Opening A Discussion On Severe Mental Illness

[Reefgazer]

It may have something to do with being a fairly small hospital and not a large and formal medical center in a large city.  I was honestly stunned at the decisions they turned over to me just on my word that I was his DD.  Mom was able to sign DNR orders based on her just saying she was next of kin, but if mom was not there, I could easily have presented myself as next of kin and went against mom's wishes.  As it turned out, we were all *mostly* on the same page and discussed everything together, and those that weren't had the sense to step aside and leave the decision to mom, even though I was the one who was speaking to docs and relaying decisions mom had made during family discussions. 

I've btdt with a mpoa with my mother's dr.  some are more willing to go with it than others.

 

[eternalsummer]

I do *not* believe that forcibly medicating the severely mentally ill will make them decide to stay on the drugs and "stop being weird."  This is not about weirdness.

 

This is about safety for themselves and innocent others around them AND their ability to care for themselves and lead as close to a life as possible. Mentally ill people should not be on the street, unsheltered, unsafe from many dangers, and unhealthy (lack of appropriate food and medical care, etc.) just because their mental illness makes them unable to agree to treatment. They are not really making a choice like someone without a severe mental illness is capable of making a choice... they may say the words and they may act as though they don't want treatment, but it is because their *brains are sick* and *they cannot understand the consequences to themselves and sometimes, others.*

 

But sometimes, I would be tempted to say regularly, people with mental illness while undergoing treatment (that is, while taking medication) decide to stop taking the medication.  

 

In general the law already provides for forcibly institutionalizing someone who is a danger to themselves or others.

[zaichiki]

http://theconversation.com/are-you-really-at-risk-of-attack-by-someone-with-schizophrenia-14656

I'm very glad that not all people with schizophrenia are dangerous themselves or others!

 

I lived with a dangerous schizophrenic (who also loved me very much and was incredibly sweet and giving when not having an episode), so it is very real to me.

 

There ARE people with schizophrenia (and it's not just a handful) who are dangerous (to themselves and others) when having episodes and they need to be treated (usually this means medication) whether they want to be or not.  

 

And what if they're not dangerous?  So we just leave them alone? It does no one any good if we just let people's lives spiral out of control because they they don't want to be treated and are not dangerous... and they end up unable to keep a job, living on the streets, addicted to drugs/alcohol (because many schizophrenics self-medicate), constantly afraid, starving, dirty, sick... when it is beyond their control.  Again, I say, it is beyond their control. We can help. We can force treatment because we know it is better for them (and us).

[eternalsummer]

 

How can *we* as able-bodied, able-brained people sit by and let that suffering happen?

 

We do try to address specific infringements on the rights of others, though, right?  Like in theory we do what we can to keep abusive parents, whatever the cause of their abusiveness, from having custody of their children.  We put violent offenders in jail or institutions.  We even put people who we know are a danger to themselves in institutions against their will.

 

However, we sit by and let some suffering happen because we are afraid of going too far in the opposite direction (sterilizing people with schizophrenia, for example - would prevent a lot of suffering!) and in the US, we are still pretty tilted toward individual liberty, especially from government.

[eternalsummer]

I don't want to live in a society (and thank god, neither do most people in my society) where the government can force me to take drugs because they know it would be better for me - not because I am dangerous to others, not because I am dangerous to myself, but because it would make my life better by the common definition.

 

No thanks, nope, nada.

[zaichiki]

But sometimes, I would be tempted to say regularly, people with mental illness while undergoing treatment (that is, while taking medication) decide to stop taking the medication.  

 

In general the law already provides for forcibly institutionalizing someone who is a danger to themselves or others.

Yes they do.  All the time.  Because their brains are sick.  It is beyond their control, many times, to be able to make the right/safe/healthy/better decision.  They cannot see the consequences.  They need help.

 

It's NOT so easy to enforce involuntary treatment. You say " the law provides."  But who will do it?  And what if no one is paying close enough attention to get there in time?  

 

Why wait until someone is dangerous? Why not treat someone to help keep them healthy because it is the right thing to do, regardless of whether or not their sick brain can see the logic in it?  We cannot rely on a sick brain (one that is legally not able to be held accountable for its actions) to make the choice to keep taking the medication.  The decision needs to come from outside the person.

[zaichiki]

I don't want to live in a society (and thank god, neither do most people in my society) where the government can force me to take drugs because they know it would be better for me - not because I am dangerous to others, not because I am dangerous to myself, but because it would make my life better by the common definition.

 

No thanks, nope, nada.

No.  Not for people who are not sick.

 

Who made the earlier analogy?  If a person has cardiovascular disease, we don't wait until their symptoms are gone until we choose to treat it. 

 

The thing is, with severe mental illness, the inability of the brain to choose treatment IS one of the symptoms of the illness.  So, we have a loop here.

[zaichiki]

because it would make my life better by the common definition.

And I'm saying the "common definition" of a better life is one that is *not* lived on the streets, cold, dirty, sick, afraid, addicted to drugs/alcohol...and all of this ONLY because one's brain is sick.  The person isn't making a choice.  They are suffering from an illness.

[Melissa in Australia]

I'm very glad that not all people with schizophrenia are dangerous themselves or others!

 

I lived with a dangerous schizophrenic (who also loved me very much and was incredibly sweet and giving when not having an episode), so it is very real to me.

 

There ARE people with schizophrenia (and it's not just a handful) who are dangerous (to themselves and others) when having episodes and they need to be treated (usually this means medication) whether they want to be or not.  

