I know a lot of beneficiaries . . .

‘I know a lot of beneficiaries and they are all dead-beat shitheads who will never work’ – good for you. You’re generalising to a huge and diverse population. Three quarters of all unemployment beneficiaries will be off the benefit in under a year, and in the meantime every extra penny makes a difference in their kids’ lives.

Even if someone is on a benefit long-term, $25 per week makes a huge difference to their kids’ lives – because no, beneficiaries do not all waste every penny on booze, drugs, and gambling. They are human, and have the human range of vices, but also the human impulse to protect and provide for their kids. There are always exceptions, but they should be seen for what they are – exceptions.

There are middle-class parents who smoke and drink and gamble their money away, and a $25 per week pay rise will not benefit their kids at all – shall we say that they don’t deserve their raise? No, because that’s bullshit. We don’t do that to ‘respectable’ people, why should be do that to poor people?

There’s this idea that poor people are that way because of some moral failing. That’s just blatantly wrong. People are poor for a variety of reasons, and ‘because they’re a lazy sheathed’ is way down the list of causes. Coming from a poor background, or being Maori, or being disabled, are much more common reasons, and we can stop pretending that any of those things are moral failings. Poor people are not inherently scum, and treating them like they are makes you a despicable person.

The way to tackle poverty is to make sure poor people have enough to live on. It’s that easy. Poor people tend to be excellent budgeters, because otherwise they’d starve in the streets. They know how to get the most out of the worst. Give them some fucking dignity and let them live like whole people, rather than half-shunned lives.

The answer is not this or that intricate programme that someone dreams up – fruit and vegetable baskets to poor families do nothing to get the power bill paid. A meat hamper is pretty fucking useless if you don’t have any gas to cook it on. Insulation in the ceiling is no good when there is water seeping up through the floorboards.

Give. Poor people. Enough. Money. Stop judging them. Start trusting them with their own lives.

The joys of dealing with WINZ

A heart-wrenching story came out today of one woman’s latest clash with the denizens of the WINZ office. A sufferer of a condition that causes her much pain, coupled with anxiety, makes going into the WINZ office very difficult. It’s not good for her to need to attend the office too often, as her medical forms state clearly.

WINZ showed their usual remarkable competence by losing her paperwork at a critical time – only a week or two before they were going to cut her benefit for not putting in enough paperwork. The usual rigmarole that they put their clients through on a regular basis (pro tip: if it’s common knowledge that you often lose paperwork, perhaps it’s time to look at your systems). She was subjected to the stress and cost of redoing all of her paperwork, a task that’s not ideal for a very unwell person.

Finally, she had the joy of meeting a WINZ functionary who appeared to know nothing about what might be going on and recommended contacting her case manager – an activity that she had been engaged in trying for the best part of a week.

This is unacceptable.

WINZ is dealing with some of the most vulnerable people in the country. Those in poverty, those taking care of kids on their own, those who are too ill to work. Their job is to make sure these people are not having to turn to crime or begging to survive, or quietly starving. I know they really don’t want anyone getting a benefit, but that’s not realistic. Making it difficult to get a benefit, especially one that is as sorely needed as a sickness benefit, is despicable.

WINZ should have better document logging and handling. Losing stuff is so unprofessional that they should hang their heads in shame. Maybe if it happened once or twice, it would be understandable. Once or twice per person? That’s ridiculous. That’s a critical failure in processes.

WINZ need to critically assess what their staff are doing. They simply do not treat people like people. There are some lovely case managers, but the culture of those offices is one of humiliation and degradation. Their goal is not to support people into a job, it’s to shame them into taking whatever is available, no matter how unsuitable it is. Or to shame them just for being people who are down on their luck. Sir Bob Jones would be proud.

Classifying sick people as ‘Jobseekers’ is ridiculous. Many have jobs that they cannot do because they are too ill. They’re not being lazy. They’re sick, damn it! They don’t need to be lumped with those who are genuinely looking for work (or not, depending on the person). There’s a reason that sick people (and sole parents, but there’s a rant for another day) were in a separate category from the unemployed. Their needs are different. And they don’t need the pressure of being told to get ‘work ready’ while they’re doing their best to recover.

