Monthly Archives: June 2013

Pushing the Mentally Ill Into Work

News broke today of a new scheme for the mentally ill on sickness benefits in New Zealand. The Government is going to pay private employment agencies to move them into work.

Moving people who are stable and ready into work is a noble goal. It can be really hard to get back into work with a gap in your work record, maybe no good reference from your last job because your illness affected your leaving circumstances. The current job market is so tight that employers can be very picky about candidates, and having any kind of black mark against you can mean losing out to one of the other couple of hundred people that apply for almost every job. So any help or support that’s offered is awesome.

But I don’t think this is about that. They say it’s for people with “entrenched mental health issues”, which to me reads like people who are very unwell, probably long-term sufferers. Being on the sickness benefit specifically means that a doctor has certified that these people are unable to work – if they were well enough for work, they would be on an unemployment benefit, not a sickness. So, by definition, these are people who cannot work.

Perhaps we can look at it charitably, and imagine that they’re trying to create sheltered work environments, sort of like what used to be found for the intellectually disabled. Maybe they imagine that people with “depression, stress and anxiety disorders” aren’t that very unwell, and given the right opportunities they can work, and maybe it will even help them become well again. And they might even be right in a few cases, especially of people with less severe illnesses that they are becoming able to deal with, through therapy and medication. It could be a godsend for people like that.

But I don’t think it’s like that either. It’s not being talked about in terms of the wellbeing of these people. It’s “to reduce the potential lifetime benefit liability”. And there it is, as baldly as possible. It’s not about people becoming well and returning to the workplace as part of their treatment plan. It’s about saving money. If these were cancer patients undergoing chemotherapy, there would be an outcry. They can’t work! They’re too ill! Well, mentally ill people are no different. When they go into remission, they may well be well enough to work, and they deserve support to do so. But they can’t work when they’re acutely unwell.

The organisations ‘helping’ these people into work are private entities. They can earn up to $12,000 per person for this, and they will earn part of that just for taking the case, even if they don’t find them a job. They plan to ‘help’ around 1000 people per year – that’s up to $12 million that the government plans to funnel into private hands, on a plan that really doesn’t seem feasible.

Providers will have six months to place these clients before they are “exited” from the service. What exactly does that mean? What happens to those that aren’t placed? Are they still eligible for a benefit? And what happens to the money already paid out to the private entity who has failed to place them? What kind of pressures are going to be placed on these people by the providers to take possibly unsuitable employment in order to squeeze the most profit possible out of the system?

And where are these jobs going to come from? The market is very tight right now. Why are we trying to put people certifiably unable to work into jobs when there are myriad unemployed people desperate for jobs? It makes no sense.

This scheme is simply not going to work for seriously ill people, and people with “entrenched” mental illnesses would seem to me to be seriously ill. Severely depressed people who can’t even function well enough to dress themselves in the morning (as I was only a few weeks ago) cannot work. People with anxiety disorders who are forced into work are going to become even more anxious and less able to deal with their illnesses. And those off work due to stress will become even more ill if forced back into jobs that cause them more stress.

“Bids from private organisations closed on June 24 and agreements are due to start from tomorrow.” So it’s too late to do anything about it. I wonder if any mental health advocacy organisation was consulted about this, because from what I can see, it’s a bad deal for the mentally ill.

The Idol of Talk Therapy

When you are talking about medication with a psychiatrist, there’s always emphasis on the fact that it may not work, that it may have nasty side effects, that it may take several tries and a considerable amount of time to get it right. That even when you get a good combination, it’s not magic, and it won’t solve all your problems.

So why is it that when talk therapies of various varieties are discussed, there’s no such warning? Talk therapies are presented as a bit of a silver bullet, a method of learning to control your illness so it doesn’t control you, with no potential problems?

Talk therapies have the potential for negative as well as positive effects, but that’s never talked about. It’s talked about as an essential part of the process of becoming well, but there’s nary a word about what to do if it goes wrong. Meds not working? Try something else. Talk therapy not working out? *crickets*

There’s simply no talk at all about what might go wrong, no tools for what to do if it’s not working or causing miserable side effects. Why is that?

Talk therapy is not working out for me. Am I alone in this? I feel like maybe I’m the only one that has had this problem, that no-one says anything about it because I’m some sort of freak that can’t do talk things. Or that I’m at fault somehow, that I’m just not trying hard enough.

Talk therapy has been dragging me down. It makes me feel like I’m really unwell, that my reactions to the world are completely abnormal, that I’m utterly broken. The incessant challenging or deconstructing of everything I say makes me not want to speak, because I feel like every utterance is wrong.

Perhaps it doesn’t come with warning because it works for everyone except me.

Leaving My Psychologist

This week, I decided to leave the care of the psychologist I was seeing. I do so with very mixed feelings.

One one hand, I did not feel comfortable with her. There were several reasons, from the banal (she was almost always running late) to the more important (her insistence that she was not an expert). I just never really felt good with her. It all came to a head last week, when she wanted to talk about my suicidal thinking, and I said I didn’t want to. The truth was, I didn’t feel safe enough with her to talk about it (but I couldn’t tell her that). This completely derailed the session, and we just couldn’t find a way around it. Even when I said we could just go back and talk about it, it seemed that it had just gone too pear-shaped to recover.

On the other hand, every professional that I have been in contact with over the past nine months has strongly recommended that I see a psychologist, and the one I was seeing was highly recommended. I feel like if I don’t work with her, that I’m not doing everything I can to become well and stay well. It feels like a personal failing that it isn’t working out, because everyone says I need a psychologist’s input, and it seems to work for other people, so why not me?

It’s all twisted up inside me. I guess it will take a while for me to figure it all out. Maybe I’ll try again later, with someone else. Right now, I think I need to recover more from the intense appointment overload of the last nine months.

