How to deal with mental illness in society?

This is a huge ‘problem’ without any one solution. Mental illness isn’t a cut and dry kind of issue because so much of it is bound by societal norms and expectations. What we consider insane now may not be eventually considered as such. I don’t think mental illness is something we can fix just out of nowhere and I don’t think criminal activity done by mentally ill or otherwise people has much to do with HOW we approach the mentally ill in our world. For me, it’s all about the WHO – who is mentally ill? Am I mentally ill – I’ve certainly been diagnozed with depression and a panic disorder and I am not well sometimes and I’m on medication and see a psychiatrist..would I kill anyone? Highly unlikely and it wouldn’t be because of my mental shit anyhow. Generally, people don’t treat those with mental illness well and this can be seen at the policy level too – here in NYC, the homelesness problem got exacerbated because somebody (we won’t name names) decided it was a good idea to close down institutions and get people out on the streets instead and that’s just the tip of the iceberg. Many cultures make it impossible for people to seek help even if they want to (cue the whole machismo thing and general stigma). Many health care administrations or insurance companies don’t find it necessary to even provide coverage for mental health concerns. Etc., etc.

There are lots of ideas, but they cost money and in times like these, the programs are being cut. Probably the most important thing that could be done is to provide real universal health insurance. If the mentally ill could see psychiatrists and get their meds without having to worry how to pay for it, nor having to deal with a bureaucratic system they are uniquely unprepared to deal with, it would go a long way.

But, no services, and people end up in the street. Sometimes some organization picks them up, finds them housing so they can get services. Some cities are taking the approach of providing free housing.

Another thing is dealing with the stigmatization of the mentally ill. People tend to think that the mentally ill are crazy (they usually aren’t), and have this picture of a schizophrenic or someone who is so totally manic they have no idea who they are, and they are afraid of these people. The mentally ill rarely endanger others. And the ones who do pass for ordinary people, anyway.

We need a society where it is ok to be mentally ill. If people understood that these disorders are curable and people can lead productive lives afterwards, I hope they would have a different idea about who we are. In fact, a lot of the mentally ill are pretty damn smart folks.

There is so much to do. But step one is making it easier for us to get help.

There used to be lots more people receiving needed treatment. Then, the spending cuts began.

One of the problems is the mentally ill often don’t think they are. So how can we help people that don’t think anything is wrong with them?

What @wundayatta said: I second it.

I’m of the opinion that the US as a society took a baby step forward when the last congress enacted a law requiring health insurers to give parity to mental illness. I once had a job with an insurance plan that limited me to 20 visits to a psychiatrist/therapist in my lifetime. I’m bipolar. I see a therapist more times than that in a year. Can you imagine receiving health insurance that limited your doctor visits to 20 in your lifetime? It’s unthinkable, yet this was exactly the system we had before this new law.

I’m lucky in that I live in a state that has a semi-public system for dealing with the mentally ill. Private companies manned by psychiatrists, nurses, and social workers are paid by the state to give care to the mentally ill. I go to such a clinic, because in the rural area where I live, I have no other choice. The system here is exacerbated by our geography. Being a chain of islands, it’s not possible to get to the big city where the vast majority of psychiatrists are.

If there is one core issue I could point to and name it the root of our problem with mental illness, it’s lack of understanding, which stems from a lack of education on the subject. People think of mental illness as being crazy, and those aren’t the same thing. When mental illness is mentioned, people most often think of the extremes. There’s a whole range of mental illness just as there is a whole range of physical illness. For some, mental illness is debilitating. For others, it’s a hindrance. Some people catch the flu and have to stay home from work, and some catch a cold and can still function at a high level.

I have to take a moment to address @JustJessica. It seems to me that what she wrote here may come across as a blanket statement. The majority of the mentally ill do in fact recognize that they have a disease, and they seek help for it. They keep their doctor appointments, and they take their medication as prescribed. No one likes depression. I certainly don’t like the ups and downs of bipolar disorder. A child with ADD is almost always very unhappy with the inability to concentrate even on pleasurable tasks. We help the mentally ill by providing systems for them to receive the care they need.

Mental illness is not one single disease or problem that can be fixed by providing one pill or one type of clinic. It’s a gamut. It’s wide ranging. It’s fix is going to have to be just as wide ranging.

I think the stigma of receiving help often prevents people from seeking treatment. People are afraid that they will be judged and that others will think they are “crazy”. There are undercurrents of these judgements everywhere so even though many recognize the importace of seeking help- people are often ashamed to seek it out…..or they wait until things are too out of control. So one thing that we can do is not to judge those who seek help. And listen….listen to those around you. So often, those hurting reach out, but in an isolated society, no one really hears them.

If by mental illness, you mean people who are homocidal, then there are not very many good choices. There is clearly no cure. So what else is left besides locking them up?
If you mean day to day neuroses, it’s sort of like being obese. Some people take action on their own behalf, others do not.
Those who do not, have all sorts of reasons for not doing it, including all the usual suspects: stigma, lack of acceptance of a problem, money.
Not much “we as a society” never been totally sure what that means can do unless you want to kidnap them and take them to a counselor, then pay the bill.

The courts are mostly to blame for allowing suspected mentally ill persons roam the streets. as long as a person is ruled “competent” to mingle with the public, there is nothing the police or citizens can do to prevent it. i use to see both men and women talk to themselves all the time of the public streets. you know they should not be on the streets, but some judge, somehwere has made the competency ruling and that’s that.

I was just wodering if anyone knows the mental background of the shooter in Arizona?

@incendiary_dan after the Virginia Tech (Blacksburg, Va.) massacre in 2007 we had these same discussions. In this case, 32 innocent people lost their lives. Let’s not have any illusions about what laws can do. Psychotic mass murder is rare.

