More Guns = More Suicides

Compare states to states.  Compare regions to regions.  Compare states within regions to other states within the same region.  Compare people of the same age group, in any age group, men to men and women to women.  Compare unemployed people to unemployed people, working folk to working folk.  Compare city dwellers to city dwellers, country folk to country folk.

Compare people with depression to other people with depression; people who are suicidal to other people who are suicidal; people who have a plan to other people who have a plan; people who have a past suicidal attempt to other people who have a past suicidal attempt, for God's sake!

More Guns = More Suicides.

Get it?

Homicide and Firearms - Some Facts

While I was researching this post, a Facebook friend posted this  picture.  I commented, giving information I discovered and found surprising.  The stats are below, under domestic violence.  A friend of my friend then commented, Dearest Willa......useless, worthless statistics.  Lies, damn lies and statistics.  Go back to class and learn forgiveness, and while you're at it....drop dead!

Well.  That was disturbing.  To my knowledge, I do not know the person who called me Dearest Willa, said I need to learn forgiveness, and then told me to drop dead.  It occurs to me that facts have power, if they evoked this response.

My facts come from the Centers for Disease Control, Bureau of Justice and Federal Bureau of Investigation, from reports and data bases that count people who died and how they died.  That is all these sources did -- they counted.  They made no policy recommendations.

I make no policy recommendations in this series, either.  I am reporting their numbers.  I do hope they are not useless numbers.  I offer them to you to help you weigh the costs and benefits of gun ownership.

How Many Killed Since Newtown?

Technical difficulties have delayed my research on homicide and firearms.  I can't figure out how to make the story not tedious.  So I will skip it.  Maybe next week...

Until then, here is a resource to keep you up to date.  Slate Magazine and the Twitter feed @GunDeaths are crowd sourcing data to answer the question:

How Many People Have Been Killed by Guns Since Newtown?

The answer is not easy to find.  Coroners do not publish this information in real time.  Perhaps you noticed that my statistics last week were from 2009 and 2010.  The tally is collected only at the end of the year, and it is not official for some months after.  Suicides, in particular, are underreported, even in official statistics.  They get caught up in investigations that take months beyond the reporting date.  Eventually the numbers for 2011 will be corrected, when these investigations are completed.  Meanwhile, the smaller number has been published in places that will not be corrected and will nonetheless be repeated (including Prozac Monologues, if I try to publish the most current sources.)

Guns and Death, Death and Guns

I have a friend, a young mother of two toddlers, whose New Years resolution is to get her license to carry.  This series is for her.  Live long and prosper, dear one!

My Next Series -- Facts About Firearms

I have a plan.  No, not that kind of plan.  Well, yes, I do.  But that is not the plan I mean right now.  I plan to do a series about firearms.  It is my intent to provide facts, just facts.  There are a lot of facts out there about firearms.  A lot of nonsense is disguised as facts.  But genuine facts are available, and more useful than our impressions for making sound decisions.

I am not going to write about my opinions about firearms, because, well really, who cares about my opinions.

Keeping Track of How People Die

Firearms are a cause of death, which means that the US Centers for Disease Control keeps track of them.  Wait, wait -- it doesn't keep track of the firearms, just the deaths.

Elections and Mental Health

Full disclosure: I am a Christian.  Every baptism I attend, I renew my vow to follow and obey Jesus Christ as my Lord and Savior.  When I was ordained a priest, I made another vow, to pattern my life in accordance with the teachings of Christ.  So that I don't just make it up as I go along, I also vowed to be diligent in the reading and study of the Holy Scriptures.

I'm telling you -- I'm serious about this.

Just so you understand -- that means I am a Christian first, an American second.

When I vote, my faith determines my vote.

In my reading of the Holy Scriptures -- and I read it a lot, and I read the whole thing, and keep reading it to catch things I missed the first and second and twentieth time round -- it is very clear.  According to Jesus and the prophets, a nation will be judged not by the private morality of its citizens, but on how the nation itself treats the most vulnerable in its midst.

When I vote, I am voting for policies that determine how my nation will be judged, because I believe this nation will be judged.  Since this is a democracy, as a citizen, I also bear some responsibility for what happens in this nation, and expect to share in its judgment.  So I am voting for people whose first priorities will be the hungry, thirsty, alien, poor, sick and those in prison.  Because those are the priorities on which we will be judged.  Matthew 25.  Got that?

So I am voting for mental health.  We throw around a lot of words, but behind these words are real people.  I know some of them.  Even if I didn't. I am commanded, by somebody I have vowed to obey, to do for them what I would have done for me.

Medicaid, veterans, parity, research, access to health care, including sufficient professionals to provide mental health services -- there is a lot at stake in this election.  Follow the link to NAMI's What's at Stake in the 2012 elections? for the details.  Then decide who you think has the same priorities as Jesus and the prophets.  I am not assuming anything here, just telling you where I stand.  Maybe you share these priorities, maybe you don't.  But figure it out.

And be honest about it.

Then go vote yourself.

clip art from Microsoft.com

icon of Christ Pantokrator, 6th c. St. Catherine's Monastery, Mount Sinai, in public domain

Purple Heart for PTSD

I am pleased to have scooped NAMI and Fox News on this one by two years.

Some people say we have dumbed down PTSD, and that we dishonor the suffering of soldiers when we give the diagnosis of PTSD to people who have the same symptoms and same brain dysfunction of PTSD, but whose traumas were of a lesser severity.  In other medical departments, a broken leg is a broken leg, whether the person fell three feet or thirty.

Back in May, 2010 I proposed that the way to honor soldiers whose PTSD is the result of war injury is the way we honor any soldier wounded in war -- the Purple Heart.

Better yet, let's honor their sacrifice by preventing their trauma in the first place.  No more!

Meanwhile, check out Guitars for Vets.

Those Who Have Eyes, Let Them See

Yes, I said I was on sabbatical.  But I do have to write.  Like, I do have to breathe.  My facebook page this morning, somebody posted an Ernest Hemingway quote, There is nothing to writing.  All you do is sit down at a typewriter and bleed.  I have learned there is more than one way to bleed.  Teresa of Avila's stigmata, by the way, were interior.  Mine (writing) seems better than other alternatives.