Religion is Not a Mental Illness

I spend a bit of time on atheist blogs, and something that comes up fairly often is equating religion with mental illness. And that is not ok.

I’m an atheist. I do not believe in any gods, or any higher power. We’re alone in this world, and only humanity can make humanity any better. No-one’s going to reach out a miraculous hand and heal me, or anyone else. I rely on the best science has to offer me in order to be well.

I believe religion is a delusion. It’s not grounded in logic, or science, or reality. But that doesn’t mean that religious people are mentally ill. Many people hold delusional ideas about the world without being mentally ill – it’s simply a process of social and cultural pressures that perpetuate false ideas.

Religion is a choice – you can choose to leave it at any time. There are complex social pressures that make it difficult, but it is possible, however difficult for some, to walk away from it. Mental illness does not have that element of choice. I cannot choose to not be mentally ill, no matter how much I wish I could.

Religion has a cure – deconversion. On leaving the church, you can let the old ideas go and make room for new ones. Mental illness does not have that luxury. There is no cure for what ails many of us. There is remission, which may even be permanent. There is management, learning to live with the hand you’ve been dealt. But there is no cure.

Comparing religion to mental illness hurts the mentally ill. We are made less by trying to include a group that is fundamentally different from us.

The Texas Filibuster

Today a very dedicated woman stood on the floor of the Texas Senate and fought for a woman’s right to choose. Wendy Davis, a Democratic senator, undertook a mammoth task – to speak for thirteen hours in order to prevent the Republican majority from passing a bill that would severely limit access to abortion for Texan women.

I have nothing much to say about this that won’t be covered by myriad bloggers over the next couple of days, but I wanted to say that this woman and those that continued the fight when she was silenced have my highest respect. She very literally stood up for a woman’s right to choose. What she did to help the women of Texas is truly impressive.

Social Media and Slurs

I have a fairly wide range of Facebook ‘friends’, from as far back as primary school. Having been exposed to many different social groups in my life means that the people I know are wildly different in any way you can think of – race, gender, sexual orientation, level of education, religious beliefs, and so on.

My own world views have changed over this time, going from fundamentalist Christianity through to atheist humanism. I’ve learned that a lot of the things I thought when I was younger were misguided or outright wrong, and while I’m embarrassed at some of the things I said and did, I’ve moved on to doing my best to be better.

I know that some of the people I know will hold different beliefs to me, and for the most part I try to leave them be. I’ve learned that calling people out on beliefs that I think are wrong doesn’t really help, and ends up being very frustrating for all involved. So unless people are commenting on what I’ve posted, I leave it be (at least these days).

But there’s one place that I feel very torn about speaking up, and that’s on the topic of various slurs (mostly gender or sexual orientation-related, because that’s what I see coming up). I see someone with a sore throat saying that they’ll have a ‘tranny voice’ or someone throwing around gay as an insult, and I get pretty pissed off. I don’t want people to just not have their cruel words let slide.

The truth is, I’m not good at calling people out consistently. And when people are consistently using nasty slurs, I tend to just hide them from my feed. Because I don’t want to have to deal with homophobes every day. It’s exhausting. I sometimes justify it to myself as ‘I don’t really know them very well, why would they listen to me’ or ‘I don’t want to cause problems’.

I think that the way I’ve been dealing with it (just pushing the problem away) isn’t good enough. The LGBT community can’t just push these things away. It’s their constant lived experience. The least I can do is try and make a little difference by standing up and saying ‘this is not ok’. It’s not going to change the world, but it’s better than doing nothing at all.

Invading My Space: The Lip Gloss Incident

One of the tools in my stepmother’s arsenal of ways to hurt me was a consistent invasion of my bedroom. That was the closest thing I had to a safe place, and she would violate it regularly, probably with the aim of making me feel like a less valuable human being than she was. The room she shared with my father was absolutely off limits to my brother and I – she had sacred space but we were not allowed to have any.

Invasions of my bedroom while I was not at home were always coupled with desecrations of some type. She would find things that I held dear and destroy them.

I was maybe thirteen years old, and it was a summery day. I remember going home with a fairly light step that day – things had been pretty good the day before, it was a lovely day, and maybe today would be a good one as well. I still had some hope at that point, instead of the constant anxiety and fear that marked later years.

I got home, and she was nowhere to be seen. I don’t remember where my brother was. He usually got home before me, because he went to a school much closer to home than mine. But I don’t remember him on this day.

The silence felt ominous. Not being greeted when I got in was often a sign that things were not going to be good that day. I went to my room to drop my bag and change out of my uniform.

The christmas before this incident, I had been given a little heart-shaped pot of sparkly pink lip gloss. I loved it, used it rarely so I didn’t use it up too fast, and it sat in the centre of my dresser. It was one of the few things I owned that made me feel special when I used it.

The first thing visible on entering my room was my mirror. It was on my dresser right opposite the door. And it was graced with the word ‘slut’ in huge letters in my precious pink lip gloss. It felt like my heart actually dropped out of my chest. Today was not going to be a good day, and I didn’t know why. She had just felt the need to desecrate my space. Maybe it was something to help her cope with her own demons. I don’t know. But I remember the feelings of that moment.

I was thirteen years old, and I’d never even had a boyfriend. I’d never kissed anyone. I don’t think I’d even held hands with a boy. But the word ‘slut’ sparkled here in the afternoon sun, condemning me for things I had never done. The heart-shaped pot of lip gloss sat in the centre of my dresser, almost used up in the writing of hate.

I was made to clean it off before my father got home, and somehow I felt like I was at fault. If I hadn’t . . . something, maybe this wouldn’t be happening. If I was a better person, maybe she wouldn’t need to hurt me.