Tuesday, July 31, 2012

DROP THE INSANITY BID, MAGNOTTA ET AL (DON'T GIVE US YOUR STIGMA!)

By now, we have all heard of several incidents of gun violence setting its cloud over the city of Toronto, as well as the murder and dismembership of a Chinese national student in Montreal, and more recently, a shooter at a theatre in Aurora, Colorado, at the premier screening of the Dark Knight Rising. Reports coming from Colorado indicate a substantial spike in the number of people accessing guns. Reports in Toronto cite the growing anger of people in the vicinities where the shootings, cited as gangland style, have taken place.

How many readers are believing that the shooters ought to be "insane", particularly Luka Magnotta, originally born Eric Newman, as his deed was most dreadful, filming himself dismembering the body of Jun Lin, a Chinese national who had been attending Concordia in Montreal? I don't believe in "insanity". Perhaps, some may want to re-word the term as "mental illness". Nah, don't think so. First, there is no research that shows that people with Axis I Disorders, or conditions that we refer to as "schizophrenia", "bipolar affective disorder" or "schizoaffective disorder", are more prone to commit these kinds of dreaded acts of violence than anybody else. Secondly, we are doing people with mental health conditions no favours by analysing these people's actions as "sick", "crazy" or "psycho".

True, we do need to distance ourselves from the kinds of people who do these dreadful things. We like to believe that we ourselves would never be capable of doing something like Magnotta, or lately, James Holmes in Colorado, just did. But, does that mean these people are "psychotic" or "mentally ill"? It certainly does help things when Greyhound Bus beheader, Vincent Li, suddenly reveals to the police he was "hearing voices" while on the bus, telling him to kill the passenger next to him. I am not sure if I believe this, but that is what the media reports, and what was put forward in the courts. To me, it was just defence counsel doing his job in protecting a client from having to serve a likely indeterminate life sentence for his heinous act on the bus, and unlikely due to any "real evidence" of mental disorder. I am not sure how to explain the behaviours of these people, but to me, citing them as having "mental illness" and being "not responsible" for doing this deed, is akin to saying "the devil made them do it".

We will likely never know what was going on with Vincent Li that day on the bus, but in my opinion, as well as the opinion of many people who watched this scenario cycle its way through the news, his lack of conviction for this offence, and the very likelihood he will be out in a few years is less than what he should have received. By even allowing this kind of "defence" of "not criminally responsible due to mental disorder" diminishes virtually every other person with the same diagnosis, or potentially the same diagnosis, in terms of who they are, and what kind of future they should have. While this business with Vincent Li was flowing through the airwaves and was the talk of the town, I was in the midst of fighting disability claims on behalf of three persons, all with distinctive histories and issues. Due to privilege, I cannot cite the specifics of these cases, but nevertheless, where one could have benefited from an evaluation from one of the consulting psychiatrists that I have worked with, all three declined to get involved with anything even nearly "mental health" related due to the stigma.

I have had others who experienced severe stress and anxiety as a result of their involvement with litigation and/or appeals, who could very well benefit from even one to one counselling with a professional. I was in a position of arranging a third party to take up the expenses of this support service, but still they refused, not necessarily denying they were likely suffering from a form of mental distress, but again, because of the stigma. Virtually all of these people self identified as being very much a part of the community, the workforce, their families and other social spheres, either prior to the matter that led them to my front door, or even still, while they were involved with my office. Many feared they would lose their job if "anybody found out" about this, or would never again be respected by their families, or friends they continued to cling onto.

This issue is coming up at a time where our society is not exactly empathetic towards persons with disabilities - any disability, including mental health disabilities. To add the burden of people like Vincent Li, Luka Magnotta, and James Holmes, on top of the growing antipathy towards people with mental health issues, is not the way to invite people to seek help, even when their problem is severe enough for a short-term hospitalization. They become even more treatment resistant, and they are more likely to hide their personal experiences, even from somebody like myself. I have had middle aged men, though not exclusively, come into my office to appeal a case for Canada Pension Plan disability, or ODSP, who omit any references to any "mental health history" when they explain to me why they believe they should be getting either or both benefits. It is often the case of the "bad back", the "inflamed knees" or "tremours" (and they would emphasize them as they hold their hands up for me to see), but not the lengthy hospitalizations and years of treatment for various mental health issues they want to focus on.