 

And what if they're not dangerous?  So we just leave them alone? It does no one any good if we just let people's lives spiral out of control because they they don't want to be treated and are not dangerous... and they end up unable to keep a job, living on the streets, addicted to drugs/alcohol (because many schizophrenics self-medicate), constantly afraid, starving, dirty, sick... when it is beyond their control.  Again, I say, it is beyond their control. We can help. We can force treatment because we know it is better for them (and us).

is the forced treatment better for you because you no longer can see them?

[SparklyUnicorn]

As far as I know no mental illness is 100% genetic in nature--twin studies tend to show a genetic contribution, so if one twin has, say, schizophrenia there is a much higher probability that the other (genetically identical) twin will also develop it than the probability of a random person in the population developing it, but it is not a 100% certainty; half or more of those with an identical twin who develops schizophrenia never develop it themselves. The correlation is lower for many other mental health conditions. It is not as simple as "you have x gene, you will develop y disease."

 

Yes and despite the fact stuff gets passed down, things other than genetics can be passed down.  Which is confusing as all get out to me (probably because I am not so well versed on the subject of biology), but something I learned fairly recently.

[SparklyUnicorn]

is the forced treatment better for you because you no longer can see them?

 

sing it...

[SparklyUnicorn]

I'm very glad that not all people with schizophrenia are dangerous themselves or others!

 

I lived with a dangerous schizophrenic (who also loved me very much and was incredibly sweet and giving when not having an episode), so it is very real to me.

 

There ARE people with schizophrenia (and it's not just a handful) who are dangerous (to themselves and others) when having episodes and they need to be treated (usually this means medication) whether they want to be or not.  

 

And what if they're not dangerous?  So we just leave them alone? It does no one any good if we just let people's lives spiral out of control because they they don't want to be treated and are not dangerous... and they end up unable to keep a job, living on the streets, addicted to drugs/alcohol (because many schizophrenics self-medicate), constantly afraid, starving, dirty, sick... when it is beyond their control.  Again, I say, it is beyond their control. We can help. We can force treatment because we know it is better for them (and us).

 

None of my family members were dangerous. 

 

They can't keep jobs anyway, even with treatment.  That's the thing.  Schizophrenia for a lot of people is pretty much a life long sentence of trying to simply exist in a way that makes them tolerable to other people. This isn't about them holding down jobs.  A lot of them don't....EVER. 

[SparklyUnicorn]

I'm very glad that not all people with schizophrenia are dangerous themselves or others!

 

I lived with a dangerous schizophrenic (who also loved me very much and was incredibly sweet and giving when not having an episode), so it is very real to me.

 

There ARE people with schizophrenia (and it's not just a handful) who are dangerous (to themselves and others) when having episodes and they need to be treated (usually this means medication) whether they want to be or not.  

 

And what if they're not dangerous?  So we just leave them alone? It does no one any good if we just let people's lives spiral out of control because they they don't want to be treated and are not dangerous... and they end up unable to keep a job, living on the streets, addicted to drugs/alcohol (because many schizophrenics self-medicate), constantly afraid, starving, dirty, sick... when it is beyond their control.  Again, I say, it is beyond their control. We can help. We can force treatment because we know it is better for them (and us).

 

And believe me, I get it.  I am not at all HAPPY about the childhood I had.  It wasn't easy to live like that.  Yet, my parents were always undergoing some sort of treatment.  I can't say it did not help, but mostly it made my parents tolerable to other people.  It didn't make them feel better.  It didn't make them function better. The person(s) with schizophrenia were never able to hold down a job even at their absolute best (one had bipolar and he did hold down a job, but it was extremely difficult to do so and really only because he had an amazingly understanding employer was that possible).  It didn't make my life better.  It was pure hell most of the time.  I think the one reason I never realized it was I didn't know any different.  I didn't know life could be different.  I still struggle with realizing that. 

 

So to add to the pile of what's wrong with mental illness treatment or lack of..is treatment and help for the people in their lives.  I remember one therapy session (rare...didn't do much therapy as a kid really), where they said something like, "We know this is hard."  This was after my parents had both been in the hospital for months and my sister and I were being taken care of by relatives who were very vocal about how much they didn't want to be taking care of us.  I was like really..that's the best you got?!  We know this is hard?  You have no damn idea.  I haven't had a good opinion about therapists since. 

 

I guess my bottom line point is I want people to know that even if someone is 100% cooperative, the treatment that is available is nothing magical especially for the more difficult cases.  It doesn't even really allow the person to lead a normal life.  So imagine you cooperate with the treatment and realize that it doesn't make you feel better.  You realize you can't have a normal life.  You realize you have to spend any bit of money you have on your treatment.  You realize people will discriminate against you and not trust you.  It's hard to be the bigger person and continue with treatment.  This is a hell of a lot more complicated than people imagine. 

[Reefgazer]

Yes, the field of epigenetic's is of growing interest in biology. Things like a propensity to diabetes and heart disease can be passed down in a non-genetic manner, in addition to mental illness. There's a good Ted talk on YouTube that is about 20 minutes long and is worth listening too if you're interested in the topic.

 

Yes and despite the fact stuff gets passed down, things other than genetics can be passed down. Which is confusing as all get out to me (probably because I am not so well versed on the subject of biology), but something I learned fairly recently.

[Reefgazer]

Of course. No one wants to see a fellow human being in difficult circumstances, tormented by demons and suffering. I hope that doesn't strike you as wrong; not wanting to see someone in a difficult circumstance. Most of us don't want other human beings to suffer, even if we don't know them from Adam.

 

ETA: Don't assume this means I am pro forced treatments; I really go back-and-forth in this matter and I don't know what the right answer is. My tendency in severe situations is to let a loved one get guardianship and make the decision to medicate *once*, and from that point on, let the person with the illness make the choice, when they're on the medication and stable, to continue with the medication or not. To me this seems a middle ground between forcing medication for life and leaving someone uncared for in the streets.

is the forced treatment better for you because you no longer can see them?

