not mad, but sad

So how come you’re not working in psych anymore?”

“Burnt out.”

Not surprising.”

“What do you mean?”

Well, what a job working with mad people and all. No wonder something rubbed off on you.”

I sigh; look at the sky, taking the time to allow my spirited self to calm down before replying.

“I burnt out because of the system not the clients. And what the hell are ‘mad people’?”

Oh you know what I mean.

“Okay then so you think folk with mental illness or emotional struggles are mad, and that they are different to you and that mental illness is contagious.”

I didn’t say that.”

“Well you did actually”

I’m just saying…”

“You know I don’t really care what you think you’re saying. The fact is you said what you said. You just told me you categorise anyone who comes to the psych system for help as ‘mad’ people. You just told me that you think anyone who is unfortunate enough to experience mood problems, psychotic disorders or simply has problem coping in this life is not only mad but you wouldn’t want to be around them. Actually…you just told me you are an idiot!”

Hmmm. I guess my spirited self didn’t calm down as much as I would have liked. The idiot line could have been left out but seriously!

The following day I had to attend an appointment due to being unemployed now. As we talked of the lack of success I was having getting even an interview for jobs I was applying for, (which is pretty much any job in the small town I live in) and the terrible financial strain this was causing, the ‘employment consultant’ says;

“They probably think your twenty-four years of psych has rubbed off on you.”

“What?”

“Well you know…that you’ve caught something.”

I stared at him waiting waiting waiting for the word ‘idiot’ to stop dominating my thoughts. It didn’t though so instead I had to speak slowly to prevent it escaping.

“You know that’s nonsense don’t you?”

“I suppose. But a lot of people do worry about that. And your whole CV is about psych.”

Leaving him I went home and sat by the creek that rambles past my house. I thought of all the years put into mental health education and wondered if it had made any real difference. I noted my angst, my passionate internal responses still intense despite having left this vocation.

An estimated one in four people globally will experience a mental health condition in their lifetime. People with mental, neurological and substance use disorders are often stigmatized and subject to neglect and abuse. The resources available are insufficient, inequitably distributed and inefficiently used. In the majority of countries, less than 2% of health funds are spent on mental health. As a result, a large majority of people with these disorders receive no care at all. http://www.who.int/mediacentre/news/releases/2010/mental_health_20101007/en/index.html

I won’t be going back to working within our mental health system. The current system ruled by budgetary constraints and pharmaceutical domination mean that truly helping has become nigh on impossible. Be it a failing or a strength in my personality the fact is I’m unable to watch folk suffer unnecessarily any more. I guess that’s the burnt out bit. 

But I would still like to increase folks understanding. Not only in the hope that we can all become a little more compassionate but also so that if we end up the ‘one in four’, or our loved ones do, we won’t at least be weighed down by misconceptions that will interfere with recovery…or that will stop us seeking help.

So I will write of my experiences, sharing the stories and learning of those twenty-four years. Maybe some publisher will like it. Maybe not. But I must try.

Hopefully folk will get that it is not ‘them’.

 It is ‘Us’. And it is not Us being mad. It is Us in pain.

And it is us that can help to relieve that pain.

cheers…leesa

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25 thoughts on “not mad, but sad

  1. Amen, sister.

    I have two responses within me when I hear this.

    Firstly, it seems stunning to hear people respond with such incredible ignorance, mindlessness, and prejudice. Just stunning.

    But on the other hand I know that I experienced my own “we’re all the same” epiphany *after* I had begun working in the mental health service. This makes it hard to blame people too much.

    I’m torn. I think we need to face the facts that over a lifetime there is a very high chance that either ourselves or somebody within our intimate circle of relationships will experience some form of “mental illness”. I use the scare quotes intentionally because I suspect that viewing it as “Illness”, using the medical model of mental health, and our media associations of mental illness with dangerous gunmen or psychopaths only helps to keep those suffering at arms length.

    The same-ness of everyone struck me even more when I worked in the Youth service of my work. Those kids have it rough. They are often abused or betrayed in some form by those who should be their greatest source of love and protection. They are often bullied or misunderstood by others their age. They are often plied with drugs by absolute VULTURES who realise it’s easy to sell drugs to children at a formative age.
    I saw all of this and I thought, “some of these kids have adjustment disorder or antisocial personality disorder. Of goddamn course they do! I’d be f-ked off, too!” They experience the worst kinds of betrayal and identity confusion and we not only label them indelibly but we medicalise their problems and we ostracise them from our communities. It’s a true injustice borne purely from ignorance, fear, and lack of empathy.

    I, too, hope for the future of ‘Us’. I hope we learn to love.

    • Iain I couldn’t have asked for a better response to my post. You are spot on brother!

      I truly think that many a diagnosis, many labels from personality disorders to psychotic disorders are actually preferable (to the community as a whole) for experts to create because otherwise we would have to face the suffering we cause upon others.

      It’s almost like we prefer to label and medicate a person rather than face the awkwardness, the challenge, of dealing with the way we treat each other. Actually not ‘almost’…I believe that is exactly how it is.

