Those People with Mental Illness

I spent some time in a mental health facility this past week. It was not the first time.

Even as I write those words, I realize that there is potential scandal attached to them. Someone might read a little and misunderstand. Rumors start. Reputation is ruined. All because the word “mental.” After all, there is nothing negative about visiting health care facilities. It’s the mental health part that creates the problem.

            I was there to visit a client of the facility. I had to wait for an hour first in the waiting room with anxious families, then in the client area surrounded by those being treated for mental illness. During my wait I read a bit and chatted some with other clients curious why a priest in uniform was waiting in their midst. It was a pleasant wait.

Though this facility was quite nice, I was reminded of the six weeks I spent as a chaplain intern at St. Elizabeths, a large, underfunded public mental health hospital in Washington, D.C. That was my first immersion in the world of mental illness and its treatment.

It was in this sprawling psychiatric facility that I faced the stigma of mental illness and learned that there is no “us” who are healthy and “them” with problems. There is no “those people.” There is only “us.” I can safely hazard a guess that you, my dear reader, know someone dealing with mental health issues and so I ask you to read further to understand why that is so.

St. Elizabeths was founded in 1852 as the first federally funded psychiatric hospital. It had a storied past in which it treated thousands of persons at a time, including some famous patients. By the time I was there in the late 90s, the client population (the word patient was no longer used) was about 800. Today, half that number are treated at the ever decaying facility soon to be taken over by Homeland Security who values the bluff on which the hospital sits, with its eye-catching view of the District of Columbia.

During my time at the hospital, it dealt with many of the homeless in our nation’s capitol. Persons living on the streets with mental health issues would from time to time be picked up by the police, triaged into mental health at a hospital and sent to acute care area at St. Es. There they would be stabilized on medications, moved to a step down unit and counseling and eventually sent back out into the world.

Others were in the hospital as an asylum, seeking long-term, even life-long care for that very small percentage of persons for whom medical options didn’t seem to adequately work to prevent their being a threat to themselves or others. As a chaplain, I split my time between the acute ward, with the newly arrived, and a behavior modification unit with persons who were frequently violent. Once a week, I also got to spend some group time with those about to go back out into the community and so was there for the arrival and departure of some of our clients.

I remember so clearly the behavior of those fresh from the streets and in the midst of crisis. I don’t like telling those stories, because this is what leads to the stigma. Of course, I have stories of people acting crazy. It was acute care and they were in crisis. But I also remember the ways in which treatment could help stabilize them so that light could find its way into the darkness of paranoia, or depression or whatever caused the client’s suffering.

Years later, I would begin to have anxiety issues. I was not anxious about something in particular. It was free-floating anxiety. I was just anxious and sometimes dizzy. It turned out that the problem was an under-functioning thyroid, something common on my mother’s side of the family. I now take a daily dose of thyroid medicine and face no issues from the problem. A simple medical problem with a straightforward medical solution.

Yet, some of my symptoms were what we might think of as mental health symptoms. But no stigma here. The issue was my thyroid. Why then do we attach something negative to the person who needs daily medication to keep the symptoms of bi-polar personality disorder in check? Still sometimes referred to as being manic-depressive, persons who are bi-polar have enough to deal with without the additional weight of judgment.

Chances of long term health increase greatly when others understand the illness and work to make sure that the course of treatment is followed. We do this readily for persons with diabetes and cancer, but can be unkind to persons with mental health issues.

I particularly wonder about the stigma when all of us face some mental health issues. After all, mental health is something of a sliding scale, at one point on the scale you are just depressed and you will work out of it, at another, you have chronic depression which needs a different type of treatment. But each of us knows something about what it is like to be blue or to be anxious.

This common experience with mild mental health symptoms is probably the problem. After all, we deal with it. We buck up and get over the depression or tamp down the anxiety and go on with life. Why can’t the other person? They can’t because the problem is larger for him or her. The chemical imbalance is greater. What we knew in part, this person knows in whole.

Leaving the person to “get over it” is the same as telling the person with diabetes to get over it, when all he or she needs is counseling on diet and exercise and some insulin to bring things under control. The diabetic needs support and so does the schizophrenic and the others with mental health problems. But we get so tied up in the stigma that we don’t want to let others know about the real problem.

This covering up or ignoring the problem is why so many persons who face mental health problems self medicate with abuse of prescription drugs and use of illegal drugs and too much alcohol and other destructive behaviors. If they got the right treatment and were supported in facing the underlying psychiatric cause, so many people could live healthier and happier lives.

We deal with cancer so much better now. Once cancer patients faced a stigma that caused to the person to be cared for out of sight. Now we treat cancer patients as fighters battling the disease. This is wonderful. Why can’t we do the same for mental health problems? Why can’t we all celebrate the ways in which they fight hard against a health care problem?

In Jesus’ ministry, I find that again and again his healings brought people back into community. The leper was healed and could return home, the blind received their sight, stopped begging and joined Jesus’ on the way, and so on. Jesus sought physical healing that brought people into community. In supporting persons facing mental health issues, we can help restore community, which was part of how Jesus was seeking to change lives.

            (The Rev. Frank Logue is pastor of King of Peace Episcopal Church in Kingsland.)

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