So yes, I am on sabbatical.  That means I don't have to post.  I might anyway.  Oh well.

NAMI National Convention 2012

It started with Shepherd.  He stood straight tall.  Life has taken a lot out of him, including a lot of teeth.  But he stood straight tall.  I remember him as a black man, with piercing light blue eyes.  I know that's possible, a black man with blue eyes.  Maybe it isn't true in this case.  My brain really isn't that dependable anymore.  But the piercing part is the most important.  I am so glad I wasn't afraid to look in his eyes.

Real Mental Health Advocacy - We Have Begun

Okay, so I just blew away this week's post.  Sigh.

Instead, I will honor the people in Chicago, who have tried every form of education, conversation and persuasion they could devise to convince Mayor Rahm Emanuel not to close six of the city's twelve mental health centers.  Finally, they staged an occupation.  For seven hours, they held the Woodlawn Mental Health Center, while Occupy Chicago gave support from outside the clinic.

They are my heroes.

Read the remarkable details here.  The videos seem to be missing from the text.  Here is the link to the story as recorded in stages on youtube.

Mental Health Day -- The Funner Version of Advocacy

Last week it was Mental Illness Awareness Week, according to NAMI.  So today it's World Mental Health Day, according to WHO.  The World Health Organization, that's WHO.

That's a week for mental illness, a day for mental health.  Whoever organizes these things must be reading my mood chart.

I cycle within cycles.  In the larger circle, I have been able to maintain a stable state for a while now -- the state of jaded, that is.  So I take up this week where I left off last week, continuing the repost of a series on the sorry state of mental health advocacy.  This second post takes a glass-half-full approach.

Not exactly mental health, but at least the upside of mentally interesting.  I mean, we got these diseases for life.  We might as well learn to make them work for us.

Mental Illness Awareness Week - Because We Are Really Good at Delusional

Imagine this -- Somebody from NAMI attends one of those campaign events and gets to the microphone.  Intending to ask about the candidate's views on funding for community mental health, this poor parent begins with a statement: 

People with severe mental illness die on average twenty-five years before everybody else.  They have the expected lifespan of Somalia. 

Nowadays the crowd will cheer.  But that particular youtube wouldn't go viral.

I am jaded about this Mental Illness Awareness thing.  It will not be subjected to any Best Practices evaluation.  NAMI and the pharmaceutical industry have been making us more aware of mental illness for decades now.  The numbers on prejudice have not budged.  They have not budged.

That negativity -- does it mean I am currently displaying symptoms or that I have done my research?  Both, actually.

I'll cop to the irony here.  I myself was a speaker at one of those Mental Illness Awareness Week events once, held on a Sunday night in a not-much-traveled portion of a university campus.

It was very moving, the candles and all that.  And it did raise awareness, in the sense that it made those of us who were there, people with mental illness and those who love us aware that we are not alone.  But did it increase funding for research and treatment?  Did it reduce prejudice?  I don't think so.

Let me answer that another way.  Did it increase funding for research and treatment?  Did it reduce prejudice?

Nope.

So symptoms, research, irony and all, my contribution to Mental Illness Awareness Week is a repost of what I think we ought to be doing this week.  And next.  And next. 

From Friday, March 11, 2011:

Ignore/Laugh/Fight/ -- Mental Health Advocacy That Wins

If they don't want to employ you, if they are afraid of you, if there are four times as many of you in jail as in the hospital, then it's not just stigma.  It is prejudice and it is oppression.

The twentieth century offered a whole degree program in prejudice and oppression.  Others have made progress against what beat them down.  Though we are now stalled and falling behind, we can move forward when we adopt their methods.

The Map to Liberation

Mahatma Gandhi was not the first freedom fighter.  But he is the great theoretician.  He gave us the map.

First they ignore you.
Then they laugh at you.
Then they fight you. 
Then you win. 

Four simple steps.  The good news -- we have already taken the first.  Got that one down pat.

Liberation 101: 

We are in charge of the map.  The oppressor doesn't decide that oppression will end.  It endures until the oppressed decide that it will end.

What we have to do is provoke the next step.

Then they laugh at you.

Well, that's where we are stuck, because we are unwilling to be laughed at.  Last month's NAMI meeting was about Iowa's upcoming budget cuts.  Somebody said, When we complain, they say we are crazy.  I think she is a therapist.  She has that therapist look, if you know what I mean.

Therapists say the funniest things.  When we complain about how we are treated, they say we are crazy.

But we are crazy!  We start off ahead of all the other liberation movements that had to get crazy to take it to Gandhi's next step.

Think Martin Luther King.  Think Nelson Mandela.  Freedom?  People called them communists.  Either that or just plain nuts. 

Like these other movements, we have to find a spiritual taproot deep enough that we can endure being laughed at.  Just like the tree, standing by the water... 

The spiritual work will be impossible if we expect our care providers to lead.  They get twitchy if we talk spirituality.  I will address that work another time.  Right now I will sketch out how we break beyond First they ignore you, and move to Then they laugh at you.

What that means more precisely is, we have to do things to make people think we are nuts.  Like, DEMAND that we receive funding for research and treatment, DEMAND that we have the same access to health care as anybody else, DEMAND that we receive our health care in health care facilities, not in jails.

It's all about budget cuts right now.  Corporate tax cuts -- that's a given.  Corporations spent good money for our current crop of legislators, and they expect a return on investment.

So who will pay for these tax cuts, the people with mental retardation or the people with mental illness?  The Iowa State legislature has a committee that has asked us to decide.  Well, isn't that special.

We have to DEMAND that they change the rules of this game.  We have to REFUSE to play Survivor.  We have to refuse LOUDLY.

How?  African Americans sat down.  That is when they moved off Step One, when they REFUSED to be ignored any more.

So how about we lie down?


Lie In/Die In

Picture this.  The next Loonie Lobby Day at the state legislature, we don't get all showered and neatly normaled up and go have sincere conversations with our legislators who are really sympathetic (their brother has depression, so they know what we are up against, but their hands are tied by that pesky deficit...)

