By Marvin Ross
In a number of my blogs, I’ve pointed out that those with serious mental illness are patched up in hospital, discharged before they are properly rehabilitated or stabilized and pretty much abandoned in the community. Many are not well enough to work full time or even part time if there were jobs they could manage so they get put on a disability allowance that is so low that it is cruel, and they are mostly left devoid of meaningful activities.
There are few community supports or places to go and they are given so little money from disability that they would find it hard to even go to a movie. In fairness, some hospitals or agencies do try to provide activity for them but they are few and far between and often hard to get to. So, what do they do with their time? Enter the drug dealer many of whom inhabit the parking lots of psychiatric hospitals or residences where the mentally ill live.
The drugs are tempting as they alleviate their misery for a time until they take over and the person ends up in the clutches of an addiction.
For many without a mental illness but who suffer from chronic unemployment, poverty and no meaningful activity in life, drugs have an appeal. Addiction has been with us for many years but it really took off in the US Rust Belt with the rise of massive unemployment as businesses began to close.
How addiction takes over ones life was first discovered by a Simon Fraser University psychologist, Dr Bruce Alexander, in the 1970s. As psychiatrist Dr Lloyd Sederer said in Psychiatric Times, “Researchers had already proved that when rats were placed in a cage, all alone, with no other community of rats, and offered two water bottles-one filled with water and the other with heroin or cocaine-the rats would repetitively drink from the drug-laced bottles until they all overdosed and died.”
Dr Alexander wondered if their addiction might be from their isolation so he built what he called a rat park for them. The parks had all the amenities a rat could want to amuse himself including other rats to play with. They still had a choice between sipping water or water laced with heroin or cocaine but they mostly sipped water. They would have an occasional taste for the drugs but they were no longer obsessed with it to the point of death.
Their lives were full and meaningful.
Dr Sederer said drugs impact us “In immediate and powerful ways, they change how we feel, think, relate, and behave. Or transport us away from loneliness and isolation. That is why we use them!”
Sederer goes on to say that what Alexander taught us is that “Humans, not just rats, need to be part of a community, encouraged to relate and experience the support of others. This is about as basic a psychological truth as exists, yet does it find application in clinicians’ offices?”
All of this sounds like a simple solution but it isn’t. Our health care system is not geared to ensuring that people have meaning in their lives and sufficient funds to live well. We need to provide people with meaningful activities and sufficient income to live with dignity even if they cannot work. A universal basic income would go a long way to accomplishing that as would an extensive network of community supports and good supportive housing.
To see the rat park experiment in action, take a look at this video https://youtu.be/d-0KfwFCMRM
Mind You Reflections on mental illness, mental health and life 
Amen.
LikeLiked by 3 people
Thank you, Marvin. Seems so humane & simple. Why can we not, as a society, even manage to do this? I.e., to provide safe shelter & companionship for our most vulnerable citizens who—due to the cognitive deficits caused by their illness & absolutely through no fault of their own—-cannot organize these very basic necessities for themselves.
What is wrong with us? Everyone agrees that the abandonment & neglect of the mentally ill is a travesty. What is to be done?
LikeLiked by 4 people
I came across the idea that our daughter (deceased) was considered “disabled” due to episodes with anorexia, an eating disorder, a mental illness unlike any other. But I think instead she was ill, experiencing known symptoms of the disorder, understood and treatable–and she needed and expected treatment. “Don’t leave it to me,” as a fear. Application of rigid guidelines until cognitive and then physical health is restored. Prescribed program works.
The difference this-time-around, was that SHE submitted herself for treatment. There is some-rule in B.C., that a person that arrives seeking help, cannot then be discouraged from leaving–that ALL decision are “their own.” As if that were true.
Her writing indicates, “I will go to the appointment at outpatient clinic, hope for the best, expect the worst, do whatever they say,” which would have meant familiar trip by ambulance to hospital for separating from disordered thoughts and behaviours.
Resourced authorities imagine there is no difference between supporting disabled people and treating mental illness. Letting familiar patients “decide for yourself,” is siding with mental confusion. Toying with illness, betting on the person to figure out how to treat themselves is a plan for disaster. In B.C., there is a rule that medical people cannot communicate with a mental health patient’s family or near-family, is a discharge plan for the poorest of outcomes. It should never happen. It happens all the time. Medical assistance in dying is happening all the time, “Sorry. Not sorry.” Lonely mute people can’t figure it out, same with addicted people. “It’s entirely up to you.” Great. Knowledgeable people use a personal template to make life-and-death decisions.
Written guidelines are a requirement. “Oh, but every case is unique.” But not having ANY basis for agreement on what might help a person, means they suffer because of every health professional with a personal opinion. Guidelines and agreement (not just, shrug, acceptance) on a plan is called for. Make it so.
LikeLiked by 2 people