Category Archives: mental health
I’m in a marathon rewatch of Six Feet Under right now because I’m working on an ongoing series over at I Fry Mine In Butter on the show’s depiction of the funeral industry1. One of the recurring themes of the show is mental illness and a number of regular characters including Billy Chenowith and George Sibley are mentally ill. Right now I’m wrapping up the third season, where a number of mental illness-related topics come up, including depression in the case of Vanessa Diaz, who is struggling after the death of her mother, and Ruth Fisher, who is experiencing disorientation as all the people around her go through huge life changes.
Usually mental illness on television leaves me cold. When I’m lucky, it won’t actively enrage me, and when I’m not, it will leave me writhing on the floor in a state of extreme infuriation, because it seems like television series invest pretty minimal energy in actually researching mental illness and talking with mentally ill people about their lived experiences to, you know, get the depiction even vaguely right. Writing about this issue at Bitch earlier this year, I said:
Given the distorted image of mental illness that the media puts forward, it is perhaps no wonder that depictions of mental illness in pop culture rely heavily on some really harmful ideas about us, people with mental illness. We are dangerous. We need to be medicated for our own good. We are out of control. We are irrational. We lie, cheat, steal. We use our mental illness as an excuse for bad behaviour. We are burdens on our families. Our lives are tragedies. We will never know love, because we can never be good enough for romantic partners.
The show’s handling of mental illness is not always pitch-perfect, but it does a better job than most in terms of providing a more honest depiction of mental health issues. It feels like the writers and actors actually know what they are doing. Either they are reflecting their own lived experiences, or they researched and paid attention to the outcome of that research. It’s the kind of show I feel comfortable recommending to people and it’s also a show I really like mining for the depth of its content. Even as on the one hand we have throwaway lines like ‘when he takes his meds, he’s fine,’ the show also has great little exchanges like this, where characters exert autonomy and also have a little fun in the process:
Billy: Oh read that part out loud.
Brenda: You’re sick.
Billy: If by that you mean suffering from bipolar disorder with occasional psychotic episodes than yes I am.
Both mentally ill characters and caregivers come up over the course of the series and I appreciate that it avoids putting either one in a box. When Rico and Ruth are dealing with mental illness in their partners, they are not depicted as selfless saints sacrificing everything to care for their partners. They are real. They are frustrated and angry sometimes and they love their partners deeply and they try to establish boundaries and they struggle with assumptions from others. Sometimes they snap and say or do things they regret but the show also manages to avoid positioning Vanessa and George as burdens with no personality; both characters are very humanised and we see situations from their point of view instead of solely seeing them positioned as objects on the screen, like props to be moved around to advance the plot.
Like I say, the show is not always perfect; I find a lot of Billy’s handling to be difficult to take, for example, primarily because the show often strips him of agency and shows him to us primarily through the lens of caregivers and people around him, rather than allowing Billy to speak for himself. In the overall balance, though, Six Feet Under is solid in its depiction of mental illness more than it’s infuriating, which is better that a lot of pop culture.
I’m so used to seeing partners and caregivers positioned adversarially, where we only see the caregiver perspective and the partner is just a lump off to the corner of the screen. In Six Feet Under, we see both perspectives and the show does things like giving people their own scenes! And monologues! And interactions! It’s almost like it thinks people with mental illness are human beings! Sure, the show also evokes stereotypes like ‘the crazy, you know, it makes you soooo creative,‘ but sometimes it subverts and plays with those stereotypes also, challenging viewers to think beyond their assumptions.
- If you’re longing to read some examples, ‘Six Feet Under and the Funeral Rule‘ and ‘Marketing To Death‘ give you a taste and there are upcoming entries planned on exciting topics like the show’s depiction of independent funeral homes and natural burial. Yeah, ok, you kinda have to be a funeral nerd to appreciate this series, I suspect. ↩
When I hear people joke about cutting and self harm, I often shake my head with amazement at how little they seem to understand that behavior. I’ve always kind of assumed that if someone went to a hospital seeking help for their own self harm, they’d find people who were better informed and better equipped to help them. Well, according to the results of a recent survey of National Health Service professionals in the UK, that’s not the case:
Less than half of NHS professionals believe they or their team have had sufficient training to undertake assessments of people who self-harm, according to research by the Royal College of Psychiatrists. The College asked more than 1,500 of its members whether they felt they had adequate training and less than half of respondents felt their training was insufficient to carry out assessments… 26% of staff felt that they did not know about self-harm to communicate effectively (59% of staff in the emergency department).