Instead, we stand in the rotunda and read off the names of their constituents who have committed suicide.  Each time a name is read, somebody falls down.  They have to step over our bodies to get out of the building.

Mental Health "Parity"
 
The Mental Health Parity and Addiction Equity Act would be better called the Swiss Cheese Mental Health Act.

1) Only large employers are affected.

2) If they can demonstrate it causes them financial hardship, they can get an exemption.

3) Parity is a laugh anyhow, if reimbursement rates are so low you can't find a provider who accepts your insurance.

4) The provisions of even this piss poor legislation that address reimbursement rates are now the top of the list on Congress's chopping block.

So off we head to Washington.  There are 13,000,000 million of us with serious mental illnesses in the US, including 5.7 million with bipolar, 2.4 million with schizophrenia and 7.7 million with PTSD.  The numbers add up to more than 13,000,000, because some of us get to double dip.  Piece of cake to pull together 34,000 to do a die-in around the steps of Congress, representing one year's worth of the deaths by suicide in the US.  We will drape American flags over the bodies of the vets.

Yes, we are dying out here.  Let them step over us.

How nuts are we to think we can turn around this systemic discrimination?  In this political climate?

Progress Report

Remember, When we complain about how we are treated, they say we are crazy?  By now some of my readers seriously want me to reconsider Seroquel.  Others -- if you are still reading, your doc wants you to up your dose.  This means we are making progress.

At some point, laughter becomes a cover for scared.  Then it's time for the next step.

Then they fight you.

Remember, this is our map.  We are the ones who push it forward.  Nobody else will.  And if I am scaring you, look at it this way.  If we aren't scared already, we'd have to be crazy.

Until we change our advocacy, we will continue to lose psychiatrists.  We currently have less than half the psychiatrists we need to provide a even a shoddy level of token med checks.  In Iowa, we have one fourth.  While demand is going up (think Iraq, think Afghanistan), supply is going down, as retiring psychiatrists are not replaced by new doctors.  Why go that far in debt to get through med school and then choose a specialty with the lowest pay scale on the block?

Until we change our advocacy, we will continue to lose community mental health centers.  Remember community mental health centers?  The places we were supposed to go when they kicked us out of the hospital?  They are disappearing already.  Here are the Kansas numbers.  You can find the same story for any state you google.

Until we change our advocacy, we will lose what parity was promised.  Again, all employers have to do to avoid it is demonstrate that it costs them money to provide it.

Until we change our advocacy, we will lose even the programs that jails now provide.  Why should criminals be coddled?

Desperate Times Call For Futile Gestures

What were we thinking?  That public demonstrations would make a difference to cold hard facts?  Were we nuts?  (By the way, what have we been thinking, that talking would make a difference?)

After the strategies designed for Then they laugh at you prove futile, we up the ante.  In place of our bodies, we substitute urns full of ashes and dump them on the floor of the assembly halls.

In 1987 AIDS activists entered the New York Stock Exchange.  Seven people unobtrusively chained themselves and a banner to the rail overlooking the trading floor.  At the opening bell they unfurled their banner and blew fog horns.  They drowned out the opening bell, and prevented traders from trading, while they brought national attention to their demand that pharmaceutical companies stop profiteering at the cost of their lives.

Wall Street is our audience, too -- all the businesses that insure some of their employees but not us, all the health care companies that pay reasonable reimbursement to some doctors but not ours.  How about we bring ambulance sirens? 

A Day Without Mental Health Care 

Next we head to Main Street.

The 2004 film A Day Without A Mexican imagined what would happen if one day everybody in the US from Mexico, Guatemala, Honduras, Nicaragua, et al disappeared.  Economic havoc, that's what.  A few years later, the movie inspired a political demonstration.  Workers stayed home for a day.  In some places, restaurants simply closed for the day, unable to serve their customers.

So last week the Wall Street Journal reported a survey by Workplace Options.  The survey discovered that 41% of workers polled had taken 4-9 days off work in the previous year to care for their own, their friends', their coworkers' or family members' mental health issue.  Half work in offices with no benefits, support or services to deal with mental health issues.

They think they can't afford to provide services?  They haven't a clue how much it already costs them not to. 

There you have it, a National Day Without Mental Health Care.  Everybody who has a mental illness or loves somebody who does -- stay home.  I'm thinking Monday -- to make that moon connection, and maybe even disrupt Monday Night Football?

Going To Jail

At this point, we are littering, destroying property and generally disturbing the peace.  We are going to jail.

Everybody on a three-month wait list for an intake interview,

Everybody on a two-year wait list for the judicial review of an SSDI application,

Everybody on a four-year wait list for sheltered housing,

Everybody who had been doing okay, but stopped taking meds when the day program closed,

Everybody who can't afford the copay for that third tier prescription anyway,

Everybody who doesn't have health insurance at all,

Everybody who is homeless,

Go downtown and set a trash can on fire.

We Need Some Coordination Here

No, not everybody.  Jail is not a good place for people with OCD, PTSD, nor Borderline.  You all, your part is to run right down to the courthouse, legal brief in hand, to make sure the police department fulfills its obligation to get the rest of us our meds.

Prejudice And Oppression -- Some Observations

This post has been about fighting oppression, the institutional arrangements that support an unjust system.  Oppression is weighty.  It is fierce.  It does not respond to reason.  Power yields only to power.  The strategies and actions I have described are the power of anger that has been organized.

Our families and our care providers are just as scared as everybody else of our anger.  So they will not help us here.  They want to address prejudice, not oppression. 

Prejudice is the irrational thoughts and feelings of individuals.  Well, prejudice also needs to be addressed.  There is work enough for everybody.  Think of differential diagnoses as differential skill sets for the differential tasks of freedom-fighting.

That's coming next week...

banner from nami.org

image of prison bars from microsoft

photo of Mahatma Gandhi in public domain 

flair from facebook

forest photo by Maylene Thyssen used under the GNU Free Documentation license

sit in at Walgreen's in Nashville, Tennesee, March 25, 1960, in public domain

photo of die in casualties by Brendan Themes and used under the Creative Commons Attribution 2.0 Generic license

fist graphic in public domain

Uptown Bill's - One Candle

Okay, let me be very clear.  And let you not perversely misunderstand.  Justice beats charity any day.  The current tax structure of the United States is unjust.  At least, that is what Jesus and the Prophets would say.  Charitable people can't make up for the size of this injustice, and shouldn't have to try.  The fixed notion that we can is diagnosable.

