I have been meaning to write about this issue for a very long while, but have left it on the burner for so long I forgot about it. Then today in psych class I had it thrust into the forefront rather brutally. Before I go on, I want to share this episode of Frontline from 2005, one that I hadn't actually seen before. I should expect that it won't take long to get the gist of a truly magnificent breakdown of how we manage mental illness in the U.S.
It didn't take very long to provide you with a pretty good idea as to just how truly screwed up this is. Keep in mind Frontline filmed that episode in a prison that is still considered a model for psychiatric care in the prison setting. This is no way to treat people with mental illness, even people who really do need to be locked away from society.
What really makes me angry about our new model for dealing with serious mental illness, is that all the excuses made for closing state institutions are exacerbated by this method of dealing with the seriously mentally disturbed. It is far more expensive to deal with the mentally ill either in prison, or on the streets coasting in and out of jail. The biggest reasoning was expense - but the expense has dramatically increased. It is a huge expense for local communities and ultimately still costs the state more.
On top of this, it is extremely hard for the seriously mentally ill to actually get the help they need and even qualify for. There are "homeless" mentally ill persons who aren't actually homeless. They have a place in a group home and access to care. But then they wander off from home and end up living on the streets - off their meds, hungry and exposed. And there are truly homeless mentally ill persons who aren't getting any help - not because they don't qualify, but because they are not together enough to go out seeking it. And even if they try, the system is not set up to be managed by a paranoid schizophrenic who believes there are people trying to kill her, or someone with bipolar who walked nearly a hundred miles from people who knew him while in a manic phase. That is not the "freedom" that wellmeaning, but ultimately ignorant lobbyists/policy makers were trying to provide with the idea of mainstreaming.
And the local communities - the communities in which people who know and love a particular mentally ill individual lives, are not set up to deal with them. We have had forty plus years to get it together and help these folks and still we are flailing about, failing too many. Even here in MI, where the quality of care provided by county Community Mental Health (CMH) services is generally quite exceptional, we are allowing too many to slip through the cracks. In many places, there is virtually no organization to provide services to the mentally ill. In others, southern California in particular, the services provided are truly abysmal.
And again, the states are still fitting a huge portion of the bill - in many cases a much larger bill than the state hospital system cost.
Michigan is particularly hard hit right now, as we have closed some of our mental health facil...Excuse me, prisons at the same time we have also eviscerated the budgets of the county CMHs. We are dumping these folks onto their local communities and pulling the funding that might have provided services for them. The clinics that manage paroles and people on probation are getting overwhelmed - in many cases with clients who should not be outside of a lockdown facility. Meanwhile, people with less serious mental problems, but who do not have insurance and do not qualify for medicaid are screwed.
Myself for example. I finished with my last therapist about a year ago. I was told that I would see another intern therapist last summer - then that was bumped to the fall...I haven't bothered trying to call again - I know what is happening and know that I am not going to get help. At least I am on meds and not left completely screwed. For more people are worse off than I am. No therapy, no psychiatric services - they won't get help until their mental illness becomes acute and they either commit a crime and end up in prison, or at least get picked up by the cops and pushed through the medicaid requirements.
Please don't think that things are much better elsewhere. For the past several years MI has managed to provide mental health services on a shoestring, that far outstrip the quality of care offered in many other states that have substantially larger budgets per public mental health consumer. It is not like those services have improved as budgets get hit across the U.S. Indeed the quality of care here has not actually suffered that much, we just can't provide that care to the people who desperately need it.
I have some hope that the new healthcare plan is going to help with some of this. The APA has managed to push for some provisions that should improve access to mental health services and they went through. But it is only going to help with people in temporary crisis. People who are dealing with situational mental problems or who exhibit mild symptoms. It is not going to do a damned thing to change our prison and "homeless we can ignore" based system of care for the seriously mentally ill.
Just so we are perfectly clear about this, those scenes where they showed these yellow cages in a half circle - their "group therapy" session - that is not a reasonable way to provide group therapy. Not an effective means for any sort of functional therapy. Punishing inmates for breaking rules they don't understand is not effective therapy. Pretending that there is anything valid about an admission of guilt for rules violation, coming from a guy who is incapable of understanding what he is pleading guilty to is a fucking atrocity.
And remember, the system we got a glimpse of in that video - that is a model system for prison based mental health care. That is worlds apart from what one gets in county lockup or most prisons in the U.S. It gets far, far worse than what we see in that episode of Frontline.
