Knock LA

When doctors work with patients, they are guided by the core principle of the Hippocratic Oath to do no harm. But TV doctors aren’t beholden to such a constraint, and Kathryn Barger’s nomination of Dr. Drew to the Los Angeles Homeless Services Authority (LAHSA) Board of Commissioners would do profound harm to our County’s and City’s ability to confront the root causes of homelessness directly.

As the lone Republican on the Board of Supervisors, Barger represents some of the Trumpiest parts of LA County. Her brother, John Barger, was a low-profile Republican donor appointed to be a governor of the U.S. Postal Service until he helped install Louis DeJoy as Postmaster General. Last fall, protesters picketed Barger’s San Marino home after DeJoy was accused of manipulating the Postal Service’s operations to suppress vote-by-mail turnout in an effort to reelect Trump.

Pinsky himself was a willing Trump collaborator, too. He took to the airwaves to fuel the fire of COVID skepticism, for which he later apologized after suffering a COVID infection himself. But his opportunistic work with Trump’s allies runs deeper. In December 2019, when many Americans were transfixed by Trump’s first impeachment trial, Pinsky accepted an invitation by the disgraced former president to keynote a White House “summit” on mental health and homelessness. This was just a few months after Trump visited Los Angeles to use our streets as a campaign photo-op to burnish his persona as a reactionary strong-man: “The people of Los Angeles are fed up. And we’re looking at it, and we’ll do something about it.”

In the eyes of Trump, poverty was an aesthetic issue that disrupted his ability to pretend it did not exist. But to Pinsky, a TV doctor, internist, and snake-oil salesman, houselessness is a frequent conversation topic on his show in which he centers himself as a savior. As an “addiction specialist,” he offers pseudoscientific rationalizations about human behavior that fulfill his audience’s desire to have a paternalistic media personality mirror their frustrations and validate their own lack of insight into the root causes of a vexing public policy issue.

Pinsky can be counted among the growing chorus of anti-intellectuals who use social media platforms to monetize the bliss comfortable people find in their ignorance by preaching a variety of false gospels that fuel systemic racism denialism. For example, African Americans make up only 8 percent of LA County’s population, but 42 percent of its homeless population – a staggering overrepresentation that is caused by structural and institutional racism in housing policies. According to the National Low Income Housing Coalition, there are fewer than four homes affordable and available for every ten extremely low-income households. But Pinsky has said “Housing First is a hoax,” denying facts which demonstrate the primary driver of homelessness is the fundamental mismatch of income and housing costs.

Pinsky’s prescription for homelessness also meets people’s need for a quick and easy solution that cuts through what they believe is red tape. That of course is a euphemistic way of saying he does not support patient choice for mental health and substance use treatment, a view that is not supported by evidence – it can be dangerous to force a person with opiate dependency into a taper – and yet is increasingly favored among people who, like Trump, are “fed up” with what they think the problem truly is: constitutional laws that protect people’s civil liberties. But reframing it as an addiction issue, particularly in a way that views addiction as a medical and psychiatric issue, also offers people an alternative hereditarian hypothesis for understanding the gross overrepresentation of black people among those living on the streets.

Pinsky’s views, which are the functional equivalent of medicalizing incarceration, also ignore the problematic history of psychiatric diagnoses, such as schizophrenia, which black people are more likely to be diagnosed as suffering. According to a recent study, the LA County jail mental health population has a significantly larger proportion of black people than the overall jail population, a problem which the Office of Diversion and Re-entry is doggedly trying to reform.

But to call this a mere “over-representation” would be unfair. What Pinsky’s prescription ignores is the historical function of the schizophrenia diagnosis, which has changed dramatically over time, as chronicled in Jonathan Metzl’s book “The Protest Psychosis: How Schizophrenia Became A Black Disease.” Metzl’s book links the diagnosis to “drapetomania,” a made-up syndrome used in the 1850s to explain why slaves ran off the plantation. Today, Dr. Drew talks about the prevalence of “anosognosia” — the lack of ability to perceive their reality of their own condition — as an explanation for why houseless people choose to live on the street.But just as not all people with severe mental illness have symptoms of “anosognosia,” not all unhoused people who reject services lack insight or awareness of the consequences of accepting the resources that are offered to them.

Pinsky presents himself as a disruptor of the discourse around homelessness by advocating for reforms to laws that would make it easier to institutionalize people who reject help, to force people into accepting the resources that are offered. He frequently uses inflammatory rhetoric to attract attention to himself and intimidate his critics, calling them “murderers” who advocate “genocide.” In this way, he isn’t simply favoring institutionalization, he is also delegitimizing the views of those who recognize the need for holistic, community-based care that would help prevent people from losing their housing in the first place.

Finally, while Pinsky has been in the public eye for decades, his appointment to the LAHSA Commission should be rejected because of what we do not know about him. We know he earns money by espousing certain opinions, but the public may never know what interests he’d be representing in his role as a policymaker.  In 2012, the pharmaceutical manufacturer GlaxoSmithKline reached a $3 billion settlement with the Department of Justice for using a network of paid “experts,” including Pinsky, to promote off-label uses of the antidepressant Wellbutrin SR as a libido enhancer. The DOJ alleged Pinsky was paid a total of $275,000 over two months in the late 1990s for speaking “in settings where it did not appear that Dr. Pinksy was speaking for GSK.”

Pinsky has said all he wants to do is donate his time to help Los Angeles. But it took a federal investigation, and more than a decade, for the public to discover his paid work for Big Pharma. Given this track record and the scant financial disclosure requirements he’d be subjected to as a Commissioner, how can the public be confident he isn’t using his position to promote his self-interest? There are numerous plausible theories as to how he might stand to gain personally from changes to LA’s homeless policy, especially reforms that favor solutions like institutionalization and medicalization – which ultimately serve corporate interests at the expense of community-based care – but the public is unlikely to ever know.

Pinsky’s nomination has been roundly mocked by people who see it as a goofy example of a weirdly celebrity-obsessed SoCal culture. But many had the same reaction to Donald Trump when he rode his golden escalator down to public life. Pinsky is more than just a buffoonish TV doctor. He is an inappropriate pick for the LAHSA Commission and the County Board of Supervisors should reject his appointment.

Phil Portnoy is an activist, media critic, and advocate for criminal legal system transformation.