New Freedom Commission on Mental Health
One of my assignments for my practice class is to keep a journal of things that come up for me during the semester. I haven't been very good about it and I'm trying to catch up.
In my policy class, we have been discussing Bush's New Freedom Commission on Mental Health. From the opening letter:
On April 29, 2002, you [Mr. President] announced the creation of the New Freedom Commission on Mental Health, and declared, “Our country must make a commitment. Americans with mental illness deserve our understanding and they deserve excellent care.” You charged the Commission to study the mental health service delivery system, and to make recommendations that would enable adults with serious mental illnesses and children with serious emotional disturbance to live, work, learn, and participate fully in their communities.
Generally, the recommendations are a good start toward better policy and don't pull too many punches about the current state of mental health care. However, I find that I have real issues with the premise on which the commissions findings are based: "After a year of study, and after reviewing research and testimony, the Commission finds that recovery from mental illness is now a real possibility." It seemed that I was the only one in class who took issue with the use of the word recovery.
How exactly does one reduce or remove stigma from mental illness if official policy states that recovery is possible? What exactly constitutes recovery? My instructor suggested the definition of recovery is being able "to live, work, learn, and participate fully in their communities." Really? That's an interesting definition. Do you think if you talked to someone with diabetes who has their symptoms under control with insulin shots and dietary restrictions if they had recovered from diabetes they would say, "Oh, yes." Do you think if you asked someone with schizophrenia who has learned to manage their disorder with medication and counseling if they feel they have recovered their answer would be yes? Of course not. They would both tell you they have learned to manage their illness. Recovery is when you can stop taking pills and you don't have to worry about symptoms returning, like, oh, gonorrhea. Ten days of antibiotics and you're good to go. Otherwise, if the cessation of pill popping precipitates a return to a prior dysfunctional state, it's not recovery. It's managing your illness. Redefining recovery to mean "symptom management" doesn't do anyone any favors. It only muddies the waters and complicates and already complicated issue.
Someone in class said they were offering hope. I'm sorry, but what good is hope if it's a false hope? Do you think a client who has bi-polar tendencies is going to be just a tad disappointed when he learns that your definition of recovery includes taking pills daily for the rest of his life that may also make him feel lethargic and interfere with little things like his libido? By stating that recovery is possible you're still saying it is not okay to have a mental illness. How many of you balk when the person you're dating reveals they're on psychotropics? Why? They're recovered, right?
Policy makers and insurance companies are so enamored of the medical model of disease for mental health. They want it predictable and measurable. Like the medical world has all the answers for it's own domain of problems. The ultimate goal is to find a pill for all that ails you. None of that costly long term therapy. "Do you find yourself boiling your paramour's pet rabbits? Do you spend hours hiding in the bushes near the home of your latest obsession? Have you ever come completely unglued and beat your child with the forbidden wire hanger that found its way into your child's closet? Then ask your doctor about antifatalmominase, our new anti-borderline pill. Side effects include nausea, vomiting, anal leakage, migraines and high blood pressure. If you find yourself having hallucinations contact your doctor immediately as this may indicate a rare but serious side effect that could lead to a murderous, psychotic episode."