On Mental Illness and Identity

Watching a PBS Frontline documentary about the rise in diagnoses and medications for young children with mental illness, I was caught by something.

This documentary, which is supposed to objectively address the controversy surrounding early childhood mental healthcare (particularly early exposure to psychoactive medications) and which featured psychologists, and psychiatrists, experts in the field, was making a glaring error.

"My patients were bipolar."

Your patients are not bipolar.  For a lot of people struggling with mental illness, the recognition that they do not have to be defined by their battles, is a massive step forward in recovery or control.  You would never tell a cancer patient that their diagnosis made THEM cancerous.  We recognize that an illness does not have to fundamentally define the person who has it.

And yet, one of the most stigmatizing things you can do to a person with mental illness is to define them by their illness.  Your patient is not bipolar.  Your patient has bipolar disorder.  Your patient may also have acne, irritable bowel syndrome, blue eyes, or a debilitating disability.  None of these things define that patient.  They are a whole, complex human being, defined by their wants and needs, goals, history, friends, family, talents, weaknesses, and more.  You provide a huge blow to their sense of self-worth to reduce them to their diagnosis.

Especially as a care provider, this kind of stigmatizing language is incredibly unacceptable.  How is a patient supposed to see themselves as something beyond their disorder if you, as the expert who is supposed to help them, cannot?

Identifiably yours,
Rachel Leigh

On Poverty and Mental Health

I've started to think that mental health is a problem for the wealthy.

I don't mean to say that it's a first world problem which doesn't matter for anybody else -- I think just the opposite.  The National Day Without Stigma was this past week, and as always, it just reminded me of how prevalent mental illness is in the world.

And what it really made me start to wonder was about what your options are if you don't have health insurance and can't afford to see anyone.  I've been working a bit with a substance abuse rehabilitation facility in Richmond, and to some extent, it's become clear that for some people, that is their option.

Mental illness does not discriminate based on age, race, or social class.  If anything, being in a poorer situation increases the chances that you will struggle with depression and anxiety.  But the options we have to help people work through these concerns are expensive -- expensive therapies, expensive drugs, appointments with expensive therapists.  The options for those who can't afford those are, statistically, homelessness, prison, substance abuse and rehabilitation (if they can afford it or it's court-ordered), or hospitalization in extreme, high-risk cases.

The fact is that we've created a system that works pretty well for those who have access to it, but we've economically-barred some of the highest-need populations from being able to access mental healthcare.

Mental health advocacy is not simply advocacy for those who have the resources.  It is also advocacy for those who have never had the resources to get the help they need.

Thinking,
Rachel Leigh

On the Shutdown

If you've been under a rock for the last three days, let me let you in on a little secret: the government shut down.

Have you tried turning your government off and back on again?

It's all been very exciting and such, what with people worrying about what it means for the progression of our country.  But I'm getting kind of tired of hearing people (namely, Fox News people) say that no one has really been affected.

First and foremost, we look like a laughing stock.  One of Congress's big jobs is to approve a budget.  In fact, it's pretty much their biggest job.  People forget the power that money has -- setting a budget essentially sets the priorities for the next year.  The fact that political tensions have gotten so high that Congress can't perform its fundamental function speaks volumes about the general illegitimacy of the U.S. system right now.

Contingent Consent.  Maybe you've heard of it.  Chances are you probably haven't.  Contingent consent is a necessary piece in a functional and competitive democratic state.  It's the idea that you will win some elections and lose others, and that whichever side (or sides) loses will agree to live under the laws and rules of the side that won -- with the understanding that in the next election, you have the ability to unseat the other party if you don't like what they've done.

The only way to preserve rule of law under a democratic system is the acceptance of this idea of contingent consent -- the system can't function if you play by the "I lost, so I'm taking my toys and going home" mentality.  Which is exactly what we've got going right now.

Aside from the general "the reputation of the United States as a whole is at stake (compounded with the PRISM fiasco, the invasion of sovereign borders, several unnecessary wars, growing distrust of the U.S. and the West, etc)" issue, there are people being affected.  A friend of mine can't work on his thesis because he can't access the Library of Congress or the National Archives.  Many women and children who receive federal WIC funding will not receive their stipend in time if this isn't sorted out.  National Parks, federal funding for public education, GDP, "nonessential" federal employees, and more all stand to lose out if this shutdown and budget crisis aren't dealt with immediately.

The fact that you got your mail like always today doesn't mean that people aren't hurting.

Frustratedly yours,

Rachel Leigh