From the wise words of the late Anthony Bourdain regarding one’s ideal pace in the city of Rome: “take it slow and as it comes.”
In Italy, it’s often expected that a group of people will remain at a restaurant’s table for the entire night. Such is not the case in the United States: a family orders, the kitchen delivers, the family eats, check, go—and the staff immediately cleans the table in preparation for the next customer.
The dining cultures of both countries are understandable, particularly in the case of the U.S.—a country solidified on a quick pace and turning a profit.
For food, such ideas may be acceptable, but should those maxims of speedy service and turnover apply to the care of the mentally ill? Such a concept may seem outrageous, yet it remains to be the case.
First, let me be frank. Modern day mental health facilities are far better now than they were half a century ago. Still, the image of the outdated insane asylums are so powerful that the common stereotype of the psychiatric ward still exists. You know the one: a person curled in the corner of a padded room rocking back and forth in forced restraint.
Such an image would have been plausible many years ago. These days, however, the situation is far more progressive, though there’s much left to be desired.
A facility today has likely thought of all the tragic contingencies. Patients must relinquish their belts, any shoes with laces, any other straps, as well as all the treasured objects in their pockets. The tops of most doors are slanted, the curtain bars are replaced with Velcro. Shower handles are instead cone shaped. The door handles are rather lipped. The sheets on the bed can be easily ripped given enough force. The nurses check on patients every 15 minutes (every 5 if the patient is feeling particularly low). The entire time, the staff at the hospital demonstrates their unwavering care for these patients, so what is it that’s ineffective about the system?
It seems to be the case that these facilities are intended to prevent a bad outcome rather than treat the problem itself.
Still, when one of the largest complaints by patients is that they are not allowed to bring a blanket to group, it’s clear that there’s progress. The underlying issues, though, are subtle, hardly noticeable, and yet they are devastating. The staff is well intentioned, but the system behind it all lacks a key component: compassion.
Mental healthcare does not appear to be about fully tackling the problem but rather to suppress it to a measurable degree of satisfaction. Many hospitals are focused on quick turnover.
Even in a case I’ve witnessed that one may find severe, the brevity in which it was handled is nothing short of staggering. A man who hung himself, unsuccessfully, with a fresh scar around his neck, was given a short hospital stay and medication, and he left with little follow up care.
That seems to be the U.S. way: here’s the problem, here’s your meds, now off you go.
The care he received was not about taking it slow. The underlying issues were likely not addressed, and for all the shortcomings of this healthcare system, the shortcomings within the mentality of our society regarding such compassion are even more acute.
The image of a middle aged homeless man muttering to himself as he slowly limps his way down the street conjures a rationalization to stay away, preferably as far as possible. Such a person likely has some form of schizophrenia, and when it’s as developed and untreated as it is in the case of the homeless, the prognosis is so poor that one may as well consider the matter hopeless. Nobody with any decent moral compass would have the same thoughts for someone with cancer—regardless of the stage.
The efficacy of medication aside, I’m of firm belief that genuine support and compassion from friends and family have a far better effect than the treatment received at a hospital.
Do not wonder how someone close to you is doing. Do not tip-toe around the issue. Demonstrate care and the willingness to stay with the person, because such demonstration of care works.
One may even find that the issues a friend is going through strikingly resembles their own.
Schizophrenia is not a character deficiency. Rather, it is a mental illness born out of a physical malady.
It’s not fully understood when schizophrenia truly develops. Most psychologists say it’s in the middle of young adulthood while some believe it has always been within an individual, lying dormant until a psychotic episode erupts. Whatever the case may be, the manifestations of this illness, to whomever may be so unfortunate in developing them, dip their arrowheads in the poison of gripping depression before taking aim at their lives.
In the case of one individual I’ve spoken with (who shall remain anonymous), the voices came after other symptoms, abruptly, right before bed, in the dead of night—all in what seemed to him like an attempt to create another sleepless venture. “We’ve only just begun,” one voice declared, as if it were insinuating the prospect that these voices would be there to stay with him.
To this day, that person cannot say the voice was wrong, as he’s lived with them ever since—sometimes they’re benign and other times they’re sinister. Notice how I assign these voices the pronoun of “they,” a curious proclivity compelled by many people and its underlying reason, which I will get into a bit later.
Be these voices as it may, it might not be so much the voices that commit the greatest disservice to someone with schizophrenia. That corollary belongs to delusions, which can be so absurd in their nature and unshakeable in their foundation. For anyone who values the gift of reason, they’d know that the degradation of such faculties is truly heartbreaking, though modern medicine can help the issue dramatically.
For many, the hardest part of schizophrenia can be coming back down to reality—knowing that what was thought or said was not aligned with the beliefs in their lucid state. In many respects, after gaining normal clarity, patients with schizophrenia sometimes feel as if they have been wronged, not of their own mind but almost as if another entity within them has done the misdeed. Such a feeling, however, is a little illogical, no matter the illness.
Author Christopher Hitchens said it best on the personification of illnesses when describing his own struggle with cancer:
“When I described the tumor in my esophagus as a ‘blind, emotionless alien,’ I suppose that even I couldn’t help awarding it some of the qualities of a living thing. This I know to be a mistake: an instance of pathetic fallacy...by which we ascribe animate qualities to an inanimate phenomena.” (Hitchens Mortality, pg. 11)
I dare say I’ll go one step further than Hitchens and state that there can be different degrees of personification across every illness, and none can seem more personified than schizophrenia, a disorder in which the host has actual voices to combat. And my use of that word, “combat,” is precisely the point Hitchens was making.
This apparently is not an illness patients are trying to suppress but rather one that they are “fighting,” and family, friends, doctors, and therapists can all be reinforcements. In the end, though, an illness like schizophrenia truly is a battle with the self in the same way that the battle with cancer is. That being said, people with schizophrenia often have little help to achieve their goals. According to the National Alliance on Mental Health, many people with schizophrenia are simply too embarrassed to announce their illness, thereby reducing potential support and contributing to an erroneous stigma.
Despite my philosophy, I don’t mind calling the treatment of this illness "a fight," as it’s one I know many can “win.”
I believe the voice mentioned earlier was correct in the way I’ve interpreted it. We’ve only just begun to spread awareness on mental health, and I’ll continue to pursue such a cause.