Kudos to Ruth Sheehan of the N&O for an excellent column in Monday's paper. For those unmoved (and I really hope very few of you are) by the plight of Phil Wiggins, the mentally ill man she has followed for several years now, read this and think about it. Sheehan talks to the mother a bipolar disordered teen son who is at the end of her rope trying to care for her boy and protect his fellow high school students from what could happen when he is off his medicine. Although, as the column makes clear, even on his medicine he is a challenge for his mom because of the amount of support he needs. Not only is his medicine exorbitant, "but at 6-foot-2 and 380 pounds, he is a force unto himself."
Now, here I could go in several directions, pointing out that some of that nefarious community support we've heard so much about would obviously help someone in this boy's situation, including (gasp) a trip to the movies or a visit to a friend's house accompanied by someone trained to help a person hearing voices – even on meds – socialize normally. Or I could go off on the system that punishes people with private insurance, or a private mental hospital that would call a mother and tell her to pick up her son or they'll take him to a homeless shelter because his paid days are up, and in spite of the fact that they must know he needs more help. All of these nightmarish pieces of the unholy mess that is mental health reform deserve attention. But why don't we look back (in anger, perhaps?) at what brought our society to this point.
In the sixties, to those galvanized by the civil rights movement, deinstitutionalization seemed like the dream solution to the sometimes draconian asylums that dotted the country. Of course, it was predicated on the availability of new drugs that were going transform mental illness into something manageable for most patients, allowing them to live and participate in the community. To a certain extent, this happened. But the medicines were oversold or, maybe more accurately, the amount of support these people would need was undersold. There are some great reasons to stay on psychiatric medicine, but there are also some compelling reasons to go off them. The side effects can be gruesome, from serious weight gain to the pointless involuntary movements of tardive dyskinesia. Not to mention that they're expensive and can be difficult to keep up with on a daily basis, even for someone with no other problems. So we were supposed to create a great network of services available to people on an outpatient basis that would keep them on their prescriptions and able to function. I used to live in a densely populated, small city where it was clear to any and all how necessary such a system was, and, indeed, we had a good enough one to be referred to as "The People's Republic of __". Now, in a city as sprawling as Raleigh, it is a lot easier to avoid some of the unpleasant facts of life, and pretend, unless you're related to them, that the mentally ill are taken care of, or someone else's responsibility, or whatever, who cares? So when the state says we haven't got this great community care system in place (because we never really created it after all), but we can accomplish is by privatizing anything and everything, there are many, many people who think that's peachy and sufficient, not to mention (note to self) an opportunity to make a profit. Unfortunately, the least of our brothers aren't here for their potential profit margin. They're here to enrich, challenge, defy and improve us. Pretty much like every child who's ever been born. But the mentally ill need a lot of help and we need to pay for it. Because it's right and just, and because there but for the grace of a few dopamine receptors, go any one of us.