I don’t know the answer to help people with severe mental illnesses like this. God knows I really wish I did. I know there are things we don’t need to do. We aren’t talking about somebody who has been diagnosed with depression or ADD. When you are dealing with this severity of mental disorder, passing new laws or having insurance pay 100 percent isn’t going to do very much in these instances.

We decided a half a century ago to not easily lock our “mentally disturbed” people into asylums. The mass deinstitutinalization left many people to their own devices and many families at a loss how to handle their loved ones. It was a humane decision, but it came with consequence.

People who may need quarantine are allowed to roam on the streets. Years ago troubled people like Cho Seung Hui or Jared Lee Loughner would have been locked away in a state hospital. But in the name of tolerance and a decency as a society, we made a trade off. You can’t force someone into treatment.

Have any of you dealt schizophrenia yourself or had a close relative with schizophrenia or any other serious psychosis? I have. It isn’t a matter of money, stigmas, shame or laws or Republicans or Democrats or whatever else political rhetoric you want to spin. We have made strides in how we deal with mental illnesses, but it isn’t something you can throw money at to solve.

@john65pennington The shooter was known to be mentally unstable. His community college banned him from attending classes. There has been criticism of gun laws that allowed him to legally purchase a weapon.

But, it should be noted thst the majority of mentally ill people are not violent and want to be well.

The biggest driving factor in that shooting, in my opinion, is he was full of hate.

@bkcunningham My brother was diagnosed as schizophrenic when he was very young. My parents had no idea how to handle it, and botched their job badly. He acted bizarrely as a teen-ager and spent time in a state hospital for several years. After the hospitals were closed down, he supported himself most of the the rest of his life at various jobs. He was never violent.

@YARNLADY I certainly didn’t mean to insinuate people with mental illness are violent. I don’t know what level of schizophrenia your brother had, but I feel for him, you and your family either way. One of my brothers, only two years older than me, was diagnosed with chronic paranoid schizophrenic in his mid-20s. I tried to protect and defend him from elementary school until he refused communication with the family for about 8 years until our mother died in 2006. Two children, a wrecked marriage, numerous suicide attempts and 30 years later, he’s living with one of my sister’s and her husband. I love him more than all God made and still try to protect him; but I have a feeling of dread everytime her number shows up on my caller ID.

@john65pennington – From what I understand, when Loughner was tossed off his community college campus for appearing dangerous, he was told to bring documentation from a shrink that he wasn’t a danger to others. He opted not to.

Perhaps there are a very limited number of cases where treatment doesn’t matter, but for the vast majority of the mentally ill, access to care is crucial and they don’t get it. Why? Because they don’t have health insurance. I can’t tell you how many people have showed up in my group, desperate for help and forced to try to handle it on their own because they have no health insurance, and have no prospects of getting any.

It is incredibly sad, because none of the advice we can give them will make much difference. Most of them don’t come back, and you have no idea what happened to them. Occasionally someone does come back, and it turns out they’ve been hospitalized, and set loose again with a prescription and no place to go.

Money makes an enormous difference. Anyone who thinks it doesn’t must be completely out of touch. The people who do well with mental illness are those with resources. The fewer resources you have, the poorer the outcome. What’s true in physical health is the same in mental health.

@wundayatta I’m not familiar with your group or where it is located. It is sad that you know people can’t find resources for help. There are numerous free, low cost, sliding scale and pro bono mental health care providers and facilities. I’d be happy to try and search some out in your area if you wanted to PM me. Public schools, colleges and universities maintain clinics and are a good starting point. Most teaching hospitals that train psychologists and psychiatrists are another good source to look for help. The National Alliance on Mental Illness has a number you can call to get direction: 1.800.950.6264.

@bkcunningham I appreciate the offer. We have two people who work with support services organizations, helping people get Medicaid and on housing lists and other services. They are overwhelmed with work. And they are being moved into cubicles where there is no room for their books and for any privacy with which to talk to clients.

We’re associates with DBSA, but of course there’s a lot of connection with NAMI as well. There are some service providers who will provide services for low or no cost. But, as I’m sure you know, people who are sick are in no condition to advocate for themselves. Most of them have low self-esteem and if they are denied care, and they give up. Even people who have wives or husbands or siblings or friends who are willing to try to help run up against dead end after dead end. It’s a systemic issue. Individuals can do a little bit, but there aren’t enough. We need a systemic solution, or we are going to all be standing around trying to stick our noses into a hole in the dike because our other four limbs are already busy.

Sane/Insane, Rich/Poor. I know its not that clear cut, but thats how i see it.

Also, this.

@Simone_De_Beauvoir : Thanks for that link.

@hawaii_jake Sure!

Reducing stigma. Improving diagnostics. Improving therapies. Giving health care to everyone.

I recommend reading three Psychiatrists who speak critically of their own profession:Szasz, Breggin, and Liefer.
I would then point to the growing movement of antipsychiatry groups formed by patients as well as the regular and routine disregard the mental health system has for both state and federal laws applicable to their processes. It is all based on coercion(force), and the results are clearly abysmal, but the solution is to end all of this nonsense now, end labelling of the so-called mentally ill, provide basic needs for those who cannot provide for themselves for any and all reasons, and stop the torture, drugging, shocking, committing, and labelling in the name and auspices of science where no such a thing truly exists. Read Liefer, get educated. Activism is fine, but the bill of goods sold this society by the media, which makes the Loughners and Hinckley Jrs. of this world appear to be the norm and always connect same with “mental illness”, is ridiculous. Oh—and if you question where I am coming from or what gives me the authority to speak out on this, the answer is involuntary commitment at age 11 and the suffering until age 45 when a gluten free diet was started due to Celiac Sprue. I thus regard all the medical profession but first and foremost Psychiatry as morally and practically bankrupt.