Edited January 13, 2017 by reefgazer

[maize]

On 1/13/2017 at 6:23 AM, SparklyUnicorn said:

None of my family members were dangerous.

 

They can't keep jobs anyway, even with treatment. That's the thing. Schizophrenia for a lot of people is pretty much a life long sentence of trying to simply exist in a way that makes them tolerable to other people. This isn't about them holding down jobs. A lot of them don't....EVER.

 

Edited October 22, 2020 by maize

[maize]

My husband, in his right mind, would never choose ANY of the behavior he engages in when deeply depressed.

 

Why in the world should we assume then that a person who is irrational in every other way is capable of making a rational human choice when they reject medication? If we make the choice for them we are not depriving them of the ability to choose--the disease has already done that. We are helping to restore that ability.

Edited January 13, 2017 by maize

[SparklyUnicorn]

But for other mental illnesses the situation is different.

 

My husband has either severe chronic depression or bipolar II, depending on which doctor you ask, accompanied by serious anxiety.

 

With consistent treatment he is able to hold down a good job, function normally, and contribute to society and our family.

 

Without treatment he becomes entirely irrational, unable to work, suicidal, and abusive towards his wife and children.

 

The contrast is stark and very, very real. A true Doctor Jeckyl/Mr. Hyde scenario. In the grip of the disease 100% of his own personality disappears.

 

We have been fortunate that so far I have been able to cajole, persuade, and as necessary bully him into treatment. If that were to fail? His life would fall apart completely, even if he managed to stay alive he would lose everything he cares about, everything that gives him purpose and meaning and a sense of self respect--including the children and I.

 

I love this man too much to not be horrified by that thought, and horrified by the knowledge that similar disease has robbed millions of people worldwide of their lives either through death or by robbing them of their functionality and leaving them lost as irrational shells of themselves.

 

It is hard to force someone to take a handful of pills every day, but maybe we can develop more time-release medications that can be injected or implanted under the skin.

 

Really I hope that some day true cures will be possible; we are still barely emerging from the dark ages in our understanding of brain function and the causes of mental illness. In the meantime, however, we do have treatments that in spite of side effects are reasonable effective for a great many people, keeping their brains active and functional.

 

Yes I realize that.  My father's illness is a lot more treatable.  We have been talking a lot about schizophrenia in this thread.  Those are the people you tend to see that are homeless or seem especially out there.  I have seen my dad "out there", but it's nothing like schizophrenia.  (And the person making the comments about a person in her life with schizophrenia not wanting to take meds so they can hold down a job....not happening for a large number of schizophrenics to be honest). 

 

There are a lot more drugs now too.  My dad for years had to take lithium.  It worked well for him, but it destroyed his body.  The stuff they have now isn't quite as bad. 

 

 

[maize]

Another thought:

 

My analysis of what happens in my husband's case that makes him want to go off medication is a combination of a few factors, primary among them being the fact that when he is irrational the impairment in his brain (neurons failing to communicate) results in poor self awareness, situational awareness, and ability to form memories. When medication is working and his brain is functional he isn't really able to remember what it was like to be irrational. He feels fine, thinks fine, doesn't like side effects, doesn't like being dependent on drugs, assumes that he can continue to think if he starts tapering off medication and that he will be able to recognize if he starts deteriorating and adjust accordingly.

 

But it doesn't happen that way. Mental functioning begins to break down and he is not in fact able to recognize that fact and adjust his behavior in a rational way.

[SparklyUnicorn]

Another thought:

 

My analysis of what happens in my husband's case that makes him want to go off medication is a combination of a few factors, primary among them being the fact that when he is irrational the impairment in his brain (neurons failing to communicate) results in poor self awareness, situational awareness, and ability to form memories. When medication is working and his brain is functional he isn't really able to remember what it was like to be irrational. He feels fine, thinks fine, doesn't like side effects, doesn't like being dependent on drugs, assumes that he can continue to think if he starts tapering off medication and that he will be able to recognize if he starts deteriorating and adjust accordingly.

 

But it doesn't happen that way. Mental functioning begins to break down and he is not in fact able to recognize that fact and adjust his behavior in a rational way.

 

That and I think some people might feel like a drug is a cure or something that can fix something.  I know  I sometimes feel that way.  Like even with my acid reflux I think the drugs will fix it.  Or at least I hope they do.  I guess they don't.  I don't really like taking them and I hate feeling like I have no control over something with regards to my body.  Like maybe if I do things in just the right way I'll fix it.  I guess not. 

 

And the money.  Money is a HUGE factor.  I know people will say oh but this is so important it's worth every penny.  Yeah, but we also want to have money to spend on stuff we want (and not just minimally need).  I haven't met too many people who are just happy to have their bare bone basic needs met.  I didn't want to spend thousands of dollars on my teeth.  Teeth are hugely important, but I still didn't want to blow that kind of money on something so not sexy.  Just being honest. 

[MaryMak07]

We have spent over 10k treating my PPD (doctors, therapy sessions, meds). It worked and helped tremendously but as has been said here, isnt how we would have preferred to spend that money. This summer is our 10year anniversary and it would be lovely to have that 10k for a trip. Instead we might do one night away.

 

BUT I have a friend who lost her very best friend to suicide bc of PPD. It's WORTH it that we spent the money to get me well, but it still stinks that it had to be done.

[katilac]

   

From my perspective, as someone who is not mentally ill, I find it interesting that we have, in the American legal system (and presumably others) a "get away with it clause." If one is found severely mentally ill, one cannot be found guilty of a crime (including murder) because one had no control over one's actions.  

 

It's not nearly as simple as that; prisons are full of people who are severely mentally ill. 

 

Every state has their own rules.

