I just listened to a 50+ minute National Public Radio show hosted by Diane Rehm on January 11th. You can find the web page and audio link here. The topic of the show was called "Serious Psychiatric Disorders Among Young Adults" and was aired in response to the January 8th shooting by Jared Loughner in Arizona. For the past week I've been avoiding listening to or reading news reports about the shooting, but then I read Jen's Blog today and that got me thinking about the lack of basic services in this country for the mentally ill. There's no doubt in my mind that anyone who wields an automatic weapon and fires on innocent and defenseless people is mentally ill. I still believe that violence is a form of mental illness in anyone, but we live in a culture that defends certain forms of violence particularly by police officers and soldiers. And I bet if we could get inside Jared Loughner's mind, we would hear similar justifications about why he resorted to violence. But aside from some people's fixation on the right to bear arms in the United States, the real issue here is not only the need for gun control, but the need for a vast improvement in mental healthcare services in communities both large and small all across the country.
There has been massive deinstitutionalization of mental patients since the 1960s, the result being that many of those patients became either homeless or put in prison. What was needed then and still is needed some 40 years later is a functioning community service system for outpatients which includes access to medications, housing, therapy and local mental health support groups. Of all those things, the one thing that doesn't require much money is support groups, preferable groups for families and friends of the mentally ill and and groups for the mentally ill themselves. Advocacy groups for and by the mentally ill like NAMI are doing a good job in creating a weekly 90 minutes peer led support group in some places, the problem is that there is both an application and approval process and a 3 day training program that must be gone through before a group can start under the auspices of the NAMI organization. Unfortunately, the training programs are relatively few for the size of this country. In my state of New York this past year were only about two. NAMI is an important organization, but it is not large enough to supply the services that are needed, particularly in rural communities. I believe that there should be other organizations that focus specifically on cultivating the wide spread of mental health support groups.
I have stressed the importance of support groups before and have even dreamed of starting a group in my town, but on my own and without help from others I am not strong enough to get the job done. Initially there is the need for a couple of highly motivated people in the community to set up two groups, one for the family and friends and one for the afflicted. These people need to be either mentally healthy or firmly in recovery, able to show up to the meeting place each week, rain or shine, regardless of whether anyone else shows up. I base this idea on the Al-Anon group I used to go to where there were two to three people who showed up each and every week. Their dedication made the group viable and welcoming. And though I have never had a sponsor, I think sponsorship should be encouraged in mental health meetings that have people who are grounded in recovery and willing to guide a member who is less far along. This is just common sense. I also believe that every college out there should have at least one mental health support group organized by the counseling center or the students themselves. The university in my town gave up on a group a few years back because no one was showing up. To my mind that is not a good enough reason to stop. The founder of the Al-Anon group I mentioned showed up consistently for months before a few people started to show. A meeting place, preferably two people and consistency are key. That should be doable, especially in a college.
It's so obvious to me now that those with schizophrenia go through definite stages, a "normal" stage, a pre-psychotic stage, an acute psychotic stage and, for those who survive the acute stage, a recovery stage which can be broken down into various other stages from mild recovery to strong recovery. Those in the pre-psychotic stage or prodromal phase might get the help they need very early if family and friends and teachers, etc... are perceptive enough to notice and remark on certain behavioral changes. I lived in an extended prodromal stage from my mid 20s to my mid 30s. I was socially isolated. I didn't get a job or leave home and I heard occasional voices which I didn't discuss with anyone. By the time I was 27 I was in a relationship with an abusive, addicted and mentally ill partner. It was only then that I began to admit that I was mentally ill. It took three years out of that relationship before I showed signs of being delusional and paranoid.
The problem with the early stages of the acute phase of psychosis is that some of us are not ready to accept the label of schizophrenia and others aren't able to admit that they are ill, but it is then that an intervention can really do some good. Jared Loughner acted out enough in school and in his YouTube video to warrant an early intervention, but the people in his life didn't take action soon enough to prevent him from acting out with an automatic weapon. The people in my life didn't take action either, though, in retrospect, I wish they had; it might have led me into treatment much earlier, might have kept me from getting involved with an abusive person, might even have averted the suffering of acute psychosis altogether. As it stands, I wasted a chunk of my young adulthood, hurt my partner by accepting his abuse, and endured a lot of psychotic pain. Like most of the mentally ill, I didn't become violent, but I know that if the circumstances had been a bit different, I could have.
The hard part for all of us is taking responsibility for ourselves and each other. I think that when people act badly, it is because they feel badly. So the loud, obnoxious, abusive people in this world don't need to be dismissed or put in jail, they need to be taken care of. Suffering is expressed in all sorts of ways. If violence was seen as mental illness, Jared would have been treated a long time ago.
A Recovery Blog
This blog is about my continuing recovery from severe mental illness. I celebrate this recovery by continuing to write, by sharing my music and artwork and by exploring Buddhist ideas and concepts. I claim that the yin/yang symbol is representative of all of us because I have found that even in the midst of acute psychosis there is still sense, method and even a kind of balance. We are more resilient than we think. We can cross beyond the edge of the sane world and return to tell the tale. A deeper kind of balance takes hold when we get honest, when we reach out for help, when we tell our stories.