Saturday, May 19, 2007

The STIGMA in Mental Health is STILL the Same

Did you ever wonder why a student at Virginia Tech would suddenly blow a gasket, take a gun and go around shooting up his school?

How about another fellow who deliberately drank a twelve pack of beer, then walked into a Florida bar with a gun and shot up the establishment?

Of course, you are thinking ... these people have got to be mentally ill. Nobody in their "right mind" would dare to do something like shoot up a school, a bar or a former employer. That is insane!

On the more subtle side, we hear from "experts" that a disproportionate number of people that live on the streets are mentally ill. The implication of course is that such persons cannot stay in housing because they can't manage their money, they say. How about the man that was found in a Toronto apartment building surrounded by pigeons and other wild species - to a point that it got so bad, that the police shuttled him off to a mental health facility and the animal rescue people were called in to get the animals out of there.

Were these people "mentally ill" or is somebody just giving them a label because of their attitudes, behaviour and ideas? Who determined these people were "mentally ill"? Are you "mentally ill" simply because you spent a night in a mental health facility? Nobody knows "Pigeon Man's" mental health history, but they shuttled him off to a mental health facility anyways, so therefore, because he was sent to a mental health facility - everybody now believes that "Pigeon Man" was mentally ill.

How about the rest of the 99.999999% of people who apparently suffer from some type of "mental illness", whether that be anxiety, depression, schizophrenia or obsessive compulsive disorder or a whole whack of other "conditions" that continuously seem to be added year over year to the psychiatric Bible, known as the Diagnostics and Statistical Manual of Mental Disorders, the short term being the DSM-IV? Are all these people like the "Pigeon Man", living among the homeless, or are they like Cho, the infamous Virginia Tech school shooter?

Let me tell you one thing. In a recent report of the Canadian Senate, it was cited that approximately 90% of those who have been diagnosed with serious "mental illness" are unemployed. Whenever somebody with a known "mental illness" wants to move to any neighbourhood, the picket signs go up and the stigma goes full tilt. People scream about the Chos, the Pigeon Men, the bar shooters and all the other horrific characters that are simply part of the 21st Century ... to no avail. People who are open about having a "mental health" history are as good as dead even in 2007.

What is the truth? First, there is NO evidence that people who have been diagnosed with a "mental illness" are any more dangerous than you or me. Second, there is no evidence that people with "mental illness" are any more likely to do stupid, outrageous things than you or me. You point to the "Pigeon Man". I point to Criss Angel, the Mind Freak, who has his own show on A & E, where he has done a string of stupid things, ranging from from lying in the path of a mega-SUV, had himself buried alive in a coffin under a ton of dirt, as well as pretended to walk on water over a swimming pool - all on national TV! We are entertained by Criss Angel, yet nobody carts him off to a mental health facility!

You tell me that people with "mental illness" should be supervised with their money. I point out that I know many well-paid professionals that go to the casino all the time and owe hundreds of thousands of dollars, often resulting in the break-up of their marriages and the loss of their homes. I also know of many individuals who are like you and me who buy a new car every two years, put everything on credit cards, and live the life of envy of most and beyond their means, but yet never get labelled "mentally ill" or told that somebody has to manage their money for them.

What about the homeless, you say? Okay, let's make this one simple and straight forward. Can you manage to pay for a place to live, food to eat and other necessities with a sum total of $536 a month? In most places, this is even becoming difficult to do with an ODSP cheque of almost $1,000 a month. Yes, some of these people may be "mentally ill", but many of them are also physically disabled, blind, suffer from migraine headaches, or not suffer from any conditions at all. Let's be honest about this one. This is an income problem first. Once we resolve the income issue, then we can look at everything else -- too many people with a direct and financial interest in the outcomes of these issues want to put the cart before the horse and receive money for what they do, instead of allowing the people who need it the most to use it to pay for their own needs.