As one of the members of the working group involved in the survey and report points out, this is a serious problem: “When a person turns up to hospital having harmed themselves, this may well be the first time they have had contact with the health service. Failure to deal effectively with a person at this stage can have major repercussions. It may discourage them from returning in a later crisis and stop them getting the care they need.” It’s also a problem because the general stigma against people who self harm goes unchecked: “large numbers of healthcare staff have a profoundly negative reaction to patients who harm themselves, compared with those with physical illness, and … this is likely to be reflected in the quality of clinical care.”
Not only is this problem serious, it’s also pervasive, as the report estimates that 4 in 1,000 people in the UK self harm, resulting in 170,000 people presenting themselves at hospitals for help with self harm every year. And of course, members of some groups are more vulnerable than others, including asylum seekers, minority ethnic groups, prisoners, QUILTBAG people, and veterans. Young people are also more likely to engage in self harm. And these people are not getting the help they need, the help they deserve.
(You can download the full report here.)
Note: This post is going to discuss representations of psychiatric abuse in pop culture.
Have you ever watched a genre-show where the main character is one you know, for certain, is sane, because you’ve been watching them for a season and a half, and yet the episode opens with them being in an asylum, accused of heinous crimes, drugged up, and undergoing treatment they scream their way through? Whether it’s Will Riker of Star Trek: The Next Generation loudly insisting “I may be surrounded by insanity but I am not insane!”, Sarah Connor in Terminator 2: Judgement Day screaming the truth at Dr. Silberman, or Priya Tsetsang/Sierra of Dollhouse describing the asylum as “hell, I’m in hell”, storylines of characters we identify with and know are sane are pretty common. And no matter what the purpose of the particular scene is, there’s one thing all of them have in common: What happens to the character is terrible because we, the audience, know they don’t deserve it. They’re a sane person stuck in an insane asylum, and that’s what makes it creepy.
I hate this plot.
Not because the shows or movies are poorly written: I am still a huge fan of ST:TNG, and Terminator 2 is still one of my favourite movies. I was not a fan of Dollhouse, but can see why many fans of the show were quite taken with Belonging. They’re also typically quite well acted, and even with my dislike of Dollhouse I gotta admit that Dichen Lachman was amazing as Sierra.
No, no, I hate this plot because there’s never any real attempt to discuss that what makes this plot work is the very frightening idea that what happens to these characters would be in someway okay if they were actually diagnosed with the mental health conditions they are accused of having.
In the Star Trek: The Next Generation episode “Frame of Mind”, the opening teaser is of Commander William T. Riker explaining to an off-screen interrogator that he’s not crazy, that he understands his actions, and that he’d like to now be released from the asylum. This scene is repeated throughout the episode, both as a scene from a play that Riker is performing with Commander Data, and as scenes from the actual asylum that Riker has been forced into by the antagonists of the episode, the hospital administrator on Tilonus IV.
Memory Alpha sums up the episode as “Riker thinks he is losing his mind when reality keeps shifting between an alien hospital and the Enterprise, where he is rehearsing a play.”
Throughout the episode we see scenes of Riker being taunted by the staff at the asylum. We also see a few other inmates, with the implication that these people, unlike Riker, are actually crazy, since one of them uses a spoon to attempt to contact Star Fleet. Finally, we see Riker strapped down, forced to undergo treatment that will permanently alter his personality and change him into a different person. In the end, he’s rescued by his shipmates. There’s some implication that the asylum may be shut down, but it’s not clear by the ending.