      From acute psychiatric wards, to adolescent centres to prisons, what I have personally seen is terrible pain. Pain that started very early on. And whilst this is dispiriting it is also good news for pain can be healed. But it grieves me deeply that the ‘system no longer allows the time for healing to occur.

      Thank-you for your comments Iain.

      • Thanks, Leesa 🙂

        “It’s almost like we prefer to label and medicate a person rather than face the awkwardness, the challenge, of dealing with the way we treat each other. Actually not ‘almost’…I believe that is exactly how it is.”

        I definitely agree with you there.

        I won’t go into too many details, but even in our Adult Respite crisis service (approx. 18-20 through to 65 years age) I have seen people send their ‘young adult’ children through to the E.D. / Psychiatric Emergency Service as a mental health crisis case when, as far as I can tell, the primary reason was because they were too busy having marital problems and going to work (dual income) rather than being able to help their child or even allow them to stay in their house while they were away.

        That might be an over simplification since if their child required close monitoring to avoid self-harming then the parents may genuinely not be sufficiently equipped BUT sometimes I feel that parents ‘accessing crisis’ on behalf of their children is just another way of putting somebody in the too hard basket.

        I’ve also seen the other side of that medicalisation process. It is quite common for residents of our service to access their PRN rather than find a non-chemical way of dealing with boredom, anxiety, stress, or even restlessness at night. Now, granted, I know that people can somebody have very good reasons for taking drugs and in many cases it is highly, highly recommended that they remain on their prescribed regimen. I’m just concerned that many residents are lacking basic coping skills for how to deal with their feelings or thoughts (which are often very normal and common by anyone’s account) and instead are taught either directly or inadvertently that drugs are the magic cure-all to their problems.

  2. This is a great post, Leesa. Absolutely spot on. It’s interesting to hear what “other” people think of folks like me and the people who work with us. Personally, I don’t know what everyone is so afraid of. I remember sitting in a lawyer’s office listening to people talk over my head about the ‘devastating circumstances’ of my illness once and all I could think about was how sane life felt on the MHU (I was lucky to be hospitalized in a very positive environment), and how insane the world beyond the MHU felt.

    Capitalism is truly an oppositional force to mental health here in the States. My ex husband tried to have me institutionalized so that he would not have to pay alimony. I could not believe he was capable of such ugliness.

    I may be among the poorest of the poor but our System is set up to keep people on disability; I would prefer to earn income for my skills and education, but I know that my best work comes from a quiet, home environment… and somehow that just doesn’t translate to employers as being “committed.” Just once, I would like to be honored for the way I work most productively. I know I work outside of the box, but when I work in agreement with my spirit, I am very productive, disciplined, and well-skilled.

    Too bad I’m crazy. 🙂

    ~meredith~

      • I don’t know that you can change the system. The system is set up for profiteering in the drug industry, and in health insurance. We have so much fraud within both the industries and with elected officials that I don’t know what to do about the system.

        One thing I would certainly change if I had a magic wand: I would have respite access of some kind for both families and persons who deal with chronic mental illness. I don’t know how to make it happen, but I think it will come out of a grassroots movement. I think we, ourselves, have to think about how best to network and form grassroots movements.

        We, as people, are not powerless simply because of obstacles like DID, PTSD, Depression, etc. So… we all need to learn to how to speak up for ourselves, and each other. That’s where the action really starts, I think.

        ~meredith~

      • Oh mate this is an enormous question. Briefly:
        much of the medical model would be thrown out the door,
        a true person-centred approach implemented,
        in-patient units would be based on the theraputic milieu model,
        all staff would continue studying a broad and cross-cultural range of theraputic responses,
        ‘significant’ others would be involved in recovery,
        education and re-empowerment would have higher priority,
        medication would be seen for the majority as a short-term response to enable intensive therapy,
        Psychosoical environments of clients would be given much more importance,
        Oh and much much much more more….

    • Thanks Meredith. I agree about the rather insane world. Your ex-husband…many innapropriate words come to mind :). “Too bad I’m crazy”…seems to me, reading your blog, there is no crazy; just amazing insights, courage and a person who would make an awesome healer.

  3. and Iain…spot on re your last comments. I am developing writings on both the issue of parenting responsibilities and on our general attitudes toward medication that is so counter-productive to the healing of the psyche

  4. Leesis…I wonder…would it be possible for you to work on your own? For you to provide care outside of the system? Yes…it would mean that people would have to pay cash…but then you could also charge according to what you think is fair. I don’t know…but, if you could do that, maybe you could get a part time job at something else to supplement?

    I sure do understand your frustration at the “system”…although it may be different in our two countries. I know of therapists who struggle with our system, too. The best therapists I have had looked at their work as more “ministry” than as a job. They also supported themselves in other areas…like teaching classes at the local college on parenting, foster parenting and relationships, etc. It helped them to keep the balance in their lives. I don’t if any of that kind of thing would help you or not.

    I offer hugs. And good job on your fight to keep “idiot” from flying out of your mouth. My gosh…they REALLY believe that it is contagious???? Let me pick myself up off the floor now!

