RSS

Tag Archives: rehab

Shameless

The University of Colorado, Denver has been conspicuously silent about their former graduate student turned gunman. There’s nothing particularly surprising about that. Universities are loath to discuss their students or alumni unless doing so will bring glory to the institution. Universities are also part of the elite group of organizations known as suffering from acute “litigation paranoia.” But onlookers accept the silence as being a vague yet misguided attempt at protecting someone’s privacy.

If what we were discussing was a physical disease or impairment, patient privacy would be a valid and even laudable motivation. As a society we’ve determined that patient privacy, even when a diagnoses could involve potential contagion, is necessary. We’ve also determined that when a disease poses an imminent public threat the afflicted will be quarantined (and thereby outed.)  In other words; public good trumps the individual. On the most basic level we apply this same principal to mental health as well. If a person states (unequivocally) that he/she is going to hurt him/herself or others, they are held (usually for a very short period) until they can be examined and either sent on their way or hospitalized.

This flaccid approach to protecting individuals and the public stems from the deinstitutionalized of mental healthcare several decades ago. The “expression of specific harm” is employed to prevent people being hospitalized against their will. One only need sit with the preceding sentence a bit to see the absurdity of this approach. People struggling with mental health issues rarely are clear and conscientious enough to seek hospitalization on their own. We leave it to the ill to state clearly their intentions to do harm before highly trained professionals are allowed to intervene. That’s a problem.

Adding to that little issue is the fact that we are freaked out by mental health issues. Yes, we’ve been Oprahfied enough to (sometimes) toss around the right terms. But we are glaringly uncomfortable dealing with real life mental health. If we see someone, day in and day out, who we consider odd, what do we do? Maybe we mention it to a friend, but beyond them who would we actually tell? And what is exactly do we say? Is the guy who only comes out at night and keeps his door covered in aluminum foil a danger to anyone? Are his odd behaviors actually highly honed coping skills for his illness? Maybe he sees a psychiatrist every day and is adequately medicated. Maybe he’s just eccentric (versus ill.) More often than not, we say nothing and just hope to avoid someone who makes us uncomfortable.

There is somewhere where aluminum foil should send an observer directly to the phone, and that’s at a university. Most students (graduate and undergraduate) are under 30 years of age; a primetime for the onset of very serious mental illnesses. Students are often sent away to school already presenting symptoms and perhaps fully medicated. The beauty of a controlled environment (like a university) is that elaborate and accessible systems are in place. A professor who observes disturbing behavior knows exactly how to report it immediately. No doubt, they sometimes do. But too often we err too heavily on the side of our own discomfort (which we shroud in “patient privacy” rhetoric.) It’s very unsettling to be the person who may upend someone’s life. However it’s far worse to be the one who stayed silent.

When we stop seeing mental health issues as being somehow shameful we will be a safer and more humane society. When newsreaders no longer intone (in sotto voce;) “He even spent time in a mental hospital” we will be further ahead. When a political candidate gains sympathy points for a spouse with a physical illness and looses popularity for one with a mental illness, we will be further ahead. When we stop using the word “rehab” (invoking images of large sunglasses and hangovers) as a euphemism for mental health facility, we will be further ahead. And when celebrities stop claiming to be suffering from “exhaustion” (as if it’s the 1900s) versus having depression, we will be much further ahead. There is no shame in illness of any kind. The only shame is silence.

 
Leave a comment

Posted by on August 27, 2012 in Cultural Critique, Education

 

Tags: , , , , , , ,

What Would Bill W. Do?

Not too long ago, there was some media buzz about the efficacy of addiction therapy.  This is not a popular subject.  If one works in the rehabilitation (rehab) industry one is understandably resistant to any metric devices that might prove the methodology ambiguous.  Addiction is a very resistant phenomenon.  There are occasions, when a society of thinking people can agree, that lacking a 100% guarantee, erring on the side of empathy and care is optimal.  For some addicts, the simple act of stopping something in motion, is enough to change their lives.  Rehabilitation can be that barricade.

Addiction to alcohol, drugs or eating disorders has never seemed quiet or private to me.  I recognize someone in the throes of the phenomenon (whether they are using or not.)  People with a Faustian relationship with food are very obvious to me, and I completely understand the entertainment value of metaphorically playing with one’s food.  Of course, when it spills into passive suicidal tendencies, all bets are off.  It is torture to be in the life of an addict.  Addicts can be very unpredictable and by definition, not reliable (their primary relationship is to their addiction.)  Empathy can wear thin after multiple incidents.  It is helpful to remember that people use drugs, food, and alcohol to the point of personal destruction, NOT because the substances or processes are so tempting, but because without them, life would be unbearable.  In other words; drugs, eating disorders and alcohol work.  They numb and distract from an inner pain that for some people is devastatingly crippling.

Posh rehab centers are part of the American lexicon.  Most of us can rattle off one or two without thought (Hazelden, Betty Ford.)  Colleges and universities now address eating disorders via education campaigns, marketing (‘all you can eat’ dining have been replaced with ‘all you care to eat’ dining) staff training and additional counseling staff.  Certainly excessive/binge drinking (which can be an indication of alcoholism) has been the bane of higher education for some time (drug abuse, because of its inherent illegality poses more of a conundrum.)  Employers contracting with treatment providers has become de rigueur.  Clearly, there is treatment available for some.

But what of the veterans?  Veterans are returning, and mercifully will continue to do so in even greater number now.  They will come back to what kind of treatments and where?  This week it was reported that 1 in 5 suicides is that of a veteran.  Now, I’d be the first to say that NOT screening people for mental illness before enlistment is absurd.  But regardless, we have a problem here.  I don’t mean to imply that veterans (or anyone) who commits suicide is an addict.  Not at all.  But there is overlap.  Suicide, most often, is not a well thought out end of life plan, but an act of someone who feels they have no options.  Addiction is also the result of feeling there are no feasible options.  Teaching people to recognize their pain for what it is, and providing them tools to pull themselves out of that pain, is effective.  Rehabilitation, at its best, does just that.

So what’s our plan?  If rehabilitation is accepted by the wealthy, the educated and corporate America, as viable treatment for addiction, shouldn’t it be available to all?

 

 



 
Leave a comment

Posted by on October 12, 2011 in Cultural Critique, Well-Being

 

Tags: , , , , , , , , , , , , , , , , , ,

 
Follow

Get every new post delivered to your Inbox.

Join 1,897 other followers