Republicans think an overhaul of the mental health system will stop mass killings. It won’t. This bill is pushing people toward mental health care that, in my experience, does nothing to improve their long-term outlook.
In the wake of the recent Planned Parenthood shooting in Colorado, House Speaker Paul Ryan called for a renewed commitment to passing The Murphy Bill, legislation designed to overhaul mental health services in this country. Ryan’s contention is that mass shootings are not a result of lax gun laws but rather a failure of our mental health system.
There is plenty of data that shows that his postulation is inaccurate. Still, while an overhaul of the mental health system will not stop mass killings, fundamental changes to mental health treatment are sorely needed. Unfortunately, the Murphy Bill misses the mark here as well. The bill includes mandatory outpatient treatment (under threat of involuntary inpatient commitment) and loosens an individual’s right to privacy around their mental health care. This bill is pushing people toward mental health care that, in my experience, does nothing to improve their long-term outlook.
My opinion is based on my years of searching for adequate mental health treatment for my own depression and anxiety. At my lowest points I was diagnosed with catatonia and psychotic features. After numerous inpatient stays at multiple hospitals, a string of outpatient programs and private therapy, I am recovered. I will always be on medication and I must be extremely vigilant in responding to early warning signs of depression or anxiety, but I live a happy and productive life.
Given what I have seen during this journey, I cringe when politicians and private citizens alike appeal to the importance of giving the mentally ill “help.” There is a very naïve belief that pushing someone into the hospital system or placing them in the care of a mental health professional will magically “cure” what ails them. However, many of these solutions are temporary at best and detrimental at worst.
Once when I was inpatient at a community hospital, a man sitting next to me in the common room said, “All we do here is watch TV. I can watch TV at home.”
“Why are you here?” I asked.
“I tried to kill myself.”
We sat there in silence, both knowing how this would end. At some point he would tell the psychiatrist that his suicidal thoughts were gone (whether the statement was true or not would be irrelevant; eventually you will say the things you need to say to be rid of the hospital) and be sent home with a prescription and precious little else by way of help.
No meaningful therapy is done in short-term hospital stays (usually under 10 days). There is some educational programming, which ranges from the ridiculous to the moderately helpful. Just as I finished my talk with the suicidal man, the TV was turned off and we were all given a word find with mental wellness terms. This satisfied the hospital’s requirement to provide programming.
Short-term hospital stays are almost solely about medication adjustments. Medication can be an extremely important part of some individuals’ treatment plans, but a week or two is not long enough to find the right combination. Many psychiatric medicines take weeks before their impact is fully realized. So instead, there is a tendency to sedate rather than properly medicate.
I was once sent home from the hospital on a medication that made me sleep 18 hours a day. I had trouble stringing together anything more than simple thoughts when I was awake. I went into the hospital depressed to the point of thinking about hurting myself. Leaving with the assumption that I had to spend my life on this horrible drug did not lift my spirits. I ended up in another hospital in short order. Being told I was stable when, in fact, I was sedated did not constitute “help.” The drugs were a bridge from one hospital to another.
Treatment options are not limited to medication. The third time I fell into a depression that required hospitalization I was convinced to try electroshock therapy (ECT) at a very prestigious hospital. I didn’t believe I had any options left. The treatment, which is in fact painless and quick, did not break my depression. What it did was wipe out my memory from the previous six months or so. I don’t mean that I had foggy memories. That time is a black hole.
After the hospitalization, I attempted to return to work. I was still depressed and anxious and then, on top of that, did not remember anyone I had met in the last six months, even people I had had apparently worked closely on a project with. The return was doomed to fail.
The next types of treatment available to people in crisis are outpatient programs. Most programs run every weekday either all day or in the mornings only. They provide structure to people who are stable enough to be out of the hospital but who are not yet ready to resume work or school. The best of these programs focus on behavioral therapy and provide real time support for what is going on in the participants’ personal lives. They can help you get your life together.
Unfortunately, good fits can be hard to find. Once, in order to satisfy my short-term disability requirement, I ended up in a program for addicts, listening to the verbiage of Alcoholics Anonymous. I don’t drink or use drugs.
A psychiatrist assigned to my case once insisted that I institutionalize my son who has Down syndrome. She assured me that caring for him was incompatible with my mental health. I needed her to approve my continuation in the program so I didn’t feel I could respond. But no real therapy could happen from that point on.
Another program I attended focused on the relationships between peers in the outpatient group. Participants were encouraged to spend time with one another outside of the therapeutic setting. People were sleeping with one another, drinking with one another. A would-be sexual assault was interrupted at a party attended by group members. Not every health care provider is fit to be practicing.
I have many more stories I could tell about mental health “help.” In full disclosure, I should add that my experience has been easier than most because I have had good private insurance throughout this journey. As such, I have had many more choices in my quest to heal myself.
Because I am financially stable, I was ultimately able to find some real help, in the form of a residential inpatient program. In this program, I stayed in the hospital for seven weeks. My medication was properly adjusted with an eye toward my living a productive life, not just being sedated.
My day to day responsibility was to get up and attend therapy and classes. I started the program in a state of partial catatonia. Getting up and going to class was all I could manage in the beginning. But it got me out of my depressive isolation and the succeeding at going through my schedule every day gave me something to build on. The therapy was tough, sometimes confrontational, but it pushed me along. The education was practical, challenging me to learn my patterns and interrupt a negative cycle before it really had a chance to take hold.
I wasn’t totally solid when I went home but I had a strong foundation to build from. And four years later, I still rely on that work.
The program was my help, yet my insurance company would not pay for it. Instead I took on a debt that could have bought a small house. I was lucky to be able to do it. Most people could not.
Fixing the mental health system is a huge task, one well worth tackling, not because it will solve mass killings but because there are many people who could live productive lives with better treatment. The Murphy bill won’t accomplish this change just by giving outsiders more authority to shuffle the mentally ill into ineffective treatment programs.
If we want to affect real change, mental health treatment plans should match an individual’s needs, not their wallet. The goal of every stage of the process should be to assist a person in living a productive life, not on cosmetically reducing symptoms or minimally providing mandated service. If you want to increase the number of people receiving treatment, eliminate the stigma of mental illness; pushing people into treatment they don’t want will do nothing for society or for the individuals themselves.
Anne Penniston Grunsted writes about parenting, disability, and family life from her perspective as a lesbian mama. She has been published in The Washington Post, Brain, Child Magazine, Mamamia, and won the 2014 Nonfiction prize from Beecher’s Magazine. She lives in Chicago with her partner and son.