ST:TNG was pretty episodic, and only rarely touched directly on previous episodes. (This isn’t a criticism!) My issue isn’t really with the fact that the Enterprise may have warped away from an abusive asylum without a second thought, since that wasn’t really the point of the show. It’s just that this episode is pretty much predictable in how it plays out, and manages to reinforce the idea that yes, what happens to Riker is terrible, because Riker isn’t crazy.
I really enjoyed this episode when I first watched it, and thought it was very powerful. Since then, I’ve become a lot more aware of forceable institutionalization and the practice of forcing people into Electroshock Therapy against their will, and the episode is a lot less enjoyable.
More recently, of course, is Dollhouse and “Belonging”. I was actually asked to watch and review this episode when it first aired. I watched it with a few friends who weren’t familiar at all with Dollhouse and found the entire idea of the show – Wikipedia sums it up as “The show revolves around a corporation running numerous underground establishments (known as “Dollhouses”) across the globe which program individuals referred to as Actives (or Dolls) with temporary personalities and skills. Wealthy clients hire Actives from Dollhouses at great expense for various purposes” – very very creepy. I ultimately ended up not reviewing it because the episode left me so angry and drained that all I wanted to type was “arg arg arg arg I hate you show I hate you”.
I have some distance from that now.
In this episode, it’s revealed to the audience that Sierra was sent to the Dollhouse to become an active because she was diagnosed with a mental health condition. Topher describes it to another character, Boyd, as “I helped Sierra, you know. She was a paranoid schizophrenic, psychotic. I helped her.” This idea of having “helped” Sierra is very important to Topher’s sense of self. When it’s later revealed that Sierra wasn’t actually psychotic, but had been drugged to the point of appearing that way, that’s when Topher suddenly believes that tying her down to a chair and forcing her to undergo painful treatment that she kicked and fought against might have been a bad idea. Because doing that to an actual crazy person is okay, but doing it to a sane person is wrong.
As I said, I wasn’t a fan of the show, and this was the only episode in Season 2 I watched, but I did follow what else happened in the series. I know that this is a pretty pivotal episode to Topher’s arc, and it’s in realising that he’d forced a sane person to undergo this horrible treatment that he begins to really question what’s going on with the Dollhouse and what his role is in it all. I also think it’s pretty clear from the show that we’re supposed to view the folks in the Dollhouse as being people who are “morally suspect”.
I still hate the episode.
I hate it because there are so many genre-shows that do basically exactly this, and this episode is part of that trope. Despite the fact that the characters are presented as morally ambiguous, they’re still our point of view characters, and they’re still saying “What happened here is wrong” as being directly tied in to Sierra not having been “psychotic” in the first place.1 They’re also not unique in this view, and it’s a pretty common idea that it’s okay to force people who are “crazy” into treatments that would be considered torture if they were done to anyone else.
What I hate about this trope is that it’s done all the time, it’s very rarely analyzed in a way that discusses the message of “It’s okay to do this to a crazy person, but it’s off-limits if the person is sane” as being problematic, and because it implies that these sorts of things don’t happen in real institutions. Except that, in many (but by no means all), these images are not exaggerations, but understate the amount of abuse and forced treatment.
I think that this trope, like yesterday’s one about Crazy Roommates, comes from an exaggeration of the natural fear of being forced into medical treatments you don’t want because somehow you’ve lost control. The problem with this particular trope is it’s not based on fiction: this is the real experience of thousands of psychiatric patients and survivors. This is frightening to me because it’s true, and I wish that particular truth wasn’t used as fodder for genre shows to add depth to their characters.
- I really really really want to find the time to write about the repeated trope of fear of institutionalization in Whedon’s work. It’s on my list of things. My list is long. ↩
Don and I went to see a movie the other night, and gosh, we had fun! I mean, there’s nothing funner than going out for a nice evening with your husband and being confronted straight on with the knowledge that one of the scariest things some people can imagine is being forced to live with someone like you! Yay, fun times for everyone!
The particular film trailer that is paining me this month is for “The Roommate”. At first looks like some sort of “And then they went to university and had awesome adventures” sort of film, right up until that immortal line “She is taking her medications, right?”
