Furious Seasons

May 23, 2006

More Thoughts On The DC Tragedy and Mental Illness In America

The Treatment Advocacy Center’s executive director Mary T. Zdanowicz had an op-ed on Sunday in the Washington Post. It’s not a bad piece, but of course I have some nits to pick in a moment. And yeah this is going to be a long post.

Still, it’s weirdly encouraging seeing so much ink splashed around on the matter of mental illness in America. Maybe now that eyes are getting opened in the nation’s power center we might see some real changes concerning how we treat mental illness in our culture. Because American culture is a mess on mental illness—people lose jobs, homes, money, friends, family, lovers and their damn souls the moment they develop, or get labeled with, a mental illness. Even in its moderate and mild forms. Why’s that?

Because we are still tagged with the old assumptions about the mentally ill being dangerous. We aren’t and there is ample scientific proof of that. Even for the most ill of schizophrenics. But American society hasn’t caught up with that reality and even if you are being a good actor and taking your meds, you are forever suspect. Should you cross the slightest behavioral tripwire, society is going to throw you out and then tell you to go live a reduced life. It takes a lot of fighting to get back from that status, which is why so few make it. All as a result of bullshit prejudice.

And that’s what burns me up about episodes such as the recent murders of two cops in the Washington, DC area. Those bad assumptions about the mentally ill are going to get pushed right back to the surface, after so much work has been done to shove them down into the murk where they belong. But I guess that’s the nature of the media and public discourse on these matters.

Which brings me to the op-ed. Like the other opinion pieces in the WaPost of late, it argues that outpatient commitment laws are weak and that delusional folks need to be forced into treatment. That’s fine. It amazes me a bit that it takes three opinion pieces in one of the world’s most important newspapers for the Post to feel that the argument has been made, especially since there has not been one opposing opinion piece published by the paper (er, as far as I know). Even the Mindfreedom people have been quiet this time out. But the broad point that TAC has gotten out there is acceptable.

But there’s a certain responsibility that comes when speaking to the conditions under which the most disadvantaged of our citizens will exist on Earth and how their essential civil liberties will be regulated. You had better have your facts in line, so that you don’t overstate your case. You had better be damn careful about what terminology you use.

People like me have fought for well over a decade against the moronic stigma around mental illness, not by doing anything more special than fighting back and making our lives work and paying our taxes and not asking for a handout of any kind. And, yes, playing by the rules and taking our meds, even when they crush us as much as the illness ever did. We have made some progress—people like me are actually allowed to have useful, engaged productive lives these days, although in my opinion we have to push against so much that it’s no wonder a paper came out at the APA convention yesterday asserting that almost 40 percent of all bipolars are unemployed. That’s fucked up.

And that’s why we will not tolerate dishonest numbers being used to describe the mentally ill nor will we tolerate language that is over-broad. We will not tolerate being tarred with the same brush we’ve managed to hold at arm’s length for so long. Everyone likes to talk about society’s needs and the pain of families, and a lot of public policy gets made on the backs of those concerns.

What about us? When do we count as something other than a brain to be zombiefied? Do you understand why some of us are a little touchy when we see one of these bad scenes go down and the media comes in and does its usual stigmatization dance because they just don’t get it? Do you understand that such a dynamic has major impacts on the lives of people who are playing by the rules?

People who don’t understand that, who don’t acknowledge it publicly and in print should be force-fed 800 mgs. of Seroquel for two weeks and then be asked to hold down an 8-hour a day job, or maybe to subsist while unemployed. Society is ok having us beaten to the ground and so are our families, who somehow feel redeemed as long as we are alive. But in this nation if you don’t have a job, then you are shit out of luck.

That’s what the game is about, fueled by opinionating like:

”Not all people with mental illnesses are dangerous; in fact, most aren't. But some people with severe mental illnesses can be dangerous, particularly if they are not taking their medication.”

That’s TAC’s ED in her recent op-ed. And it’s that kind of looseness of rhetoric and condescion of tone that makes things really problematic for the rest of us. Because what the public will take away from such phrases is that the mentally ill are dangerous—all of us—especially since TAC doesn’t offer the data and the studies to prove that such is the case. And, then, follows that phrase with a whisper in America’s ear:

” A recently published national study documented that schizophrenia patients with specific symptoms -- paranoid delusions, hallucinations, grandiosity, etc. -- were at least three times more likely to be violent than other schizophrenics.”

In other words, TAC just said: Most mentally ill are not dangerous. OK, some of them are. You know, the delusional ones. In the public’s mind, that turns into: My son was saying weird things the other day. He seems remote. He’s delusional and a danger to America. I think we must force him to take Zyprexa, even if he is 25 years old. And then we get:

” Psychiatric beds for patients in crisis are in short supply, so new laws also should facilitate court-ordered outpatient treatment, which has been shown to reduce violence, improve quality of life and reduce the stress of those who care for the mentally ill at home.”