Fair Taxes

Warren Buffett was curious and did some research.  Last year Buffett's taxable income was roughly $40,800,000.  That's after deductions.  His taxes were 17.4% of that amount.  Every other person in his office paid somewhere between 33% and 41% of their taxable income, an average of 36%.  He doesn't think that's fair.

Nobody thinks that is fair.  In fact, a lot of rich people and the Republican Congress think he paid too much.  Nevertheless, there are indeed other rich people who agree with Buffett, that they get more than most out of government services, the type of services that help them accumulate even more, and they should pay more.

I have enough to rant about without taking on tax policy.  So let me focus on the implications of our current tax policy for mental health policy.

What Jesus And Amos And Muhammed Said 

Last week I told you it is time to step up, join with others, and do what the government and the people who own the government do not have the political will to do.  Feed the hungry.  Welcome the stranger.  Visit the sick and in prison.  Those phrases come from the Christian Scriptures, Matthew 25, but were spoken by a Jew who got his religion from a long line of Jewish prophets.  We can round out the authorities of monotheism with the Muslim requirement to give alms.  For you non-theists, you have to be your own authority.

I'm just saying -- Do it.  Charity is an insufficient substitute for justice.  Do it anyway.  While Facebook and the blogosphere are filling up with calls for justice, people are dying out here.

That is where I left off last week.  This week, the example I promised, one light lit against the darkness, Uptown Bill's.

Bill Sackter

Bill Sackter spent most of his life in a Minnesota state institution, placed there when he was seven, because he was mentally retarded.  He got out when he was 53, when institutions downsized and transferred care to the community.  Only there wasn't a community.  There was one social worker with a case load too large to give Bill adequate help to adjust.

Bill was on the verge of going back to that hellhole, as he called it, when Barry Morrow, a young filmmaker in search of a project met him, befriended him, became his guardian and brought him to Iowa City, Iowa.

Barry worked for Tom Walz, the head of the University of Iowa's sociology department and the kind of idealist that thrived in Iowa city in the 70s and 80s.  Except Tom is a practical man.  And he listens.  And he got Bill the kind of job that Bill could do.  He could make coffee.  He couldn't make change, but he could make coffee.  That was fine, because the social work students who patronized Wild Bill's Coffee Shop could make change for themselves.

Barry made two movies about Bill's life, starring Mickey Rooney, and Bill became a symbol of how people with disabilities can contribute to our common enterprise.

Uptown Bill's

That would have been the end of it, but, like I said, Tom Walz is a practical man.  A practical man with a vision.  When Bill died and Tom retired, Tom helped to create Uptown Bill's, a small mall of businesses owned and operated by people with a variety of disabilities, a book store, a graphics design business, vintage store, furniture repair and refinishing, and yes, Wild Bill's Coffee Shop.

Today Uptown Bill's includes all of the above, plus a music shop, home repair and maintenance business, classes on how to start e-businesses, and programming in the arts.

This is community care that works.  Emphasis on the the works.  I think it works for two reasons:

1) People with disabilities have abilities.  My dog Mazie taught me that we all come with surplus.  To lose one, or even several, leaves us with loads.  Well, we all have things we can and cannot do.  Whether we fit into the economy, whether the community is structured so we can contribute and receive, says more about the community than about us.  For that matter, our labels say more about the way the community is structured and less about us.

That is both obvious and invisible in the public arena.  But some people have eyes to see.  So a place like Uptown Bill's is possible.  People with disabilities can run our own businesses.

2) If you own the business, you don't get laid off when the funding gets cut.

Now after the manner of Hebrew poetry, I said there were two reasons why Uptown Bill's works, and I add a third.

3) There are people who do not carry the label disabled who decide to work in partnership with others who do carry the label.  They don't run the show, but they add their own abilities to the mix.  These people don't have to believe in one sort of tax structure for the United States or another, have one faith perspective or another or none at all.  They just have to want to live in a community that can receive the contributions of every member of it, without regard to labels.

Off The Grid

I write this from Costa Rica.  I live in a little fishing/tourist/beach town with enormous disparities of wealth.  Michael Jordan and Madonna own property in this part of Costa Rica, though I don't think they can see the doorway where that man sleeps from their infinity pools.  I live behind razor wire, in a middle class/working class mixed neighborhood.  Some of my neighbors make do with barbed wire.  And I watch the United States on a trajectory toward the same.  Except there won't be papaya trees growing wild up north.

When I go downtown, I see a mentally ill and homeless person who makes a living by buying a pack of cigarettes and selling them one and two at a time for a profit.  I see people who buy their cigarettes one and two at a time from him.  Because they are a pueblo.

Sure, keep trying to turn the Titanic around.  But do something else, as well.  Our government doesn't work for us.  I think it is time to figure out how to piece together a pueblo, instead, to join with others and do what we can with each other.  One candle, one cigarette at a time.

flair by facebook.com

scales by Johannes Regiomontanus, 1512, in public domain.

image of the prophet Amos by Gustave Doré, 1866, in public domain

book cover by amazon.com

dvd image by amazon.co

photo of razor wire by Helen Keefe and used by permission

photo of cigarette in public domain 

1000 Points of Light Revisited

                              OR

Gosh, We Could Use A Candle Down Here

I wonder if the US has passed the tipping point.  For decades, a thriving middle class fueled the economy and supported our democracy.  In the Bush years we decided to pay for those two wars, um... later, so the super rich could get richer.  During the Obama administration we decided the tax cuts will stay; so the poor, the sick and the elderly will pay for those wars and the tax cuts.  Meanwhile, the middle has shifted.

From Vernellia R. Randall, Professor of Law, The University of Dayton:  [In the last two decades] the gap between the rich and poor in the United States grew at the same pace as the economic growth.  Statistics show that the richest 1 percent of the US citizens own 40 percent of the total property of the country, while 80 percent of US citizens own just 16 percent.
 
