She had become the unwanted mad
October 18, 2017 10:01 PM Subscribe
Culture profoundly shapes our ideas about mental illness, which is something psychologist Nev Jones knows all too well. David Dobbs writes about her experience at the intersection of culture, mental health, and academia.
Nev Jones on twitter.
Nev Jones on twitter.
Thank you for posting this.
posted by MexicanYenta at 12:52 AM on October 19, 2017
posted by MexicanYenta at 12:52 AM on October 19, 2017
That was a terrific read on every level. Thanks very much for sharing.
posted by smoke at 3:18 AM on October 19, 2017
posted by smoke at 3:18 AM on October 19, 2017
I understand why those of us with mental illness or who have family members with mental illness really like the biological model. I certainly understand why practitioners like the medical model. It's been pounded so deeply into the industry and even into activism, the same that being gay as a biological problem felt freeing because it proves it's not the persons fault, many feel this is essential for activism- it HAS to be a medical model or else it's not real, and the need for help and love and support or modified life and functioning expectations aren't real.
I don't think we need to cling to the medical model to prove that human needs are real. And so often what a person with what we call "mental illness" a biological problem of their brain is in fact someone to fight for them to have safe housing, to be protected from violence, to be welcomed into a family, to be shown love and empathy for deep traumas, to have access to healthy food and to be allowed to reduce their work or school hours while still having enough money to live healthily.
We need more people fighting those fights and less people fighting to force people coping with these pains to accept more meds and more labels and more control by people around them who aren't even fighting to understand or meet their needs.
I also think the fact that we explain away crime as mental illness regardless of if the person even had mental illness add to this idea that all mentally ill people are very dangerous and need to be controlled for their own good and the good of those around them. This attitude leads to an innate battle between those who are coping with emotional or mental differences/difficulties that leads many to start fighting against "CARE (HAHA control more like it) and then be shamed for not being "medication compliant" or for being "resistant to treatment". Their subsequent treatment is then confrontational and shaming/forceful and people are more likely to become aggressive and self harm or fight back at others when they are being treated like that.
This cycle reinforces the attitude that such people are difficult and resistant to help and need to be forced and controlled for their own good that permeates mental health and crisis "care". If you don't want their labels, if you don't want their claims that it's all your brain and nothing in the environment they are forcing you to be stuffed in with no outlet... then mental health "care" is not for you. It's against you.
posted by xarnop at 6:08 AM on October 19, 2017 [19 favorites]
I don't think we need to cling to the medical model to prove that human needs are real. And so often what a person with what we call "mental illness" a biological problem of their brain is in fact someone to fight for them to have safe housing, to be protected from violence, to be welcomed into a family, to be shown love and empathy for deep traumas, to have access to healthy food and to be allowed to reduce their work or school hours while still having enough money to live healthily.
We need more people fighting those fights and less people fighting to force people coping with these pains to accept more meds and more labels and more control by people around them who aren't even fighting to understand or meet their needs.
I also think the fact that we explain away crime as mental illness regardless of if the person even had mental illness add to this idea that all mentally ill people are very dangerous and need to be controlled for their own good and the good of those around them. This attitude leads to an innate battle between those who are coping with emotional or mental differences/difficulties that leads many to start fighting against "CARE (HAHA control more like it) and then be shamed for not being "medication compliant" or for being "resistant to treatment". Their subsequent treatment is then confrontational and shaming/forceful and people are more likely to become aggressive and self harm or fight back at others when they are being treated like that.
This cycle reinforces the attitude that such people are difficult and resistant to help and need to be forced and controlled for their own good that permeates mental health and crisis "care". If you don't want their labels, if you don't want their claims that it's all your brain and nothing in the environment they are forcing you to be stuffed in with no outlet... then mental health "care" is not for you. It's against you.
posted by xarnop at 6:08 AM on October 19, 2017 [19 favorites]
This story resonates so much with what I've seen in communities where there are people going through shit, and it's just so tough.
