08 September 2019

Mental Illness Is Not a Political Football

by Mary Fernando

I have previously written about the myth that those with mental illness are dangerous. Spoiler: they are not.

What is happening now politically is very concerning. Politicians are blaming mass shootings on mental illness and – as I cited before – Dr. Michael Stone, a forensic psychiatrist at Columbia University who maintains a database of 350 mass killers going back more than a century, has found that only one in five are psychotic or delusional. This means that 4 out of 5 mass murderers are people who are clinically sane.



Why do politicians blame mass murders on the mentally ill? Many agree with Fareed Zakaria that “turning immediately to the "sickness" of the shooter and piously calling for better mental-health care is, more often than not, an attempt to divert attention from the main issue: guns.”

This may well be true but it is damaging to label those with mental illness as dangerous to society. The prevalence of mental illness is difficult to nail down but “Around 1-in-7 people globally (11-18 percent) have one or more mental or substance use disorders. Globally, this means around one billion people in 2017 experienced one.”

This means that when we think of those with mental illness we should think of our family members, our partners, our children our friends and neighbours because that’s where you will find them. Or not find them because many hide their symptoms and suffering for fear of - you know - being labeled dangerous. That’ll certainly send someone into hiding.

Worse - mental illness is being used as an insult to those with political views we disagree with.


This is my tweet from this week:






tweet

The politician my tweet was directed at is not as important as the patients this politician’s tweet was directed at: those with mental illness have become the scapegoats of politicians.

Paraphrasing MLK gave me pause. However, his writings are filled with empathy for those suffering from discrimination and I thought that it might be appropriate to use this for this very maligned minority.

What I want to address is my dream: blaming and insulting (along with the unrealistic depictions in books and on screen) presents a very unrealistic portrait of those suffering from mental illness. After a long career of treating mental illness, I can describe them with some degree of confidence. They are just like you and your family, friends and children. They have the same wonderful qualities and the same vulnerabilities, the same bad jokes and the same hilarious ones. I could go on, but you get the picture.


I feel I must say this very loud for the people at the back: mental illness is a medical diagnosis no different than that for diabetes. It requires diagnosis and treatment and both should be given with care and compassion. Just like someone with diabetes or cancer - everyone with mental illness will have their own unique personalty but not the ones that politicians try to give them.

I was pondering - ok, I was fuming - about this issue the other day and thought about the origins of medicine. Originally all disease was thought to be in some way connected with the evil doings of those who are ill. So, diabetes, cancer and depression fell into the same category: “In prehistory, people believed that pain and disease originated from evil spirits. Disease resulted when these evil spirits entered the body. Witch doctors and shamans were employed to exorcise wicked beings…”

The belief that illness is caused by evil spirits taking residence in a patient changed when modern medicine discovered the actual etiology of physical illnesses. However, some still think that there is something evil in people who have mental illness.

Today many use the term ‘mental health’ “… to reduce the stigma surrounding mental illness, and said ‘illness’ reinforced prejudices against asylum patients because it implied segregation between the sick and the well. Focusing on health countered a persistent misconception that only some people are prone to psychiatric problems.”

This terminology is a double edged sword. Focusing on what is healthy in these patients is a good thing. However, there is value in identifying an illness. To tell a patient they have a physical illness is often a relief because they finally have an explanation for the symptoms from which they are suffering. They can explain this to those close to them, and get comfort and help when the symptoms flare up. The same applies to those with mental illness. I have found patients are immensely relieved to finally have a diagnosis and treatment plan. I have seen their relief when they can speak to those they love and get support in the same way those with physical illness get to lean on those in their life. 



 I’m comfortable with the term ‘mental illness’ and also happy to use the term ‘mental health’ if people prefer. What I want is to end the stigma, to treat each patient as just that: a person with an illness that can be be diagnosed and treated. The illness doesn’t define the person. Their character defines them.

5 comments:

janice law said...

A good post. We've come a fari way from attributing mental illness to demons, but clearly not quite far enough.

O'Neil De Noux said...

I agree. Character defines them. Our problem, as the poet Brian Bilston puts it – "America is a gun."

Eve Fisher said...

I agree. But we have both trivialized and criminalized mental illness. 90% of the inmates I work with have addiction issues; at least 40% suffer from some sort of mental illness, from depression to bi-polar disorders, and most have never received any treatment; and the number of mentally disabled people who are locked up is appalling, enough to shame our nation forever.

Leigh Lundin said...

Wow, Marie, what a challenging article. Some might argue those evil spirits didn't enter the mentally ill, but the politically-minded. Setting aside the thought that wanton killing an insane act, have we seen a time when insanity hasn't been politicized?

Not being able to 'see' emotional and mental illnesses like we can physical trauma allow simple-minded and simple-messaging politicians to exploit the situation. I've heard professionals like you say that a dollar spent on treating mental illness is more productive than a dollar spent on physical issues, and at times treating the one helps the other.

We have a sad history of using prisons to house the mentally ill. For a while in the mid-20th century it seemed we might obtain enlightenment, but with the closures of public mental health facilities, we've returned to warehousing people in prisons.

Yet another part of the problem is political abuse of statistics or, in some cases, wholly fabricated stats. Remember the grim joke– 98% of statistics are made up. Part of that problem is that experts' voices are seldom heard giving distorted information on homicide victimology, rape and false rape, campus crime, and of course, mental illness. The gap between what we think we know and actuality is dismaying. The motivation is manipulation through fear.

Turning to criminals who are mental ill, a specialist in criminal psychiatry criticized Dr. Phil for saying those convicted of sexual crimes can't be cured. This doctor, another Canadian, I believe, said so-called common knowledge was often wrong. He went on to say without any treatment, nearly a third of patients (30+%) never reoffend. The United States too often drinks from the fountain of Calvinism. It doesn't much believe in mentally treating inmates, and the results are predictable.

Leigh Lundin said...

PS. Mary, I know you worried about framing and phrasing your article, but it's beautifully and sensitively done. Nice!