For those who have already been treated for mental health disorders, many are afraid to return to treatment due to the negative effects of many of the medications still used for the treatment of various types of conditions. If you looked up many of these drugs on the websites, you will find many of these drugs are the subject of legal actions, and people are seeking damages for various "effects" from taking these drugs for a period of time. I also know people who have developed severe forms of diabetes, heart disease and movement disorders as a result of overuse of these drugs as well. A dear friend is now reliant on the use of a power chair to access her surroundings. I later learned that she had spent many dreadful years being treated as a guinea pig for "mental health" issues it turned out she did not have. She has paid the price big time, while still trying to educate those around her as to what she could have been, had she not been subjected to these things.

In my youth, I became an avid follower of Phoenix Rising magazine, as well as the early psychiatric survivors' movement. This artefact is still available through the Psychiatric Survivor Archives of Toronto, currently maintained by "veterans" of the early movement, such as Don Weitz, Geoffrey Rheaume, David Reville, and likely Carla MacKague. These same people did not follow through and join the movement of "consumer-survivors" in the 1990's due to the co-opted nature of the funding for these initiatives. In those days, I as well as a small group of people here in Niagara took over the co-opted initiative, and formed our own "mental health survivors' network" that was decidely pro-choice, although not 100% anti-psychiatry. The Niagara Mental Health Survivors Network became a regional, member-based advocacy organization that had several committees, representatives on external bodies, as well as working deeply within the political system to fight for change. As its Executive Director, my function was multi-varied, including counseling individuals and their families with respect to their rights, access to services, and other related issues, such as how to access income support benefits. We also published a quarterly newsletter Niagara Survivors Journal, which reported on various important issues affecting our members. We also gave input to various policy and legislative initiatives. We pushed for "normalization" of expectations among persons with mental health issues, as well as access to supports as needed, and controlled by the individual.

Membership in the Niagara Mental Health Survivors Network was not limited to those who self-identified as having a "mental health disability". Members could be family members of individuals with a "mental health disability", community workers that worked in the "mental health" field, legal professionals, as well as others that gave a damn! Our board still had a majority of its members being persons who self identified as having "mental health issues", as well as the majority of our committees. Over the four years I led this organization, I met hundreds, if not thousands of persons, who experienced various aspects of the mental health system, for the sake of calling it that, here in Niagara, or elsewhere. Some of our members were anti-psychiatry, meaning they promoted the views of writers like Dr. Thomas Szasz, Dr. Jeff Maisson, Dr. Peter Breggin, among others. Others were more traditional in their beliefs, where they saw the value of medication and the mental health system.

However, my work with the Niagara Mental Health Survivors Network, and various other policy levels I was involved with before that, and afterwards, I knew very few persons who suffered one of the more commonly known "mental illnesses" like "schizophrenia" and "bipolar disorder" who had a violent bone in their body. In fact, I knew many so called "forensic patients", some of whom were housed at forensic wards in the prison system, who would not likely be released due to a finding of being "not criminally responsible". The vast majority of those deemed to be "not criminally responsible" were not psychotic in the traditional sense, but were broken in other ways. Their likely final diagnosis was some type of personality disorder, as opposed to an Axis I disorder like "bipolar disorder" or "schizophrenia". These are people we truly do not understand very well. We may some day understand them, but through my interactions with people like this, as well as professionals that worked with them, they were certainly a different mindset than those with traditional "mental health" histories.