First, I want to say that DePaul's behavior sounds disgraceful. That nobody was willing to help, and that everyone freaked out immediately upon what seems clearly to have been unsettling symptoms of illness rather than anything definitely frightening - that's an incredible disgrace and failure and all those people should be ashamed.
That said, I wish there were:
First and foremost accessible, appropriate care when people have some kind of mental breakdown. I've been in situations where I (and the people around me) were at a complete loss about what to do or how to help someone.
This society isn't set up to have someone just work through their illness in relative safety - that's what strikes me when the article describes other cultures and madness. If someone is ill enough to make dangerous decisions or be unable to work or need a lot of assistance, there's no slack - they can't just safely wander the village and then go back to their craft-based gig when they get better. Just like with physical illness, we're not set up to support people in getting better - if you have a sick family member who requires a lot of care, it's a horrible catastrophe.
And this itself militates against non-family being willing to assist. After a couple of experiences that ended really badly for all concerned (and which I feel super shitty about) I've pulled back from, for example, inviting people who are having trouble housing themselves to stay with me. I pull back a little bit from helping people when they're in an episode now because I know that unless I have hours and hours over months and months to devote to assisting them, there's very little that I can do - accessing care, caring for people, housing them, and dealing with the stress of the whole situation is overwhelming, and I have to earn my own living, etc. (Which isn't to say I don't, like, give people money or buy them food, but when the foundational problem is "I am sick and don't have a reliable place to stay", you feel like garbage if you don't house someone, and yet housing people is a very, very big commitment.)
I really hate this. It's part of why the two options are pretty much "try to force someone into a hospital" and "do nothing", because there's no room for anything else.
On a practical level, guaranteed safe housing would make everything about serious mental illness more manageable. Like, if someone has a place to stay that they can't lose, you really can say, "I have the time to assist this person", because there is no possibility that you'll also have to house them and worry about them 24/7, which is where it gets impossible IME. "I can help you make phone calls or talk to your doctor or take you to appointments or make sure you get groceries or stop by and hang out so that you don't feel totally isolated" are all things that people can realistically be expected to do.
Further: I wish there were some way (through the schools, if our schools weren't oppressive and terrible) to teach people basics about going through mental illness and how to assist people. I've definitely seen, in activist volunteer spaces, that two things happen:" Someone manifests lasting symptoms that are genuinely difficult to deal with* and everyone freaks out disproportionately and asks them to leave. For some people, this is because they have an unrealistic understanding of the symptoms and think that they're dangerous; for other people, they don't have the tools to support the ill person or set necessary boundaries, so they can't conceptualize anything between "things go on exactly as they are and it's upsetting and unmanageable" and "this person leaves".
It's really a garbage situation.
*For example, talking a lot about violent things in a way that is upsetting but obviously not materially dangerous - that was a precipitating thing in one situation.
posted by Frowner at 6:43 AM on October 19, 2017 [16 favorites]
First, I want to say that DePaul's behavior sounds disgraceful. That nobody was willing to help, and that everyone freaked out immediately upon what seems clearly to have been unsettling symptoms of illness rather than anything definitely frightening - that's an incredible disgrace and failure and all those people should be ashamed.
That said, I wish there were:
First and foremost accessible, appropriate care when people have some kind of mental breakdown. I've been in situations where I (and the people around me) were at a complete loss about what to do or how to help someone.
This society isn't set up to have someone just work through their illness in relative safety - that's what strikes me when the article describes other cultures and madness. If someone is ill enough to make dangerous decisions or be unable to work or need a lot of assistance, there's no slack - they can't just safely wander the village and then go back to their craft-based gig when they get better. Just like with physical illness, we're not set up to support people in getting better - if you have a sick family member who requires a lot of care, it's a horrible catastrophe.