 

Three states do not allow for an insanity defense at all. 

 

About half of the states follow some form of the M'Naugten rule,  which essentially states that you can only be found not guilty due to insanity if you were unable to recognize right from wrong at the time. So, any attempts to cover up or evade police are generally taken as evidence that you did know it was wrong in the eyes of the law. 

 

Some states use a standard that the person had to 'lack the capacity' to follow the law, even if they were aware of it. 

 

Regardless, the link below states that 1% or less of cases go for the insanity defense, and very few of those succeed. Of those that succeed, most spend as long or longer in a mental hospital as their prison sentence would have been. So, it's actually not a huge problem and people seldom get off on the insanity defense - we hear about it when they do exactly because it is so rare. 

 

The link is the FAQ related to a Frontline program, A Crime of Insanity, which is about a person with schizophrenia who commits a violent crime. I don't see that you can currently watch it, but they do have tons of related information about the person, the trial, mental illness and crime, and so on. 

 

http://www.pbs.org/wgbh/pages/frontline/shows/crime/trial/faqs.html

[Charlie]

I don't want to live in a society (and thank god, neither do most people in my society) where the government can force me to take drugs because they know it would be better for me - not because I am dangerous to others, not because I am dangerous to myself, but because it would make my life better by the common definition.

 

No thanks, nope, nada.

 

Agreed. 100%. Bodily autonomy is a fundamental right we shouldn't take lightly, even when moral dilemmas are real and practical issues for many good and innocent people. But if we change the vocab and replace this particular risk with other known risks, perhaps it will be easier to see the  problem.

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the child who is not vaccinated, themselves)."

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the drinker, themselves)."

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the fundamentally religious person, themselves)."

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the white nationalist, themselves)."

 

Unless the argument is to compel treatment for other well known links to potential dangerous behaviors, this prejudiced approach directly conflicts with the goal of removing the stigma of mental health, which is a fantastic idea for so many reasons. While it may be easy to understand why this proposed solution is popular, surely we can do better as a society. Surely we can come together to consider the facts and apply them in such a way that is both practical and ethical. Or who knows, maybe someone will figure out a way to make a profit off helping people with severe mental illnesses in such a way that preserves the integrity of their person. That person will change what sympathy looks like. Until it becomes profitable however, we can only go forward by changing our approach to reflect the knowledge we have, and inspire researchers to uncover more knowledge. What might happen if next summer's bucket challenged targeted schizophrenia?

 

Edit: Don't get me wrong. I'd love to see every child vaccinated. I'd love to see the end of violence and accidents caused by inebriation. I'd love to see all religious teachings to be so benign that no one fears shopping for Christmas presents or seeking medical care at their local Planned Parenthood. But not at the expense of giving up my own autonomy. I value my liberty and the liberty of my society too much to give it up for this, especially when there are alternatives.

Edited January 13, 2017 by Charlie

[SparklyUnicorn]

We have spent over 10k treating my PPD (doctors, therapy sessions, meds). It worked and helped tremendously but as has been said here, isnt how we would have preferred to spend that money. This summer is our 10year anniversary and it would be lovely to have that 10k for a trip. Instead we might do one night away.

 

BUT I have a friend who lost her very best friend to suicide bc of PPD. It's WORTH it that we spent the money to get me well, but it still stinks that it had to be done.

 

Yeah it goes well beyond this for many (not to minimize how hard this is for you).  They go without basic stuff or they live at a level that is just above basic.  My parents never even so much as went on a date.  We once went on vacation which entailed driving a couple of states over to stay with family.  After awhile they couldn't even afford that.  At one point there were three people in the house who needed psych meds, therapy sessions, hospital stays, etc.  And my dad was the only one bringing in money so when he got sick it we quite scary.  We never had stuff like dental cleanings.  We went longer than was ideal with outdated prescription glasses.  Some years they couldn't manage to afford transportation.  My dad's work was 15 miles away and sometimes he had to walk.  There was no public transportation. 

 

When they had school trips I never got to go....couldn't afford it.  I couldn't join clubs or sports...no money for that.  I worked myself at various jobs started at 12.  At one point when we went a long time without food my mother got desperate enough to contact social services.  They came to the house to look through closets for signs indicating extra money.  They saw my paper route bag and said I'd have to pay my paper route money towards what kind of aid we might get. 

 

And then so during these very hard times of paying rent late and not having food (because someone couldn't work) things might finally get better.  During those better times it was a matter of catching up to pay people back.  Trying to manage that caused stress which might lead to a relapse.  My parents weren't stable for many years even when cooperative because sometimes it takes a long time to stabilize someone.

[Reefgazer]

I think it is unrealistic to discuss severe mental illness that impairs objective decisions and executive functioning with a physical illness that does not impaire judgment about that illness. I could have all manner of illnesses that manifest in a physical way and not have my mental judgment about treatment clouded. By definition, the same is not true for many mental illnesses. So while removing the stigma of mental illness is important, I don't think that should be done at the expense of looking after this objectively.

 

Agreed. 100%. Bodily autonomy is a fundamental right we shouldn't take lightly, even when moral dilemmas are real and practical issues for many good and innocent people. But if we change the vocab and replace this particular risk with other known risks, perhaps it will be easier to see the problem.

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the child who is not vaccinated, themselves)."

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the drinker, themselves)."

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the fundamentally religious person, themselves)."

 

"We can make sure treatment is undertaken in order to keep people safe, even if it means they do not agree. Because the alternative, many (not all. never saying all) times is that innocent people will be hurt (including the white nationalist, themselves)."

