The frustration of incremental progress

The place I work does a lot of trainings for other organizations on health care programs. A number of health care programs are available only for people with long-term disabilities, so the trainings always include a fair amount of discussion of what disability is and who is disabled.

My organization is relatively progressive and puts a priority on protecting vulnerable populations. We have a section of the training talking about the government’s requirement to provide translation and interpretation services for people who do not speak English. We discuss programs for minor children who want to obtain family planning or pregnancy services without their parents being notified. We highlight the special rules for homeless people to work around their lack of a fixed mailing address or phone number.

When it comes to disability issues, though, there isn’t always the level of awareness and sensitivity that I would like. Recently, I was sitting with two co-workers talking about potential interactive activities to add to the training. One co-worker suggested making a poster with photographs cut out of magazines that we should show to the trainees and ask them to point out who is NOT eligible for Medicaid (the U.S. goverment health program for very low-income folks).

“We can use the photos to show them that people on Medicaid aren’t just homeless people pushing shopping carts on the street,” she said. “And it’s also good to remind people that you can’t tell someone’s disability status just by looking at them.”

“Yeah,” responded another co-worker. “It’s always good to remind them that someone could have a mental health disability or something like fibromyalgia that you can’t see just from looking at them.”

HURRAH, I thought. People who are aware of these issues of disabilities that aren’t immediately apparent by looking at a photo. People who want to include this information in a training, want to highlight it with an interactive activity, to make sure everyone understands that. This is progress. This is positive.

“We could Britney Spears and Lindsay Lohan on the poster,” my co-worker continued. “Nobody knew how crazy both of them were at first! I mean, who would have imagined that they were so totally loopy and unhinged? They’re SO CRAZY!” And then she and my other co-worker laughed and laughed.

I froze. Do I mention that we don’t actually have access to their medical records or diagnoses so have no idea what’s going on with them other than what’s reported in the not-at-all unbiased mainstream media and gossip columns? Do I mention that if we go by what’s been reported, I have the same diagnosis as Britney and could be considered just as “loopy and unhinged”? Do I distinguish between drug and alcohol problems and mental health disorders? Do I argue that laughing at people with disabilities that way undermines the message they’re trying to convey with the activity?

I didn’t say anything. I’d already used up a lot of my “humorless” allotment arguing against using an example of a welfare recipient as a single mother with 11 kids so felt that to make any inroads on this issue, I’d have to disclose my own status, which I just wasn’t willing to do. So I let it go by.

Incremental progress.

6 Comments

  1. So close, and yet so far. *sigh*

  2. Ouch, ouch, ouch, ouch, ouch.

    One thing that strikes me, hearing your story, and thinking about some things that have taken place this week in my life, is how much disability activism could use allies. In the same way that having straight/cis allies helps the LGBTQI/trans* movements, and having men speak out on feminist causes like domestic violence (Patrick Stewart, I am looking at you with hearts in my eyes), I think we– or at least I, personally–would benefit supremely from having people say “This kind of language is not OK; people with mental health issues are people, too.”

  3. Wow. That’s horrible. And it’s so hard to always be the person calling people out as well – which I think is where Monica’s comment on allies comes in.
    .-= anthea´s last blog ..A tale of two universities… =-.

  4. Oh god. I have had so many of these experiences recently. That’s a great example of it too – not bad people, but they wouldn’t even understand why you would find that offensive at first. *head-wall*

    I am so sick of feeling like I’ve already said too much in protesting (far too mildly IMO) one form of discrimination and if I shoot down everything people say it’ll get really awkward. Come on people, can’t you have a discussion without making some sort of hideously offensive comment about a group or individual you’ve decided belongs to that group??

  5. Gently inquiring, why do you “distinguish between drug and alcohol problems and mental health disorders”? Nobody but nobody gets addicted to drugs and alcohol for shits and giggles. It’s a miserable life, and despite what some say, no addict would not quit instantly if s/he could.

    In many (if not most) cases, the addiction is directly related to another mental illness (co-morbidity) or to a physical disability. For example, anxiety disorders are known to predispose to alcohol abuse. (Many anxiolytics are addicting, too.) Undiagnosed, untreated depressed persons often serendipitously discover the medicinal benefits of street amphetamines–speed was one of the original antidepressants–and are off and running on a course to a full-blown addiction in no time flat. Many alcohol and drug abusers suffer from undiagnosed and untreated PTSD. (Just pop in to any women’s AA group and ask how many of them were sexually abused as children: nine out of ten hands will go up.) The triad of alcohol/marijuana/uppers abuse is such a common self-medication tactic for bipolar symptoms that it signals the clinician to consider bipolar as a possible co-morbid disorder. The list goes on and on. These are just four examples of many, many links established by decades of research between abuse/addiction and other mental illnesses.

    Addiction is, in fact, a class of mental illness, just like the affective disorders and the psychoses are classes of mental illness. Addiction is no more a matter of character than agoraphobia is, but separating out addiction as if it were not a mental illness implies just that. Furthermore, doing so makes it just that much harder for the addict to give up trying to solve the problem by willpower and seek treatment.

  6. @Virginia – those are all great points and I agree that there is definitely a significant amount of co-morbidity between addiction and mental health disorders. (and strongly strongly agree that addictions are serious, not whims that an addict could stop if only they tried hard enough.) i also see a lot of attempts to self-medicate with illegal/nonprescribed drugs by people who have no meaningful access to mental health care. my main goal in distinguishing them is just to prevent conflation of the two issues. the assumption of the people i was talking with seemed to be that all people with mental health disorders have alcohol and/or drug addictions, and that all people with addictions also have a mental health disorder. and no matter how significant the overlap is, i don’t think it’s helpful to smush the two issues into one.

    at any rate, attempting to diagnose a celebrity with either addiction issues or mental health issues based solely on media reporting of alleged substance use seems very problematic.