Since the 1990s, 40 percent of the increased wealth went into the pockets of the rich minority, while only 1 percent went to the poor majority.

From 1977 to 1999, the after-tax income of the richest 20 percent of American families increased by 43 percent, while that of the poorest 20 percent decreased 9 percent, allowing for inflation.  The actual income of those living on the lowest salaries was even less than 30 years ago.

Businessinsider.com tells the story in graphs for you visual learners.

And here is the way Warren Buffet tells it.

The upshot from the mental health perspective -- states are slashing mental health budgets.

After the Jared Loughner shootings, Arizona talked a lot about the need for better services.  Then it cut $36 million from its mental health budget, or 37%.  Across the nation, the average cut is 8%.  Emergency rooms, jails and homeless shelters take up the slack.

There is a lot of slack.

Home ownership, those 401K's we were supposed to use to replace pensions...  I won't linger here.  I just wonder if this income shift can be turned around.  Mostly I wonder what we will do in this new America, which will look more and more like other countries that have wealth gaps this large and the security budgets to protect the spread.  Mexico comes to mind. 

What We Will Do

We were a decade into the beginning of the shift when in 1989, at his inauguration George H. W. Bush called for 1000 points of light, voluntary organizations across the country to address human need, the homeless, children, persons addicted to whatever substance (including welfare, he said), unwed mothers.

This was the Read my lips: No new taxes guy.  So there was a certain cynicism mixed with his compassion, a rich man calling on the virtues of those with less to take care of those with even less.

It sounds different when the poor themselves say it.  And, of course, Bush was referencing the poor man who said, You are the light of the world... let your light shine before others, so that they may see your good works and give glory to your Father in heaven. (NRSV)  The guy who said that said it to other poor people who were taxed into poverty to pay the salaries of the police state that was just looking for a reason...  In his case, they found one.

The philosophical debate, to what extent should the United States of America accept a common responsibility for the common welfare, is just that, a philosophical debate.  As a political debate, it is pretty much over.  We won't.    Them that's got shall get; them that's not shall lose.  And them that's got have got the government, the means to keep the government, and no intention whatsoever of paying for the benefits they receive from the government (infrastructure, security, subsidies, an educated - more or less - work force, international trade agreements, subsidies.)

So we are back to those 1000 points of light, or rather, to You are the light of the world.  For what it's worth, the only light there is going to be.

Those voluntary organizations that Bush Sr. was counting on to pick up the tab never had the resources to do it.  And they have less now.  Voluntary organizations have been contracting since 1964.

This is candle in the wind time, folks.  But it's time to sign up.  Why?  Because it's getting dark down here, and you are the last flame.

It is time for secular humanists to get over their sense of intellectual superiority.  It is time for the spiritual but not religious to get over their allergy to accountability.  It is time for religious people of whatever stripe to get over their delusional straining for influence.  The only shot we have is to do it together.

Somebody has to do something, and it's just incredibly pathetic that it has to be us. -- Jerry Garcia.

But there it is.  Those of us who have lost our jobs, our pensions, our insurance, our health, or are bracing for the blow have to get it together and do it ourselves, have to organize, to feed the hungry, welcome the stranger, visit the sick and in prison -- whatever kind, compassionate, fair, sensible thing it is.

Next week, an example.

book jacket for The World is Flat by Thomas Friedman from amazon.com
photo of emergency room by Thierry Geoffroy and used under the Creative Commons Attribution-Share Alike 3.0 Unported license
print of Lazarus and the Rich Man be Print by Gustave Doré, 1891, in public domain
photo of candles by Nevit Dilmen,  Permission granted to copy under the terms of the GNU Free Documentation License  

Jared Loughner -- It Doesn't Have To Work This Way

The man who wants to put Jared Loughner to death is concerned for his health.

The United States attorney for Arizona, Dennis K. Burke, wrote to the Ninth Circuit Court of Appeals that despite being under suicide watch, Loughner’s unmedicated behavior is endangering him. 

It has been determined that Jared suffers from schizophrenia, and is unable to participate in his defense against the 49 charges stemming from the Arizona shootings that left six people dead and thirteen wounded.  Now somebody wants to get this desperately sick young man some help.  Because if he can't stand trial, then he can't be prosecuted, convicted and executed.

Jared's attorneys think it is not in his interest, under the circumstances, to take Risperidone, a standard antipsychotic medication given to people who think that somebody is trying to kill them.  It might have been in his interest earlier on.  But the community college that noticed his bizarre behavior, including the speech salad that is the dead giveaway of schizophrenia, simply expelled him.

The Ninth Circuit Court of Appeals agreed with the prosecution, and Jared is now being forcibly medicated.

I intended to return to my NAMI Convention reporting this week.  But wow.  This story lands on my laptop, the very essence of the Prozac Monologues spirit.

There are so many layers of meaning here.  I don't think I am up to the task of analysis.  Instead I will tell another story, the original sequel to last week's rerun.

This is how a Christian community responded to the violent act of a mentally ill man. -- as they understand what it means to be Christian.  From January 21, 2010 --

The Miracle of Gheel

It was seventh century Ireland.  The Queen died.  King Damon's grief was so deep that it moved into depression and then psychosis.  He thought his daughter Dymphna was his queen.  Rather than submit to his advances, Dymphna fled to Belgium, to the town of Gheel.  But her father followed.  When she again rebuffed him, he killed her, cut off her head.  Dymphna was buried in the local church.

Six centuries later, her coffin was found during renovations.  Signs on the coffin demonstrated her holiness.  She began to be venerated.  Cures of the sick were attributed to her.  She was canonized in 1247 as the patron saint of the mentally ill.

Okay, here the one last bit of unrecovered Catholic in me demands to be heard, to note Rome's fascination with girls who prefer death to rape.  Even as a nine year old, that troubled me.

Abandoning The Mentally Ill -- Or Not

Moving on.  People came to Gheel for healing.  Many brought family members who were mentally ill.  Sometimes they left them there.  The priest housed these abandoned ones next to the church.  When the job of caring for them became too much for him, townspeople started bringing in food.  They built a hospital in the 14th century.  When it was full, the real miracle of St. Dymphna occurred, or rather, began.  Townspeople took some of the patients into their own homes, reserving the hospital only for those most ill.

