It’s enough to make your head spin, these two posts I read one after the other with my morning swear words. Liberal bastion Thorn in my side Huffington is screaming for forced drugging and involuntary commitment (Britney, et alia) —
It’s outrageous that she was released from the hospital …all the experts say she needed to have been held for a minimum of 30 days!
while the wingnutty Washington Post says flat out that the medical model has got to go.
Here’s the problem: The WaPo piece says nothing about forced commitment and the HuffPo piece says nothing about the medical model; but I can say with assurance that these 2 posts are general critiques of the other, that in mental illness discourse we shake out on partisan lines and this has got to get more explicit or it’s just circular wankery and talking past each other.
There is a disconnect underlying most of what passes for learned opinion regarding mental illness in the blogosphere. The disconnect is on writers who don’t know what they’re talking about because they haven’t done their homework. Pundits should be conversant with the various models of mental illness and the body of scholarship that underpins each, at the very least they should recognize when they are promoting the medical model, and what that means, because when you don’t understand something you can make it mean anything. Is that too much to ask? So of course when a knowledgeable commenter like the following comes along and offers a recognizable critique he is shot down for being a pedant, complicator, and delusional ex-patient with an ax to grind:
No other medical condition is the basis for incarceration. Those of us with mental illness are denied rights that everyone else enjoys. Thanks to people like you who have no concern for our rights and have no understanding of our illness, we are singled out, stigmatized, imprisoned, ridiculed and ostracized.
…Were it not for you and those who are likeminded singling us out in the ways just described, we might be more accepting of ‘help.’
That comment in the Huff post is an implicit smackdown of the medical model. The same model explicitly identified and shitcanned over at the Washington Post today:
Larry Davidson, a Yale researcher on recovery from severe mental illness, has examined the data and found that this model is flawed, at least in the field of mental health. “In the medical model, you take a person with a mental illness, you provide treatment in the hopes of reducing symptoms, and then they’re supposed to approximate some notion of normality,” he told me. “Our research shows the opposite. You take a person with a mental illness, you then reduce the discrimination and stigma against them, increase their social roles and participation, which provides them a reason to get better in the first place, and then you provide treatment and support. The issue is not so much making them normal but helping them get their lives back.”
These are fighting words. They sound so benign that it’s easy to overlook that fact, that when we hear someone talk about social support, engagement, participation and community roles they are not speaking in a vacuum, and they are not talking about a subordinate adjunct to the medical approach, but invoking an alternative, social model of distress and recovery, which has all but been silenced by the dominant paradigm whose signifiers are doctor, hospital, medication, stabilization, biology, genetic, heredity, bloodlines, as in tainted, etc. These are the dogwhistles that point to a belief system known as the medical or biological model of mental illness. So it’s about language, and learning the words that the bad people use.
Is this necessary? Why not just say, gosh, with so many conflicting and complex models to choose from, why not have the consumer do the homework and direct their own personal care and treatment, whether medical or alternative or an eclectic mix of both, or decline all of it and que sera. But to make this assertion is itself a partisan stand, because any alternative to the medical model will, by definition deviate from the medical model, and that’s the mortal sin. It’s not the particular treatment choice under fire, but choice, period. And so every alternative falls under the single rubric of “filthy hippy healthcare” coined by medical model monster E. Fuller Torrey, who wants you to believe irresponsible advocates would force bipolars off their evil meds, when what we actually demand is that bipolars be empowered to make fully-informed decisions ourselves, without penalty, and with the understanding and expectation that we will make mistakes and change our minds just like everybody does, with the same right to learn the hard way, while do-gooders suck it up and wrench their garments in dread, too bad, so sad.
I’m pretty sure the WaPo author would agree with me; his piece indicates we share the same politics, the HuffPo author not so much, because oddly enough we don’t. Once again it looks like I dared to take the true blue liberal stand on a mental health matter at a liberal blog. Or thought I had. I don’t even know anymore.
As long as I’m free to complain and orient myself like this I’m happy that people are talking more openly about mental illness in the blogosphere. I can’t say why anyone would deny their own bias, but I know one way to shut down the opposition is to pretend there is no opposition, and some people do operate in total bad faith like that, but maybe others just don’t understand enough about the terrain they’re on, and deserve to be given benefit of the doubt while they navigate the learning curve, yes, with feet held firmly to the fire, on notice that teh willful stoopid will not be tolerated without one minute of surcease, seriously, it’s embarrassing. An opening salvo? Yes, I’d be delighted:
Mental illness is a political issue.
