Chapter 24: Community Control of Community Mental Health by George Clements
The second Vatican Council has, to put it mildly, generated a revolution within the structure of the Catholic Church. However, no phase of that revolution has been more dramatic than the emphasis that has been placed on the role of the parish council in parochial control. It is interesting to note that the loudest hue and cry for effective parish councils have been sounded by the parishioners of inner-city churches, and more specifically by those in black communities. There are many parishes whose parish councils are floundering because the pastor is giving only lip service to the need for relinquishing much of the administrative control of the parish to the parish council. Today, across the nation we are witnessing the formation of groups that are identifying themselves increasingly with community control. In every major city of our country there has been created, or there is in the process of formation, Afro-American patrolmen’s leagues, black lawyers guilds, black teachers’ associations, Afro-American firemen s leagues, black doctors’ societies, black ministers’ caucuses. I’m not sure -- there may even be a black psychiatrists’ group.
All these organizations are addressing themselves to the pressing need for community control, particularly among powerless people -- Mexican Americans, Blacks, Puerto Ricans, Appalachian whites. The current hassle I am involved in with my own church authorities in the Archdiocese of Chicago is largely a result of the phenomenon of community control. Sparked by St. Dorothy’s Parish Council, the black community demanded from church authorities the same recognition for our black community that is accorded, with no question, to the Polish, the Lithuanian, the Irish, and the German communities.
And now we are face to face with the potential of community control of community mental health. It would devoutly be hoped that professionals in the fields of mental health and, religion could learn from the mistakes that have been and are being made by other groups supposedly working for the betterment of our communities. Certainly the most obvious pitfall is that of reluctance to, and even hostility toward, listening to the vital components of the community, the residents themselves. Social agencies, welfare groups, religious organizations, commercial concerns, all have marched into our communities -- especially our inner-city communities -- with preconceived notions of superimposing their structures upon a community, of afflicting a community with a structure that was developed in some think tank without consulting any significant forces within the community itself. We would do well to ask ourselves how sincere are we in our concern for community mental health if we are unconcerned about consulting the community.
Another area of legitimate concern is that of actual involvement of the community in the administration of community mental health. It is so easy and so ridiculous for us to slap on a white collar or a white smock and assume that we have the trust of a community. Certainly in the black community nothing could be further from the truth. I am a black man, and yet I am automatically suspect in the black community. Recently a meeting was held in the basement of St. Dorothy’s Church in Chicago. Participating in the meeting were members of a young radical, activist, militaristic black group. After several hours of wrangling back and forth -- rapping is the term we use -- one of the young black men jumped up and yelled at me, "Father, what you are saying makes a lot of sense -- what does not make sense is that white man’s collar you have around your neck!" That incident has really made me stop and re-evaluate my position in the community. If that happens to me, a black man striving to be relevant, a fortiori it will happen to Caucasians -- excuse the expression -- in spades. It is the height of arrogance as well as folly for professionals in the field of mental health to ignore actual involvement of the community in the administration of community mental health.
Also we must be cognizant of the necessity that the community have reasonable control over allocation of funds for community mental health. For example, I really wonder how often community residents have been consulted prior to construction of community health facilities in a given neighborhood. Here are people who have lived in the community a great deal of their lives, and yet they are not considered qualified to state their opinions as to how much money should be spent in construction of a community mental health facility and where it should go. We who are professionals are very squeamish in furnishing information to the community about our financial affairs. Very few members of the community know how much money the pastor really receives or what the salary is of the professionals staffing our community mental health centers. We tend to shy away from letting the community get too close a look at us for fear that they might begin getting truly serious about this business of community control. Certainly if members of the community held the pursestrings and signed the salary checks of those working in the field of mental health in the community, we then would have a much more enlightened and much less patronizing behavior pattern displayed toward the community.
Furthermore, our efforts should be directed toward community participation in and sharing in the responsibility for mental health, not because of any ulterior motives but because this is just and right. There are skills that we professionals possess that are of immense value to our communities, especially our inner-city communities, but we are grossly derelict in responding professionally to our communities if we do not take the lead in giving them an effective measure of control in their own destiny. It is my hope and prayer that we will take heed and listen to our communities before we plunge headlong into them -- or we might find that we have plunged into a nest of hornets and will not have any communities left to diagnose. Finally, we ask ourselves possibly the most poignant question of all -- Should not the community have a say-so in the definition of terms of mental health? Just exactly what is mental health in the context of the community? Is one, for example, mentally healthy if he leaves his family because that family will fare better on ADC than they ever could on the meager unemployment compensation checks he receives?
If there is to be little or no effective community control of community mental health centers, then let us abandon the farce of the appellative designation, "community." Let us call them what they really substantially are -- federal, state, or county mental health centers. After all, these are the names given them by the people who actually live in the community.