I don't support the use of "mental illness" as a reason to "mitigate" one's responsibility or accountability for one's actions. Instead, I support if someone is in need of help, that they be sentenced normally, but treated while incarcerated in a prison system that is geared more to rehabilitation than the semi death row boot camps that Prime Minister Harper wants to set up. We hear that prison does not offer treatment programs for mental health, addictions or really much of anything. I say, why not? I have known people who have been in prison who have been denied care for even physical ailments, such as diabetes and heart disease. This is totally against the Geneva Convention, as far as I am concerned. The overall effect this has is to terrify certain individuals who have done something horrible, who would seek any way out of a life sentence in the barbaric conditions of the modern prison system. This in effect pushes a few of them to try the so called "insanity defence" to see if they can avoid prison, while people outside who "hear voices" and have been in psychiatric hospital who have never hurt anyone, will now be viewed by employers, neighbours, family and others, as somebody who just "might" hurt someone, as the particular diagnosis "schizophrenia" becomes tied to the kiss of death. In fact, a large portion of people with this diagnosis end up dying from suicide.

Throughout my career in the mental health field before I joined the legal profession, I experienced the suicides of many people. The suicide of my older brother is what triggered my understanding of many of these things, and my push to make things better for everybody. Each one hurt just as much as the one before did. The sad thing is that many times, I only spoke to the person a few hours before they finally ended their lives. Before their suicide, their lives were always off balance. Absolutely all of them saw no way out of their situation, whatever that might be ... and quite often, poverty, shame and stigma led them down that path, leaving some crisis or other to break the camel's back and turn their minds to suicide as the only way out. I've experienced suicide among some of my legal clients as well, which continues to bring despair to me. I knew many of them, their issues and their lives well enough to know what likely tipped the balance, but specifics could not be shared with even family.

What I do support however is something that everybody in our community would support if they knew it would make a difference. Social inequality leads to a major cause of mental disorder in the community, and worsens the impact and social isolation of those with diagnosed conditions. Research from the so called Third World has demonstrated that persons with even the most severe of diagnoses, such as "schizophrenia" do well in places where they are accepted and included, as part of whatever community they live in. The rate of "social recovery" from mental health disorders in these types of societies is very high, up to ninety percent in some regions. In the Western world, "schizophrenia" was originally referred to as dementia praecox (which referred to a person who is young and is permanently deteriorating in their personality). Never mind the extensive work I have done in reviewing the history of "mental health issues" and disability, and how eugenics, social isolation and even genocide, was a major issue, given society's view that people with these conditions will never get better.

We need to be open and accepting of people, even if they are "different". We have to put an end to chronic poverty, which leads to homelessness in some, as well as poor health and continued descent into the "black dog" of depression and other forms of mental distress. All people, regardless of their abilities, culture, level of appreciation, and so forth, have to have cause for hope, and a sense of belonging. While I am not a fan of the modern "consumer/survivor movement", it does give an important message to people not in the know. The needs of people with mental health issues is really no different than those of others; they all need a "home, a job, and a friend", just like the rest of us. If we continue to gear our society's direction to isolating people with mental health problems, deeming them to be less responsible than other persons, unable to make choices, and so forth, they will become what we believe them to be. If we continue our attitude of "everybody for themselves", which appears to have been set into place more and deeper since the mid-1980's, we will continue to see a rise in the number of theatre shooters, school shooters, dismember murderers, and so forth.

As Michael Moore explained on Piers Morgan last night about recent mass shootings in the U.S., he cited there are so many more mass shootings on a per capita basis in the United States, even though the prevalence of so called "mental illness" is roughly the same everywhere. Norway had its own whack job last year, that shot and killed about sixty people who were convening on an island for a type of retreat. However, this is something that does not happen to the extent that it does in the United States, and to a growing extent, Canada and Great Britain. To me, people like Wilkinson and Pickett, Author of the Spirit Level, are on to something. It is well known that societies that are less equal than others are prone to these sorts of outbursts of violence, spates of "mental illness", obesity, teen pregnancy, high school drop outs, and so forth.

However, I am not optimistic that things will change soon under our current government structure, with people in power that do not understand how inequality is ruining our nation and vulnerable individuals within it. I listen to Bruce Cockburn's Santiago Dawn http://www.youtube.com/watch?v=kTYTreb4qeU, and it is my dream that someday the society's most oppressed will find their way back home and find a way to belong and to participate in our community, and the jackboot law and order mentality will fade.

Your thoughts?