Improves quality of life? By what measure? Whose life? Mom and Dad’s? The patient’s?

And that’s where I sort of part company with the family-led end of the mental health movement, or whatever the hell we are calling ourselves these days. It’s all about them, and their grief and their guilt and their “stress.”

I guess that’s why TAC now says it is standing by its numbers on the statistical risks that the seriously mentally ill pose to the public. , and now have two stats experts backing me in saying that those numbers overstate the case. TAC needs to get an independent expert to review their stats. It’ll be much easier for them to make their public policy arguments with accurate and fair numbers rather than using bogus ones and having clowns like me biting their ankles.

Yesterday, I twice asked TAC by email whether they have data on how many of the incidents of violence that they track the way NBC does on-line predators involve people who were on meds. So far I have only hemming and hawing on their end for an answer. So, hey, guys: Answer that point, please. I just want an honest answer.

I also want an honest answer to TAC’s assertion that “treatment works 80 percent of the time.” As I put it to them today in an email: How do you define “works?” What time period are we talking about here?

I don’t think they can make that can make that 80 percent number prove out, but I’ll be interested in seeing them try. And as long as they are honest about their data, I’ll consider their evidence.

And speaking of honesty, once again TAC cast the recent CATIE paper on violence among schizophrenics to its advantage—once again failing to acknowledge some key essentials of the study. The patients were medicated at the time of their bad deeds (again, I still await final confirmation of that from the study’s author who like everyone else in the psych world is at the APA). Many of the patients involved had been the victims of violence and sexual assault. The study authors took pains to point ou that they could not statistically establish a definitive link between schizophrenia and violence, meaning they could not rule out other drivers of the phenomenon such as violence done to the study subjects—and the kind of basic crap that America shoves down the throats of the mentally ill…which can make the steadiest of mentally ill folks desperate.

And, once again, advocates of outpatient commitment failed to acknowledge that there are studies out there—and their data is far more impressive than TAC’s—establishing that schizophrenics are not more violent than the general public, and that there are studies establishing that patients medicated (oops, that’s “treated”) under outpatient commitment laws still have delusional breakthroughs and still commit low-level assaults and the like.

When the outpatient commitment crowd—TAC and NAMI primarily—get honest about things like that and use reliable data and make sure their language doesn’t turn into a set-up for the rest of us, then they won’t only get my respect, they will get my support.

And, for those of you who might be wondering, I am in a fabulous mood. I wrote this while smoking a Dominican cigar and watching the Mariners beat the Orioles into the turf at Safeco Field.

Posted by Philip Dawdy at May 23, 2006 12:01 AM

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Comments

Philip, stand up and take a bow. I applaud your honesty, and straight talk. Thank you. Keep it going!

Posted by: Stephany at May 23, 2006 05:05 AM

http://news.bbc.co.uk/2/hi/health/635415.stm

Wednesday, 9 February, 2000, 11:45 GMT

Media 'unfairly stigmatises mental illness'

This is an interesting article from Feb 2000 BBC news

Nice commentary on:
..""But they present an inaccurate picture of the numbers of homicides actually committed by people with mental illness."
..."don't think these newspapers realise how many of their readers are affected by mental illness, or indeed how many of their readers they are potentially offending."

That was written in 2000, looks like the World is still in the dark ages regarding reporting data, etc.

Posted by: Stephany at May 24, 2006 09:37 AM

http://news.bbc.co.uk/2/hi/health/1158797.stm

Mentally ill 'less likely to kill strangers'

Another article from BBC news. Though the story is 2001, and stats are not based on American data, etc. it makes the point we are all talking about here; regarding media reporting that mentally ill people are all dangerous and potential murderers, that as a result, promotes stigma.

