Unhinged
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Some states also still allow physicians to dispense drugs from their own private, wholly-owned pharmacies (as Dr. Nickelback did), which motivates unscrupulous physicians to generate profits directly from the drug markups. Powerful lobbyists for various pharmaceutical companies push both insurers and the government hard for policies that will benefit the companies’ profits above all, and as a result, insurance reimbursements for expensive drugs rise while reimbursements for long-term cognitive behavioral therapy from psychiatrists, psychologists, clinical social workers, and other allied health practitioners is shrinking. Managed healthcare plans might pay for only five—or at most, ten—cognitive therapy sessions per year, almost never enough to bring about the level of personal insight and long-term behavioral changes necessary to alter destructive behavior patterns (and with it, brain chemistry) in the chronically mentally ill. Insurance coverage for other types of cognitive therapy from complementary medicine disciplines (e.g., art and music therapy, occupational therapy, yoga, meditation, and mind-body exercise classes) that have consistently been shown to be effective when combined with traditional Western treatment methods in the mental health systems of other countries—most notably, India—are almost unheard of in the United States. As a result, the long-term cognitive behavioral strategies often shown to be the most effective at controlling and managing severe mental illness over the long term are increasingly becoming luxuries only the rich can afford. The rest of us are relegated to popping pills in a mainstream drug culture so passé it is frequently satirized on television shows like The Simpsons and South Park and made the topic of ridicule on late-night TV talk shows and standup comedy routines.
Compounding the increased financial barriers to obtaining cognitive behavior therapy in addition to or as an alternative to drug-based therapy is the overall social stigma of mental illness, which remains profound and pervasive despite recent strides in our society toward breaking it down. For example, many American universities have reportedly recently adopted highly publicized policies to expel students who display depressive symptoms or suicidal tendencies.[8] While the university administrators adopting these ludicrous policies explain they are primarily for “liability” purposes, or a misguided attempt to keep mental illness from “spreading” in dormitories (like mumps or chicken pox) and to “protect” other students from engaging in so-called copycat behavior, in reality these policies act as an added incentive for depressed or otherwise mentally ill college students to hide their illnesses—often resulting in exacerbated symptoms, substance abuse, even successful suicide attempts—and as an added disincentive for them to seek help and treatment.
As universities develop prejudicial, Orwellian policies designed to oppress and harm the mentally ill, so does Corporate America. Most corporate employees are afraid to speak out or seek treatment for their mental illnesses, and they have good reason to keep silent. Firings of employees suffering from mental illness remain common, despite the fact that this practice is prohibited by the Americans with Disabilities Act. Those who do seek help or counseling, either from employer-based assistance programs or employee health insurance policies, often find that information about their illnesses, which by law is supposed to be kept confidential and separate from their personnel files, is instead used against them—either at annual raise time or as an all-out justification for termination.[9] Major corporations have also been slow to offer health insurance plans to their employees that cover conventional mental health treatments at parity with other types of medical care, even when state and local laws mandate it. Perhaps most sinister and Orwellian in nature, corporations are increasingly using unscientific “personality tests” in their hiring practices in an effort to “weed out” the supposed mentally ill from their applicant base—up to and including discrimination against persons who, according to these pseudoscientific tests, merely have the potential to become mentally ill.[10]
I can certainly attest to the stigmas that have victimized and oppressed me—past and present—in corporate, social, and institutional settings, both as a mental health consumer myself and as a relative of multiple mental health consumers. In addition to being ostracized in school and in social settings, I’ve been fired from jobs as a direct result of both more than once, and in no case was assistance or support offered by my employer, even when the employer had an “employee assistance program” as part of its fringe benefits package. I believe these supposed “employee assistance programs” too often are used improperly to weed out “problem” employees from the ranks rather than assist them.
It is tragic that such backward notions of mental illness and the mentally ill themselves continue to pervade our society, given that good treatment and support is available, and when that good treatment and support is properly administered, recovery is possible. I’m living proof of that.
Since I began writing this book, my husband George has opened up about mental illness in his own family—including the story of a cousin of his who makes a living driving a taxicab on the island of Macau. That cousin, a known family eccentric and a probable paranoid schizophrenic himself, once told George how every night, his wife removed her head from her body, set it on the night-table, combed her detached head of hair as if combing a wig on a dummy, then refastened her head to her body. He apparently told this story in total seriousness and seemed to believe in it as much as he believed in his own existence.
“I think maybe my cousin is messed up the way your brother is messed up,” George says. “I was too embarrassed to talk about it before now, but your writing about your brother helped change that.”
