Doris Jones (pseudonym) of Scarsdale, NY (where I grew up) felt sad. Her husband left her, the kids were at college and she was feeling alone in her big house on three quarters of an acre. At the same time, Alejandro Morales, a 25-year-old man with schizophrenia, started becoming paranoid.
Free hotline services, support groups and counseling were instantly made available to Ms. Jones, but nothing was available for Alehandro Morales. As a result, he stabbed to death 9-year-old Anthony Maldonado.
Ms. Jones mental "health" needs trumped Alehandro Morales's mental "illness".
This is the result of an intentional, disastrous and massive migration in America away from treating the seriously mentally "ill" in favor of improving mental "health".
Mental "health" is defined "as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community." Mental health services focus on making the worried-well less worried. There's plenty 'o funding for that.
On the other hand, mental illness is a biologically based no-fault medical problem that resides in the brain's chemistry or neuroanatomy. Untreated, it can lead to irrational thinking, and therefore irrational behavior. There are virtually no programs left for this group. According to a Treatment Advocacy Center study, in 1955 there were 340 public psychiatric beds available per 100,000 U.S. citizens. By 2005, the number plummeted to a staggering 17 beds per 100,000 persons.
The amount spent on mental health has exploded exponentially as every life experience is medicalized. On the side of increasing 'mental health' services at the expense of mental illness services are providers of mental health services, state mental health departments, the Center for Mental Health Services, the National Institute of Mental Health, the Mental Health Association, 501c3s galore, misguided advocates, a government funded consumertocracy, stewards of political correctness, and the medico-psycho-industrial complex.
Hardly anyone is still fighting for the mentally ill. In fact, it is no longer even considered politically correct to use the term "mental illness". One must say "mental health". You are not allowed to say "patients", you are supposed to say "consumers" as in "consumers of mental health services."
The people we see under 12 layers of smelly lice-infected clothing talking to themselves, fearing their hallucinations as they forage through garbage cans looking for food are not "consumers". They should be patients, but no one wants them. Oops. Was that politically incorrect? I don't care.
One organization that tries to bring attention to their plight, the Treatment Advocacy Center in Arlington, Va. is considered a pariah by some mental "health" organizations. They think the fact TAC addresses issues like hospital bed shortages, violence and incarceration by the untreated is stigmatizing to the treated.
That's like saying focusing on women who need mastectomies is stigmatizing to those opting for enlargement. Oops. I did it again.
Ethan Walters wrote about this mission creep in a thought-provoking article (even though I don't agree with it all) in the New York Times Magazine:
Westerners share...evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is more healthy than stoic silence. We've come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection -- a penchant for "psychologizing" daily existence.
...(W)e are investing our great wealth in researching and treating mental illness -- medicalizing ever larger swaths of human experience -- because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.
State Offices of Mental Health: It's not just NIMH that is avoiding the mentally ill, so are state departments of mental health. The NYS Office of Mental Health is led by Michael Hogan, PhD. (NYS used to have a requirement that the Commissioner of Mental Health be a medical doctor, but they have waived that so sociologists and other PhDs, can apply)
The important question for OMH to answer according to his statewide plan for mental 'health' services is
How do we create hope filled, humanized environments and relationships in which people can grow?
So much for helping people with serious mental illnesses and for the medical model. NYS OMH is now going to help people "grow". It's not just rhetoric. NYS is racing to kick people out of hospitals and Assisted Outpatient Treatment, two of the programs that actually helps the seriously ill. They have made electroconvulsive therapy, an important treatment, harder to get.
Pharmaceutical companies: Pharmaceutical companies run massive advertising campaigns designed to convince people they have a mental health issue that only their medicines can solve. So millions of people who have had their life experiences redefined as a medical issue are now taking the medications.
Perhaps the most absurd result of this is that it is making it more difficult for those who truly need the medications to get them. Insurers resist paying for them, since so many who don't need them take them. And now research is being done that shows some of these treatments are no more effective than placebos. Why? Because the people taking them in the first place didn't need them so naturally they didn't help. If these studies were done among the genuinely ill, the results would be much different.
Mental Health Services Providers: Because up to 50 percent of Americans have now been defined as having a diagnosable mental disorder, providers have more customers than they can handle. So what do they do? They pick and choose the easiest to treat. The ability to get care is now inversely related to need. Seriously ill need not apply.
Advocates: Advocates are running TV campaigns that say the "mentally ill are just like you and me". But they refuse to show the seriously mentally ill in their commercials. You won't see anyone standing on a street corner screaming, "I am the antichrist. Follow me". Ask anyone who has experience with schizophrenia. Are people with schizophrenia human and have the same needs as us? Yes. But would you define yourself as being like them? Not likely. They have a serious illness and need our help. But advocates have addressed their needs by ignoring and shunning them. Even advocates for the homeless, who know up to one-third of the homeless have serious mental illness, do PSAs showing most homelessness is the result of joblessness.
Consumers: Under the guise of empowerment, validation, recovery and opportunity, high-functioning ex-patients have been given massive funding by the Substance Abuse and Mental Health Services Agency, put in charge of peer programs, and given virtual black ball power over which state programs get funding. And the only ones they want funded are their own. A former deputy director of NAMI/NYS described the opposition to Kendra's Law, a law that allowed courts to commit the NYS Office of Mental Health to provide services to the seriously ill they preferred ignoring. According to NAMI/NYS:
(T)here is a movement to stop the law led by...a consortium of mental health rehab organizations that I cannot respect on this issue. These organizations do skills acquisition, not symptom management. To benefit from their programs, one must be stable and have insight into one's illness. Yet their leaders are foolish enough to plug their own programs as an alternative to AOT.
Their leaders tend to dismiss "the medical model" and adhere to a philosophy of self-determination. Unfortunately, for those who need AOT, this approach is something of a cruel joke. As Edgar Rivera (who lost his legs when he was pushed onto an oncoming subway by someone with schizophrenia) so eloquently put it in his testimony, those who need (what this law offers) don't need philosophy, they need help.
Police and Criminal Justice: Tah Dah. They are the only ones advocating for the seriously mentally ill. Police and Sheriffs are the ones who are called in to provide the services mental health departments have decided not to provide the ill. The largest psychiatric hospital in New York is Riker's Island Prison. In California, it's the L.A. County Jail. The few advocates left who still care about the seriously mentally ill have been blessed that progressive criminal justice types are working to fill the void left by mental health advocates. Using the parens patraie powers of the state to help those who can't help themselves, the police will help the seriously mentally ill who are homeless and psychotic in ways the mental health system would never consider. They will pick these people up, bring them to the hospital, and sit with them -- often for hours -- until a doctor sees them. Unfortunately, at that point the mentally ill patients become part of the mental health system and are usually refused admission. Today, it's harder to get into Bellevue than Harvard.
We have to dismantle the mental health system and return the dollars to where the public wants them: helping the mentally ill.
(Note from DJ: A critical comment about NIMH was removed, because it was based on dated research. When I looked at more recent data, my comments were unfounded. The Director, Thomas Insel, has done a good job turning the Institute around).
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