All across Europe, people with mental illness were thought to be possessed.  They were exorcised, tortured and burned at the stake.  But not in Gheel.

Imagine it!  A psychotic foreigner commits a terrible deed.  But the townspeople do not close the borders.  No, they open their homes.

And they still do.  Through plagues, wars, revolutions, recessions, depressions, during the Napoleonic "Reform," when all the mentally ill people in the country were ordered into one big hospital, during the Nazi occupation, with their "final solution" for mental illness, during the latest reform when the U.S. of A. was/is dumping all our mentally ill people out of the hospitals, onto our streets and into our jails, the people of Gheel developed and continue genuine community-based mental health care.

What Community Care Looks Like

Today, there are 700 foster homes for 1000 people with mental illness.  A person will enter the hospital for evaluation and stabilization.  S/he meets the psychiatrist, psychologist, nurse, social worker and family practitioner who staff one of the five neighborhood community mental health centers.  Each of these staff people spends half a day each week in the hospital, so everybody gets to know everybody.  The potential foster family and patient meet at the hospital, then over tea at home, then over a meal, then over a weekend before placement.  Outpatient care, medication monitoring and therapy continue at the neighborhood center.  If possible, the biological family participates in the treatment plan.

Once part of the family, the person shares in family activities, chores and church.  The church doesn't have special bible studies, services or programs for the mentally ill.  They are fully integrated, regular readers, members of the choir, ushers, etc.

But What About Relapse?

What if the person's symptoms flair?  We say s/he is having a bad day.  Because the person lives in a family, not on the streets or alone in an apartment, problems are caught and addressed early, not after getting fired or evicted or arrested or in a bloody mess.  If needed, s/he can go back to the hospital for a while.  In fact, the hospital is not the place of last resort.  When the foster family has to go out of town, say, for a funeral, the person can stay at the hospital.  There is continuity of care.  There is care.

Three years ago I wrote a chapter for Deep Calling called, If This Were Cancer.  I detailed all the ways that hospice patients receive the support of others, and that people who have suicidal depression do not.  If this were cancer, there would be casseroles...  I imagined the total collapse of care for the mentally ill, under the weight of our crazy health care system.  In fact, it's happening as I write.

I imagined that the Church would step in to meet a desperate need, to create hospice for the mentally ill, as the Church originally created hospice and hospitals.  I claimed that the Church has the resources to organize for such care on a local basis.  It has the faith to imagine such a thing, the love to cast out fear, and the values to demand it.  I will have to rewrite that chapter.  I didn't know it had already been/is already being done.

I am ever so grateful to Janet, whose last name I don't remember, who gave me Souls in the Hands of a Tender God: Stories of the Search for Healing and Home on the Streets by Craig Rennebohm, the source of this story. 

Lord God, Who has graciously chosen Saint Dymphna to be the patroness of those afflicted with mental and nervous disorders, and has caused her to be an inspiration and a symbol of charity to the thousands who invoke her intercession, grant through the prayers of this pure, youthful martyr, relief and consolation to all who suffer from these disturbances, and especially to those for whom we now pray. (Here mention those for whom you wish to pray.)

We beg You to accept and grant the prayers of Saint Dymphna on our behalf. Grant to those we have particularly recommended patience in their sufferings and resignation to Your Divine Will. Fill them with hope and, if it is according to Your Divine Plan, bestow upon them the cure they so earnestly desire. Grant this through Christ Our Lord. Amen. 

... I think maybe Jared could use our prayers, too.

photo of Risperidone by V1ND3M14TR1X and used under the terms of the GNU Free Documentation License

image of Dymphna in the public domain

A Kitchen Interior by Joachim Beuckelaer, 16th c., in the public domain

book cover from amazon.com

On The Road Again -- NAMIWalks 2011

It's that time of year again.  Across the country people with mental illness, our friends, family, care providers, even law enforcement officials are pulling on our walking shoes to raise money for NAMI -- National Alliance on Mental Illness.  Last year soldiers in Iraq pulled on their hiking boots and their 40 lb. packs and ran while NAMI San Diego walked.

So what is this all about?  Here, my friends, is my testimony.

A couple years ago, I wrote a post on holiday gift giving for your favorite normal.  I asked my spouse, What would be a good present for the family member of somebody with a mental illness?

She didn't even look up from her computer.  Without missing a beat, she said, A cure.

A cure.  I know that mental illness is a family illness.  The whole family lives with it.  But her words caught me.  What she wanted was for both of us, a cure.

It's something she can't give me.  I can't give her.  My doctor can't.  You can't give it to the person you love.

We can, however, learn to manage symptoms.  We can claim the very best lives we can live.  We can live in recovery. 

Peer To Peer Program

I learned about recovery from NAMI, from their Peer to Peer program.  P2P is a ten-week course taught by people with a mental illness for people with mental illness about what we do after the doctor hands us a diagnosis and a prescription.

P2P teaches us how to live.  It is why I bust my butt for this walk.  It's not a cure.  But it's a lot.

That first class, I heard that I am not alone.  The very first note I took said, More unites us (our experiences) than divides us (our diagnoses.)

Next P2P showed me the immense dignity of those who live with mental illness.  It made me proud to know and be known by and be in community with others who live with mental illness.

It supplied tools like dialectical thinking, mindfulness, relapse prevention planning, techniques for emotional regulation and getting a good night's sleep, strategies for staying safe and coping with hospitalization.

P2P gave me something to do when medication didn't give me a cure.

And it opened for me a path into my future.  It reminded me that I am an advocate.  That is who I am.  I still have an identity, after all

So I bust my butt for this walk.  It is how I give back.

NAMI Walks

Now, the first time I did a NAMI walk, to tell the truth, I was scared.  Would it be grim?  A protest and a wailing against what is not possible, what we have lost and what we have to face?

If you have walked for NAMI, you are laughing here.  You know a NAMI Walk is so -- not grim.  It's a party!  With balloons and babies and dogs, music, belly dancers, football players, great food.  In Johnson County, Iowa, the Old Capitol City Roller Girls lead off the walk.  In San Diego, you are likely to hear a didgeridoo.

