Every now and then it happens…I have an aha moment that has me convinced perhaps Alex Jones of Infowars.com and the late night radio show of the same name are not as crazy as mainstream media would have us think. A moment where all the millions of pieces of a puzzle fit together to make sense, only not the sense I would have if I were in charge (if?! I am in charge! For the people! By the people! Wake up, Whitney!).
It started this morning while talking with my sister by choice, Cassie, about her husband’s refusal to speak up. For instance he refuses to send back his steak if it’s wrong. Yesterday he read an article in the Chicago newspaper that had a picture of an AR 15. The picture had arrows pointing to the hooks where a back-strap hooks in. Jeremie became enraged because the newspaper called those hooks places where grenade launchers and other evil accessories could be attached. Jeremie is a republican who loves his guns and serves in the military. I’ll talk about guns more in a minute. I digress. Cassie tells him to write the editor and tell them they’re just fueling public fear and it’s stupid. Jeremie refused to so she did. He told her she was always starting stuff with people. Why can’t she just let it lie? Why can’t she do like he did and just post on Facebook “You can have my guns when you pry them from my cold dead hands!”? He apparently demanded to know. To which she replied he is what is wrong with American society (republican status notwithstanding). Posting pictures and voicing opinions on Facebook don’t get a lot done.
Gun Control? No. Mental healthcare.
So we began talking about Sandy Hook and this media outcry for gun control, the outcry from celebrities for gun control, and how there’s been a focus on gun control. I told her from my perspective the issue is one of mental health care, and it is (More later). I was very disappointed that Obama’s plan to stop gun violence was simple feel-good legislation. He focused on 23 points. These are mostly empty pieces of junk meant to make us feel better and they accomplish very little. Only 4 items address mental health.
They are: “Release a letter to state health officials clarifying the scope of mental health services Medicaid plans must cover || Finalize regulations clarifying essential health benefits and parity requirements within ACA exchanges || Commit to finalizing mental health parity regulations || Launch a national dialogue led by Secretaries Sebelius and Duncan on mental health.” I can’t stress enough that these mean NOTHING.
It’s like reminding your kids to do homework even though they know they’re supposed to do it. Meaningless essentially. They know this already.
Oooh, a letter. I’m shakin’ in my hippie feet over here. I’ll skip the self explanatory “executive mandates” (ha! It’s kind of like mandating that people breathe…we already do) and address the last one for its sheer idiocy. Launch a national dialogue regarding mental healthcare. Fun! You mean the one that the National Institute for Mental Health or NIHM is already supposed to be having?! You mean the ones that the nationwide publicly funded Mental Health Mental Retardation Centers are supposed to be having in communities (MHMR)? What a joke!? Talking about it nationally!? Will talking about it generate the millions of dollars in funding our dilapidated mental healthcare safety net needs to serve our population? Nope. Talk is cheap and that’s why he’s “ordered” it.
I think that NIHM and MHMR and the ACA, AMHCA, APA and the other APA have all already told the government that they need to stop using the phrase mental healthcare systemand start using the phrase mental healthcare safety net because that’s what it is. It is not cohesive institutionally, funding is so poor that people go unserved, people have to wait for months for appointments in some locations for income based services, some refuse services for fear of being discovered by employers or others, others never get help and can’t hold jobs because of their mental issues and end up homeless of the burden of a family member, or in the worst case scenario they go fruit loops and shoot up an elementary school while also living with their mothers at home because they can’t hold a job because they’re so emotionally disturbed and mentally ill. These major organizations of professionals have been crying out for help and lobbying and advocating for these populations that are very underserved for decades and the government has not listened. We can spend four months in congress debating the necessity of Big Bird as an American icon and whether or not we should pay him, all the while ringing up a daily bill of 8 million dollars just for people showing up and turning on the lights in congress and get NOTHING done, YET we cannot spend another dime on mental healthcare.
So I think if I was stingy with money and in the government and aloof and removed from tragic happenings like these that I would absolutely sign off on just ignoring the problem in favor of collecting assault rifles and blaming gun laws which will cost little to round up and tighten up in comparison with the serious funding issue to public mental health. If I were an evil, greedy, uneducated blob of gelatinous muck like anyone in congress or the senate. Sure, blame the guns.
The issue is mental health. Nuff said.