There’s a whole genre of these particular films which take an idea that can be pretty scary – moving in with a stranger or virtual stranger – and kick it up a notch. If it’s a comedy, then obviously the problem will be someone who drinks all the milk or borrows all your clothes or is just really annoying, and that particular story will usually be about two white dudes, and in the end the hero will get the girl. When they want to really frighten people with some thriller-version, then it’ll be all about the scary white chick who moves into some other white woman’s life, kills some of her friends, seduces her boyfriend, and tries to steal everything away from her, while some family member eventually reveals that the crazy lady is on medication for some undefined mental health condition.
Gosh, I have no idea why stigma is still attached to mental health conditions!
I really hate that I can’t turn around twice without being reminded that people like me, just by virtue of existing in the world, are scary. There’s always someone reminding me of that, whether it’s a classmate telling me she’ll just say she’s crazy if she kills someone so she can get off without punishment (even though Canada’s jails are full of people with mental health conditions), the near constant repetition of the myth that crazy people are more likely to be violent (even though people with mental health conditions are actually far more likely to be the victims of violent crime rather than the perpetrators), or waiting for the next remake of Single White Female to be put into general release.
I know. They’re just films, and they really are just taking the perfectly normal fear of moving in with someone you don’t know and exaggerating them for effect. But I also know that people are really afraid of those of us with mental health conditions, and that the stigma and myths about mental health conditions can make it really hard for people who are having problems to seek out help. I have also had many discussions with people who have been honest about their mental health conditions to roommates or university officials, and suffered the consequences.
I often see the housing concerns framed as a concern for other students – being around someone with a significant mental illness might traumatize them. And I agree that finding me dead in a bathroom would have traumatized someone. But my self-harm and my mania did not seem to me to be any more potentially traumatizing for other students than my dormmates who would go to the communal bathroom to throw up after every meal, those who were using hard drugs like cocaine, or even those who would binge drink until passing out naked on the stairway, none of whom ever suffered any potential housing consequences. To say nothing of my then-boyfriend, who was then causing me active and ongoing psychological trauma through his emotional abuse and who got to stay in the dorm with all our mutual friends after I was shipped across campus. That I was the only student looked at by the university and potentially subject to penalties – and identified as potentially problematic because I sought lifesaving and appropriate care – speaks volumes about how students with mental disabilities are seen by administrators.
I hate these movies because of the stereotypes they reinforce. I hate that these stereotypes are the main reason I don’t discuss my diagnosis. I hate that I can’t just go to the movies without being reminded that my existence is scary-thriller frightening to enough people to make these movies popular.
Mostly, I’d just like to go see a movie without the reminder. It makes my popcorn taste bad.
This weekend, s.e. and abby both read The Summoning, by Kelley Armstrong. Rather than fighting over which one got to review it, they decided to have a chat instead! Here’s the synopsis from the publisher, and be advised that mild spoilers lie beyond!
My name is Chloe Saunders and my life will never be the same again.
All I wanted was to make friends, meet boys, and keep on being ordinary. I don’t even know what that means anymore. It all started on the day that I saw my first ghost—and the ghost saw me.
Now there are ghosts everywhere and they won’t leave me alone. To top it all off, I somehow got myself locked up in Lyle House, a “special home” for troubled teens. Yet the home isn’t what it seems. Don’t tell anyone, but I think there might be more to my housemates than meets the eye. The question is, whose side are they on? It’s up to me to figure out the dangerous secrets behind Lyle House . . . before its skeletons come back to haunt me.
Gentle reader, be cautioned: comments sections on mainstream media sites tend to not be safe and we here at FWD/Forward don’t necessarily endorse all the opinions in these pieces. Let’s jump right in, shall we?
Sydney Morning Herald: Why I’m not in the queue for the disabled loo by Liz Ellis.
There was a debate over policy and procedure but ultimately it came down to human conscience, something that I am incredibly appreciative of. But should I really have to rely on human conscience overriding policy and procedure?
The Globe and Mail: The sound (and sight and feel) of music for the deaf by Jill Mahoney.
Frank Russo helps make music for the deaf.
