Monthly Archives: August 2013

When The Worst Happens

This week I came across the story of Julia Lovemore, a severely mentally ill woman who killed her own daughter. It was a tragic intersection of severe bipolar disorder, religious fanaticism, and the shortcomings of mental health care.

Mrs Lovemore came to the attention of authorities in the year before baby Faith’s death, after beating their elder daughter, Angel, over the head with a hairbrush. Angel was put on the ‘at risk’ register, and when Julia became pregnant with Faith, she saw a consultant psychiatrist, who warned of the risk of a psychotic episode after childbirth. The family proceeded with a home birth, and Mrs Lovemore requested that health visitors stop visiting. Finally, on 17 June 2009, a community psychiatric nurse and a health visitor visited the Lovemore residence, and found Mr Lovemore (who also had serious mental health problems) in a psychotic state, praying intensely in a trance-like state. The two workers left for assistance, but it was too late. An hour later, Mr Lovemore walked in to a GPs office, with one child dead and the other doused in white spirits.

This case is old, but it shows some of the flaws with the mental health system of the UK, which is very similar to the one in New Zealand. The various authorities probably did the best they could with the resources they had, and within the guidelines they had. But it wasn’t enough, and to some degree this tragedy, and others like it, can be avoided.

Relatives say that they had been pushed away and branded as heathens, which suggests that Julia was probably isolated to some degree. We don’t know what kind of part the Lovemore’s church played in their lives, and whether they were a good support network. That they were getting regular visits from health workers suggests that perhaps they didn’t  have much support, but scheduled visits really don’t compare to having people to call on.

Mr Lovemore was also seriously mentally ill. The main support person for many people with mental illness is their partner, but that doesn’t work well if you are both unwell at the same time. He also may have seen medical attention as less important than prayer, which may have had an effect on the couple’s attitude to psychiatry. We don’t know whether they were prescribed any medications, or whether they actually took any meds.

Health visitors and psychiatric nurses were visiting regularly, but we don’t know whether she was assessed by a psychiatrist during those critical post-partum weeks. Psychiatric illnesses and childbirth are not a happy pairing, and she should have had at least one evaluation.

Even if the family were getting the best care that outpatient mental health services could give, it was still not enough. Because some people are just too unwell for outpatient services. For this type of family, who are very high needs, sheltered accommodation is the best option (in my opinion). Sheltered accommodation isn’t cheap, but it would keep at-risk families together and keep them safe. The family already had a history of abuse, and severe mental illnesses, and these are things that simply cannot be adequately dealt with in an outpatient setting. This death could well be the tip of an iceberg of families who are struggling, who are trying to deal with mental illness with a lack of tools and support. For this one death, there will be more who are abused by a parent too sick to know better, but who don’t grace the front page of newspapers because they’re not quite dead.

Watching Your Own Highlights Reel

A few days ago the excellent Bipolar Bear considered how neat it could be if you could watch a highlights reel of your life. And that would be seriously neat. Remembering all the good times, reliving the best of your life – that would just be amazing.

Depression for me means that the reel playing in my head is ugly. It’s only the bad stuff, the things I am ashamed of. And there’s a whole lot of that. The reel plays constantly, but it’s always got new material – I’ve lived long enough to do a lot I regret. So I distract myself, because the weight of my sins will overwhelm me if I let it.

I want a better reel for my mind. Maybe not a greatest hits, but at least something a bit more balanced. Maybe that would be a sign of getting better. I wait, without much hope.

Of Rich People, Poor People, and Kidneys

Sir Bob Jones has once again attacked his keyboard with a screed that has enough in it to tick almost every even vaguely liberal reader off. This time, he takes on the issue of selling organs, and he does it with his typical grace and style.

He begins his argument with a pot-shot at abortion rights, because everyone knows that the best way to get conservative readers on-side is to throw in some irrelevant anti-abortion rubbish. It’s an obvious case of pandering to his target audience, a tactic to get them nodding their head, with the hope that they will continue right through the article without thinking too deeply.

Mr Jones, abortions are not a matter of ‘trivial inconvenience’, and you’re both uneducated and rude.