In my line of work, I handle appeals for various kinds of disability benefits among other things. In particular, the appeals I handle for people seeking ODSP benefits are difficult because roughly half of my appellants end up having at least one spell of homelessness while waiting for the government to get their act together. The people that end up homeless have all kinds of disabilities, e.g. very bad backs, multiple sclerosis, arthritis, Parkinson's disease, deaf or hard of hearing, spinal stenosis, cancer, etc. as well as a few that have a so-called "mental illness". In fact, most of my homeless appellants have not had a history of "mental illness". They just have a hard time convincing the peons of government bureaucracy they have a legitimate disability and they cannot compete adequately in today's labour market to sufficiently earn enough money to support themselves on a persistent basis. This has also happened to several of my worker's compensation appellants ... people who held legitimate jobs, but sustained injuries while working that disabled them. The proof is in the pudding. Welfare rates are grossly insufficient for people to live on, let alone maintain a home. Because we often have to fight uphill battles to obtain just about anything else on behalf of these folks, welfare becomes the income of first resort - not last resort - and because this income is grossly insufficient, many fall behind in rent payments and get evicted or lose their homes to forclosure. Some may be able to keep their homes, but end up in a serious debt crisis. I am working with a man who has put well over $75,000 on his credit card in order to prevent what is often inevitable if he were to turn to the welfare system.

Nevertheless, once I do get the appellants on disability and they receive their retroactive back pay, they *are* able to find and secure housing on their own. This includes those with "mental illness", if you must call it that. I don't know of any of my appellants subsequently losing their housing, except for one or two -- one I do recall had an addiction to crack and his behaviour when he was using it caused him to lose one apartment, but nevertheless, he got help (at my urging) and is now housed and has been for the past five years. Yes, these people can and do get housing - however, as I often write in these columns, eating is quite a different matter. This is why a *substantial* increase in social benefits are in immediate order. Third world style malnutrition is not difficult to find among many recipients of social benefits; it's either that or substantially increased health care costs. I know of people who have been forcibly incarcerated in nursing homes because they were unable to afford proper nutrition for themselves and their health suffered the consequences. As a society, we need to consider if we could afford to continue allowing this to happen.

One person once tried to convince me of the alleged inherent stupidity in these folks by telling me that many people on ODSP have to use the direct pay system for their landlords, so that is why they don't lose their housing. That system is actually in place *because* many landlords, upon learning that you are on social assistance, actually demand it. It has nothing to do with the recipient's own ability to manage their funds. I know this because I represented landlords before the Landlord and Tenant Board, which have made arrangements upon the recipient moving in, or as a condition of them staying, to receive direct pay. Some of my ODSP clients also offer this to prospective landlords to make themselves more desirable to rent to ... many landlords still do not like renting to people on any form of public assistance. To add a tidbit to this discussion, the vast majority of people who I helped landlords evict are tenants with jobs, some of whom were making good money. They just don't like to pay rent.

However, in spite of all this, we continue to hear the bells tolling by the so-called mental health sector that want people with "mental illness" to live in segregated housing or to work in jobs created just for them. Despite their goodwill gestures here, this actually adds stigma to the vast majority of people with mental health issues who can and will manage their lives well despite their problems. Many just can't get jobs because people believe the Hollywood images of psychos, or listen too much to the so-called "experts" who have pre-diagnosed people like Pigeon Man and thousands of others through the media before they can turn their lives around. Those people with serious mental health issues that DO get jobs LIE about their histories so they can be hired on the basis of their qualifications only, nor do they DARE ask for accommodations fearing their prospective or existing employers will treat them differently upon learning they have the red scarlet letter on their forehead of "mental illness".

There are other stigma producers, such as those who believe people with "mental illness" all want to live with others who also have"mental illness" or work with them. They create housing that is specifically made for "them", even though none of these people if asked likely will demand this kind of "support" and suffocating lifestyle these set-ups entail. Those in these types of housing are mandated to take their medications, attend counseling sessions and have "life skills" training in areas they likely already do well in. Some of these programs will actually evict someone if the resident chooses to stop taking their medications, for example. To me, this is not a "home". They may as well remain in the hospital with regards to the choices they are given under these circumstances. If one desires supports, they should NEVER be connected to the home they live in and only be delivered by whomever one chooses and in the manner and to whatever extent is desired by the person. This would be no different than somebody who - for example - requires assistance with bathing three times a week and help with light housekeeping, but can manage most other aspects of their lives. These other supports are provided to people because they request them, not because somebody else says they need them.

