Saturday, January 15, 2011

Mental illness, Parents, and Support of Society

I think that many parents struggle to help with their children with mental illnesses as long as the parents are alive. But the fact is, it becomes harder to control their behavior-- harder to get them to take their medicine, harder to make... them get up in the morning, or do the dishes, or go to the doctor. Some parents have been terribly hurt by out-of-control rage attacks by mentally ill almost-grown or adult children. Schizophrenics sometimes hear voices which are terrible and compelling, screaming at them to kill or hurt people they would normally love. We cannot pretend this is easy. I am a gynecologist. I have had mothers with mentally ill daughters come to me in tears, as they strive to help meet the family planning needs of their daughters. These moms know that if she gets pregnant, the primary caregivers for their grandchildren will be themselves-- older and more tired than they already are. Mental health services are also very hard to come by, and no insurance company wants to give this care to grown children, without prohibitive policy fees. Many mental illnesses are waxing and waning in nature, and sometimes the patient needs hospitalization, which is extremely expensive. In Arizona, there is almost no medical care for the uninsured, poor, unemployed mentally ill. In some schools, the school is required to help until the student turns 18-- then they are on their own. Why are these patients living under bridges, and alongside highways, where rape and murder happens so easily? Because we don't want to abridge their freedom! In California, Ronald Reagan emptied the mental hospitals, so that these poor patients could enjoy this freedom-- but no follow-up clinics got set up to help them when they failed to be able to care for themselves! This is blind and stupid, to not look at their need for safety, their fragility and their vulnerability to the terrible curse of mental illness. Their poor parents-- being told to "keep on, keeping on," because society does not want to help shoulder the burden for their care!

1 comment:

Rick Loftus, M.D. said...

I was having a discussion with my partner this morning about this very topic, Martina: How prioritizing freedom winds up putting the well-being of the mentally ill, and thus rest of us, in jeopardy. A local newscast here featured the family of a young schizophrenic man similar to Jared Loughner. They had contacted authorities, warning them about their son's potential for violence. A judge ruled the patient could not be committed. The young man then wound up going on a rampage and shot several people. (The judge could not be reached for comment.)

Like a disease flare with complex physiology, shootings like what happened in Tuscon are "multi-factorial," and include factors such as a climate of violent political rhetoric; insanely indiscriminate access to assault weapons designed to kill a large number of people quickly (and I would say the voters of Arizona have only themselves to blame for that); our health culture's neglect of mental health services; our society's neglect of health care access to the poor and disenfranchised.

Even if Jared's parents had insisted he see a psychiatrist, and somehow found the money to get him to one, there's no guarantee that this would have prevented the shooting. But perhaps it would have. We'll never know.

Thanks for the insightful post.