No more Kumbaya background music. It’s time to balance the feel-good nature of my last two posts with a little harsh truth. As far as background music goes, Ozzy’s the way to go this time.
Recently, an acquaintance suggested that if I thought I knew so much about mental health services, I should write about how to fix the system in my blog. I wanted to snark back, “well, if you’re so fatalistic about its flaws, why are you in the field?” But I didn’t.
Sometimes snark-offs can be fun, especially alliterative ones; this wasn’t one of those situations.
First of all, if I or anyone else suggests they alone know how to fix the mental health system, that person is probably Donald Trump, and you probably shouldn’t listen. Joking aside, mental health services post-deinstitutionalization is a complicated hot mess, and in my experience there is no one easy fix.
As I replied to my acquaintance, though, I have already written about what I think Step 1 of the fix should be, even though I don’t think a blog is the right venue for such conversations. Step 1: Switch from a diagnosis-driven system to a needs-driven system.
The problem being, paradigm shifts in mental health policy are like unprotected lit matches in a downpour. With high winds.
Inherent in this person’s snark was the challenge: if I think I know so much about mental health services, what am I doing writing a blog? The answer is a simple. While I did work in the field for a period of time, it was never my intent to do so. Writing and creative endeavors have always been my passion.
My time in the field was more an evolution of my career greatly influenced by people around me who thought my skills were a good fit. However, after decades of experience with the mental health system as a client and as a professional, I finally accepted a harsh truth.
Talking to mental health professionals and policy-makers — even the most well-intended ones — about fixing the system is kind of like what Samuel Clemens said about the weather. Everyone likes to talk about it, but no one wants to do anything about it. Except not doing anything about the weather doesn’t result in my peers landing in jail cells. Or on shelter cots. Or in graves.
I can’t quantify the number of these types of conversations I’ve had over the years. Most left me feeling like, in the end, the folks in charge of the system are okay with so many mentally ill people turning up in jails and homeless and in active addiction or in any number of other unnecessary and often avoidable crisis situations.
I’ve heard variations of, it’s not anyone’s fault; there’s nothing to be done; it’s impossible to reach certain populations; it would take too much coordination between federal, state, local and private interests; yadada, yadada, yadada.
No matter the justifications and excuses, the underlying message remains the same: it’s okay that the system is failing so many mentally ill people. When I worked in the field, it bothered me that more than a few of my colleagues and elected officials seemed to be okay with that underlying message.
Pondering why it’s okay for so many of my peers to experience so many negatives outcomes was definitely enough to give me pause. The only conclusion I could reach is: it’s okay because people still think the seriously mentally ill are substandard human beings.
Which would mean I, as person in recovery with serious mental illness, am a substandard human being. And people, my very colleagues, would have been okay with me experiencing those outcomes that trouble me. It would have been okay if I cycled through series of negative and often avoidable outcomes instead of achieving what I have as a parent or a professional.
Thinking about that made me sad, not for me but for all my peers who may not have access to the kinds of treatment modalities and opportunities that I did years ago.
If people with cancer were showing up at jails and homeless shelters in droves and their conditions contributed to those outcomes, people would be outraged. There would be an all-hands-on-deck response. Providers, community members, elected officials, all walks of life would be coming together to identify why these things were happening and how to fix the problems.
The idea of expecting law enforcement and corrections to act as oncologists/cancer professionals would be viewed as ridiculous.
Change the diagnosis to bipolar or PTSD or depression or substance use disorder, and suddenly those outcomes are okay. Of course it’s okay to expect law enforcement and corrections to act as mental health/addiction clinicians and professionals.
Parity, my hindquarters …
Contrary to the underlying message I keep hearing, the outcomes — like jail, homelessness, rampant addiction — mentally ill people, are experiencing in increasing numbers are not acceptable for fellow human beings with serious health conditions.
If you find yourself thinking these outcomes are okay, please ask yourself why.
If you find yourself thinking that those outcomes are okay because those people are crazy anyway and there’s nothing we can really do about it, so it doesn’t really matter — that’s what I mean about thinking I am a substandard human being.