Who Advocates For The Mentally Ill?

Jeff and I got back the other day from a trip to Tri-Cities, and during our road trip we talked a lot about the disastrous results of inadequate funding for social services — the safety net that guarantees support for those who simply cannot make their way through life, for the working poor, and for those who find themselves, through no fault of their own, in crisis. (Worry not — on road trips, we also talk about our favorite episodes of “Quincy.” We’re really much more romantic than it seems).

As a culture, and as Christians living in and against it, we tend to not give a whole lot of thought to the strength and flexibility of this safety net, because we don’t think we’ll ever need it and we don’t, frankly, go out of our way to seek common cause, much less relationship, with those who do. Meanwhile, the poor continue to suffer, and those who never thought they’d be “poor” find themselves nonetheless in really tough circumstances for which their tax dollars prove insufficient to remedy. Here’s another way to say it: They’ve worked hard and paid their dues — taxes — and yet have no help available for them when things go sour. The resentment and disenfranchisement is the least dangerous result to our communities.

The two people I write about below are composites, designed and described to protect their privacy, but the story of the ER visit is entirely true.

This was especially brought to my mind the other day when my friend Barb in Lewiston called me after the kind of ER visit that leaves your heart pounding and your body chilled to the bone. Her uncle, who through one of those late-in-life births is only a couple of years older than she is, has been recovering from surgery and, for the first time in his life — his hard-working, tax-paying, and community-involved life — finds himself profoundly depressed. Neil has become increasingly despondent and increasingly concerned that he’s despondent, at least when he’s not looking longingly at a bottle of pills that he knows would end his physical and mental pain. So he went to the ER in Lewiston and was told by a very compassionate and very frustrated ER doctor that unless he, Neil, was in imminent danger of killing himself, with method, plan, and follow-through all nearly executed, he couldn’t be admitted, treated, and helped — unless Neil announced or demonstrated specific intent to kill or harm someone else. Even then, Barb understood that the hold was only for 72 hours with little or no guarantee of follow-up.

It would have been better for Neil — more satisfying, more helpful, more comprehensive in treatment — if his arm were dangling from his body due to a farming accident. Blood and guts, blocked arteries and dying hearts guarantee immediate treatment. But even though depression, acute or chronic, is a real condition, its inability to be spotted by MRI, and the continuing ignorance and fear of mental illness that pervades our culture — and is exploited by insurers — means that these life-threatening conditions remain at the very bottom of the “list” of funding priorities. This is true, I think, even during healthy economic times and in states more . . . ummmm . . . progressive . . . than Idaho; it’s particularly true when states are looking to trim and tighten already torn safety nets.

Education, jobs, health care — these are the three things that most require the attention of the Legislature as it determines budget priorities, and Idaho has not proved, in good times or bad, to be a place where help is available to “the least of these” in God’s eyes and in our own — whether they occupy that unfortunate tier of negligible social value permanently or find themselves there by circumstance. I shudder at the wreckage left in the wake of this recession all across the country. I truly believe that when the economy recovers, as I hope it will, the damage done to people and communities through the disintegration of this tax-funded social safety net will be incalculable, far more expensive than initial funding to care for those in need would have been.

But it seems clear to me that those among us who deal with mental health issues will suffer particularly because of the invisibility of their illness and the shame that surrounds it. As someone who has, God be praised, been treated successfully for depression, I grieve for the loss of potential and production that others not treated suffer, and having lost to suicide a beautiful young man in my Spanish-speaking congregation, I know how very real the loss is when someone who feels they can’t hang on by themselves reaches out for help that simply isn’t going to be there.

There’s no doubt that the Church should do more to help people struggling with mental illness. Until it does, though, with equal parts compassion, funding commitment, and clinical understanding, the State will continue to be where those who cannot afford private treatment turn. The nation’s economic crisis, and the slashes in health care funding for the weak and sick that accompany it, is like a plane crash whose debris not only scatters far beyond the crash site, but continues to be uncovered years and years after the initial crash, with victims discovered all around us. Shame and ignorance are, indeed, a powerful combination. The State shouldn’t rest in it, and the Church cannot enable it. Economic justice requires a prophetic voice, and that voice must be raised in favor of those who suffer from conditions that might originate in the brain but are not “all in one’s head.”

Leave a Reply