In extraordinary ways being “mentally ill” in America is as much about being poor as anything else. And right now in America there are few more dangerous things to be. It is not true in every case. It is not true even in a lot of cases. But to an extraordinary extent it is true. And that truth is a mark of shame on all of us.
If you are diagnosed with a psychiatric diagnosis you are disproportionately likely to be unemployed, disproportionately likely to be chronically unemployed, disproportionately likely to be homeless, disproportionately likely to have no health insurance, disproportionately likely to not have adequate medical care, disproportionately likely to have a criminal record, disproportionately likely to have a substance abuse problem, disproportionately likely to be a victim of violence or abuse and finally disproportionately likely not to live as long as someone without a psychiatric diagnosis.
A few years ago they closed a state psychiatric hospital in East Tennessee. When they looked at the “chronic” patients and why they had been there for so long they discovered the commonality was not diagnosis or behavior. They were poor and basically alone in the world and had no place to go. As much as anything being in a state institution in Tennessee was about being poor and having marginal or no access to any resources or support that might help to maintain them in the community. They had no where to go and nobody to go with.
Community mental health centers serve poor people. In the last few years I have met many many people labeled with psychiatric diagnoses. With a distressing and highly predictive frequency they are poor.
We dont often talk about the relationship of “mental illness” to poverty. Perhaps it is not polite. Perhaps it is not medical enough. But to be “mentally ill” is too often to be poor and to be poor means to live with injury, trauma, and injustice as everyday companions in life. And it is to live a dangerous life.
There is a growing attack on the poor in this country. Particularly with the coming of the new Republican Congress and the increasing amount of state legislatures dominated by Republicans. Thousands and thousands of people with mental health needs of one kind or another live in states that deny them access to adequate health care. In Tennessee studies I have seen say close to 80000 of the uninsured have mental health needs. They cant get access to services to maintain a stable life in their communities or medical services to even stay healthy. I have read in the last few days that in a couple of years disability checks will be cut 20%, of people who believe that those on food stamps like to eat food too much, of a presidential candidate who thinks 50% of those on disability are liars and cheats, of people who dont think mental health stigma is real or makes a difference and of one state (florida) that has killed over 360 of its prisoners in the state prisons in the last few years.
And we have a mental health reform bill introduced by a Republican congressman who has voted consistently against health care reform. I am waiting eagerly to see how he votes on disability and hunger but I dont think I will be surprised.
If you take Murphy logic and follow it to the end it takes you to some strange places. If mental illness is simply a brain disorder needing medical treatment and if many of the “mentally ill” are poor then you are left to wonder why so many poor people have brain damage. It is at least a convenient way not to have to concern yourself with matters of hurt and injury, of fairness and trauma and most of all justice.
It will it seems get more and more dangerous to be poor. It will get more and more dangerous to have a psychiatric diagnoses. If the Murphy Bill becomes law we will legislate the curious conclusion that the injuries and distress people live with are purely medical matters, but that the conditions which cause them are irrelevant to consider.
Mental health reform and justice seem so tied to me.
And I am so afraid of what is ahead for so many good and decent people who have the misfortune to be poor.