And this itself militates against non-family being willing to assist. After a couple of experiences that ended really badly for all concerned (and which I feel super shitty about) I've pulled back from, for example, inviting people who are having trouble housing themselves to stay with me. I pull back a little bit from helping people when they're in an episode now because I know that unless I have hours and hours over months and months to devote to assisting them, there's very little that I can do - accessing care, caring for people, housing them, and dealing with the stress of the whole situation is overwhelming, and I have to earn my own living, etc. (Which isn't to say I don't, like, give people money or buy them food, but when the foundational problem is "I am sick and don't have a reliable place to stay", you feel like garbage if you don't house someone, and yet housing people is a very, very big commitment.)
I really hate this. It's part of why the two options are pretty much "try to force someone into a hospital" and "do nothing", because there's no room for anything else.
On a practical level, guaranteed safe housing would make everything about serious mental illness more manageable. Like, if someone has a place to stay that they can't lose, you really can say, "I have the time to assist this person", because there is no possibility that you'll also have to house them and worry about them 24/7, which is where it gets impossible IME. "I can help you make phone calls or talk to your doctor or take you to appointments or make sure you get groceries or stop by and hang out so that you don't feel totally isolated" are all things that people can realistically be expected to do.
Further: I wish there were some way (through the schools, if our schools weren't oppressive and terrible) to teach people basics about going through mental illness and how to assist people. I've definitely seen, in activist volunteer spaces, that two things happen:" Someone manifests lasting symptoms that are genuinely difficult to deal with* and everyone freaks out disproportionately and asks them to leave. For some people, this is because they have an unrealistic understanding of the symptoms and think that they're dangerous; for other people, they don't have the tools to support the ill person or set necessary boundaries, so they can't conceptualize anything between "things go on exactly as they are and it's upsetting and unmanageable" and "this person leaves".
It's really a garbage situation.
*For example, talking a lot about violent things in a way that is upsetting but obviously not materially dangerous - that was a precipitating thing in one situation.
posted by Frowner at 6:43 AM on October 19, 2017 [16 favorites]
I also think the fact that we explain away crime as mental illness regardless of if the person even had mental illness add to this idea that all mentally ill people are very dangerous and need to be controlled for their own good and the good of those around them.
Yes - see mass shootings in particular.
the two options are pretty much "try to force someone into a hospital" and "do nothing", because there's no room for anything else.
On a practical level, guaranteed safe housing would make everything about serious mental illness more manageable.
Also yes. It's very difficult to be able to meaningfully offer the intermediate level of support most people are capable of.
posted by PMdixon at 6:48 AM on October 19, 2017 [4 favorites]
Yes - see mass shootings in particular.
the two options are pretty much "try to force someone into a hospital" and "do nothing", because there's no room for anything else.
On a practical level, guaranteed safe housing would make everything about serious mental illness more manageable.
Also yes. It's very difficult to be able to meaningfully offer the intermediate level of support most people are capable of.
posted by PMdixon at 6:48 AM on October 19, 2017 [4 favorites]
Thank you very much for posting this and making me aware of Nev Jones and her early intervention programs initiative. I hope the post and the comments will help me sort my thoughts and find my voice so that I can more effectively advocate for better mental health treatment for myself and others.
posted by danabanana at 7:08 AM on October 19, 2017 [2 favorites]
posted by danabanana at 7:08 AM on October 19, 2017 [2 favorites]
I would also like to sign on to the statement that interactions with the medical system can be as traumatizing as the symptoms, from first hand experience.
To this day I still don't trust doctors.
posted by PMdixon at 11:03 AM on October 19, 2017 [3 favorites]
To this day I still don't trust doctors.
posted by PMdixon at 11:03 AM on October 19, 2017 [3 favorites]
Oh, coincidences. After reading this, I discovered Ursula K. Le Guin's story "SQ".
Hegemonic sanity is insane.
posted by runcifex at 11:09 PM on October 19, 2017
Hegemonic sanity is insane.
posted by runcifex at 11:09 PM on October 19, 2017
« Older Powerless Posing | beyond the trailers Newer »
This thread has been archived and is closed to new comments
posted by rawrberry at 11:47 PM on October 18, 2017