WINZ is incompetent, inefficient, and humiliating to their ‘clients’. Those in poverty deserve respect, just like their wealthy countrymen. They’re people, and should be treated as such. They also deserve to be treated professionally, with all the efficiency and competency that involves.

What we have now is unacceptable.

State house wreckers

In today’s ‘why do I even read the news it only ever pisses me off’ adventures, I came across an article on Stuff about terrible people who destroy state houses, with urgings for a crackdown on said people.

People who damage houses that are not their own and then attempt to run from the consequences are terrible people, and should be held to account. It costs landlords thousands upon thousands of dollars every year to fix the damage, and often insurance will not cover it for various reasons. So it’s a big deal.

These are my favourite two paragraphs:

By October last year, Housing NZ already had 7000 tenant-damaged properties on its books, for which it had to spend $16.2m in three months.

The majority of the damage repair bill was for fair wear and tear, natural disaster and fire repairs.

$16.2m. That’s a lot of money, and people shouldn’t be doing that much damage. It’s scandalous! And to think, it’s all wilful . . . wait. It’s mostly wear-and-tear, natural disaster, and fire damage? Whoa, you almost had me believing that there was some sort of meth-lab/wild-party/chainsaw-redecorator epidemic going on. I notice that the number is quietly not subdivided into ‘wilful damage’ and ‘normal maintenance and emergency damage’. No, that might take away from the sensationalism of the numbers.

About a tenth of Housing New Zealand’s 200,000 tenants still have damage debt owing, according to figures released by Housing NZ under the Official Information Act.

Well, that’s a very high number you’ve got there. Are we going to look at how much they owe? Those numbers are not forthcoming, suggesting that perhaps it’s not as dramatic as it sounds.

In Wellington, tenants owed a total $40,421 at October 2013 for damage to state homes they wrecked and deserted.

Oh god, $40,000 and change. For all of the Wellington area. That’s pathetic. When you look at the operating budget of entities like Housing New Zealand, this kind of number is not enough to write a newspaper article about.

Nationwide, four state-owned homes had to be demolished in 2012-13 after chemical damage caused by drug labs rendered them too dangerous to live in.

This is just another swipe at the poorer people of New Zealand. It’s sensationalising the behaviour of a few, extrapolating it to many in an unwarranted manner, and sending the result to the masses so they can judge for themselves information that’s already been tainted.

It seems that people that depend, even in part, on the state need a regular demonising so that other people don’t start thinking that poor people might actually be, well, y’know, people.

Why is depression given no heed?

Depression is a potentially fatal disease. It can, and does, kill. So why do people brush it off as easily as brushing off the bad latte that came with lunch? It’s a bloody big deal, people!

Depression is a big deal, but the word is thrown around so often that no-one takes it seriously. “I’m feeling a bit depressed today, my cat didn’t come home last night” – having a cat missing is distressing, it’s bad, but it’s not clinical depression. “My boyfriend left me, I’m so depressed!” – well, such things can again be distressing, can even trigger depression in some people, but again, unless someone is already predisposed to mental illness, some counselling and support and tincture of time are often all that’s needed. It’s not a terrible way to use the word, but it’s not really accurate. “I broke a nail at netball yesterday. It’s so depressing” . . . you, ma’am, are the problem. That kind of flippant, throwaway line is what delegitimises the real suffering that is the experience of clinical depression.

If the feeling is transient and self-resolving, then it’s not clinical depression. If you feel really shit for a while and then get better, it’s not clinical depression. If it’s sadness and anger because you missed the latest episode of Glee, it’s not bloody clinical depression, and would you please stop using the term?!

We’ve devalued the term so much that anyone who’s never has a brush with depression, whether personal or in someone they know, usually thinks of depression as something minor, something that can be brushed off. Worse, perhaps, are people who had a mild personal experience, eventually resolving on its own or with a wee bit of counselling or a few months of medication. Knowing a little about depression, but coming out the other side easily makes many people instant judges of people who are harder hit. “I had depression and I came out of it ok, changing your eating habits and exercising more will get you better. It worked for me! It’s not hard, why aren’t you trying?” – knowing a little bit doesn’t stop you being part of the problem with minimising the realities of depression.

