One Consumer’s Observations of the Mental Health Care System in America
The mental health system is a unique culture. Psychiatry itself is, unlike any other medical specialty. Mental health is an enclosed system. That means it is a world within a world. The doctors, therapists, patients, and support workers play roles. It’s a reciprocal environment. Each player in the system allows the other person the opportunity to act out his or her role. For example, the psychiatrist gives you a diagnosis that has no basis (Yes this does happen from time to time). You, the patient, having complete faith in the powers of the behavioral health system, accept this diagnosis as the gospel truth. In time, you begin to notice certain behaviors and thoughts that you believe may be a sign of your supposed illness. You return to your doctor and report these symptoms. Your psychiatrist agrees with your observations and writes them down in your medical record. He also inserts his authoritative comments to support his opinion. Therefore, both parties in the relationship are mutually validated in their roles.
When one has been playing the patient role for so long, a person begins to identify himself or herself as a “psych patient.” That’s who you are. This is the term that defines your very existence. You belong to the mental health system. Soon enough you find that every activity you engage yourself in is related to your disorder and the medication your doctor prescribed to suppress it. It’s a sad commentary indeed. It’s sadder still for the person who needlessly struggles against an undefinable defect in his or her character as if the diagnosis were the irrefutable truth. I acknowledge the fact that the unsettling scenario I am painting here is not true for every psychiatric patient.
At some point, the psychiatric patient discovers the benefits of being labeled mentally ill. There are mental health workers, such as case managers who assist the “consumer” in obtaining a free living allowance from the Federal government in the form of Social Security Disability Income or Supplemental Security Income in whatever minimal amount it may be. I will add for comfort that social security disability benefits are reported (by the government) to run dry in 2016. A consumer is often entitled to free housing, health care, food assistance, and much more. The mentally ill person may even have the right under certain disability laws to bring a pit-bull into a no-pet residential community. Technically speaking, you could even take it on a commercial airliner. The reason is simply because your therapist deemed it necessary that you have an emotional support animal (oops was that a secret?). Don’t get me wrong. I’m sure there are people who require a companion animal for their emotional health. I’m not trying to be disrespectful to those who are struggling. What I’m saying that there are incentives built into the system for many people to accept their diagnosis and play out their role.
There are case managers and outreach workers that will go to court with you, and advocate on your behalf before the judge when you run afoul of the law. They will help the mentally ill with all of their personal affairs. What a bargain! Run out and tell all of your friends about it. Let the government take care of you. It makes being a psychiatric patient seem so much more attractive. Why wouldn’t anyone want a psychiatrist label to them disabled? Again, I’m being sarcastic to make my point that people, who are improperly labeled with a DSM V diagnosis, run the risk of becoming dependent on the mental health system for their needs.
This kind of social welfare encourages people to give up their ambition and motivation. It instills the idea that living a marginal existence is sufficient. I, for one, believe in the greatness people can achieve for themselves and the world by applying themselves.
Remember this. Once you get into the mental health system your chances of getting out are slim. There are a number of reasons for this. Primarily because the psychiatrist or psychologist has you convinced that you have a serious medical problem, which you can’t handle yourself. We all know that’s ridiculous. Many people manage their depression and anxiety remarkably well without the use of psychiatric medications. If Ativan calms your nerves and helps you function, then that’s great. On the other hand, I have seen plenty of people become addicted to sedatives. These drugs are unsafe. I wouldn’t put your faith in the safety of the anti-depressants either. I think the pharmaceutical giants are quick to point that out as a result of the numerous class action lawsuits filed against them.
Some blame can be placed on the pharmaceutical companies for this unnatural drug dependence. As I was writing this article, I surfed NAMI’s website (National Alliance for Mental Illness) and noticed “In Our Own Voice,” a public education program, is funded by a grant from Eli Lily. This is the pharmaceutical giant that manufactures psychiatric drugs like Prozac, Zyprexa, and Cymbalta. I gather (without too much mental effort) that Eli Lily’s generosity is a publicity campaign to make them look like one of the good guys in the mental field, and as a result, boost sales. As I surfaced the Internet, I found that NAMI has been receiving their fair share of criticism for their questionable association with pharmaceutical companies. I will not say NAMI is immoral or unethical. That would be too easy. If Ely Lily offered me thousands of dollars, I would have to seriously consider taking it. Sometimes the decision to cross the line depends on one’s real life needs. Other times it just has to do with making a buck. There is no denying that this kind of corporate misconduct adversely affects the mental health system and exacerbates the suffering of its consumers. Again, I know some people require the assistance of the pharmaceutical companies and the psychiatric community. The screening process for prescribing these medications is a big part of the problem. That’s because there is no adequate process in place for dispensing these potentially dangerous drugs.
Society itself contributes to this dysfunctional culture. The general attitude of the public is “As long as they are not bothering us you can do what you please with them.” This gives the mental health providers even more authority to do as they please. And so the psychiatric patient is stripped of his or her rights. As I see it, a psychiatric patient is a human being without respect or dignity. You can call my words dramatic if you like.
It may seem as I am playing the blame game and the taking on the victim role. Allow to clarify the role of the patient in the mental health system (those like myself). I will be the first to admit that the informed psychiatric patient is the one who is primarily responsible for his or her unfortunate situation. We have to accept our role in the system. No one can twist your arm behind your back, and say, “Go see a therapist about your anxiety.” At least that’s true in most cases. When you reflect on why you did it, you will say, “It seemed like a good idea at the time.”
The worst thing a mentally ill person could ever do, is telling someone about his or her condition. As soon as you do, the other person looks at you differently. An automatic flash goes off in the person’s brain, “Oh God. Here we go. His illness is acting up.” This attitude is especially noticeable in the face of a mental health professional, your family members, and closest friends. It’s a universal reaction. From the moment you reveal your secret, everything you do will be blamed on your illness. The ways in which you express yourself as a normal human being will be measured against your supposed disorder. If you are frustrated about something, the people in your life will conclude, “His meds aren’t working.” When people think you cannot hear them, they will gossip amongst themselves, “Oh he’s a psych patient. That’s why he looks agitated. That’s part of his illness.” This attitude is quite common. It comes from a lack of understanding. How could a person know, unless he or she has personally experienced it.
If you should attempt to verbalize your rights as a human being, the mental health provider will proceed to have you committed to a psychiatric hospital against your will. The patient can be held for an indefinite period of time until a clinician decides the person has come to his or her senses. The mental health professionals can essentially do whatever they want with you because no one is going to speak out against them. In Massachusetts, psychiatric patients must retain a specially trained lawyer to represent them before a mental health court in order to be released. This is where we are in 2013. I’ll bet most of you reading this article didn’t know how our behavioral health system works. We are still in the dark ages.
The only time the state of the mental health system is brought to light is when a patient commits suicide or kills someone. Then there is a public uproar and the psychiatrist or therapist are blamed or in some cases sued. In their defense, no doctor can control the behavior of their patient in society. That is not their job as I see it. The mental health professional cannot be held responsible for the actions of their patients, unless they were grossly negligent in some way. We are free and sovereign human beings. In the United States, people are generally allowed to operate freely without undue interference from others. The American attitude is “No one has the right to tell me what to do.” It’s a slightly different story if the patient states that he or she intends to commit suicide or kill someone. Then the call to duty is activated.
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