the Global South, and every international human rights and welfare organisation — yet, the United States largely hasn’t been held accountable for the torture that occurred under the watch and awareness of Congress, numerous government agencies, and President Bush, with no strong indicator that it’s stopped.

The APA has a position on torture: The short version is that the organisation finds it unacceptable. I’m glad to hear that, as any sensible professional organisation in the medical field should oppose torture (along with the death penalty) and should require its members to refuse to participate in acts of torture. It should also mete out significant punishments for those who do — expelling members from the APA may be a start, but it should also be involved in investigating individuals implicated in torture and, when warranted, revoking their licenses to ensure that they cannot continue to practice legally.

Even the APA admits that at least several members were involved in the Bush-era torture programme, though it insists that the problem wasn’t systemic and widespread, and that it was as shocked as the rest of the world when the truth came out. However, that’s a bit hard to swallow; and the fact that the organisation didn’t aggressively pursue its anti-torture stance as information about the programme came to light is troubling. The APA knew about Abu Ghraib just like every other civilian who saw the horrific images that emerged from the infamous prison. It knew about other acts of torture as they unfolded in the media. It could connect the dots.

The APA could have investigated members working at government agencies, as well as those acting as ‘consultants’ to agencies like the CIA. In fact, as a professional organisation in the mental health field with a clear anti-torture stance, it had an ethical obligation to its members as well as its mission to ensure that none of its members were condoning or participating in acts of torture, whether as passive observers or active interrogators. Yet, by all accounts, it didn’t.

This isn’t just something the APA should be ashamed of. It’s something that the organisation should consider in the context of the fact that members of the public will likely lose faith and trust in psychiatric professions as a result. Those who need mental health services are going to be less likely to seek them out when they associate mental health care with torture. People working in therapy are also likely to be uncomfortable — even if it’s very obvious that their own therapists didn’t participate in torture, how ethical can they be when they’re operating under the guidance of an organisation that effectively whistled to itself rather than listen to the cries of people being tormented in the name of the United States?

Photo: Flowers at the Triangle Psychologists Social Hour, Abby, Flickr