 

Unless the argument is to compel treatment for other well known links to potential dangerous behaviors, this prejudiced approach directly conflicts with the goal of removing the stigma of mental health, which is a fantastic idea for so many reasons. While it may be easy to understand why this proposed solution is popular, surely we can do better as a society. Surely we can come together to consider the facts and apply them in such a way that is both practical and ethical. Or who knows, maybe someone will figure out a way to make a profit off helping people with severe mental illnesses in such a way that preserves the integrity of their person. That person will change what sympathy looks like. Until it becomes profitable however, we can only go forward by changing our approach to reflect the knowledge we have, and inspire researchers to uncover more knowledge. What might happen if next summer's bucket challenged targeted schizophrenia?

[SparklyUnicorn]

Well and in the meantime through all of that life goes on and you have to deal with the real world and relationships.  When one spouse is sick it can stress you out and make you sick.  And no matter how understanding you might be it wears on you.  And then you do stuff to cope.  And that stuff might not be good.  And that leads to other problems.

 

Geesh, maybe I should write a book. 

 

 

[gardenmom5]

Of course. No one wants to see a fellow human being in difficult circumstances, tormented by demons and suffering. I hope that doesn't strike you as wrong; not wanting to see someone in a difficult circumstance. Most of us don't want other human beings to suffer, even if we don't know them from Adam.

 

ETA: Don't assume this means I am pro forced treatments; I really go back-and-forth in this matter and I don't know what the right answer is. My tendency in severe situations is to let a loved one get guardianship and make the decision to medicate *once*, and from that point on, let the person with the illness make the choice, when they're on the medication and stable, to continue with the medication or not. To me this seems a middle ground between forcing medication for life and leaving someone uncared for in the streets.

 

 

it isn't that simple.   people "feel better", and think they're "better" and don't need the rx anymore -so. they. stop. taking.t them!   (that's an issue with antibiotics and contributes to rx resistance)  as has been said -poor self-awareness, they don't see how others perceive them.  they don't see how dysfunctional they are - because for them, 'it's their 'normal".

 

or a rx might work for awhile, then stop. the person doesn't realize it's not working - only someone on the "outside" who can see 'it'.   my friend has that with her stepson.   I had that with my mom - sort of.  another family member took over her care and her rx ran out and wasn't renewed becasue "mental illness doesn't exist" (that was the family member who. makes. me. furious!).   so, she wasn't taking it, she eventually was in lala land.  things got pretty ugly before I figured out that she hadn't been taking her rx! for months! (in my defense - I had a 3yo undiagnosed aspie.). previously - she had always been in charge of her rx because she was compliant.  as soon as we  got her back on them, she stabilized and was cognizant again.  she died shortly afterwards.  I take comfort that she was stable and happy when she died.

[SparklyUnicorn]

it isn't that simple.   people "feel better", and think they're "better" and don't need the rx anymore -so. they. stop. taking.t them!   (that's an issue with antibiotics and contributes to rx resistance)  as has been said -poor self-awareness, they don't see how others perceive them.  they don't see how dysfunctional they are - because for them, 'it's their 'normal".

 

or a rx might work for awhile, then stop. the person doesn't realize it's not working - only someone on the "outside" who can see 'it'.   my friend has that with her stepson.   I had that with my mom - sort of.  another family member took over her care and her rx ran out and wasn't renewed becasue "mental illness doesn't exist" (that was the family member who. makes. me. furious!).   so, she wasn't taking it, she eventually was in lala land.  things got pretty ugly before I figured out that she hadn't been taking her rx! for months! (in my defense - I had a 3yo undiagnosed aspie.). previously - she had always been in charge of her rx because she was compliant.  as soon as we  got her back on them, she stabilized and was cognizant again.  she died shortly afterwards.  I take comfort that she was stable and happy when she died.

 

I think it's different for different people and illnesses.  When my dad was on a manic high he felt pretty damn good.  That is when he was most unpleasant to be around though.  So basically he is told to take a medication that makes him more tolerable to others while he feels great.  The medications dull him and often depress him.  My mother, on the other hand, had some pretty severe side effects from the medications.  She was exhausted to the point where it was hard to do anything.  And it never worked 100% at preventing things like hallucinations.  She still had them.  She was just more dulled and doped up. 

 

I don't really know what people imagine with some of these medications and treatments.  Of course there are some people who truly do well with them.  They probably aren't the people we are talking about here though. 

Edited January 13, 2017 by SparklyUnicorn

[gardenmom5]

about living . .

my mother had her house, had a condo, dh literally took over her finances (she asked) and gave her a WEEKLY cash allowance.  she had no ability to handle money.  he took care of all necessary bills, and I took her shopping weekly.

the untreated family member - lived  in what was basically a flop house.  had multiple usually non-working cars (wouldn't sell them to get one that worked.) so he had transportation. usually. when he was younger, he worked on a food processing line enough hours to collect unemployment the rest of the year.  his mother regularly sent him money - which he gave to his druggie friends. not sure if he did drugs or not, but untreated, dirty, lived just above street level.   

[gardenmom5]

I think it's different for different people and illnesses.  When my dad was on a manic high he felt pretty damn good.  That is when he was most unpleasant to be around though.  So basically he is told to take a medication that makes him more tolerable to others while he feels great.  The medications dull him and often depress him.  My mother, on the other hand, had some pretty severe side effects from the medications.  She was exhausted to the point where it was hard to do anything.  And it never worked 100% at preventing things like hallucinations.  She still had them.  She was just more dulled and doped up. 

 

I don't really know what people imagine with some of these medications and treatments.  Of course there are some people who truly do well with them.  They probably aren't the people we are talking about here though. 

 

 

yeah - the pros and cons of side effects are a real problem.  

people feeling good and not wanting to take them is a real problem.

I honestly think those who've not dealt with mentally ill don't understand how much of a problem.

most current rx don't do a lot, and it's a lot of pros and cons.   

