ON MENTAL ILLNESS: What we are up against

Jack Bragen
Friday April 07, 2017 - 06:15:00 PM

Forget for a moment about the debate of forcing treatment on persons with mental illness who are uncooperative—whether we are talking Laura's Law, or the laws that existed beforehand that allowed for involuntary treatment of people—who are a threat to others or to themselves, or who are gravely disabled. Forget for a moment about how to get mentally ill homeless off the street. Forget, for just a moment, about the fact that jails have become the primary mental health facility. We can come back to this later.  

There is a lot of difficulty obtaining any mental health treatment for those that want and need it. There have been budget cuts, and the mental health treatment systems, at least in my county, and likely elsewhere, are overloaded. The number of persons who have acquired mental illness is up, and facilities are operating far beyond their capacities. And this is just the beginning of our woes.  

I don't have to research the exact figures and facts to know that there is a shortage of psychiatrists and other treatment practitioners. I don't have to do extensive research to know that if a mentally ill individual wants outpatient treatment, and if they are mostly independent and high functioning, treatment is very difficult to obtain. I have seen this firsthand.  

Those who have Medicare and Medicaid coverage may have to wait a number of months to get admitted to outpatient treatment. I am fortunate that I am seeing a psychiatric practitioner who is very good at the facility where I go for most of my mental health needs. I also recently found a psychotherapist in private practice who is willing to see me, after a wait of a number of months.  

Not all mental health consumers are that fortunate. Those who do not have Medicare from working or through their parents must rely on Medicaid, and this essentially means they must get treatment from their county facilities. This might mean seeing a psychiatrist for about fifteen minutes every month or perhaps every two months. 

This is but one of two of the big quandaries we face. 

The housing crisis in the San Francisco Bay Area affects disabled people who live on public benefits and who can't shell out 1600 dollars a month for an apartment, or who can't even pay 800 dollars to rent a room in someone's house. And, if you are a HUD renter, you may find very limited choices in your housing options. Some persons with psychiatric illness may be forced to live in institutional housing, simply due to economic pressures. This is inappropriate for those who could take care of themselves but who can not afford the high costs of living in the Bay Area.  

These are frightening times for the disabled, since we have a government in power that lacks compassion for the least fortunate in society. We have an administration that wants to make conditions better for the rich, and which couldn't care less concerning the fate of the poor and disabled.  

I say we need better programs--ones in which there is some sort of guarantee that persons with psych disabilities can be housed and obtain treatment. However, this may never happen in the foreseeable future.  

Other than that, even those of us who might be nominally able to hold a job may have an improbability of ever being hired at a decent job. Few employers are willing to hire a mentally ill person for professional employment.  

In short, persons with psychiatric disabilities are being muscled out of existence. If we are unable or unwilling to live in a restricted situation of no privacy, no personal space, and inappropriate supervision, then we are often out of luck.  

Many persons with psychiatric disabilities are stuck in lives of being bussed to daycare and back, when at home getting a dinner of hot dogs and baked beans, getting a shot or pill of medication, and watching television. This is punctuated by an occasional smoke on the front patio when permitted, and "milieu therapy," which means commiserating with others in the same situation.  

For someone who has his or her faculties, this is no way to live. No hope is offered of something better. If the consumer wants something better, he or she will have to make that happen, and in doing this, they are up against numerous obstacles.