Tuesday, July 24, 2007

For Grace Who Is Still Alive And Living On The Street

Posted by olvlzl.
In Sunday’s Boston Globe, Louise Kennedy wrote an important article about the difference between the dramatic and literary depiction of severe mental illness with the reality as experienced by the family and friends of severely mentally ill people.

Most of the article deals with the romantic view of mental illness in One Flew Over the Cuckoo’s Nest.

Two of these tales are onstage now in the Berkshires: "One Flew Over the Cuckoo's Nest" at the Berkshire Theatre Festival and "Blue/Orange" at Shakespeare & Company. Each production is strong and interesting in its own way. Seeing them on successive nights, however, left me repeating an old lament: If only mental illness were as fascinating, artful, and life-enhancing as it sometimes looks onstage.

Those of us who have endured the disability of a beloved relative know better. We know that while people with schizophrenia or bipolar disorder or severe depression may have flashes of creative genius and almost spooky moments of intellectual and emotional insight, the facts of their illness are scary, repetitive, and debilitating. In the long run, it doesn't lift you up to be crazy; it wears you down. And so, try as we might to surrender to the power of psychosis as a symbol, we just can't stop noticing the difference between reality and fantasy.

Kennedy talks about her experience with her severely ill mother and the effect that her illness had on her mother and those who loved her. For those of us who have experienced the loss of a close family member to severe mental illness the false picture presented by fiction and drama is quite often cruelly unrealistic.

I’ve often wondered if the popularity of the book and then the movie of Cuckoo’s Nest didn’t aid the cost-saving effort to dump even the most severely impaired people out of the hospitals and onto the street. The policy was presented as a civil rights issue, it was supposed to give them a better life than they would have in an institution. But it didn’t work that way. Treatment of severely mentally ill people is often just not provided, they are simply dumped on the street where they are particularly vulnerable to a large list of horrors.

Families that try to care for severely mentally ill people get little help in most states. If they aren’t wealthy they will find the situation almost impossible, in the case of the most severely ill, it is almost always impossible. The institutions of the past were certainly not worthy of replication but what we have now is worse. A member of my family who was schizophrenic gave us an enormous education in the buck passing, let’s pretend world of the mental health establishment we have today. The private clinic 28 day miracle treatment curiously coinciding with the length of time the insurance company would pay, the ineffective even dangerous administration of drugs coupled with inadequate counseling, the refusal to call a schizophrenic a schizophrenic because it might require the system to spend money, we saw it all. Not even the most obvious self-destructive behavior would move the system to require hospitalization. The one and only time her mother got her into the state hospital, before she reached the age of 18, she improved greatly. But as her pediatrician told us, once she reaches 18 you are not going to be able to do anything.

Our experience is that even as the self-destructive behavior leads to death, the system won’t do anything that would require them to hospitalize an entirely irrational person who is clearly unable to make rational decisions for themselves. We know this is true because after 16 years of dealing with the mental health system, years of deterioration and self-destruction the member of my family finally died. It wasn’t suicide, she wanted to live but she couldn’t stop destroying herself. The system we have doesn’t work, its only accomplishment is in coming up with words that excuse their inadequacies in a clear abuse of the language of civil rights. When someone is unable to think rationally, certainly their first civil right is to being protected.

I’d like to know how other people who have experienced the reality of trying to help or save a severely mentally ill person from their irrationality see Cuckoo’s Nest and other romanticized pictures of mental illness. I'd like to hear your experiences with the mental health establishment in your state.