 

the suggestion upthread of "perfect rx" - well, we're a long way from that. 

 

my dad had (genetic.  lovely/)  chronic depression - granted it was the 70s and rx was even more primitive (that is the decade of valium being passed out like candy) and less effective than it is now.  rx didn't do much of anything, and he did eventually kill himself.

and yeah - my schizophrenic mother (she developed it in adulthood) . . she was pretty much a zombie on her rx, but she was totally out of it in lalalalnd when she was off of them.  she was functional enough to do something - but her employment did go downhill until there was nothing.  before I knew she was off of rx (due to relative), she called me from the ER, (where relative had taken her) to prove she knew who she was, and she "wasn't crazy" (repeated many times.  it was heartbreaking)  - and she wanted me to be in control of her (not the relative, who that night had manipulated her (with a nurse helping him.)  into signing something he'd written giving him control.  the ER dr witnessed the manipulation - and was ready to have security throw him out.)

 

 I think that is something else people don't' realize - some of the people most likely to victimize the mentally ill - are family members.

 

 I do have the experience with the untreated relative - who was violent, was aggressive, and was downright scary to be around.  I never ever relaxed when he was around.  

[SparklyUnicorn]

sorry about your dad

 

and your mom

 

 

[G5052]

Well and in the meantime through all of that life goes on and you have to deal with the real world and relationships.  When one spouse is sick it can stress you out and make you sick.  And no matter how understanding you might be it wears on you.  And then you do stuff to cope.  And that stuff might not be good.  And that leads to other problems.

 

Geesh, maybe I should write a book. 

 

nm

Edited August 12, 2017 by G5052

[SparklyUnicorn]

You and I both. I spent an hour on the phone with my therapist yesterday because the family situation is blowing up again. Of course I barely slept last night. It's so unbelievably exhausting. Sometimes I can barely function outside of thinking about it.

 

But I was responsible today. I went to the dermatologist for my late "annual" skin check, then to the gym, and then picked up a mystery at the library that I'm looking forward to. I took action on a hard decision and made another appointment for a stress-related medical issue that I need to have looked at. I have some work-related tasks this afternoon and evening.

 

Next week I have a face-to-face with my therapist. Half of me hates going because she talks turkey to me, but half of me knows that I need it. Narcissism has developed along with the delusional thinking and paranoia, and I'm at wits end with the individual. They refuse treatment. So I go to the therapist, not them.

 

You are a bigger person than me.  I don't deal anymore.  Nope....I just don't.  Period.  I'm done.

 

I would help my dad if he needed it.  But he's stable and very cooperative.  Anyone else in my family?  Probably not.  One asked me for money once.  I did give her money ONCE.  That was it.

[TravelingChris]

I am well aware that people with mental illnesses are more likely to be victims than perpetrators.  But my state jails and prisons are full of mentally ill who have done crimes and currently there is a law suit that the prison system is inadequately caring for them.  My state has closed psychiatric facilities in the last ten years and more and more people who are mentally ill just end up in the criminal justice system.  It is because of lack of facilities, psychiatrists, and general mental help.

[redsquirrel]

I haven't read all the responses, but my mom worked with the severely mentally ill population. Many, many of them end up in the prison system. They get involved in criminal groups or get used by criminal groups, but sometimes they commit violent crimes on their own.  My mother worked in a maximum security prison but she actually worked in the mental hospital of the prison. Her patients were all either severely mentally ill or mentally handicapped. Both those populations are terribly underserved once they are adults and can so, so easily end up in prison.  Sometimes that is the safest place for them, but in the vast majority of the time it isn't the right place for them. In a prison they get heavily medicated and warehoused. They are warm and fed and their other medical issues are cared for, but most of them don't really belong in a prison. 

 

One of the problems specific to schizophrenia is that when they are on their meds, if they can get meds, many can function well. They don't need ongoing institutionalization, that would be a waste of resources. But, the danger comes from go off their meds. And even when someone is taking their medication they can still destabilize. Or because they are doing well and can work they lose their Medicaid. For many to get the medical care they need they have to qualify for public assistance, so that means often getting to the point of homelessness before help is available.  One of the great parts of the ACA was that it mandated mental health treatment at par with physical health treatment. No one could be denied health care due to a mental illness, and all insurance had to cover mental health services.. It isn't uncommon for insurers to consider even seeking help for depression or stress in college as a disqualifyer, a 'pre-existing condition'..so what is someone with a diagnosed mental illness supposed to do? There is no insurance that will cover them. That can make it very difficult to afford medication until there is a crisis.

 

I grew up knowing a family with a son who was schizophrenic. He was brilliant and funny and seemed 100% like an average kid. There was nothing, NOTHING to indicate what was to come.  His illness manifested when he was 18-19..away at college, and legally an adult so there was nothing his parents could do about it.

He went in an out of stability. Sometimes he was his old self, sometimes he could tell you that he was a spy on the run and people around us were actually foreign operatives...and he was SO convincing when he told you this, with full detail that you could almost get caught up in it.  He killed himself, jumped off a bridge in his late 20s. He had been doing so well, but had been having problems again. My mom said that is a danger time for people with mental illness, when they have been doing well but know they are destabilizing. He just couldn't go through that one more time.  His family was very brave and in his public obituary they said that he died due to mental illness. 

Edited January 13, 2017 by redsquirrel

[SparklyUnicorn]

I haven't read all the responses, but my mom worked with the severely mentally ill population. Many, many of them end up in the prison system. They get involved in criminal groups or get used by criminal groups, but sometimes they commit violent crimes on their own.  My mother worked in a maximum security prison but she actually worked in the mental hospital of the prison. Her patients were all either severely mentally ill or mentally handicapped. Both those populations are terribly underserved once they are adults and can so, so easily end up in prison.  Sometimes that is the safest place for them, but in the vast majority of the time it isn't the right place for them. In a prison they get heavily medicated and warehoused. They are warm and fed and their other medical issues are cared for, but most of them don't really belong in a prison. 