Working with a team of researchers, the Ryerson psychology professor invented a chair that allows deaf people to feel music through vibrations. He also works with both deaf and hearing musicians to compose music that focuses on vibrations and vision rather than sound.
The Los Angeles Times: Mentally ill prisoners get a second chance by Lee Romney.
Mental health courts are operating in 29 California counties, helping offenders and reducing crime in their communities.
As I mentioned a few days ago, I’m writing for the NSW Don’t DIS My ABILITY campaign at present. Here, have some tacky self-promotion!
This will be a bit of a shock if you’re invested in disabled bodies as broken and horrible and unlovable, so brace yourself.
I love mine.
I’ve been thinking about this man ever since, and the way he read me as abled. But mostly I’ve been thinking about assumptions about the kinds of people who do disability advocacy. Namely, there’s a strong perception amongst the abled public that people with disabilities are unable to advocate for ourselves. Supposedly, our abled family and friends do it all for us.
That’s all for this time. Send your links to recreading[@]disabledfeminists[.]com. Let us know if/how you want to be credited.
Content note: This post contains critical plot elements from ‘Massage Therapy,’ the fourth episode of season seven of House.
Watching the House episode ‘Massage Therapy’ and approaching the grand denouement, I got ready to be infuriated. The storyline involves a character, Margaret, with schizophrenia. She conceals it from her husband and when she gets sick, the medical team spends an extended period of time puzzling over what’s going on until they finally figure it out. What I expected from this episode was much brouhaha, followed with a brisk round of ‘you can totally leave your partner for being disabled!’ What happened surprised me.
Now, I am not a fan of keeping secrets. I am, in fact, fairly strongly anti-secret. And I do not think that concealing very significant information from your spouse is an ok thing to do, even if I understood exactly why she did it, fearing the stigma associated with schizophrenia. It wasn’t really explored deeply in the episode, but it seems possible that they started dating and she never brought it up, and it got to a point where she couldn’t figure out how to say anything. So, I sympathise with what the character did, even if I don’t agree with it.
I expected House, who is kind of known for being a jerk, to support the husband in wanting to leave his wife because of her mental illness. But that’s not actually what occurred. Instead, when the husband follows House out of the room, looking for justification and vindication, House basically gave him a stern talking to. He pointed out that, yes, marriage and love and relationships are hard, and that, no, it’s actually not ok to decide to leave your partner because you just found out she has a mental illness.
‘This is not who I married,’ the husband says. House points out that this is wrong; Billy, the husband, married a woman he loved very much and shared a lot in common with. That hasn’t changed. She’s not a different person now that he knows about her mental illness. She’s the same person, and she’s someone who could probably really benefit from the love and support of her husband right now, while she works on finding a treatment method that works for her.
‘It’s too hard,’ Billy says. Well, I’m with House on this one. Life and relationships are hard. Concealing information is definitely a problem, but it’s worth exploring why she felt the need to conceal that information for so long, why she tried so determinedly to hide from her husband. Given his reaction, of wanting to leave her because of her mental illness, I think it could be argued that she had pretty sound reasons for her decision; this is something I have encountered myself, and that some of our readers probably have too, that once you disclose a mental illness, suddenly you’re not as desirable. You’re ‘too much work.’ And the person who was happily dating you, who had a lot in common with you, who was really excited about being with you, stops calling.
I’m not saying here that people should be forced to stay in relationships they don’t want to be in. What I am saying is that wanting to leave your partner because you just found out about a disability is a shitty thing to do. Wanting to leave your partner for keeping a significant secret, being concerned about the lack of trust there, is valid, but deciding you want to leave not because of the secretkeeping, but because the secret was a disability? Not so much.
Disability complicates relationships, for all parties. Recognising when a relationship is not working and being honest about the role disability plays in that does not make people bad people. In this case, though, the husband just decided that the relationship wouldn’t work on the basis of his wife’s schizophrenia, and wasn’t even willing to try and put in the work; despite the fact that their relationship had been working well before, he suddenly determined it wouldn’t any more.