He then tries to equate three very different things – abortion, selling hair for wigs, and kidneys for sale. Let’s be very clear – selling hair for wigs (a replaceable resource which harms the donor in no way) and selling kidneys (which you only ever get two of, and losing one is not particularly good for you) are completely different propositions. They are not good parallels. And comparing abortion to selling kidneys because they both involve bodily integrity, is also flawed. Women do not abort so they can get money. It’s a deeply personal decision for each woman, and to compare it to a financial transaction is ridiculous. The issues of bodily integrity do apply to organ donation, because it’s always the donor’s (or their family’s) choice. Bodily autonomy is not an argument for the monetization of organ donation.

We break for another pot-shot at people Bob Jones doesn’t like – this time overweight women and the oddly specific body-modders who wear sunglasses on their heads. Apparently, these people make a mockery of human dignity. Perhaps the only people deserving of basic respect are people just like Bob, because he seems to take swipes indiscriminately at almost everyone else in his various articles.

He turns to the sad realities of the state of organ donation in New Zealand. Around 350 people are waiting for kidneys at them moment, and somewhere around 100-120 donations are made each year. These aren’t good numbers, and it means that there are a whole lots of people tethered to their dialysis regimes. No-one is denying this is bad. But making it about money is not the solution.

The problem with creating a supply and demand kidney economy has several flaws. It privileges the rich – if you’ve got your $15,000 then you can have a kidney, if not, good luck with the waiting list. On the poor side of the equation, $15,000 is a lot of money – it’s more than half of the annual minimum wage – and that’s very tempting. Where once metaphorically the economically privileged built their positions on the bodies of the poor, we could have it literally! This is not a good thing. It’s making quality of life decisions based on wealth – if you don’t have the money for a kidney, well, tough.

Monetizing kidney donations affects our hospital system. If every kidney is worth Bob Jones’ $15,000, then the health system will end up having to pay that for every kidney they transplant on public health money. Our painfully cash-strapped system can’t afford that. And the generous donations they rely on will evaporate if selling kidneys becomes the norm.

Kidney donors are badly needed. But we are not mini-America, and we don’t want our health system looking like theirs. The American model of free-market healthcare is great for the rich, and bankrupts the poor. Let’s not go down that path.

We could advertise for kidney donors the way we advertise for blood donors. We could run awareness campaigns. Most of New Zealand know very little about organ donation in general – if they knew a bit more, then I think that more would be willing to donate, either living or after death. But Mr Jones, take your flawed free-market health care and head off to America without your wealth. It might open your eyes a little.

More Rich People Not Understanding Poverty

A while back I wrote about a misguided offering from Sir Bob Jones about how not to be poor. Today, the Herald offered up a new variation on the same theme by Diana Clement. Again, it shows how very out of touch with poverty these people are.

Some of the advice is very good, especially for people with decent jobs. Commit to saving. Don’t buy things you can’t afford. Don’t abuse your credit card. Plan for bills that are going to come in. Save for a house. All good, solid financial advice. And if that’s all she had to say, then all would be well and I wouldn’t be writing.

” You’re broke because you choose to be. No one else makes you broke.” Really. You’re telling me that the people who apply for dozens of jobs a week are choosing to be broke. You’re telling me that people who were laid off at the beginning of the recession, that have used their retirement savings to support their family because the unemployment benefit doesn’t cover their bills, who have lost their homes to mortgagee sales, are choosing to be broke. You’re telling me that the chronically ill who have been classed as ‘jobseekers’ under the new WINZ rules, but who have no hope of finding a decent job due to the tight job market are choosing to be broke. Lady, you have no idea.

Sure, there are people who make bad financial decisions and suffer for it. I’ve done it myself, and I’ve seen friends who were in tight financial situations do the same. We tend to make the mistake a couple of times when we’re young, and with any luck, learn from it. There are probably even people who keep making bad financial decisions, and continually fail to learn from it. And they probably need Diana Clement’s harsh words.

