Monday, February 04, 2008


Not more than a dozen miles by foot (longer if you were traveling by motor vehicle) from the mission station I grew up on in Zimbabwe, Africa was the village of the local witch doctor. He had a major practice with people coming from miles around to consult with him about their aliments, but when one of his seven wives or thirty-three children needed medical attention he would send them to our mission hospital which was the second largest in Africa south of the equator. His belief in his own practices was not strong enough to risk the lives of the people in his family he loved.
A special issue of Psychiatric Services just came out with most of the issue dedicated to the discussion of mental illness and violence. When I finished reading about the studies and the conclusions that were drawn, I wondered if these folks would send their loved ones to these psychologists and psychiatrists or would they be like the witch doctor and hunt for another place to send the folks they loved.
The mental health consumer movement is as fragmented as any movement in history. There is the radical wing who deny the existence of a biological based brain disease with symptoms that get diagnosed as a mental illness. There is the conservative wing who agree that forced treatment including community forced treatment is OK because after all the person does not know or recognize they are ill. Then there are all the shades in between.
I have found a hard time finding a home. I believe we are bio-psycho-social-spiritual beings and that nothing is as simple as having a single influence. I don’t believe that my mental illness or anyone’s will ever be cured simply because they locate the correct gene that causes it and find a method to disarm the effects of that gene. We are much too complicated for that.
I am not welcome in the radical consumer movement because I know there are brain disorders because I have bipolar disorder. I am not welcome in the conservative consumer movement because I do not believe in forced or coerced treatment.
In the February 1, 2008 issue of Psychiatric News one article and author in the special issue of Psychiatric Services is summarized this way, “But the article by Jeffrey Swanson, Ph.D., pointed out that the accuracy of even the best such screening test is substantially below what would be considered acceptable in other areas of medicine, such as oncology.” He was speaking of being able to predict violence in a person with a mental illness which is criteria used for forced treatment.
My point is simple. Psychiatry is not Voodoo in my opinion, but neither is it one of the true hard sciences. It is still an art based on the ability to listen and truly hear what the other person is saying.
The deafness of the system and some practitioners is what makes some of us fear opening up and telling the truth when we visit our providers. Whatever stand you take, you must admit the best and most reliable information still is the information we provide the mental health professionals working with us. If we fear you for whatever reason, then your information will not as good. We may simple lie to protect ourselves or leave out important facts. You may get some truth, but not the whole picture.
The winning combination is still hope and trust. Think about what produces that and what destroys or eats away at it.
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