Reimagining Mental Health

            If I could change mental health care for students, homeless individuals, the imprisoned population, and employees, I would:

Schools

During P.E. in my sophomore year of high school, the coach had the class stand up in a circle. “Take everything off your wrists”, she commanded. A few teens had bandanas and wide bracelets on; they took them off. “Now, lift your hands to the ceiling, wrists facing me”, she said sternly with furrowed eyebrows. Our coach was a short, stout woman with an assertive demeanor that you didn’t want to mess with. She examined each student’s wrists, frowning and shaking her head side to side as she paused in front of some students longer than others. At the completion of the circle, she said “now sit down”. She proceeded to talk to other teachers and coaches in the corner of the gym. The conversation appeared to be filled with disdain and disgust.

No one ever told the class why that was done. Those with secrets under the cloth coverings knew, secret cries for help marked on the wrists of teenagers. There was no follow up to helping any of the exposed cutters. This was forced exposure for the sake of gossip. I know there was no action to help the hurting teens because I was one of them.

Key Facts

School staff members have the opportunity and responsibility to recognize and act on warning signs of mental crises in students, not ignore or criticize emotional battles. While Social and Emotional Learning (SEL) is implemented in public schools, it is not the same as mental health care. There must be a greater emphasis and education on mental health care in schools. We need a ratio of more psychologists to less students. These trained psychologists should then act to educate both staff and the student body to recognize and treat mental illness in the school.

Homelessness

The other night, despite better judgment, I rolled my car window down for a man holding a “help me” cardboard sign. Oftentimes, I will ignore these beggars because of past negative experiences, but I gathered some change and choose to be unafraid and helpful. I still am shocked at my audacity when I said, “Your eyes are super dilated. Are you on drugs?” He replied, “I have schizophrenia. I just take meds for that”. He was so quick and upfront that I believed he had schizophrenia. Perhaps, he was on other drugs but I figured his mental illness had a lot to do with that “help me” sign and I felt at peace with giving him a handful of change.

Many people with mental illness have poor insight into their own condition and how to best take care of it. They may have cognitive difficulties that make navigating both the health care system and taking care of their basic needs nearly impossible.  

Key Facts

While the mental institutions of the past had a lot of problems, we should have a re-institutionalization of the homeless that are mentally ill. We can do it in a way that doesn’t repeat the mistakes of the past and creates a better present and future for all.

Jail

Another population that could benefit from re-institutionalization is the mentally ill in jail. Initially, there would be an increased cost but after transitioning those in jail to safe, ethical institutions, I believe the overall cost to society would significantly be less than the current situation.

I have heard and believe that jail doesn’t rehabilitate people but makes them worse off. Someone once told me that jail is “drug school”, a place to be educated in illegal drugs and crime.

Key Facts

  • 37% of inmates in federal and state prison have a mental illness
  • 66% of inmates in federal prison report not receiving mental health care treatment 
  • Lasting effects of incarceration: PTSD, anxiety, impaired decision making ability; in prison there is loss of purpose and autonomy, family disconnection, poor and cruel conditions, exposure to violence, and solitary confinement which in itself lead to permanent changes to a person’s brain and personality.

While I agree with appropriate punishment of crimes, jail doesn’t seem to be an appropriate place for those with a mental illness. It seems like the mentally ill aren’t just being punished for their crimes but for the mental illness that contributed to the criminal act, and the punishment makes the illness worse. I believe crime would also decrease with improved care for the mentally ill.

The Work Place

“I am not ok”, I said with tears in my eyes, “I need some kind of help”. With irritation in her voice and degradation in her eyes, my boss said, “I’ll find the number for employee assistance, now put on your big girl panties and get back to work”. Her response increased my suicidal ideation.

Key Facts

  • Depression is one of the leading causes of disability worldwide.
  • Depression & anxiety cost the global economy $1 trillion each year in lost productivity.
  • 80% of workers are afraid to be punished if they ask for a mental health day.

Employees and employers would benefit from normalizing and respecting mental health care needs. It would increase productivity and employee satisfaction. It could possibly even increase the number of people in the workforce by decreasing the need for disability due to depression!

            All of society would benefit if the mental ill were better cared for in schools, the streets, jails, and the workplace.

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