Disability, Social Policy and the Burden of Disease: Creating an “Assertive” Community Mental Health System in New York

One conclusion of the decade-long epidemiological Global Burden of Disease Project is that five of the top 10 disease "burdens" the world will face by 2020 will be related to mental disabilities. Therefore, developing social policy and community responses to the ways that people with mental disabilities are treated is becoming an important focus for community practitioners, political activists and legislators. The author explores some of the dynamics of our cultureʹs approach to dealing with difference, especially when manifested in disenfranchized individuals. He discusses a community development project created by a New York City advocacy and social policy organization following the 1999 murder of a woman by an individual whose mental health disability was never treated. Parallels are drawn between the civil rights and community mental health movements, which created a precedent for the 1990 Americans with Disabilities Act. Also examined are the ways in which community mental health systems manifest social policy that alternately resists, repeats and colludes with power operations. The unexamined assumptions that drive this dynamic are examined as ableism or disability oppression.