Bottom line, a NAMI walk is a gift.  It's a public demonstration to our families, friends, politicians, our neighbors, coworkers, the people in our places of worship, the viewing public -- a public demonstration that we are here for each other.  We take a break from all that wailing.  And throw a whale of a party.

At the same time, we raise funds for the programs that help us help ourselves and one another, the things that nobody else will pay for, for people who have fallen off the bottom of the budget.  NAMI does the stuff that makes a difference the day after the doctor hands us a diagnosis and a prescription.

Team Prozac Monologues debuted last year, with results that were not too shabby.  We raised $2640.  Mazie's sponsors contributed $250 toward that total.  Helen is walking in her stead this year.  Sponsors can contribute in Mazie's memory here.

Why I Walk

Me, I am walking for everybody who used to be on a three month wait list for an intake interiew at the local community mental health center; but this year that became a six month wait list at the center the next county over.  I am walking for everybody who used to  be on a four year wait list for sheltered housing; but this year the shelter shut down.

I am walking for those who are not crazy enough to pull out a gun and get the sheriff to buy their meds; they're just crazy enough to sleep in the alley behind the homeless shelter after they have stayed their ninety-day limit.

I am walking for family members who go to work wondering what is happening at home with their loved ones, now that the day program is closed.

I am walking for the resident on call in the ER who has to send home the merely suicidal, while the flaming psychotic waits for 36 hours in the hallway for the next available bed.  And for the newly diagnosed and dazed person who just got released with not enough meds to make it through the weekend, to make room for the flaming psychotic.

I am walking for the young people I know whose brains are even now being damaged in a war that we got into for oil.

I am walking in gratitude for law enforcement personnel who are trying to figure out how to do this new job, and need new training, to take care of those who have been discarded so that the very richest people in the world can get a tax cut.  I am walking in prayer for those who get caught up in somebody's suicide by cop.

This would be the place to note that the co-chairs of Johnson County's NAMI Walk this year are Janet Lyness, County Attorney, and Lonnie Pulkrabek, County Sheriff.  Props to them and to the competition between their two teams!

I did say that the Walk would be a party.  So even while I am angry that so much suffering comes not from the illness, but from the neglect, I will nevertheless celebrate those who do what they can do.  (That sentence would be an example of dialectical thinking, by the way -- see above, the curriculum of Peer to Peer.)

I am walking in wonder and amazement at the strength of the human spirit.  I am walking in deep appreciation for those who have helped me personally, for peer teachers, support group members, care providers, friends and family.

I will be walking with tears in my eyes, that my son and daughter-in-law will travel from Madison to Iowa City to walk beside me.

I am walking on April 30, 2011 in Iowa City, Iowa for all these reasons.  And I am walking also for you, dear reader.  I ask you to support me in this walk.  Click here to make your tax deductible, safe and quick contribution to NAMIWalks Johnson County. 

Closing Shot

There are many versions of this song on Youtube.  I chose this one, despite the credits that run over it, because the ragged bunch of friends who sing it, some not sure of the words, illustrate the point.  We are a ragged bunch.  And pretty wonderful because of it.

The Scream by Edvard Munch in public domain
photo of Team Prozac Monologues by Judy Brickhaus
photo of homeless vet by Matthew Woitunski and used under the Creative Commons licencse
photo of New York City police officer by See-ming Lee, copyrighted and used by permission

Ignore/Laugh/Fight/ -- Mental Health Advocacy That Wins

If they don't want to employ you, if they are afraid of you, if there are four times as many of you in jail as in the hospital, then it's not just stigma.  It is prejudice and it is oppression.

The twentieth century offered a whole degree program in prejudice and oppression.  Others have made progress against what beat them down.  Though we are now stalled and falling behind, we can move forward when we adopt their methods.

The Map to Liberation

Mahatma Gandhi was not the first freedom fighter.  But he is the great theoretician.  He gave us the map.

First they ignore you.
Then they laugh at you.
Then they fight you. 
Then you win. 

Four simple steps.  The good news -- we have already taken the first.  Got that one down pat.

Liberation 101: 

We are in charge of the map.  The oppressor doesn't decide that oppression will end.  It endures until the oppressed decide that it will end.

What we have to do is provoke the next step.

Then they laugh at you.

Well, that's where we are stuck, because we are unwilling to be laughed at.  Last month's NAMI meeting was about Iowa's upcoming budget cuts.  Somebody said, When we complain, they say we are crazy.  I think she is a therapist.  She has that therapist look, if you know what I mean.

Therapists say the funniest things.  When we complain about how we are treated, they say we are crazy.

But we are crazy!  We start off ahead of all the other liberation movements that had to get crazy to take it to Gandhi's next step.

Think Martin Luther King.  Think Nelson Mandela.  Freedom?  People called them communists.  Either that or just plain nuts. 

Like these other movements, we have to find a spiritual taproot deep enough that we can endure being laughed at.  Just like the tree, standing by the water... 

The spiritual work will be impossible if we expect our care providers to lead.  They get twitchy if we talk spirituality.  I will address that work another time.  Right now I will sketch out how we break beyond First they ignore you, and move to Then they laugh at you.

What that means more precisely is, we have to do things to make people think we are nuts.  Like, DEMAND that we receive funding for research and treatment, DEMAND that we have the same access to health care as anybody else, DEMAND that we receive our health care in health care facilities, not in jails.

It's all about budget cuts right now.  Corporate tax cuts -- that's a given.  Corporations spent good money for our current crop of legislators, and they expect a return on investment.

So who will pay for these tax cuts, the people with mental retardation or the people with mental illness?  The Iowa State legislature has a committee that has asked us to decide.  Well, isn't that special.

We have to DEMAND that they change the rules of this game.  We have to REFUSE to play Survivor.  We have to refuse LOUDLY.

How?  African Americans sat down.  That is when they moved off Step One, when they REFUSED to be ignored any more.

So how about we lie down?


Lie In/Die In

Picture this.  The next Loonie Lobby Day at the state legislature, we don't get all showered and neatly normaled up and go have sincere conversations with our legislators who are really sympathetic (their brother has depression, so they know what we are up against, but their hands are tied by that pesky deficit...)

