Run For Your Life From The Mental Illness Ghetto
'Who put the boys in the club house? You did, baby, you did.'
The song 'Keep a Lid on Things' by the Crash Test Dummies sums
it up. Psychiatric rehabilitation organisations are often there
to simply keep a lid on things (clients' behaviour) rather than
to get them back in the mainstream of society. Their stated aims
are often vastly different from the actual outcomes.
Does the ghetto keep you sick? So it seems. Last year an
Australian research team interviewed people who had bipolar
disorder, and one of the findings was stunning--people who did
not use psychiatric rehabilitation services tended to stay well
longer than those who did*.
If you're coming out of a bipolar crisis, perhaps just out of
hospital, it's worth questioning the value of rehabilitation. If
the only place you go is the mental health clinic, you surround
yourself with others who are sick. It becomes comfortable, you
make friends, there's no challenge, and you will find over time
that you become nervous about venturing into mainstream
activities, like ringing up about a job, or going back to your
sporting club. The longer you are inside the ghetto the harder
it is to break out. Your confidence disappears. People share
stories of being victimised and discriminated against and this
shores up your growing sense that it's too hard 'out there'. You
conclude you should stay in rehab.
The religion editor of my city's broadsheet wrote this last
month:
'Victimhood is a bad address. It's a dangerous and delusory
place and definitely the wrong side of the tracks.
Unfortunately, far too many people live there.
Even if you really are a victim, you have to move out.
Victimhood offers an odd but counterfeit comfort, where nothing
is your own responsibility, where life is something that is done
to you by others, and is beyond your control, yet you can enjoy
the moral high ground... It's a short step from victimhood to
paranoia.'**
Zwartz was writing about race riots in Sydney, but these words
resonated with my experience of the mental health lobby.
Victimhood leads to a sense of futility, a wariness that
prevents fair assertion of our wishes. Countless so-called
advocacy organizations work in the short term, never daring to
jeopardize their funding by pursuing the big picture, the dream.
'Consumer' organizations fare no better. Consumer organizations
are beset with ineptitude not because of illness, nor because of
lack of skills and intelligence. The one thing that undoes the
political work of consumer organizations is the prevalence of
victimhood. These organizations include many people who have
been actually victimized, but too many are stuck in the ghetto
and exhibit ongoing 'victim behavior'. If you cast yourself as a
victim, your requests will never be taken seriously--you're too
easy to say 'no' to.
I believe this is a reason that mental health funding around the
developed world is far lower than funding for the equivalent
level of burden of disease in general health. For example, In
Australia it is only 8% of the total health budget compared with
the OCED average of 12%.
SANE Australia reported last year that stigma was the villain of
the piece, and produced startling evidence to support the view.
In Australia there have been eight State or national inquiries
in the last twelve years. Each time puny progress is made but
the underlying flaw (lack of funding) is perpetuated. As
Einstein supposedly said: 'Insanity is doing the same thing over
and over again and expecting different results.' We need to do
something different. Here is my suggestion:
* Get out of the ghetto and into the mainstream. * Do stuff that
doesn't involve mental health * When you have gotten rid of your
victim outlook, start demanding fair funding for mental health
in your country. Follow up, don't take no for an answer, and
incite all your friends and relations to do the same. * If your
consumer organisation has a victim outlook, you could try to
change it, but expect resistance. People can be codependent on
their organizations.
*Russell, S J and Browne, J L 'Staying well with bipolar
disorder' Australian & New Zealand Journal of Psychiatry 2005;
39:187-193.
**Barney Zwartz, The Age, Melbourne Australia 15 December 2005