Be careful what you wish for

from Harry Magnet’s Blog

Sunday, April 21, 2013

Bipartisan Push for Better Mental Health Care Won’t Be Helpful

In the aftermath of the shootings at Sandy Hook Elementary School, with memories of the Aurora movie theater shooting, the Gabby Giffords shooting, and the Virginia Tech shootings still in mind, people demanded that the U.S. Congress do something. These shootings, along with many others, were perpetrated by mentally ill individuals. Liberals wanted more gun control. Conservatives wanted more armed guards and armed civilians to take down the shooters. The divided congress was unable to pass a gun control measure. But apparently liberals and conservatives were able to agree on one thing, according to a recent New York Times article: better care for the mentally ill. According to the article, “[t]he emerging legislation would, among other things, finance the construction of more community mental health centers, provide grants to train teachers to spot early signs of mental illness and make more Medicaid dollars available for mental health care.” There would also be support for children who faced trauma, and suicide prevention initiatives. Approximately 1.5 million additional people with mental illness would be treated each year.

This is a good, thing, right? What’s there to complain about more mental health treatment? There’s nothing to complain about, if one believes in the current drug-based model of care. Treatment in this context will be primarily psychoactive drugs. The community mental health center will recruit and encourage people to see a doctor and get a prescription for a psychotropic medication. Teachers will spot early signs of ADHD, depression, and bipolar disorder in children, and put the children on the road to chronic stimulant, antidepressant, and antipsychotic drug treatment. Medicaid is notorious for drugging up the children who rely on it for health care. Suicide will be prevented by prescribing antidepressant drugs. The vast majority of the 1.5 million additional treated people will be prescribed drugs.

After reading Anatomy of an Epidemic (which I review here), I stopped believing that psychotropic drugs are an effective long-term solution for most mental disorders. The evidence is just not there.  

Read the rest of Harry Magnet’s thoughtful post here He illustrates his argument using the homeless problem in Salt Lake City. 

Editor’s comment: I always get nervous when people want the government to DO SOMETHING! in the face of recent tragedies. It an overreaction that invariably results in bad policies, bad legislation.

Personal problems as a just another consumer commodity

Part I

Prophets Wanted. Apply Within is the title of the upcoming sermon posted on a sign on the front entrance of the Fifth Avenue Presbyterian Church (FAPC) in New York City. I debated with myself about whether to march in and ask to speak with the author of the sermon or if I should just walk by. This was too good an opportunity to pass up, so in I went. The young woman at the reception table said the minister was not available so I opened the door to the main area of the church and found a pew to sink into. The cool interior of the church was a welcome respite from the rising heat wave in the city. I grabbed a visitor’s card and scribbled a short message to the minister.

It went something like this:

Hello – I am sorry I will miss your upcoming sermon on Prophets Wanted: Apply Within. Would today’s church recognize a prophet if one walked through the door or would it urge this person to see a psychiatrist and get on medication?

That was the abbreviated message because I had to hurridly sketch my point on the back of the visitor’s card. I ran the risk of looking like a bit of a nutter myself with handwriting crudely scratched from the pencil I found in the pew. I signed off with my pseudonym Rossa Forbes and added as an afterthought “mother of a prophet,” in case it looked like I was making a personal job application. I added my e-mail address and URL.

So, in case anyone from FAPC is reading this post, here’s what I am fumbling to say: We all know that churches are at the forefront of community outreach programs, and your church newsletter The VOICE has an excellent issue this month devoted to all the work your members are doing at shelters. But I think your church and the church at large has forgotten or suppressed something very fundamental — the prophets of yesterday, the Jonahs, the Elishas, the Ezekiels, would today be locked up and heavily sedated. Today’s prophets are devalued. Their gifts of hearing voices and seeing visions frighten people. Given the church’s longstanding affiliation with The VOICE of prophecy, shouldn’t the church be at the forefront of changing the public’s perception? The so-called mentally ill have messages and few people are listening. A simple shift in our collective thinking, to value, laud and encourage people who are struggling with forces from God that are very distressing when not properly understood, would go a long way to help people do on earth what they were put here to do. In this population you will find the poets, writers, artists and musicians, a.k.a. our prophets.

Instead, churches are preoccupied with the problem of “homelessness,” a word which has become synomymous with mental illness. To quote from The VOICE:

“Permanent supportive housing is the most cost-effective and lasting way to address homelessness,” Rev. (Kate) Dunn says. ………By supporting temporary shelter options for local street homeless, while advocating for permanent supportive housing, we have an opportunity to create a powerful witness in our backyard.”

I disagree that homelessness can be addressed by permanent supportive housing. That is an attitude that everything can be fixed if you buy the right product. I know that permanent supportive housing has great appeal to people because “homelessness” seems like a social wrong that throwing housing at will fix. But does it fix the real problem? People are homeless because they have personal and family problems that have manifested themselves to the breaking point. Many are on the streets because they refuse to take medications that pharma and psychiatry at one point in time managed to convince the public would keep them out of institutions! Many of these people have received the label “schizophrenic” because they hear and see things that we do not as we go about our consumer driven lives. Modern psychiatry has embraced the “consumer” at the expense of the individual and no longer wants to hear about anybody’s existential or spiritual crisis. They have convinced people they have a brain disease, one manifestation of which is to believe you are a prophet. Nobody believes in prophets anymore, least of all the church, which is weird, frankly, given the longstanding affiliation between the two. After all, it is probably safe to say that schizophrenics have founded most of the new charismatic Western religions, e.g. George Fox (Quakers), William J. Seymour (Pentacostalism), L. Ron Hubbard (Church of Scientology).

Part II of this two part story will look at supportive housing for the mentally ill run by a church community on Long Island. My point is not to criticize FAPC and all the other churches for doing what is popularly thought of as a good work. Rather, it is to look at where the reality of treating the so-called mentally ill has led us in the absence of holistic support to the individual. Here is a link to the article Two Flew Over the Cuckoo’s Nest, that is in this week’s The Village Voice.