I hope that if nothing else, this memoir makes family mental illness less embarrassing for everyone. After all, misery loves company—and company makes us bosom friends.
1. World Health Organization, Global Status Report on Non-Communicable Diseases 2010 ( Geneva: World Health Organization, 2011).
2. World Health Organization Global Burden of Disease Report 2002, www.who.int/healthinfo/global_burden_disease/en/index.html.
3. National Institute of Mental Health NCS-R Study 2005. Cited at “Major Depressive Disorder among Adults,” www.nimh.nih.gov/statistics/1mdd_adult.shtml.
4. Tara Clark, “Mental Illness and Families,” Jewish Family Services of Milwaukee, Robert & Mimi Habush Family Center, www.jfsmilw.org/news/articles/mental_illness_families.htm; Barry J. Milne et al., “Predictive Value of Family History on Severity of Illness: The Case for Depression, Anxiety, Alcohol Dependence, and Drug Dependence ,” Archives of General Psychiatry 66, no. 7 (2009): 738–47.
5. Fritz Mattejat, PhD, and Helmut Remschmidt, PhD, “The Children of Mentally Ill Parents,” Deutsches Arzteblatt International 105, no. 23 (2008): 413–18.
6. Brendan L. Smith, “Inappropriate Prescribing,” Monitor on Psychology 43, no. 6 (2012), www.apa.org/monitor/2012/06/prescribing.aspx.
7. Harriett Fraad, “Profiting from Mental Ill-health,” Guardian, March 15, 2011, www.theguardian.com/commentisfree/cifamerica/2011/mar/15/psychology-healthcare.
8. Sally Satel, “Expel Students Who Might Kill Themselves?” Center for the American University at the Manhattan Institute, December 21, 2009, www.mindingthecampus.com/originals/2009/12/expel_students_who_might_kill.html.
9. Dan Fastenberg, “Employers Can’t Fire Workers with Bipolar Disorder, Court Rules,” AOL Jobs, April 3, 2012, http://jobs.aol.com/articles/2012/04/03/employers-on-notice-you-cant-fire-workers-with-bipolar-disorder/; Nick Birkenhauer, “Terminated Employee with Bipolar Disorder Awarded $315,000 in ADA Case,” JDSupra Business Advisor, March 3, 2012, www.jdsupra.com/post/documentViewer.aspx?fid=dff1b455-3ee5-4880-a2f2-11a95909b932.
10. Bennett Drake et al., “Against Types: Personality Tests Are Everywhere—From the Workplace to the Courtroom. But Critics Say the Tests Themselves Don’t Pass the Test,” Boston Globe, September 12, 2004, www.boston.com/news/globe/ideas/articles/2004/09/12/against_types/?page=full.
Recommended Reading
If you found this
book helpful in dealing with mental illness issues in your family or circle of friends, I highly recommend the following other titles, which should be easily found in your local bookstore or library.
Burroughs, Augusten. Running with Scissors. New York: St. Martin’s Press, 2002.
Campbell, Bebe Moore. 72 Hour Hold. New York: Alfred A. Knopf, 2005.
Early, Pete. Crazy: A Father’s Search through America’s Mental Health Madness. New York: GP Putnam’s Sons, 2006.
Green, Hannah. I Never Promised You a Rose Garden. Henry Holt & Co., 1964.
Kaysen, Susannah. Girl, Interrupted. New York: Vintage, 1994.
Kreisman, Jerold J. MD, and Hal Straus. I Hate You, Don’t Leave Me: Understanding the Borderline Personality. New York: HarperCollins, 1989.
Mason, Paul T., and Randi Kreger. Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. Oakland, CA: New Harbinger Publications, 1998.
Secunda, Victoria. When Madness Comes Home: Help and Hope for the Children, Siblings, and Partners of the Mentally Ill. New York: Hyperion, 1997.
Styron, William. Darkness Visible. New York: Vintage, 1992.
Thompson, Tracy. The Beast: A Journey through Depression. New York: Plume, 1996.
Torrey, E. Fuller, MD. Surviving Schizophrenia: A Manual for Families, Consumers, and Providers. New York: HarperCollins, 1983.
Whitaker, Dieter. Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill. New York: Perseus, 2002.
Wurtzel, Elizabeth. Prozac Nation. New York: Riverhead, 1995.
Notes
About the Author
Anna Berry is the pen name of a successful journalist, mental-health advocate, and author from the Midwest. Unhinged is her personal memoir of family mental illness, addiction, and recovery. In order to protect her own privacy as well as the privacy of persons described in this memoir, she wishes to remain anonymous. Visit her site and blog at annaberryauthor.wordpress.com.