Mental Health (or Lack Thereof)

We’re a country in crisis. There are more people with mental health issues getting poorer care and they have fewer places to turn and it just makes me SO SAD. Last Friday’s crisis had a fair bit to do with guns, as I mentioned yesterday, but more than that, it had to do with a person who desperately needed help.

First: Mental Illness

Mental illness is an extremely varied thing. By far the most common diagnosis is depression, which in women is more a sad, bluesy thing and in men is more an irritable, crabby thing. SOME depressed people are a danger to THEMSLEVES. Most though, are not that extreme, and they are NOT a danger to others. This is the very most common mental illness.

In addition, the OTHER things that can be wrong vary hugely. Depression and bi-polar disorder are MOOD. Schizophrenia is a PSYCHOSIS, which means hallucinations (either aural or visual—more often the former). There are disorders that disturb picking up on social cues. There are disorders related to conscience (or lack thereof). Some disorders can only occur when there is something wrong with the brain, others are more a response to external stressors, the most extreme of which is dissociative identity disorder which results from long-term abuse (usually sexual).

With so many faces, caring for people is complicated and expensive. Even just getting a diagnosis is a big job. Then you add to that teens and young adults, for whom choosing medication is a moving target. Their bodies are changing, so even finding the right thing NOW, may not be the thing that will continue to work.

Talking About It

Part of the problem is most people are pretty poorly informed. Oh, sure, we’ve heard of ‘disorder of the day’—which will go drastically overdiagnosed because it’s ‘popular’. But the real experience? It’s not talked about much. It’s stigmatized so people don’t feel comfortable sharing. And because it’s varied, when somebody shares a story that doesn’t fit somebody elses view on the matter, it can get really sensitive.

There were two great articles, one of which I will just describe, as the author is getting a lot of backlash for ‘outing her son’ as having a dangerous disorder—she was amazing to read—really experiencing a son with a snap temper that causes violent outbursts. The trouble is she didn’t think about his privacy in sharing—she used a false name for him, but not herself, so anyone who KNOWS THEM now knows.

But we CRAVE hearing that voice. It shows just how hard it is to navigate caring for somebody with that extreme an illness.

The other article I am happy to share (there is some swearing—you’ve been warned) about the REACTIONS and how difficult it is to have public discourse because everybody is so freaking sensitive.

Wonkette: Not Allowed to Talk About It

I ALSO strongly recommend Carrie Fisher's books. She has bi-polar disorder and a GIFT for humor when talking about her mental illness. Wishful Drinking is the one that comes to mind, but she has several.

Why So Much of It?

It seems like there is a lot more mental illness than there used to be, doesn’t it? I think there IS more, but in addition, I think we HEAR ABOUT MORE for three reasons: 1) more people actually seeing doctors that have SOME CLUE and get somebody to a system for diagnosis—plus people no longer just shut their ill family in an attic and hide them from the world, 2) over diagnosis (a false positive of those flavor of the week diagnoses) and 3) loss of ‘community’. People used to live near family—a collection of people who could help keep an eye, assist, and otherwise channel that ‘special’ family member. But families don’t tend to be proximal anymore, so there are a lot more incidents of someone getting ‘out there’ and causing all sorts of problems.

But in addition, life has more stressors (poverty, crime) and people experience more trauma. Both of these prime our brains to maladapt. Lack of near social resources. In addition, new medications, food alterations and environmental pollutants of things that NOBODY REALLY KNOWS the long term effects of probably are altering our brain chemistry. Look at the increase in allergies from when we were kids. Doesn’t it seem like if something can make kids allergic to stuff, it might be messing with their processing a little?

And then there is the bigger tools thing… Guns, like I mentioned yesterday. Bomb-making information as handy as the internet.

Filmed at Damasch--Oregon's old mental hospital

A History of Care

I mentioned shutting the nutty relative up in the attic. I’m glad we don’t do this anymore. There also used to be mental health institutions, lovingly referred to as Insane Asylums… These places were fraught with mistreatment, but they DID keep society safe, yeah? In addition, some people had nowhere else to go. The vast majority of publicly owned mental health facilities closed in the 70s. “Isn’t it better to have people at home?” Well, sure. If that’s an option. But some people don’t have help. And some help isn’t equipped for the HUGE undertaking.

Down the street a woman died last year who was seriously mentally ill. Her mother had taken care of her for decades (while the mentally ill daughter beat on her, no less) but the mother died maybe 8 years ago… The daughter had bouts of institutionalization, getting out and doing okay on medication for a while, but then falling back into a pattern that caused me to make my kids walk on the other side of the street. When she died, nobody knew for MONTHS. Alone. Shut in. I can’t help but think if we had facilities now that we might make a better attempt at keeping them safe, pleasant places. Though I know nursing homes often have abuses, too, so maybe I’m delusional.


The Solution?

You think I have a solution?

*cough*

I do have some ideas though. I think the new health plan will help because more people will be eligible for coverage. I think wherever we can, increasing our sense of community helps. I know with HWMNBMOTI’s health trouble, neighbors and friends have been invaluable. I can’t imagine that wouldn’t be the case with mental health stuff.

But there needs to be an investment, too. And I think it starts in schools. Teachers are amazing and fabulous, but they need the backup. When I was a kid, ALL the schools had counselors. My kids’ elementary shared a counselor with 2 other schools. We’ve cut resources when we need to be ‘adding them’—well child type ‘visit and get to know’ meetings with ALL the kids once or twice a year, so there was no longer the ‘Oh, so and so had to go to the counselor’ ring to it.

PARENT RESOURCES—ohmygawd are parents already overstressed. Any system that would increase how easily they could find WHO they need and HELP they need would be good. Even respite help—taking care of somebody day in and day out is exhausting.

Extreme Measures?  Should there be institutions again? Yeah, probably. And I also would advocate, for a few rare diagnoses and with multiple doctors agreeing, that there are cases forced medication is wise--the two diagnoses I'm familiar with where people are fine medicated and can be dangerous (at least to themselves, but sometimes to others) off of meds are schizophrenia and bi-polar disorder (more so with the former)

I ALSO, and this may be controversial, believe there needs to be SOME SYSTEM whereby people can be flagged as potentially dangerous—spot the neighbor kid blowing up squirrels or something? That HAS to be reported. Animal cruelty is a high risk marker for sociopaths and psychopaths.

Would any of this have helped Friday? Maybe—I suspect that mom who made such poor choices wouldn’t have, had she had better resources to understand the risk her son posed. But maybe not. A school counselor might have flagged him. I have no idea. But I know there are a lot of people who could potentially be dangerous and we are very poorly equipped to cope with that right now.

[hey guys, be sure to read my friend Patti's comments, too. I have psychology education, but she is actually a clinical practitioner, so more informed than I am]