ON MENTAL ILLNESS: Symptoms do not Invalidate

Jack Bragen
Saturday November 23, 2019 - 10:44:00 AM

About fifteen years ago, maybe more, I participated in a pilot program intended to prepare mentally ill people for IT careers. The executive director of the program was mentally ill and was believed to be cured of her condition, or something to that effect. The program also involved mental health professionals, including, I think, a psychiatrist.

The executive director did something unethical, and this caused the program to end. The individual, it seemed to me, hid behind the cloak of continuing symptoms to explain and excuse the behavior. Yet, according to that person, he/she was supposedly not fit to run the program because he/she was still ill.

I take exception to this logic. Mentally ill people, to be valid individuals, should not be expected not to be mentally ill. 

When someone has a psychiatric illness and has errors as a consequence, it doesn't mean that you should "write-off" or invalidate the whole person. Expecting someone with schizophrenia never to be psychotic is not a reasonable expectation. A mentally ill person is a mix, just as anyone is. Non-mentally ill people are capable of errors also. 

A few years ago, a mentally ill person was helping me and my wife with housecleaning. She dropped and broke a fragile item. This didn't mean that she should be thrown out as a housecleaner. The rest of what she was doing was fine. 

A figure skater or gymnast will invariably fall on their butt at some point, either in practice or, unfortunately, while competing. This doesn't negate that they are good at what they do. 

The person in the first example could have been fired and the program could have continued. Mental illness doesn't negate culpability for a premeditated unethical action. On the other hand, mental illness can affect a person's faculty of judgment. Perhaps I am being too hard on the person, as they could have been suffering from a lapse in judgment. Yet, it is still not reasonable to end a program because a mentally ill person in charge continues to be mentally ill. 

The fact that I continue to suffer from schizophrenia does not disqualify me from writing about mental health. On the contrary. Someone who continues to have symptoms is eminently qualified to write about mental health. The main requirement, however, is to prevent paranoid beliefs from skewing the writing in a way that the material would not serve the readers. 

The concept that some miracle treatment is supposed to fix diseases that truly don't go away is bogus. If someone has schizophrenia, it is my impression that they will always have it. That said, within bounds of being schizophrenic, there is a lot of ability to raise level of functioning and to pursue lifetime goals. This is accomplished partly by remaining in treatment. 

Parkinson's is analogous to mental illness. Someday a cure for both conditions could be found. Psychotherapy won't cure mental illness, and neither will medication. These treatments can, however, help a patient do a lot better in life. 

If you use me as an example, I continue to have lapses in judgment, continue to have phobias, and continue to sometimes have too much anger (which is expressed verbally). I also have delusional systems that periodically develop, ones that I need to trim down through reality-checking and other cognitive methods. Medication alone is not good enough. However, I'm currently benefiting from an increase in a mood stabilizer. 

Even while having symptoms of mental illness, I do not consider myself unable to do things to better my life conditions. You should not expect a schizophrenic person never to be psychotic, but you should not expect them never to be worthy of responsibility.