TandC Associates, LLC

Continuing our series on lessons provided by the never-to-be-forgotten Forgotten People, we identify the following:

Lesson #2 – The needs of mentally ill are really no different from anyone else’s.

A major shift occurred in the mid-1950’s with the advent of psychotropic medications. I became aware of the first result of this medical advance when I returned to my summer job as an attendant at Westborough (MA) State Hospital to discover almost total silence. This was in stark contrast to my childhood memories (growing up on the grounds of this institution, where my father was Clinical Director and my mother was a social worker).  It was also 180 degrees away from the sounds I had heard during my first summer on that job — of a constant roar of screams.

The second very important result of the “Thorazine Revolution” was the advent of de-institutionalization, whereby literally thousands of both short- and long-term hospitalized patients were discharged to the community.  Unfortunately, there were few opportunities available for discharged patients to receive other than a kind of “custodial” care out of the hospital.  This lack of transition services (from hospital to community) often meant people were left homeless, unattended ,and by-and-large unnoticed — except for a once-a-month or so clinic contact to obtain refills of their medication.

Men and women with mental illness, however, want the same things as the rest of us: a home, a chance to go to work and be productive, friends, and a name. Dorothy, a Fountain House member (consumer) probably stated the issue of anonymity the best:

From the start (at Fountain House) everyone called me by my name.  Both staff and members, people I hardly knew, called me Dorothy.  When you are homeless and on the street you never hear your name.  It was a privilege to hear it. It felt good.

John D. identified the importance of seeing patients as people in this way:

Any alternative to the mental health system must respond to basic needs, which, in the view of the patient, usually go unfulfilled by the present array of services.  That many needs are unmet is clearly indicated by the high readmission rate of discharged patients who are sufferers of severe social and vocational disability.  Though traditional approaches to long-term illness – treatment, both psychotherapy and drug, and case management – are of genuine value in personal recovery, a third component has been found to be of help by a large number of patients of varying backgrounds, almost all of whom have undergone lengthy hospitalization. Underlying this last-mentioned approach is the belief (emphasis is mine) that the needs of the “mentally ill” are very much the same as those of the “non-mentally ill,” and require identical opportunities most successfully utilized in a supportive environment not identified as therapeutic and equally nourishing to the non-mentally ill.

Ronald was hospitalized from the age of eight to 19. Years later he offered the following testimony before a Congressional Committee:

One of my co-workers…a social worker, said something one day about his two children who had just finished college. He said he didn’t see too much difference in them after four years of college… I liked what he said because it also referred to me and my fellow (consumers)… 

How quickly do we have to change, be trained, to live independently in the community, to be treated, to no longer be chronic, no longer socially and vocationally disabled?  We have had an illness not yet understood, and we have had all kinds of medical treatments through the years.  Many of us have had many hospitalizations or spent many years in mental institutions. Our lives have been influenced by these experiences, aside from whatever our illness has done to us.

We need, therefore, to be with others who believe that we are not at our best and that sufficient time will be given to us to be at our best, maybe as much time as the non- mentally ill have in order to achieve whatever their potential might be.
One way to help us continue to fail is to expect a kind of miracle, an almost instant change, in a very short period of time. Or to believe that we cannot change, are forever chronic, always dependent, to be taken care of, to be officially segregated from our society by being evenly distributed so we don’t “overload” any one neighborhood or place.

Maybe if all of us patients who are chronic and need help in the community could become little again, it would be easier for everyone to solve the problem. I don’t mean to say we’re children, but I’m thinking about a family and what seems to go on there, at least I think so, and how this could really help a lot of chronic patients in the community.

So nowadays it comes as no surprise to hear these hopes, wishes and dreams, but back then “A Beautiful Mind,” had not been written or turned into a film. Or many other stereotype-crushing portrayals of lives lived in spite of – or even because of – mental illness.  And now with the sophisticated development of psychotropic medications, many present day consumers of long-term mental health services can increasingly achieve their aspirations, enjoying a higher quality of life than prior to the days of  civil rights and subsequent de-institutionalization movement for the mentally ill.

Again, TandC Associates reminds the reader that this abstract is from a larger composition, pending publication.  Any quotations or references to it must be made with the express permission of the authors at the URL or our e-mail below:

tandcassociates@gmail.com

 As always, we at TCA invite readers’ responses and feedback on this posting at the same sites.