Friday, August 11, 2006

It is the mental health "system" that is stigmatized, and rightfully so

Reading through newspaper clips today sparked an epiphany. It is not the mentally ill that are stigmatized by the public as much as it is the mental health “system” that is responsible for their care.

Another revelation is that the mental health system’s apparent impotency is responsible for the virtual extinction of successful “not guilty by reason of insanity” (NGRI) pleas. In Canada, one observer lamented the “crazy system” that is responsible for 2 people found NRGI there. The writer gives the impression that he is not so much concerned that “[t]he system is willing to take a chance that the offender, with the right medication and therapy, can be released into the community without re-offending.” What he really found scary was “What if he goes off his meds?”

Such concerns are understandable considering a story from Florida in which a woman who was found NGRI for killing her parents was released after 17 years in a state psychiatric hospital. (By the way, so much for the theory that NGRI’s have short hospital stays). She was released on condition that she take her medication and be monitored by a Jacksonville mental health contractor. But the contractor apparently did nothing to ensure her success. In fact, they never even reported any problems to the court despite the fact that she stopped taking her medication, stopped going to her day program, and disappeared for a month before airport officers in Washington noticed her behaving bizarrely and took her for a psychiatric evaluation.

There are many mental health programs and providers that are very competent and committed to protecting and improving quality of life for their patients. They should be furious with their incompetent colleagues that stigmatize the whole system. And the system’s clients, the mentally ill, should be even more appalled by the injustice and stigma that has been wrought upon them under the guise of “protecting their rights.”

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