Maybe we need a new name for depression, one that is clearly defined in people’s minds as serious and potentially deadly. Something which has the impact of names like ‘cancer’. The old name is too ingrained in the fabric of society to really be reclaimed.

Sweeping mental illness under the carpet, attaching stigma to it, minimising its power, all of it contributes to a world where people like me have to fight a whole lot of senseless battles in addition to our personal struggle with our illnesses.

Gentle media bigotry

Sometimes I look at our news opinion pieces and think, why do we let these people vomit their way into print? It’s making us all look bad. My shining example today is a piece by Mike Hosking, a radio DJ who probably has no business opining about anything even vaguely sensitive.

I’ve linked to the original article, but it has been artfully adjusted in a very Soviet Union kind of way. The editors removed an inflammatory comment made by Hosking, saying “This line has been removed so as to avoid future confusion.” Riiiight. This makes NewsTalk ZB, the publisher of the piece, look rather like they’re trying to make this all go away quietly, rather than having to own up to the blatant bigotry that their employee spouted.

The article was about a recent tussle between a primary school and some of its parents over their bible in schools programme, which is blatant proselytising intruding on school time. It’s not learning about religions, it’s not about learning morals and ethics, it’s about accepting Jesus as your personal saviour. A complaint has been made to the Human Rights Commission over it all.

Mr Hosking, mulling over the nature of the complaint (this is lifted from another article, which was not willing to censor the DJ’s bigotry), stated that one of that parents who complained to the HRC was “Muslim, which indicates perhaps a lack of tolerance, tolerance perhaps being one of the virtues her kids might have learned in Christian studies.”

Digest that for a moment. He’s saying that her religion automatically makes her an intolerant person, and that the way to remedy that is by teaching her kids another religion (My religion’s better that yours! Join me in being intolerant to everyone else’s beliefs!). That kind of tar-brush bigotry does not have a place in my multicultural country. Hell, it has no place in any society, because it’s just so backwards.

Do you have to be Muslim in order to not want your child indoctrinated in a religion? Well, no, but if you’re Muslim then not wanting anyone else’s religion shoved down your kid’s throats is intolerant in Mr Hosking’s world. For shame. Will he next tell us that Indians are only good for owning dairies and running restaurants, or does blatant racism seem a step too far? Blatant bigotry of other kinds seems just fine.

Of course, this all turned out to be even more ridiculous in that the Muslim woman is actually a Buddhist man. He couldn’t even gets his facts vaguely straight.

Why do we let people like him publish anything that’s not related to sport or entertainment? It’s a minefield, and they stomp around in lead clown shoes. Maybe not even sport and entertainment are safe.

Are you washed by the blood?

Wandering around today doing chores, a song fragment decided to rear its head into my consciousness. It’s a song that we used to sing in the church I went to. The bit I remember runs:

Are you washed, by the blood

By the soul-cleansing blood of the Lamb?

Are your garments spotless, are they white as snow

Are you washed by the blood of the Lamb?

When we used to sing it, I never really thought about the lyrics very much. They were familiar, they had some meaning – after all, Jesus’ blood cleansed us of sin, and that was what it was about, really.

Looking back now, the entire idea seems both disturbing and a bit bizarre. When you wash someone in blood, they are not clean. They may be ritually pure, but that doesn’t change the fact that they’re coated in death waiting to attract flies. It’s pretty gross. Get that on a piece of white clothing and you sure as hell ain’t pure – you just have a long date with the bleach.

Purifying things in blood, is a very old idea, and it’s one that has fallen out of currency with most of the world. Christianity itself tried to stamp out the ‘pagan’ cults who still made animal sacrifices, because it was abhorrent to them. Gradually, the entire western world dropped sacrificial practices. Somehow, though, Christianity still clings to the idea of blood sacrifice, idealises it even.

It seems wrong that it’s idealised in the modern world. In an age where people argue over whether it is right to deprive an animal of life to feed human beings, there are people who celebrate that a human being was slaughtered to cleanse them of sin. To people who don’t believe in sin, heaven, hell, or damnation, Jesus’ death looks barbaric and pointless.

