I have two sons with mental illness and worry all the time that they could end up homeless when my husband and I are not around anymore. Or even before, as they are adults and a psychotic break could make them unresponsive to help.
I have so many friends in the same boat, friends made during 20 years of advocacy. I’m going to work till I die to motivate people in charge to develop a humane healthcare system with equal attention to serious mental illness (SMI). We’ve gotten as far as a determination, a few years ago, by the Supreme Court in Washington, DC that people with SMI do qualify under the ADA for care, just like people in wheelchairs or with intellectual disabilities. Appropriate accommodations and care for them are required by law (Teresa Sheehan vs. San Francisco).
Enforcement is the difficulty. Funding is the difficulty. Stigma. Ignorance. I hammer away on the computer, writing to politicians and the powers that be to do something help the SMI to get off the streets and out of prison, into the proper care and supportive housing. I wish I were a great novelist and could sway the public, but that power is a gift not enjoyed by many people.
I was just reading about Dorothea Dix's visit to the jail in Boston where they kept the female "lunatics" in the cold, damp basement with no heat throughout the winter. She got the mentally ill out of jails, cages, closets, and other locked basements. She shamed the legislature with her investigative journals and persuaded people to contribute money to build decent asylums with the humane treatments available at the time. All that, when women weren't supposed to speak in public (the 1840s and 50s).
I used to dress up like Dorothea at hearings at the city hall to draw attention to the tragedies playing out in San Francisco every day. Once I pinned a photo onto my long black skirt of a young man with schizophrenia who had delusions of being followed by the CIA. He was trying to hide from “them” behind a bus. The bus driver didn’t see him, backed up, and ran over him.
With only three minutes allowed to speak and our group scheduled to speak last, I hoped to wake the supervisors up to this needless accident that had taken place right outside their building. I found that the best use of such restricted time was to ask each of them what they would have me do if I found them helplessly sprawled on the sidewalk, delusional, psychotic, and in dire need of help.
“Would you have me call the police?” (You may be shot, especially if you have anything that resembles a weapon — so few officers have the training, patience, or the ability to deal with the SMI and will plead in their defense that there was a danger to themselves or others.)
“Would you want me to just walk on by and ignore your distress?”
“Or, if there were a mobile crisis team available (the big if), wouldn’t you prefer that I called trained, empathetic mental health professionals to come and help you figure out the next step to take. Perhaps contact your doctor or take you to a psych ER if you are a danger to yourself or others?”
I knew the supervisors wouldn’t answer, but they did seem pensive.
Some people “get it” and some don’t. I keep reaching out for the people in power who do want to provide humane and evidence-based care for the SMI. One day, we’ll get to the tipping point. But it’s a tug of war. A big step would be to reform the entire healthcare system and make it available to all Americans for every illness, so I’m pushing for national, universal, or Medicare for all — whatever you want to call it. Also, for more subsidized, supportive housing. It might be the one good thing that comes from this pandemic — the realization that nobody will stay healthy unless the healthcare (including mental healthcare) umbrella covers all of us.
Thanks to everyone out there who is trying so hard. I’m grateful to all of you. You’re not alone. I’m not alone. It helps.