Granted, I disclose before I’ve been married to someone for several years, because my mental illnesses are an important part of who I am and I want people to know about them. But I can certainly understand why some people choose not to disclose. What surprised me in this case was an incidence of pop culture showing a nondisclosure in a sympathetic light, and reinforcing it with House’s speech. Usually, episodes like this end with the husband marching off into the sunset, Deeply Wounded, and everyone castigating the evil secretkeeping wife and talking about how she deserves it.
There’s been a significant push towards deinstitutionalisation in the United States over the last few years, in no small part due to the Olmstead decision, a major ruling by the Supreme Court that I discussed in a bit more detail here. Short version: Unnecessary confinement of people with disabilities has been deemed a civil rights violation. As a result, the Department of Justice as well as a number of disability rights groups have been suing in a number of states to get people out of institutions.
In Georgia last week:
A sweeping agreement this week between the Justice Department and the state of Georgia highlights an aggressive new campaign by the Obama administration to ensure that people with mental illness and developmental disabilities can get services in their communities — and not be forced to live in institutions.
As part of the accord, Georgia agreed to specific targets for creating housing aid and community treatment for people with disabilities. Those with disabilities have often cycled in and out of the state’s long-troubled psychiatric hospitals in the past. The state said it will set aside $15 million in the current fiscal year and $62 million next year to make the improvements. (source)
This is huge, and will get more help to people who need it in Georgia. The DOJ has been on fire this year with Olmstead-related cases, and the Obama administration has been a major player as well when it comes to pushing the DOJ to pursue deinstitutionalisation and more community-based services for people with disabilities. This is often framed as something ‘too expensive‘ for states to afford, which is I guess a nice way of saying ‘your life just isn’t worth that much to us.’
For people struggling to stay out of institutions and stay in the community, for people in the community without adequate care who are facing the possibility of institutionalisation because they don’t have options, and for people in institutions who want out, legal cases like this recent one in Georgia are huge. Potentially even life and death. It’s particularly galling that many states cling to the ‘too expensive’ cloak when organisations like ADAPT have documented that community based services are actually less costly; yes, it’s actually more expensive to force people into institutions than to let them live in their communities and provide them with appropriate assistance.
The agreement focuses on moving people with developmental disabilities out of institutions into community settings, where they can be closer to their community and family. There are 1,800 people in state mental hospitals, 711 of whom have developmental disabilities, which are genetic disorders that cause cerebral palsy, autism, Down syndrome. Under the agreement, the state will stop admitting people whose primary diagnosis is developmental disability into state hospitals by July 2011, and instead place them directly into community services.
Gov. Sonny Perdue said in a statement, “I am confident that we finally have an agreement that moves us towards our common goals of recovery and independence for people with mental illness and developmental disabilities.” (source)
Another important aspect of this agreement involves providing interventions to people at risk of institutionalisation, preferably before they reach the point of needing it. This is key; it’s not enough to simply change the way people are processed when they start interacting with the system, but to identify community-based needs and fill them before those people end up needing emergency care. Early diagnosis and supportive care is an important part of a programme designed to limit institutionalisation, by keeping people out of institutions in the first place.
This case was filed in part to respond to a series of revelations about horrific abuses in Georgia’s institutions, with The Atlanta Journal-Constitution playing a key role in the unmasking of systemic abuse and other problems. What this case represents, in addition to victory for people with disabilities, is also a victory for the free press. The paper’s decision to cover this issue led directly to more public attention and an outcry, and that resulted in positive change for disabled Georgia residents.
Too often, people with disabilities are covered indifferently in the news or set up as figures of tragedy rather than human beings with their own lives and autonomy and needs. It’s very rare to see one article discussing abuse of people in institutions, let alone to see a series of articles, including investigative journalism, delving deep into this issue and presenting information to members of the public.
I wish that more papers around the United States and in other regions of the world were doing this, because too often I encounter the attitude that institutionalisation should be considered the first option, and that ‘those people’ (you know the ones) would just be better off in institutions. People are routinely shocked when I provide statistics about abuse in institutions, and they shouldn’t be. The fact that they are is indicative of the paucity of coverage disability issues receive in the media.