Showing posts with label neurological disorder. Show all posts
Showing posts with label neurological disorder. Show all posts
Wednesday, April 14, 2010
Friday, December 11, 2009
Dangerous Tropes: "I Can Do and Be Anything I Want"
Most of my generation was raised on this trite bit of nonsense and a lot of us really believe it. "You can be anything you want to be." "You can do anything you want to do, if you really work at it." "Where there's a will, there's a way." "I've got high hopes..."
Human beings are extremely versatile and resilient. We are very capable of being a great many things, every one of us. Nearly everyone has a variety of skills to draw from and a variety of innate intellectual talents with which to develop those skills. But my innate intellectual talents are not universal, neither are yours. An artist may not have the raw analytical talent necessary for experimental design. A scientist may not have the engineering talents necessary for affecting repairs on a car or their home. An engineer may not have the abstract creative capacity needed to write poetry, or a good novel. While we humans are versatile, we are not, any of us, infinitely capable of doing absolutely anything that might strike our fancy. And not everyone has the physical capacity to be this sort of athlete or that.
Now this may grate against the social conditioning of many people who grew up with the feel good tropes of the seventies and eighties, a legacy that still haunts many of our schools today. I am sure that the claim that we cannot, in point of fact, be whatever we might want to be is offensive to some. Having grown up with it, it goes dead against my own socialization to express it. There is a rather big problem though - it's true. We are not all the same and we do not all have the same abilities. About the best that can be said, is that most of us are rather drawn to follow our innate abilities - to do what we are good at.
The problem is that when we happen to pick on something that we just don't have the talent for, we often feel that our inability to succeed is a moral failing. That we just didn't try hard enough. It is so firmly ingrained into our psyche that we often cannot comprehend, cannot accept that there is any reason except our own laziness or insufficient will that we could fail. Even when reality is pointed out, there is often a part of us that truly believes our failure was a moral deficiency on our part. I mean come on, everybody knows that if you want it enough, you can totally make it happen. Except when you can't. At which point it is all your fault, for not wanting it desperately enough.
There is a very serious consequence to this mentality, when we try something and fail. Because we perceive that failure as a moral failing, it becomes rather easy to decide that we just don't want to try anymore - especially if we fail more than once. Conditioning can be crippling, even to people who have never shown signs of neurological disorders. Losing faith in oneself do very absolutely can and sometimes does break people. People commit suicide or slip into severe depression for a lot less than perceiving themselves a complete failure, unable manage that mythical, "what I wanted to be."
Then there is the very dangerous cousin, "you just need to think your way out of it, think your way past it." Like many people with neurological disorders, I have heard this one numerous times in my life, from many different people. Bad enough to hear it from family or friends who really don't understand or accept problems they cannot see. I would love to see damn near every psychotherapist who utters those words, or words to that effect, stripped of their licenses. Should they manage to kill a client with that kind of bullshit, I would love to see them prosecuted for it - and telling a severely depressed client, "you just need to think your way out of it," can be and sometimes is fatal.
Essentially telling someone who is severely depressed that it is their fault they are feeling this way, is a great way to send them into a major spiral. It is not uncommon for such spirals to bottom out into such despair that trying to continue to that next breath is inconceivable. And have no doubt, if you have never experienced it - there are times for a lot of people with neurological issues, especially those with mood disorders, when every breath is a struggle - a miserable eternity that you know it going to be repeated over...and over...and over again.
Loved ones do not make it any easier, when they try to push someone through this. It just isn't that simple. But when someone who is a licensed professional, someone who is trusted as a supposed expert on neurological issues does it, it is like telling them that this person who is trusting them to help them struggle through it is a failure. That it is their fault they are feeling like this. That if they really wanted to get better, they magically would be better. That is, to be clear, not likely what the therapist is trying to say. At least I should fucking hope not - though there are some ridiculously ignorant jackasses out there. But that is exactly what the client hears.
Lets think about getting past bullshit tropes that hurt people. Lets be realistic with our kids the way that the adults in the lives of my generation were not with us.
No, you can't be anything and everything you might want to be. You have innate talents that if you work hard to foster, will allow you to be good at what you really can do. If you work extra specially hard to foster those talents, you can even be great at what you do - though that doesn't always happen because life isn't always fair. And it is totally ok if you need some help along the way - all of us do really. It's just that some of us have brains that sometimes work against us. If you need medication to make it, that's ok. Getting cognitive therapy along with the meds is even better. No, you don't have to just think your way through it, because that is not how it works - unless you happen to have a very mild neurological issue.
Another thing to consider...A lot of substance abusers do so because they have failed too many times...