I don’t wan spotless garments soaked in symbolic blood. I want to symbolically end my life with the stains of the world that I’ve enjoyed. I don’t want to be pure – I want to live life.

Being an Inpatient, part 2

The first couple of days I was in, I was too scared to feel anything. The other people there were mostly very unwell, and some of them were quite frighteningly so. One woman tried to set her room on fire. Another would touch me every time she saw me, so she could ‘read’ me. Some were so drugged out that they were just zombies. I was afraid of the place I had come to for refuge.

By about day three, my terror had begun to subside, and I was able to think about more than just how afraid I was. And the crippling suicidal depression hit me again. I asked my nurse not to let me outside the unit, because I was afraid I would do something to myself. Her reaction stunned me.

Instead of just telling the door guard to not let me out by myself, her first reaction was ‘Oh, ok, let me see what meds we have for you to take PRN (as needed)”. She wanted to give me sedatives so that I wouldn’t be a problem. She was not happy when she found that the only meds I had listed were an antihistamine and an antiemetic. So she called in the duty psychiatrist.

It was 5pm on a Sunday night, during a holiday weekend. The duty psych was probably at home with his family. It took him more than an hour to come in, an hour in which I hid in my room. I didn’t want to be drugged out of my mind. I just wanted to be kept safe until the storm passed.

I told the duty psych that I didn’t want any PRN medications listed, that I just wanted to be safe, and that I thought it was a waste of his time to be called out for this. I don’t remember much of the conversation, except that my nurse was rather unimpressed with my telling him that I thought it was a waste of his time. I did not have any medications added to my chart.

I did have one excellent experience with a young nurse, who did all his medication rounds and so on, then came and talked to me for a half-hour or so. He listened, he suggested different strategies for coping, and he made me feel more human, and less of a number.

I waited for proper assessment and treatment til Tuesday, because a holiday weekend means that there’s only bare-bones staff on. When the next working day rolled around, all I wanted was to get out. I think that I would have lied through my teeth to get out at that point, no matter how I was feeling. I was still down, but by that time I had figured out a couple of different ways to kill myself using only the items provided in my room, so I figured I wasn’t really safe in there anyway. I was sent home.

My stay in the unit was eye-opening. I saw some very very sick people. But I saw some horrors that were very little to do with mental illness, and a lot to do with a dysfunctional system. I saw nurses pulling double shifts because there wasn’t enough staff. I saw people being doped into chemical stupor – maybe because they needed it, but maybe because the place was not equipped to deal with even minor problems. I saw people in desperate need being thrown out because the ward needed the bad, and they were not sectioned so they could be moved out.

Talking to the other people in there was eye-opening. It was supposed to be the acute inpatient unit, but most of the people I met had been there for months, even years. The closing of long-term mental health facilities has had an awful effect on acute care facilities – they can’t deal with acute patients because they’re overfilled with long-term patients.

There was a weekly planner on the wall with the activities for each day, but when I asked around, it was pretty clear that none of them had run for a while. It was not a treatment centre so much as it was a storage unit for the mentally unwell, and the primary form of therapy was chemical. I think the idea was that as soon as each patient could be stabilised on some medication, they could be released into the community to be dealt with by community mental health.

I think that the current system of inpatient mental health treatment is fatally flawed. Acute units are trying to deal with long-term residential patients, and there is no therapy of any kind offered (I could be wrong, as I wasn’t in very long, but that’s what the others that had been in longer said).

Tomorrow: How I think the system could work better.

Being an Inpatient

I spent the Waitangi Day weekend last year in the inpatient psychiatric unit. I put myself in there after feeling like I could no longer keep myself safe on my own. The five days I spent there were awful.

Getting a berth in the ship of the damned was a lengthy process. I presented myself to the emergency department of the hospital just before 11am. I was admitted to the ward at quarter to nine that night. I spent most of that time waiting for the mental health emergency team to come and assess me. I know they’re busy people, but by the sixth hour of waiting I was pacing, anxious, and regretting asking for help. A caged animal waiting for its master.

The emergency department were very good to me. They were overworked, as usual, but they brought me magazines, made me the odd cup of tea, and even brought me some sandwiches. I was grateful for that, because it was the only food I got that day. They made me feel safe in a chaotic environment, and eased my wait as much as they could.