 

One of the problems specific to schizophrenia is that when they are on their meds, if they can get meds, many can function well. They don't need ongoing institutionalization, that would be a waste of resources. But, the danger comes from go off their meds. And even when someone is taking their medication they can still destabilize. Or because they are doing well and can work they lose their Medicaid. For many to get the medical care they need they have to qualify for public assistance, so that means often getting to the point of homelessness before help is available.  One of the great parts of the ACA was that it mandated mental health treatment at par with physical health treatment. No one could be denied health care due to a mental illness, and all insurance had to cover mental health services.. It isn't uncommon for insurers to consider even seeking help for depression or stress in college as a disqualifyer, a 'pre-existing condition'..so what is someone with a diagnosed mental illness supposed to do? There is no insurance that will cover them. That can make it very difficult to afford medication until there is a crisis.

 

I grew up knowing a family with a son who was schizophrenic. He was brilliant and funny and seemed 100% like an average kid. There was nothing, NOTHING to indicate what was to come.  His illness manifested when he was 18-19..away at college, and legally an adult so there was nothing his parents could do about it.

He went in an out of stability. Sometimes he was his old self, sometimes he could tell you that he was a spy on the run and people around us were actually foreign operatives...and he was SO convincing when he told you this, with full detail that you could almost get caught up in it.  He killed himself, jumped off a bridge in his late 20s. He had been doing so well, but had been having problems again. My mom said that is a danger time for people with mental illness, when they have been doing well but know they are destabilizing. He just couldn't go through that one more time.  His family was very brave and in his public obituary they said that he died due to mental illness. 

 

It gets even stupider.  My sister initially went on disability.  The type you earn through working.  After years of job after job after job and just not managing she finally decided to see if she could get disability.  You figure given my family's history they were fairly supportive and helpful towards her because they knew the situation.  So they let her live at home when they could.  Etc.  So she was approved easily for disability.  She made $11,000 per year.  This amount put her over the limit to get medicaid.  So she is disabled due to a medical condition and couldn't get help paying for it.  The needed drugs are not inexpensive.  Therapy..not inexpensive.  Hospital stays forget it.  At that point she had to pay her rent and everything else with that.  And she lived alone.  Who the hell wants a mentally ill roommate.  So please nobody tell me she just didn't budget well enough to manage this (by doing stuff like getting a roommate). 

 

She is in a better situation now and does get what she needs.  She's stable.  She does not work though and wouldn't be able to manage it. 

 

 

[G5052]

You are a bigger person than me.  I don't deal anymore.  Nope....I just don't.  Period.  I'm done.

 

I would help my dad if he needed it.  But he's stable and very cooperative.  Anyone else in my family?  Probably not.  One asked me for money once.  I did give her money ONCE.  That was it.

 

nm

Edited August 12, 2017 by G5052

[SparklyUnicorn]

Not dealing with my situation would require separation and divorce. And yes, I already have picked out and met with a lawyer in case it comes to that.

 

oh boy...big hugs

[maize]

Not dealing with my situation would require separation and divorce. And yes, I already have picked out and met with a lawyer in case it comes to that.

:grouphug: :grouphug: :grouphug:

Edited January 13, 2017 by maize

[Reefgazer]

I have limited personal experience with mental illness (some, but not enough to cause family catastrophe), so I would definitely defer to people who have BTDT.  But I am tossing out ideas as a starting point.  Perhaps the "one attempt and you decide" plan could be implemented in conjunction with some kind of legal document, drawn up with the ill person's voluntary participation and a loved one when the ill person is stabilized, that voluntarily gives said loved one legal authority to make decisions for that specific illness.  I'm sure it won't work for every situation, but it may help those who want to function and have someone by their side who also wants to help them function.  Stuff like this won't be solved at the federal level, though; it needs a smaller and more nimble organization.

it isn't that simple.   people "feel better", and think they're "better" and don't need the rx anymore -so. they. stop. taking.t them!   (that's an issue with antibiotics and contributes to rx resistance)  as has been said -poor self-awareness, they don't see how others perceive them.  they don't see how dysfunctional they are - because for them, 'it's their 'normal".

 

or a rx might work for awhile, then stop. the person doesn't realize it's not working - only someone on the "outside" who can see 'it'.   my friend has that with her stepson.   I had that with my mom - sort of.  another family member took over her care and her rx ran out and wasn't renewed becasue "mental illness doesn't exist" (that was the family member who. makes. me. furious!).   so, she wasn't taking it, she eventually was in lala land.  things got pretty ugly before I figured out that she hadn't been taking her rx! for months! (in my defense - I had a 3yo undiagnosed aspie.). previously - she had always been in charge of her rx because she was compliant.  as soon as we  got her back on them, she stabilized and was cognizant again.  she died shortly afterwards.  I take comfort that she was stable and happy when she died.

 

Edited January 14, 2017 by reefgazer

[Reefgazer]

This is why I think block grants to local governments to deal with situations like these, instead of big federal programs, would be a good idea, because the local governments could be more agile in cutting through the BS and red tape that allows a situation like this to exist.