Posted by: Stephany at May 24, 2006 09:50 AM

I had been working at a factory, making decent money and had reasonable benefits, for 6 1/2 years before being fired. I had a "nervous breakdown" in 2003 and was diagnosed with rapid cycling bipolar. I had never heard of this and completely trusted my doctor to prescribe me the correct medications. Well, after my first suicide attempt, he prescribed me a different SSRI that made me feel like my insides were trying to crawl out. I called him right away and he increased the dosage. Of course the symptoms worsened and I called him back. I told him I could not relax at all. He tried to prescribe the same sleeping pills I had just overdosed on about 2 weeks earlier. I had myself admitted to a hospital to start me on a different medication and make sure I would not be able to harm myself. Since all of this was going on and I was still trying to work as much as possible, my coworkers knew my situation. I was referred to a psychiatrist and once again put my trust in him. I also was seeing a counselor in his office. At first I thought I was getting better. Then I noticed whenever I had a side effect or didn't feel like the medication was strong enough, he would just raise my dosage or add another medicine. I was taking four different medications, some at high dosages and still not feeling good. I was only able to just get by. Then in a period of a couple weeks, I was tardy like 3 times. Although I clocked in on time, I was late getting to my line. No one else had ever been counted tardy for this, but I was. I told them I had 2 alarms set and someone calling me, but my medicine seemed to be putting me into some type of coma. I didn't hear anything. I would then wake up late and have to speed excessively to get to work just for them to count me tardy anyway. They suggested that I make an appointment immmediately to see my doctor again. I called from our nurse's station with 2 of them as witnesses. When I went to my appointment I read a post-it note upside down in my folder. The nurse that takes all phone calls wrote in there that I needed a note for my union steward to get my job back because I had threatened to bring in a gun to work. None of this was true. She had confused me with another patient. I did not work for a union company, I had my job still and I called in front of witnesses. If I had even mentioned a gun in front of them, I would've been fired on the spot. She had the nerve to argue with me. The doctor was not going to change my medications. I told him they were to strong for me. He said he couldn't help me. When he handed me the prescriptions, I did the scariest thing yet. I put them back on the desk and told him he could keep them. Now I didn't have a psychiatrist nor did I know what medications to take. My insurance company approved another psychiatrist and they got me in within 2 weeks. He told me immediately that the other doctor had me on all of the wrong medicines. He made me stop taking everything and start on new ones until we found one that seemed to agree with me. He was so great that sometimes I didn't have to say anything, he would just look at me and know it was not the right one for me. After we found one that was working pretty well, I returned back to work. I missed 1 day in a month and a half, and tried to use vacation until I seen my doctor again, and they wrote me up for attendance again. Once again, no one else has ever been written up for missing 1 day. I went off work again and told the doctor that I could not return until he found something that made me absolutely perfect. We all know how hard that is to do. I ended up taking Nardil (MAOI), and it worked wonderfully. Not only did I return with perfect attendance, but was able to work overtime as much as possible to catch up on all of my bills I was behind on. Then about 3 months later, a group of coworkers complained that I was going to slow. The supervisor watched me and didn't find any significant evidence to prove this. Of course they wouldn't tell me who complained nor were they punished for falsifying information to deliberately try to get me in trouble. I let this go and still continued to talk to everyone and get along with them even if I didn't like what they said. The next thing I know, I am getting called in the office and asked if I had threatened anyone. I asked them what they were talking about, but for the others SAFETY, they wouldn't tell me anything. I wasn't allowed to know who said what, yet had to defend myself. I said the only way to defend myself was to deny everything. I was turned down for unemployment, so I was able to see the statements made. One girl said I had threatened to bring in a gun, (sounds familiar), but the very next day, she invited me to her house to deliver a headboard that I didn't need anymore. I followed her to her new house and was invited in with her children there. This sounds like someone that is afraid of me? Another girl wrote she overheard something but didn't know who I was talking to or how close she was to me and what she said she heard was never put on anyone's statement. I figure she got her story mixed up. Another guy asked me if I quit taking my medicine, would I catch him on fire? He then turned it around and said that I threatened to. He didn't say anything at all. He wrote on his statement that I was crazy, nuts, off the wall and bipolar. Obviously if he wrote it on his statement, he was using it as a reason for this to have happened. I won my unemployment case all by myself. Everyone said I couldn't do it so I got no help from anyone including legalaid. They have no proof besides their statement that I did any of this. When they complained of me going to slow, even though I wasn't, I started staying over into my break to do a little bit extra so no one could say that again. I gave over 100% to them and they did this anyway. My whole case is based on the stigma associated with being bipolar. They had no other reason to get rid of me. I had done everything they had asked of me plus some. Now, I have lost everything. My house, car, phone, everything that most take for granted. I had to move back in with my parents and share a room with my nieces toys and 2 animals. I have enough room for a twin bed. I'm not complaining of this, I am thankful there was someone to take me in or my son and I would've been homeless. But being a single mother, they made me lose things I had spent a lot of years acquiring. My credit is ruined. I will not be able to replace any of this for a long time now. And I did nothing wrong. The only problem was I was diagnosed with bipolar. They used the stigma against me to make me look like a dangerous person and no one stopped them. I do have a charge with the Ohio Civil Rights Commission against them. I have a good chance of winning. It still will not make up for the emotional devastation they caused. I am frozen in fear to try anything else because if I fail again, I don't know if I will be strong enough to get back up. They ruined my life in every way possible. I was so proud of myself and they destroyed me. This is why we need to get rid of the stigma or have stricter laws protecting us to make them prove by actions that someone is dangerous. Heresay should not be able to ruin someone's life. Another guy on 2nd shift, threw a piece of cardboard at someone and threatened to fight him and he did not get fired. He had words and actions that everyone was a witness to and he got to stay. The cardboard drew blood when it hit the other guy to. This has been my situation. May we change the laws to stop this from ever happening to anyone again.

Posted by: Tina Loper at March 14, 2007 02:11 AM

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