But she’s divorced from the reality of poverty. Where putting ten percent of your income aside for savings is laughable, because you’re already trying to choose whether to pay the rent, the power, or buy food. Where you’re working sixty hour weeks at minimum wage and it’s still not enough to consider such huge indulgences as yoghurt for the kids’ lunches. These people are not choosing to be broke. They’re trying to get by.

Articles like this appeal to the middle class, because they can look at it and say ‘yes, this is what I did, and it worked for me. Therefore these poor people are obviously just doing it wrong’. It allows them to look at poor people and wonder at how they must have such terrible spending habits, or they must be so lazy, because otherwise, they would be comfortably off.

The truth is that under a capitalist system, there will be a lower class. There’s some movement between the classes, but it goes both ways. And the living conditions of this lower class is dictated by those in power. In this country, it’s not too terrible, but the minimum wage in not a living wage, and the various benefits are too little for even a spartan existence. And those are things that are imposed from above onto the poor. To then turn around and blame them for being broke smells of victim blaming from people who have never experienced poverty.

We (mostly) condemn victim blaming when it comes to rape victims. We see that as sick, and wrong, and aimed at the wrong person (and anyone that doesn’t, is morally bankrupt). So can we start thinking about victim blaming in regards to economic victims? We have created a society in which the poor do not have enough, and we blame them for going into debt, for turning to crime, for needing food banks and food grants. We put them in that position, and then we blame them. It doesn’t seem right to me.

Struggling to Care

The GCSB bill passed, extending the powers of the government spy bureau to spy on New Zealanders. But I can’t write about it. I don’t have the energy to care.

I had to drop a paper at Uni because I’m too depressed to be able to keep up with a senior paper. That should bother me, but I don’t have the energy to care.

My ex-husband is being frustrating, but I don’t have the energy to get worked up about it.

But when I wanted a milkshake for dinner, and I was given the wrong thing, I nearly dissolved into tears.

Depression. It messes with your priorities.

Depressed Thoughts

Depression is everyone else seeing the entrance to the magic of Diagon Alley, when all you see is a brick wall.

Depression is looking forward and just seeing blank greyness, even if you could swear you had plans for your future once upon a time.

Depression is looking back on life and only seeing the worst things you have done.

Depression is not being able to focus on a conversation without your mind wandering off to tumble off a cliff.

Depression is dissolving into tears over the most ridiculous little things.

Depression is different for everyone. This is just my experience.

Depression is cruel. It takes away hope, and strength, and so many other things. It leaves emptiness, and guilt, and shame. And the way out is a very long path, one which sometimes seems neverending.

Tampons and Scandals

Social Development Minister Paula Bennett is having a good week if she’s not in the media for something unpleasant. This week, a blogger claimed that her department was refusing to allow the purchase of tampons and pads with food grant money, claiming that these were luxury items.

Ms Bennett claims that this is not the case, and that the only supermarket items excluded from the grant were alcohol, cigarettes, electronics, and appliances. So, on one hand, we have a blogger who has a couple of anecdotes of the problem, and on the other, the minister in charge saying that this is absolutely not the case, “end of story”.

Oooh, Paula, you really shouldn’t use phrases like ‘end of story’. Because there’s something going on here. The two women in the blog post both hail from the same WINZ office. While excluding feminine hygiene products from food grants may not be WINZ policy, these women have got this idea from somewhere. Perhaps, instead of discounting them with a curt ‘end of story’, you should do some digging. There’s a good chance that they’re getting this bad information from one of your own staff, and you should look into it before you end up looking silly.

There are so many ‘can you believe?!’ stories out there about WINZ, and while a good chunk of it comes from the arguably terrible policies that they have to enforce, there’s also plenty that come from staff that are wrong about official policy for whatever reason. Maybe they missed that day of training. Maybe they just don’t remember properly, or it’s an honest mistake. Maybe they really don’t like poor people. Whatever. There are plenty of reasons they can get it wrong, and ‘that’s not our policy’ is not the same as ‘that shouldn’t be happening’ or ‘we’ll look into it’. The former makes the ministry look like they have no idea what’s happening in the field. The latter two at least give latitude for remediation.