It Was Still a Shitty Year for the Mentally Ill

But first: what went right. The Affordable Care Act, despite the inexcusably brutal rollout, promises coverage for patients previously unable to get it because of prior diagnoses like major depression and schizophrenia. The days of insurance companies being able to maintain fake coverage pools of healthy people are over, and you really need to understand how big of a deal that is for not just people that need health care in order to not die but America as a society. There's no room here for the t-shirt rich kid socialism of "single payer or die": when talking about alleviating real misery, there is only pragmatism. Sorry 'bout your ideology.

Somewhat lost In the ACA noise of the past couple of months is a critical rule change mandating that mental health care can't be treated any differently than any other care by insurance providers: mental health parity. It's insane that has to be a White House dictate (enforcing a 2008 law), but that's what it takes to force insurers to treat mental health care as something other than a policy adjunct or third coverage tier. It really wasn't that long ago when insurance companies treated behavioral health as pseudo-medicine, and I can remember the days having to fight to get past a primary care doctor to see someone actually specializing in mental health. Fuck that.

It would be a great year then, if that was it. But there were also the guns: again and again. Some shooting occurs and half the country reflexively demands gun control while the entire country becomes suddenly way concerned about the mentally ill. In the beginning of every post-shooting spasm, there are high ideals about taking better care of our neighbors. But notice how it quickly it devolves into naked discussions of gun access: keep the guns away from the crazies. Michigan Republican Mike Rogers delivered the money quote after the Newtown shootings: "How do we target people with mental illness who use firearms?”

This kind of stigmatizing shittiness is cloudy. It doesn’t really have to do with policy and law so much as everyday alienation—and fear. It has to do with the junk that hangs in the air between people. Anyone with a bit of knowledge in mental illness will tell you that isolation is the precise opposite of treatment or cure and in pretty much any disaster related to mental illness, you’ll find it as a common thread. The suspect had become isolated.

Sadly, that’s what lists are, what a red flag does. 85 percent of Americans want the mentally ill on a national background check list. But the vast, vast majority of even untreated paranoid schizophrenics won’t hurt anything. Nonetheless, 65 percent of Americans think they probably will. The New York Times found that most incidents of forced gun surrendering in Connecticut didn’t have anything to do with mental illness. Basically, American society is in the process of scapegoating an entire population of people just so it doesn’t have to talk about fucking guns. That’s not only sick, but it does more harm than good both in terms of preventing violence and in terms of treating the mentally ill.

It won’t not be a shitty year for the mentally ill until the stigmatizing stops or even just stops accelerating. That's what it's doing now: getting worse faster. To be honest, I don’t see a whole lot of hope for that, when even would-be compassionate, progressive people engage in medication shaming. There’s only the smallest amount progressive reality in how society is presently reacting to mental illness, even if policy is going in our direction.

Shaming and listing have the same net effect of isolation, or increased isolation, and the result is a feedback loop away from good health. The worst thing is that I don’t know what to do about it and no one else seems to either. That sucks.

@everydayelk