It gets even stupider.  My sister initially went on disability.  The type you earn through working.  After years of job after job after job and just not managing she finally decided to see if she could get disability.  You figure given my family's history they were fairly supportive and helpful towards her because they knew the situation.  So they let her live at home when they could.  Etc.  So she was approved easily for disability.  She made $11,000 per year.  This amount put her over the limit to get medicaid.  So she is disabled due to a medical condition and couldn't get help paying for it.  The needed drugs are not inexpensive.  Therapy..not inexpensive.  Hospital stays forget it.  At that point she had to pay her rent and everything else with that.  And she lived alone.  Who the hell wants a mentally ill roommate.  So please nobody tell me she just didn't budget well enough to manage this (by doing stuff like getting a roommate). 

 

She is in a better situation now and does get what she needs.  She's stable.  She does not work though and wouldn't be able to manage it. 

 

 

[Anne in CA]

I am well aware that people with mental illnesses are more likely to be victims than perpetrators.  But my state jails and prisons are full of mentally ill who have done crimes and currently there is a law suit that the prison system is inadequately caring for them.  My state has closed psychiatric facilities in the last ten years and more and more people who are mentally ill just end up in the criminal justice system.  It is because of lack of facilities, psychiatrists, and general mental help.

That, to me, is the real rub. Jails are full of mentally ill people. The homeless people I saw at my sandwich shop last year were mostly, low IQ, mentally ill, or so severely addicted to heroine/ meth, that they were in NO WAY calling any of the shots in their own life. All of them should have been under the care of others. But, to a one, most of them were victims of drug dealers and other people who prey off them. I don't think any of them, even the Satanist one to freaked out my favorite employee, causing her to quit, by threatening her and yelling at the top of his lungs that she belonged to Satan and him, weren't victims more than perpetrators. They just weren't.

 

But... other people get hurt from their actions. People in the ER get hurt wresting with them during violent episodes, police get hurt dealing with their problems, their family members looking for them get sick/hurt going through homeless camps looking for them, they have kids and pets they don't care for who are deeply affected by living the way they do. No one lives in a vacuum. It is not possible for a mentally ill person to refuse to care for themselves and not hurt others. It SHOULD be possible for the rest of us to treat the mentally ill with kindness and respect, but I don't see that happening either. Too many people feed off the power of mistreating others.

[Anne in CA]

People also get hurt on a regular basis by those who use alcohol to excess. Do we force treatment on them too ? 

Jails are full of alcoholics, too. I'm not really in favor of forcing treatment on anyone who isn't hurting anyone else, even if they are miserable. If treatment were better and could only be administered by people of the highest character, I would be in favor of it. I don't see any win/ win situations with mental illness where we are as a society today. Untreated mentally ill people suffer themselves and hurt others, whether by violent episodes, or by living on the streets where they become everyone's responsibility. There is no reality where mentally ill people refuse treatment and no one but them suffers. There is no reality where mentally ill people get treatment and live happily after. But I think we should be working toward it as a society.

[Bluegoat]

Lots of people with schizophrenia are quite happy to take the meds once they see more clearly?  Or are you talking about other forms of mental illness?

 

Schizophrenia, but both, really.  Some people wish they were never made to take them and continue to refuse treatment, but a lot of people are relived to not be in the state they were admitted to hospital in any more, even if there are downsides to the medication.  Even, sometimes, if later they decide not to take them any more.

[redsquirrel]

Untreated alcoholics suffer themselves and hurt others. There is no reality where alcoholics refuse treatment and no-one but them suffers.

 

So no different, really. 

 

It seems to me that once someone is living on the streets, they've become no-one's responsibility.

 

I agree there's no reality where people get treatment and live happily ever after. The question of how to get closer to that dream is very vexed.

 

See, now I feel like when someone is on the streets they have become everyone's responsibility.

[redsquirrel]

This is why I think block grants to local governments to deal with situations like these, instead of big federal programs, would be a good idea, because the local governments could be more agile in cutting through the BS and red tape that allows a situation like this to exist.

 

Block grants are often an 'all you can eat buffet' for state and local government. There can end up being very little oversight. That is what we saw happen with TANF.  It also leads to wild disparities in what is available to people. If a state decides to not allocate any of its block grant to the mentally ill because they see it as a way to get them and their families to move to other states, well... nothing to do to stop that.

 

I'm not saying that block grants are useless, but there are lots of corporations that see them as easy pickings...and state legislatures that see them as prize money to hand out.  So I'm not sure what is gained by them other than disparities between states.

[redsquirrel]

What does 'everyone' do about the person on the street ? They may well have become everyone's problem, but I'm yet to see a society leaping into action to take care of the homeless, embracing their responsibility.

 

I said I think that when someone is on the streets they become everyone's responsibility.  I didn't say we are meeting that responsibility.

[Joyofsixreboot]

What does 'everyone' do about the person on the street ? They may well have become everyone's problem, but I'm yet to see a society leaping into action to take care of the homeless, embracing their responsibility.

Tragedy of the Commons

 

Sent from my SAMSUNG-SM-G900A using Tapatalk

[Anne in CA]

What does 'everyone' do about the person on the street ? They may well have become everyone's problem, but I'm yet to see a society leaping into action to take care of the homeless, embracing their responsibility.

Just because society doesn't leap into action doesn't mean nothing happens. The homeless go to emergency rooms when they get sick or beaten up. They get arrested, they panhandle, they raid garbage and make an unholy mess that must be cleaned up at taxpayer expense. The cost of cleaning up a homeless camp is horrific. Sometimes millions of dollars an acre when it is watershed that must be decontaminated. Everyone deals with that. It is not a void. I don't think you are understanding where I'm coming from. It would be much better to deal with the problem up front, which we are not, we are dealing with it from the back end, and EVERY contributing member of society pays more taxes and for medical care for the cost of these things. We ARE paying. It is a question of how. 

[eternalsummer]

Also, I think many members of society help the homeless (or the multitude of other people who need help) - they just do it through private organizations or churches or individual donations and assistance (espectially of those in their community or their extended family) instead of through government programs.