Human beings are extremely versatile and resilient. We are very capable of being a great many things, every one of us. Nearly everyone has a variety of skills to draw from and a variety of innate intellectual talents with which to develop those skills. But my innate intellectual talents are not universal, neither are yours. An artist may not have the raw analytical talent necessary for experimental design. A scientist may not have the engineering talents necessary for affecting repairs on a car or their home. An engineer may not have the abstract creative capacity needed to write poetry, or a good novel. While we humans are versatile, we are not, any of us, infinitely capable of doing absolutely anything that might strike our fancy. And not everyone has the physical capacity to be this sort of athlete or that.
Now this may grate against the social conditioning of many people who grew up with the feel good tropes of the seventies and eighties, a legacy that still haunts many of our schools today. I am sure that the claim that we cannot, in point of fact, be whatever we might want to be is offensive to some. Having grown up with it, it goes dead against my own socialization to express it. There is a rather big problem though - it's true. We are not all the same and we do not all have the same abilities. About the best that can be said, is that most of us are rather drawn to follow our innate abilities - to do what we are good at.
The problem is that when we happen to pick on something that we just don't have the talent for, we often feel that our inability to succeed is a moral failing. That we just didn't try hard enough. It is so firmly ingrained into our psyche that we often cannot comprehend, cannot accept that there is any reason except our own laziness or insufficient will that we could fail. Even when reality is pointed out, there is often a part of us that truly believes our failure was a moral deficiency on our part. I mean come on, everybody knows that if you want it enough, you can totally make it happen. Except when you can't. At which point it is all your fault, for not wanting it desperately enough.
There is a very serious consequence to this mentality, when we try something and fail. Because we perceive that failure as a moral failing, it becomes rather easy to decide that we just don't want to try anymore - especially if we fail more than once. Conditioning can be crippling, even to people who have never shown signs of neurological disorders. Losing faith in oneself do very absolutely can and sometimes does break people. People commit suicide or slip into severe depression for a lot less than perceiving themselves a complete failure, unable manage that mythical, "what I wanted to be."
Then there is the very dangerous cousin, "you just need to think your way out of it, think your way past it." Like many people with neurological disorders, I have heard this one numerous times in my life, from many different people. Bad enough to hear it from family or friends who really don't understand or accept problems they cannot see. I would love to see damn near every psychotherapist who utters those words, or words to that effect, stripped of their licenses. Should they manage to kill a client with that kind of bullshit, I would love to see them prosecuted for it - and telling a severely depressed client, "you just need to think your way out of it," can be and sometimes is fatal.
Essentially telling someone who is severely depressed that it is their fault they are feeling this way, is a great way to send them into a major spiral. It is not uncommon for such spirals to bottom out into such despair that trying to continue to that next breath is inconceivable. And have no doubt, if you have never experienced it - there are times for a lot of people with neurological issues, especially those with mood disorders, when every breath is a struggle - a miserable eternity that you know it going to be repeated over...and over...and over again.
Loved ones do not make it any easier, when they try to push someone through this. It just isn't that simple. But when someone who is a licensed professional, someone who is trusted as a supposed expert on neurological issues does it, it is like telling them that this person who is trusting them to help them struggle through it is a failure. That it is their fault they are feeling like this. That if they really wanted to get better, they magically would be better. That is, to be clear, not likely what the therapist is trying to say. At least I should fucking hope not - though there are some ridiculously ignorant jackasses out there. But that is exactly what the client hears.
Lets think about getting past bullshit tropes that hurt people. Lets be realistic with our kids the way that the adults in the lives of my generation were not with us.
No, you can't be anything and everything you might want to be. You have innate talents that if you work hard to foster, will allow you to be good at what you really can do. If you work extra specially hard to foster those talents, you can even be great at what you do - though that doesn't always happen because life isn't always fair. And it is totally ok if you need some help along the way - all of us do really. It's just that some of us have brains that sometimes work against us. If you need medication to make it, that's ok. Getting cognitive therapy along with the meds is even better. No, you don't have to just think your way through it, because that is not how it works - unless you happen to have a very mild neurological issue.
Another thing to consider...A lot of substance abusers do so because they have failed too many times...
Monday, October 5, 2009
PETA - You Bastards!!!!!!!11!!1!111!!!
I am looking into where we can send funds for the freedom ranch...
Advocacy Group Decries PETA's Inhumane Treatment Of Women
Advocacy Group Decries PETA's Inhumane Treatment Of Women
Friday, February 13, 2009
Why I am pursuing a education for a career dealing with addiction
I am now busy as all hell. I have a lot of writing to do in the next week and posting may get sparse, though I may throw some more up as I get into the nuts and bolts of my paper. For now, I just wanted to mention the abysmally poor record of the dominant substance abuse paradigm.