I was admitted on a Friday night, and taken to a little room that would be mine. I had to unpack all my bags, and had any contraband removed – drugs (including medications), and anything with a cord. I’m sure there were other things on the contraband list, but these were the only things I had on me. I was body-searched, which was intrusive and frightening. I understand why they had to do it, but it was another thing that made me wish I had never asked for help. They took my description and any identifying features, ‘just in case I did a runner’.

I was ‘settled in’ and left to it.

Tomorrow – what it was like on the inside.

Voice and Agency in the Mental Health System

One of my current Uni papers is a literature paper, and we’re currently wading through the ideas of ‘voice’ (who has the ability to speak/be heard) and agency (the ability to hold and exert power). This got me thinking about these qualities in the mental health system.

The mental health system has an uneven power dynamic. The patient is ostensibly the one that treatment is centred around, however, in dealing with mental health professionals, the patient often has very little power. They are there for their voice to be heard, and their reality to be treated, but sometimes the voice of the treatment provider is allowed to take over. This results in diagnoses and treatments that are not fully explained, dismissal of patient ideas and concerns left unaddressed, and a general underlining of the patient’s subordinate position. This doesn’t always happen – many treatment providers do their best to de-emphasise the power imbalance, and treat their patients very well.

Agency, the power to take control and make decisions for one’s self, is very much lacking for mental health patients. For those in compulsory care, there are very few rights left, and treatment is forced, often without even giving them a voice. In an overworked mental health system, there’s often not a lot of time to listen to seriously ill people that often cannot communicate concisely and clearly, and so they are left out of their own treatment. This may be necessary in many cases, but the situation can be more disempowering than it needs to be due to time and patience constraints.

Even those in voluntary mental health care have very little agency. The blunt fact is that there are very few choices in community mental health. You cannot choose your providers – you roll the dice, get one assigned to you, and that’s that. It’s very rare to be able to say ‘this isn’t working, I need to work with someone else’. There simply aren’t the resources available to honour that sort of request. When it comes to treatment plans, it is not uncommon to just be told what is going to happen. Sometimes you will have some choices laid out and explained to you, with benefits and drawbacks of each, but it’s equally likely that you’ll just be told what is going to happen, and your choices are only whether to comply or not. Non-compliance gets you into a bit of hot water, which is sometimes seasoned with accusations that you’re not really trying to get better.

I’m not saying that mental health should be like Burger King, with its ‘have it your way’ ethos. What I am saying is that the voices of the mentally ill need to be heard and valued more, and that mental health patients deserve to have some say over their treatment, or at least be given an understanding of what is being done and why. Some providers do this very well, but some fall down miserably.

More Euphemisms

Mental health and addiction outpatient services are often located off hospital campuses – the logic being that if they’re out in the community there will be less stigma. Which I think is rubbish. But one trend that feels even worse is the habit of labelling the venues ‘Community Health’.

By not acknowledging what these places are, the stigma of mental health is underlined. Being mentally ill and receiving treatment for it is such a stigmatised issue that we’re too ashamed to be seen going into a place that treats our ills. And that’s not ok.

It’s very rare to be ashamed to walk into a hospital. People go there all the time, to visit relatives, or because they’re ill or injured. Very few people have a problem with that. By highlighting mental illness as different, moving treatment centres off hospital campuses, and then giving them cute little euphemisms, we repeatedly tell the mentally ill that they’re different. And vulnerable people can internalise that without ever thinking about it.

I understand the idea that there are people who want to keep their mental illness hidden, who would feel uncomfortable walking into an honestly-labelled building. A large part of this is societal pressure – when mental illness is so badly understood and accepted in society, no-one wants to admit to their illness for fear of what it might mean to their job, their friendships, and so on. I’m not sure that hiding mental illness behind a wall of euphemisms is the solution though – it just reinforces the idea that mental illness should be hidden.

I don’t have a solution for all this. All I know is that the current system seems to me to reinforce negative ideas about mental health – that it needs to be hidden, that it’s not real the way physical illness is. I don’t know where the change needs to begin. But it needs to start somewhere, otherwise we stay hidden in the shadows of society.