    • I once knew a family doctor who completely disentangled himself from insurance companies because he became so fed up with the bureaucracy and all of the time spent by him and and his staff dealing with insurance.

      He set up a one-man practice, only accepted cash and was actually able to charge a bit less and help more patients than he had before. His business did very well.

      If it can be done by a family doctor I’m sure there’s a way, as you said, to do it in the mental health field!

    • I certainly am looking into how to provide a service outside of the system. My preference would be for it to be free as in my experience many folks struggling with mental health issues suffer from low finances as well.

  5. Great post, Leesa.

    As someone “with a mental illness” I’m glad to see the myths being taken down.

    Just a thought – could you become self-employed as a counsellor? That way you don’t have to be subject to the “system”.

    Jonathan from Spritzophrenia 🙂

      • My cousin (a Pastor who has done mental health work in the same NGO as myself), an old friend (a lawyer who worked for a very top class firm and is now “setting slaves free” pro bono in India (no joke)), and myself (a wannabe philosopher mental health worker) have felt it would be a fantastic dream to one day set up a Community Centre which offers holistic care for people in all areas of their life. The kind of place where caring people, skilled in various ways, gather together to pool their talents to help heal, uplift, and equip people at the local level.

        It’d be the ideal place for people such as yourself, Leesa, to come and contribute in a way unfettered by the usual restrictions and politics of The System elsewhere.

        We can always dream.

    • Jonathan, I’m a member of NAMI and subscribe to their “stigma busters” alerts. Big believer in being “out of the closet” as a person living with manic depression, PTSD, and other disorders… glad to see your clever blog title!

      Peace, Amy Barlow Liberatore

  6. Manic-depressive PTSD sexual abuse survivor checking in at the “clinic,” LOL. I know, it’s not a laughing matter at all. I applaud most who work within the mental health system; at the same time, having almost had my brain fried by an incompetent psychiatrist, I say AMEN to the comments regarding drugs companies and their peddlers. I am on a modest regimen of Rx but do most of the work myself – going to therapy, taking up yoga and writing poetry (an amazing outlet, the arts), and general self-care. Also a supportive husband, an amazing component throughout my diagnosis and even the crash…

    Iain, you made some excellent points. The interchange between you both has been wonderful, Leesa, because it gives me, a “consumer,” insight into the challenges providers face. And I feel that if mental health care were universally available and FREE in the U.S., our prisons would be half empty and the drug problem, often fueled by self-medication, would be greatly reduced. My own mother was bipolar, too, and became an alcoholic rather than face it. Thanks to all for an inspiring discussion. Amy Barlow Liberatore

    • 🙂 Actually laughter is absolutely essential I reakon!

      You make great points Amy…about what you do for yourself…about having support. I have to say the most valuable contribution we can all make is in unconditional love. Abuse or ‘conditional’ love starts the process that damages our mental health. Only approx 5% of the folk I’ve listened to have ever expereinced a mental illness as a result of purely genetic or biochemical cause. The rest have suffered at the hands of their fellow beings.

      • Mine is a combination of my mom’s family having a DNA pool that must have come from toxic sludge, and my dad’s experiences at military school, where he was the scrawny kid who was probably easy pickins for the bullies. I’ve long felt that his molestation of my sister and me (and possibly my eldest sister, although she feels my dad hung the moon) was experiential at the core, that he was revisiting on us what was done to him.

        So it’s a combo platter for me. Some from Column A, the rest from Column B. A tragic Chinese restaurant of mental health, but fortunately the right combination of professional help and self care…! Amyt

  7. You are exactly the type of person we need working inside the system! But, I completely understand your needing to extricate yourself from it. I hope you can find a way to use your expertise to continue to help those that are suffering.

  8. ‘pharmaceutical domination’

    What methods did you primarily use? You yourself.

    And I recently watched ‘A Scanner Darkly’ which depicted dissociation. If you’ve seen it, can you tell how much the depiction approached the real? If you haven’t, do the people really become so dissociated like it’s two entities in one with either entity unaware of the legit claim to the one person by the other? It’s ok to my imaginative mind but it seems fantastic to my scientific

    • hi. thanks for comming by. For your first question I presume you mean treatment options as alternatives to medication. I guess the simplest way to answer that is the current system simply assess the obvious symtoms and then trys to ‘treat’ them biologically. My response is to spend a lot more time in assessment…to find the story that led to this particular moment and then work with person to heal the wounds rather than the symptoms.

      I havent seen the show you are talking of but as far as dissociation, yes it happens Scientifically it is less fantastic than you think. The mind under great stress has many mechanisms it can use to protect itself. Depending on our genetic makeup our minds can become psychotic, neurotic, withdrawn, addicted etc in order to protect itself. These potentials may seem destructive but then I have heard many a story whereby it has been clear that the brains ability to ‘turn off to reality’ has been absolutely essential for it to survive the current trauma it is in. Unfortunately it takes a lot of work to ‘reintergrate the psyche’ when later this ‘coping mechanism’ is no longer needed. But this too is more than do-able.
      cheers…Leesa

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