In Pt. III
From this episode, I learned that there are ten times the number of people in jail today than in mental hospitals — and 90% of them are black. In Chicago, jails and prisons have 40% of their inmates with a mental illness. I see a disportionate number of black men living on the street today, some obviously disturbed and who need help.
I had read parts of Michel Foucault’s Madness and Civilization about the treatment of the mentally ill as deviants or criminals beginning in the Middle Ages. The show relates these old perceptions as being brought down to us today.
I didn’t know much about Dorothea Dix’s “moral treatment” movement in the 1800s, nor the valiant effort she made to promote the building of hospitals with natural light, spacious rooms, occupational therapy, calming influences, patient walks on the natural grounds, quiet, and safety. But people thought that patients would recover quickly and be released and it led to overcrowding and bad conditions for the patients and the hospitals.
I also learned that throughout history scientific misunderstanding created horrific treatments, like creating seizures, locking patients in hot boxes, inducing comas, wet shock therapy, and hydrotherapy (firehouse-like drenching). One therapy used malaria to create fever therapy and this actually worked for those with syphilis, though at the time the reason was not known. As I knew already, patients were submitted to sterilization in the practices of the early-20th Century beliefs in eugenics. A quarter of a million people became “warehoused for life” in the U.S. Frontal lobotomies were praised even by Ivy League universities.
When Thorazine and other drugs came on the market, the deinsitutionalization movement began.
I remember being touched by the movie “One Flew Over the Cuckoo’s Nest” and only saw it after I became ill. I did not know that the United States Supreme Court ruled against mandatory care because of a popular movement (partly because of the movie) against inpatient care that was supposedly uncaring. But JFK’s Community Mental Health Act was never successful in the local communities. I have had some experience with group therapy in the communities where I have lived; I just found some similarities with people in these groups that freaked me out. I still avail myself of therapy and outings with friends, which are indispensable.
Sadly, there is still some way to go in treatment of the mentally ill. Blacks are three times more likely to be bipolar than whites, but are less treated. As I mentioned, there are a disproportionate number of mentally ill black inmates incarcerated today.
There is some hope: with new medications, and evolving genetics and brain imaging techniques, science may be turning the page on care.
One last thing I learned in this episode was that scientists have discovered that experiences can turn mental illness genes on or off — which coincides with my last post where I mention the onset of my illness. The point isn’t that so-and-so caused it, nor that I was responsible, but that stress at the end of my college years was probably the catalyst. My doctors have said that the time of onset is consistent with the science — but it could have happened at any time with stress or another factor. My case was just typical.
In Pt. IV
The final part of the series starts with a brief history of LSD and MDMA (Ecstasy) as drug explorations. To be truthful, I have aways been frightened of LSD or really any drug, especially psychedelics of any strength.
The young man who would do anything to stop his obsessive compulsive disorder (OCD) with his breathing is particularly poignant. Having suffered for 8 years, he eventually found that electrode-implanting surgery had helped him conquer it. (The implants are similar to those that have helped Parkinson’s disease.) Some are not so blessed, with any type of mental illness.
The interviewees again say the state of the science of mental health is one of dealing with the black box of the mind. We can observe that certain parts of the brain are responsible for different sense and behaviors. We don’t fully understand neurotransmitters or how medications are helping — it’s like a shot in the dark. The interviewee says it’s not about understanding that doctors are concerned with right now, they just know when meds are working because of the patients’ responses.
The show presents how Electroconvulsive Therapy (ECT) has evolved as well. It is still used today and helps some people who have not found anything else that works. I had a friend in Virginia who had found no efficacious treatment other than ECT. He said he suffered some short-term memory issues, but otherwise tolerated it well. It may have a bad rap because of One Flew Over The Cuckoo’s Nest.
I don’t place much value in acupuncture, massage, or reiki and I think the show does not either. To me, those treatments are like the vitamin B, St. John’s Wort, vitamin E, CoQ 10, or flax seed supplements — expensive urine! (Please let me know your thoughts on this below.)
Mental illness medications are much like insulin: when you need them there should be no shame about them. One of the closing thoughts in the series is that health insurance companies have a way to go before they fully cover everything to do with mental illness in the same way they do “physical” illness. They’re the same thing.
The current combination of drugs for me works and I am thankful. Please read my piece on my lessons learned over 28 years and please leave a comment here to say you are doing well.