There is very little information available about recidivism, but what there is is chilling. I suspect that the figures we have, strongly contribute to why we don't have more. This is a link to Comments On AA's Triennial Survey, from 1989. This is analysis of survey compilations performed by AA. Of particular interest, is the graph on page twelve, showing that of those who start attending AA, only five percent are there after a year. Other studies (scroll up a couple pages) have shown a slightly better picture, but there is little question that twelve step programs are not for everyone.
Meanwhile, American taxpayers are pumping out two hundred billion a year for substance abuse issues. Add to that the loss of production and other factors, substance abuse costs us more than five hundred billion every damned year.
There is very little information available about recidivism, but what there is is chilling. I suspect that the figures we have, strongly contribute to why we don't have more. This is a link to Comments On AA's Triennial Survey, from 1989. This is analysis of survey compilations performed by AA. Of particular interest, is the graph on page twelve, showing that of those who start attending AA, only five percent are there after a year. Other studies (scroll up a couple pages) have shown a slightly better picture, but there is little question that twelve step programs are not for everyone.
Meanwhile, American taxpayers are pumping out two hundred billion a year for substance abuse issues. Add to that the loss of production and other factors, substance abuse costs us more than five hundred billion every damned year.
Thursday, January 29, 2009
ADHD, Bipolar and other neurological issues: A Quick Note
To be clear before I go further, the information available to me about those hitting this site is very limited. But one of the things that my site meter tells me about, is the referring URL, i.e. where you clicked in. And when a google search brings someone here, while I don't know who that person is, I do know what the search string was.
I have noticed that I get fairly regular hits from searches on ADHD, bipolar and neurological disorders. Often included are methylphenidate, ampehtamine, adderall, ritalin, substance abuse, etc.
Please, let me make you welcome. If you are hitting this post, feel free to peruse the rest of the blog, but more importantly, please let me know what you are looking for. While I am painfully busy right now, I would very much like to provide links in the sidebar to help facilitate your search and the searches of others who come after you. I do have several links that I intend on posting, but school and, well, ADHD behaviors have kept me from getting to it. Meanwhile, there are links to some forums that may be of use. Discussing our problems with people who have similar issues can be a major help in itself. And some of the forums provide links to other information - and you can always post a request for links.....
More than just a place to foster interesting discussions, I want this blog to also be a place where information on topics that affect me and those I love can be found. I have rather severe ADHD and not so intense bipolar issues. I have many years of experience with substance abuse issues and am studying psychology with the intent of going into addiction research and clinical work.
If you happen to be looking for substance abuse links, please take a look to the right of this, you may have to scroll down. There are some links now and that list will be growing as I have time to get to it.
So please, if you don't see what you're looking for, let me know. You can post anonymous links or email me (just write confidential in the subject line). While I am not a therapist and cannot provide mental health care, I can point you in different directions and am often happy to talk. While there is no legal compunction for me to do so, I am very discreet and will never post or talk about you. If you give me permission, I may discuss things you share with me, but would make sure to keep your identity private.
I have noticed that I get fairly regular hits from searches on ADHD, bipolar and neurological disorders. Often included are methylphenidate, ampehtamine, adderall, ritalin, substance abuse, etc.
Please, let me make you welcome. If you are hitting this post, feel free to peruse the rest of the blog, but more importantly, please let me know what you are looking for. While I am painfully busy right now, I would very much like to provide links in the sidebar to help facilitate your search and the searches of others who come after you. I do have several links that I intend on posting, but school and, well, ADHD behaviors have kept me from getting to it. Meanwhile, there are links to some forums that may be of use. Discussing our problems with people who have similar issues can be a major help in itself. And some of the forums provide links to other information - and you can always post a request for links.....
More than just a place to foster interesting discussions, I want this blog to also be a place where information on topics that affect me and those I love can be found. I have rather severe ADHD and not so intense bipolar issues. I have many years of experience with substance abuse issues and am studying psychology with the intent of going into addiction research and clinical work.
If you happen to be looking for substance abuse links, please take a look to the right of this, you may have to scroll down. There are some links now and that list will be growing as I have time to get to it.
So please, if you don't see what you're looking for, let me know. You can post anonymous links or email me (just write confidential in the subject line). While I am not a therapist and cannot provide mental health care, I can point you in different directions and am often happy to talk. While there is no legal compunction for me to do so, I am very discreet and will never post or talk about you. If you give me permission, I may discuss things you share with me, but would make sure to keep your identity private.
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