Will political liberals kindly step up and take THE goddamn LIBERAL POSITION?
There was this dreadful piece in the NYTimes regarding Britney–mentally ill flavor cause of the month and how evil it is to let people simply leave the hospital when they choose. Seems the writer was in a hospital and left. She thinks now she should not have been able to sign herself out. Might it be she regrets what she freely chose to do?
What she was treated with respect and has now developed some sort of desire to be controlled.
Obviously she wasn’t that ill and she chose to return to shooting H and living like a wild child. The choice may have been hers all along. Isn’t it better to blame and illness rather than accept full responsibility for yourself when it isn’t the illness talking?
I am not sure alcohol or drug addiction is an illness. I know I have opened the can of worms but it appears to me that mental illness–I am dysthymic with a few major depressive episodes under my garter belt–is a whole lot different than drinking and drugging.
What the hell do I know. I know me and can’t say what is best for anyone else. No sir, don’t want that job.
JS Mill is right. If Britney wants to drive fast and take pills and lose custody of her children she is choosing to do that. It isn’t the mental illness–which I am not sure she has, I have never met the woman–talking or acting. She chooses to harm herself, manic or not. She knows somewhere beneath the money and the fright wigs.
If she harms her children with her behavior, take the children. They don’t chose to get in the car with her. But if she harms herself, she is to blame. Does she know what she is doing? She does once she hears that she is bi-polar and understands what that means. We can’t lock her up against her will. We may actually prevent her from taking responsibility for her mania and her depression if we do. Only she can decide if she is going to treat herself with respect. And we have no responsibility but to treat her with respect.
If she is clearly willing to injure others, however, she isn’t bi-polar but psychotic and we have to protect ourselves and her from hurting us.
I arrived at this not only from reading Mill’s On Liberty but from leaving the medical model that suggest that I need to learn to get along with other people. As I have been told by my shrink, perhaps I don’t play well with others because the others aren’t worth my treating them well.
Think about it.
“Thorn in my side Huffington is screaming for forced drugging and involuntary commitment (Britney, et alia) while the wingnutty Washington Post says flat out that the medical model has got to go.”
Living in Bizzarro World is exhausting, no?
There’s so much wrong with the Britney story, but here’s the obvious problem. Britney had a childhood similar to Jean Benet Ramsey’s. It’s troubling that any parent would raise a child like that. Terrifying that when the child has become a wealthy and powerful adult, her abusive parents can take control back of her life. This grown woman doesn’t even have the right to talk to a lawyer without her abusive captor father’s permission. The only reason she has spoken with a lawyer is because her manager broke the law to let her. It’s terrible that the law would allow such a predicament.
The “liberal” idea that we should “help” and not punish people who are different from us is rooted in a sort of good impulse, but is evil because it doesn’t go far enough. The real liberal position ( I’m not asserting no one on this blog has ever asserting this idea before) is that we should accept people who appear different from us on the surface because in the end we are all human and each entitled to the same rights, each bound by the same laws.
I could go for some “filthy hippie healthcare” right about now. Went to the nurse having a panic attack in school, the nurse told the principle even though I wasn’t threatening anyone (Confidentiality? What’s that?), I tried to leave the building and they called the cops on me, and now I’m in the hospital posting from my cellphone. I should be out in a couple of hours, unlike last year’s hospitalization nightmare, but damn, what’s with all the people trying to ‘help’ against my will? Nobody feels like they have to respect the mentally ill, or even tell them the truth. Well, not “nobody”, but you get my point.
Jesus, what are these people thinking? Used to be standard operating procedure to go to the nurses office when in distress, lay down on a cot in a quiet room and let the trouble pass. Police state, and America asleep at the wheel.
FP- when my daughter had a panic attack and went outside into the parking lot in junior high, i got a call : “Get here in 5 minutes or we call the police to get her”. WTF I drove 55 pmh down a 35 zone to get there for that. She was not doing a damn thing to warrent police incident, they called it “safety on campus”, and also told me it would be in her file that I was to go get her EVERYTIME THEY CALLED ME WITHIN 5 MINUTES or it was the cops.
Sadly, I was working in the same school district, and got the call, and had to leave my job in their district to get my daughter. So i took her back to the elementary school where i worked.
next day, i held a meeting with the principal and told him if that happens again, it will be front page news. Since i’d already been on the front page, i held it over their small-minded asses.
This is a great article, thanks for writing it.
what kills me is that there’s been a critique of the medical model for quite a while — what? since the late 60s anyway? it’s as if someone just thought it up yesterday.