Now two major issues surface. 1) Funding (see above) and the other is 2) Accountability/Enforcement. Pretend you’re a mental health patient with schizophrenia comorbid depression/mania and a diagnosis and prescription for medications that reduce your symptoms and make you a productive part of society. You take them for a while but the side effects bother you. Some of these are confusion, dizziness, weight gain, appetite increase or reduction, sleep disturbances, night sweats, nausea, and more seriously seizure. So you don’t like feeling fuzzy or getting fat. So you go off your meds to feel better. Or you take your medicine, feel better a while and think you don’t need your meds. Now you’re off your meds. People at work and friends are starting to make you angry. You think your coworkers hate you. Your landlord is listening to your phone conversations. Things get scary. You lose your job for an emotional outburst. You are forced to live with your parents or a relative until you can get back on your feet. Your relatives know about your diagnosis and that you’ve stopped medication. They talk to you about it but you get angry and insist it makes you worse to take it .The pharmacy you get your scripts filled at notices you haven’t been in in a few months too. The clinic you went to for treatment hasn’t heard back from you in a while. You slip through these gaping holes. Maybe your doctor calls you on a whim and asks you to come in for a visit, but you blow him off. Things start spinning out of control. You think your mom is poisoning the cereal. So you kill her to save yourself and your siblings from her evil plans. Only it wasn’t real and she loved you.
Are you responsible for taking or not taking your meds?
Is your family responsible for not standing up to you and insisting on you taking your meds?
Is the pharmacist responsible for not alerting your doctor that you haven’t filled a prescription in a while?
Is the doctor responsible for not following up to make sure that you adjusted to your medication properly? Or continued taking it?
Do you have the right to refuse your medicine and put the rest of us at risk during one of your episodes?
To these I say, we hold drunks accountable for the bad decisions they make under the influence of cognition altering substances. We don’t say that people were too drunk to know they shouldn’t drive and then let them go after they kill a family of four in such an impaired state. In a diminished cognitive capacity, though, we let mentally ill people make these decisions and they hurt others.
Cognitive ability in folks with serious mental disorders are distorted and unreliable. They are made aware of this (in most cases with exception of severely disordered people). Then they choose not to take them. Or they can’t afford them, etc.
The “system” needs to address some of these issues and the fears listed above so that people can freely receive the help they need without fear of reprisal.
I am unsure of what the right answer is for these ethical dilemmas. Education, Remove Stigma Associated With Mental Health Issues, Provide Funding for Community Clinics, Provide a New Classification System to Categorize Those Who Should Not Be Permitted to Go Without Medication Unchecked (without a responsible party to care for them), Make Responsible Parties Responsible.
Some statistics. 2/3 of people who become a subject of the state court systems are mentally ill, who with proper treatment would not have become a subject of the court. State hospitals are not intended to permanently house those with mental problems or even to diagnose and treat; their sole purpose is to make people who are not competent to stand trial competent, with very few exceptions to this rule. Very little money is given to states for diversion to MHMR and community mental health clinics. Once this money arrives in Texas, it is divvied up among our counties, with more funds going toward places with more problems.
An anecdote. A young mom, Brandi Todd, of Morgan Mill, Texas visited a local city park with her young children. As she watched them play a man approached her from behind and stabbed her in the back, severing her spinal cord. Her children watched her lying and twitching and waiting for help. Michael Allen Howard told the police at the scene that he was a state mental health patient with illness dating back twenty years. He said that he waited two days for a caseworker to call him back before “invisible forces took control” of him and made him stab Ms. Todd. Howard is diagnosed as paranoid schizophrenic and had run out of medication. He said he wanted to go to the state hospital in Wichita Falls but was unable to afford the two hour trip there. The executive director of the local Pecan Valley MHMR admitted that Howard is a client and indicated that a caseworker was scheduled to call him and that MHMR would investigate the matter further. Howard was convicted of stabbing Ms. Todd and is in a state mental health facility. Todd is not expected to walk again. Here’s an even worse case. He knew he was sick and sought help only to be put on the back burner. I was unable to find information regarding the MHMR investigation into this matter and plan to call the local headquarters and ask tomorrow.
Stay tuned…this post will continue as part of a large scheme here and I promise it’s worth the read. You’ve already come this far…