IT starts with our use of language.
“Mad house”, even in quotes, just isn’t “kool”. We use the terminology without rhyme, reason, rationale. Or ration. What’s a mad house? Well, any house can be one. A mad house can be a home where parents are squabbling or at fisticuffs. A mad house can be a home where children have no discipline. A mad house can be a newsroom at crunch time. A mad house can be Parliament any time.
A real mad house, as I noted and underscored last week, is St Ann’s Hospital where any administration, all administrations, have left people to perish—yes, perish—or where patients spend the rest of their lives, abandoned by family and friends, alone in the daylight, alone in the dark. St Ann’s has many permanent residents. They have bank accounts, go into town and return “home” at the designated hour.
Women, particularly, are at risk. When I was walking “up the road” from the St Ann’s Church to the “hospital” the last time I checked myself into that hell, I stopped at a shop and penniless, asked the owner for a drink of juice. His response was to try to charge me, but not cash. Who’s mad? Who’s sick?
We also use distasteful words to describe the mentally ill, indiscriminately. I know: I’ve been called mad too many times to count. But I laugh. Do others? For me, it’s becoming a perk. People are somewhat fearful. And sympathetic. Empathetic? Maybe. Suits me. But does it fit others? Unlikely.
For example, these days, everyone is bipolar, as bipolar is bandied like a slingshot. I overhear people labelling others bipolar because it’s now in fashion. Complexity reduced to banality.
“Oh, he’s bipolar, I think!”
Don’t think in that case. Don’t think for him, for us, for doctors. Just don’t give a diagnosis where there is none from a professional.
What makes him bipolar? What makes him manic depressive, the old term for the new term, which serves to make the illness sound lighter, though there is scientific reason for its re-denomination, but for the life of me, having read and read I can’t figure out the difference? However, I will say there are assortments of “bipolars”. Bipolar 1 and 2 and it’s good to know which you are and to know the signs of going up or coming down, or if you tend to one more than the other, though for the life of me, I can’t measure me.
Last Tuesday I saw the headline in this paper, “St Ann’s on way out; mental health to be decentralised.”
I shrugged. Before reading the article I wondered: will that make a difference to mental care in this “mad” land?
Then I read the glib remark by the Health Minister. His Government is ready to “rock and roll” on mental health. I lost hope. Dropped down on the bipolar scale. What sort of language is this? He can’t be serious. We’re just a bit fortunate that Terrence Deyalsingh didn’t say Government is ready to “party”. Or fete.
On the one hand, he’s talking about “de-stigmatisation of mental health” and rebranding it to “behavioural health wellness services” and on the other he’s rocking and rolling? And how one “de-centralises” and builds a “centrally located” mental health facility is beyond my “mad” grasp. Satellite facilities for reunification? Who devised this nonsense? The de-minister?
All mental health “facilities” possess out-patient units and reunification should never be the word. Why the need to reunify? Or reintegrate? You reintegrate when you are discharged. It must be automatic or you lose your rights. “Reintegration” if you like the word, must take place within the home and the neighbourhood. Does a cancer patient need reintegration? Does a diabetic? Does a minister?
I now think the minister needs a general check-up, or a mental health day or two to settle his mind. No, that’s unfair to the ill. He needs an IQ test. He’s everywhere and nowhere because he just doesn’t get it. He reiterates that his plan is not a knee-jerk reaction (response, re-post) to the raid on that rehabilitation centre, but it is. It’s rubbish, balderdash, piffle, and idiotic.
Why build a centralised “facility” which is a re-wording of the word “hospital” and not have “facilities” on a smaller scale all over the country? In communities? Then you don’t have to “reintegrate”. You build a big hospital; you stigmatise. A St Ann’s by any other name, in any other architecture, in brick or stone, in bright yellow or dark grey, in Central or Cascade, or St Ann’s, is still a St Ann’s.
Did I hear the minister use the word “oversight”? The new building will turn into the old building, overnight. Guaranteed in this crazy, crazy land.
How did St Ann’s become Dante’s inferno?
Rumour has it that it was deliberately left to crumble because it’s prime real estate. Who’s this plan for?
The mentally ill or the “metally” rich?
Oversight, Mr Minister. Who will guard the wards and the warded? One hopes you did talk about this and it was omitted. One hopes. But one loses hope. Because if a Minister of Health can rise to his feet, but not to the occasion and talk so flippantly about mental health then there is none. For anyone.
The horizon looks bleak. Calling GARY. The Commissioner of Police seems to get it.
I imagine that the Health Minister may call me ungrateful. How he loves prefixes. Un, de and re seem to be a permanent part of his vocabulary. So I say this to him. Unwind the unseemly verbiage; re-develop your thoughts on mental health and de-think the method in your madness. And consider this: don’t talk about mental health if you don’t know what you are talking about. It’s akin to laymen diagnosing people bipolar.
When the minister really builds a plan for “behavioural” disorders that works and it is implemented with good sense then we can celebrate. Or rock and roll. If he pleases.
On Wednesday another Deyalsingh, this one a psychiatrist, disappointed when he said communities might have problems with mental health “facilities” being placed in their area, at the same time noting that patients are often more at risk than the communities. He suggested a model community, a test lab, if you will, where one could see if patients are not a bother to the communities and could be “rehabilitated”.
You see the challenge? Even the psychiatrists have and/or reinforce biases. I know. I have been yelled at by some. How do you rehabilitate the mentally ill, Doctor?
And why should communities be “bothered”?
It’s a fable, a myth that the mentally ill are violent. “Communities” need to be educated, not enveloped and insulated in bubble wrap.
I would argue that regional hospitals or clinics are exactly where patients need to be warded: they would feel less displaced and family and friends can visit more regularly, if they so desire. I’d also suggest some form of penalty for those who abandon their relatives at these “facilities”.
Make them pay for the eternal internment.