People with mental health conditions often get sent to work in settings that are disproportionately within the five "f's" - food, filth, filing, fetching and flowers, regardless of the person's own education, training and career aspirations. Some of these settings are non-profit groups ironically set up by other consumer/survivors, as they call themselves today, that will hire people for a few hours a week in these jobs that also smack of stigma. Only a handful of people who work in these places actually hold higher-paid, full-time management positions, while the vast majority remain on their disability pensions, which these organizations ultimately leave out of the picture when they make their calculations of costs for the purposes of marketing their programs, what their actual costs are versus what subsidies they actually get. To me, ODSP subsidizes these programs just as much as any other government funding it receives if people are not likely to get off their pensions or reduce their reliance substantially in a dignified manner. Further, if you or I have a disability and run our own businesses, why are WE not *also* entitled to the same government subsidies these people get?

The real clincher is if somebody worked for one of these places for a number of years and wants to move on, despite any valuable skills and experience they may have gained, they are forced by identifying the name of the employer to disclose to *all* prospective employers that they were diagnosed with a "mental illness". I continue to advise my clients NOT to disclose to employers their mental health history and ONLY disclose this fact AFTER they get hired and ONLY IF they feel they require certain accommodations under the Human Rights Code. In circumstances where job seekers are moving on from these "special programs", they are not given the dignity of this choice. Wearing the scarlet letter almost guarantees a lifetime of unemployment, particularly for those who were not in management or supervisory positions (who may otherwise try to hide behind that fact, because many employers don't think "mentally ill" people are capable of working in higher level jobs anyways).

The chance that a person with a known mental health condition getting hired in a supervisory or management position is slim because when people believe the stigma that people with "mental illness" are unable to manage their own money, how can they handle the money of somebody else or that of an employer? Even those who have been trained and established in a profession have difficulty finding work for employers that would hire somebody in that profession, because again - people cannot envision the possibility that somebody with a "mental illness" is capable of working in a profession, let alone holding a low level job. Remember, they are all homeless, cannot manage a budget, babble to themselves as they walk down the street and don't know any better, right? That is why I am so emphatic about HOW people - including many advocates - express themselves about the circumstances of persons with mental health issues.

As long as the media continues to publish stories about people like "Pigeon Man", the legions of homeless get diagnosed long distance via the media as being "mentally ill", and people like Cho who shoot up schools get labeled as crazy, people with "mental illness" will never be thought of in any other other way. Even those who put forth so called "positive stories", such as a non-profit cleaning company for example that hires only "mentally ill" consumer/survivors, can also plant ideas in people's minds that folks who have been through experiences that society deems to be "mental illness" can only do jobs that fall within the five f's - food, filth, filing, fetching and flowers, and forget ever hiring them to do anything in management or other positions that might actually get them OFF disability and securely housed, let alone actually *own* a home for Christ's sake. Scary.

As a result, society relies on its non-existent social safety net to support these individuals, as nobody seems to want to hire them. Those who are not lucky enough to get on ODSP must survive on a total of $536 a month ... try getting even a hole in the wall for that amount of money almost anywhere. If they get on disability, they usually spend at least 70% of their cheques on shelter, leaving very little left over for food, transportation and personal care. Then, if they have trouble keeping their housing because their income is so low, then we blame them for being poor money managers. If any "middle class" person had to survive on what they get, I am sure they'd have lots of trouble too. But instead, because we want to keep the possibility of homelessness and destitution as far away from our own lives as possible, we try to convince ourselves that the homeless are different people than what we are. So different, that we are willing to shame those who are different into believing their differences is what causes them to suffer their misfortunes - and while doing so, we are only further denying the problems that we and the governments we elect have created. Shame, shame.


Erika said...

Isnt is amazing how everything is now part of a profile and medical disorder?

Tons of pills $$$ but no Cures?

I don't think everyone is mentally ill. I think today's society has become so self absorbed NOTHING makes them happy anymore.

The Advocate said...

Hi Erika,
Thanks for your comment. I am new to blogging, so lots of my stuff rambles a bit. However, as soon as I start getting pictures and things, I will be showing where some of my clients lived - one for about a year until I got him his disability benefits. He had no history of mental illness at all, but was becoming disturbed because some of the others who were sharing this "space" were crackheads -- this is no way to live. I would challenge ANY politician to live on welfare rates, use no other income, cover all their housing, food and other costs just with what is given to them from welfare ... maybe then, if then, they will open their eyes.