Instead, we stand in the rotunda and read off the names of their constituents who have committed suicide.  Each time a name is read, somebody falls down.  They have to step over our bodies to get out of the building.

Mental Health "Parity"
 
The Mental Health Parity and Addiction Equity Act would be better called the Swiss Cheese Mental Health Act.

1) Only large employers are affected.

2) If they can demonstrate it causes them financial hardship, they can get an exemption.

3) Parity is a laugh anyhow, if reimbursement rates are so low you can't find a provider who accepts your insurance.

4) The provisions of even this piss poor legislation that address reimbursement rates are now the top of the list on Congress's chopping block.

So off we head to Washington.  There are 13,000,000 million of us with serious mental illnesses in the US, including 5.7 million with bipolar, 2.4 million with schizophrenia and 7.7 million with PTSD.  The numbers add up to more than 13,000,000, because some of us get to double dip.  Piece of cake to pull together 34,000 to do a die-in around the steps of Congress, representing one year's worth of the deaths by suicide in the US.  We will drape American flags over the bodies of the vets.

Yes, we are dying out here.  Let them step over us.

How nuts are we to think we can turn around this systemic discrimination?  In this political climate?

Progress Report

Remember, When we complain about how we are treated, they say we are crazy?  By now some of my readers seriously want me to reconsider Seroquel.  Others -- if you are still reading, your doc wants you to up your dose.  This means we are making progress.

At some point, laughter becomes a cover for scared.  Then it's time for the next step.

Then they fight you.

Remember, this is our map.  We are the ones who push it forward.  Nobody else will.  And if I am scaring you, look at it this way.  If we aren't scared already, we'd have to be crazy.

Until we change our advocacy, we will continue to lose psychiatrists.  We currently have less than half the psychiatrists we need to provide a even a shoddy level of token med checks.  In Iowa, we have one fourth.  While demand is going up (think Iraq, think Afghanistan), supply is going down, as retiring psychiatrists are not replaced by new doctors.  Why go that far in debt to get through med school and then choose a specialty with the lowest pay scale on the block?

Until we change our advocacy, we will continue to lose community mental health centers.  Remember community mental health centers?  The places we were supposed to go when they kicked us out of the hospital?  They are disappearing already.  Here are the Kansas numbers.  You can find the same story for any state you google.

Until we change our advocacy, we will lose what parity was promised.  Again, all employers have to do to avoid it is demonstrate that it costs them money to provide it.

Until we change our advocacy, we will lose even the programs that jails now provide.  Why should criminals be coddled?

Desperate Times Call For Futile Gestures

What were we thinking?  That public demonstrations would make a difference to cold hard facts?  Were we nuts?  (By the way, what have we been thinking, that talking would make a difference?)

After the strategies designed for Then they laugh at you prove futile, we up the ante.  In place of our bodies, we substitute urns full of ashes and dump them on the floor of the assembly halls.

In 1987 AIDS activists entered the New York Stock Exchange.  Seven people unobtrusively chained themselves and a banner to the rail overlooking the trading floor.  At the opening bell they unfurled their banner and blew fog horns.  They drowned out the opening bell, and prevented traders from trading, while they brought national attention to their demand that pharmaceutical companies stop profiteering at the cost of their lives.

Wall Street is our audience, too -- all the businesses that insure some of their employees but not us, all the health care companies that pay reasonable reimbursement to some doctors but not ours.  How about we bring ambulance sirens? 

A Day Without Mental Health Care 

Next we head to Main Street.

The 2004 film A Day Without A Mexican imagined what would happen if one day everybody in the US from Mexico, Guatemala, Honduras, Nicaragua, et al disappeared.  Economic havoc, that's what.  A few years later, the movie inspired a political demonstration.  Workers stayed home for a day.  In some places, restaurants simply closed for the day, unable to serve their customers.

So last week the Wall Street Journal reported a survey by Workplace Options.  The survey discovered that 41% of workers polled had taken 4-9 days off work in the previous year to care for their own, their friends', their coworkers' or family members' mental health issue.  Half work in offices with no benefits, support or services to deal with mental health issues.

They think they can't afford to provide services?  They haven't a clue how much it already costs them not to. 

There you have it, a National Day Without Mental Health Care.  Everybody who has a mental illness or loves somebody who does -- stay home.  I'm thinking Monday -- to make that moon connection, and maybe even disrupt Monday Night Football?

Going To Jail

At this point, we are littering, destroying property and generally disturbing the peace.  We are going to jail.

Everybody on a three-month wait list for an intake interview,

Everybody on a two-year wait list for the judicial review of an SSDI application,

Everybody on a four-year wait list for sheltered housing,

Everybody who had been doing okay, but stopped taking meds when the day program closed,

Everybody who can't afford the copay for that third tier prescription anyway,

Everybody who doesn't have health insurance at all,

Everybody who is homeless,

Go downtown and set a trash can on fire.

We Need Some Coordination Here

No, not everybody.  Jail is not a good place for people with OCD, PTSD, nor Borderline.  You all, your part is to run right down to the courthouse, legal brief in hand, to make sure the police department fulfills its obligation to get the rest of us our meds.

Prejudice And Oppression -- Some Observations

This post has been about fighting oppression, the institutional arrangements that support an unjust system.  Oppression is weighty.  It is fierce.  It does not respond to reason.  Power yields only to power.  The strategies and actions I have described are the power of anger that has been organized.

Our families and our care providers are just as scared as everybody else of our anger.  So they will not help us here.  They want to address prejudice, not oppression. 

Prejudice is the irrational thoughts and feelings of individuals.  Well, prejudice also needs to be addressed.  There is work enough for everybody.  Think of differential diagnoses as differential skill sets for the differential tasks of freedom-fighting.

That's coming next week...

image of prison bars from microsoft
photo of Mahatma Gandhi in public domain 
flair from facebook
forest photo by Maylene Thyssen used under the GNU Free Documentation license
sit in at Walgreen's in Nashville, Tennesee, March 25, 1960, in public domain
photo of die in casualties by Brendan Themes and used under the Creative Commons Attribution 2.0 Generic license
fist graphic in public domain