Saturday, January 19, 2013

A walk down Mental Health Lane.

Evo's Coffeehouse
2 Soy Hot Chocolates w/Marshmallows
Bagel w/Cream Cheese (for 2)

I am Out today with Mr. Henry, so I will probably only begin this here and hopefully finish at home tonight.  Tonight, I say!  Anyway.

It occurred to me that I could be banned from owning a gun, depending on what form reform takes.  I have a history of periods of depression and anxiety, including a very definitive case of postpartum depression following the birth of Mr. Henry's little brother.  And while I think I've definitely improved over where I was a year ago, I know that I'm not quite out of the woods.

So my whole experience, with depression and with going through the government's mental health services, got me thinking about how it relates to the current gun regulation debate.  It raises many, many questions and we would be better served discussing these questions than wasting our breath of the non-real debate about a non-real imperialist, socialist, fascist dictator asking Congress to 'come fur yur guns!'

One of the gun-related statistics that has been brought up recently is that a person who is thinking about suicide is more likely to go through with it if there is a gun in the house.  It would make sense, then, that a depressed person might be considered too high-risk to be allowed to purchase a gun.  I knew that I would never commit suicide, but how would someone else be assured I would not?  Criminal psychologists might have to make such determinations for trials, but with the sheer amount of Americans experiencing some level of depression, who is going to be making that determination for all of these people?  At one point, it was my general practitioner who wrote my prescription for anti-depressants: Would he be the one to submit my name to some database, or would it have to be a mental health specialist?

And what if I am on anti-depressants, or even just in some kind of therapy, and I am returning to a more "normal" mental state, would I then be eligible?  Would I ever be?  After all, I've had better periods and worse periods but depression has pretty much always been with me.  If I am allowed to purchase a gun while I'm doing okay, what happens if I hit a bad stretch again, or if the pills stop being effective?  Or more likely, if I can't afford the pills anymore...?  Should my gun ownership be contingent upon an annual, or semi-annual, check-in with some government approved mental health professional?

Another big unknown is the nature of this mental health database being discussed.  Presumably, when someone attempts to purchase a gun the seller will check to see if the person should be denied because of a criminal history.  Now we are trying to add to that check whether or not the person attempting to buy a gun should be denied because they are mentally ill.  Dangerously mentally ill.  Maybe someone like me would qualify to be on it, maybe not.  Maybe this database will be only for those deemed imminently dangerous to others.  But, still...

...Where will this info come from?  Does someone have to submit a patient's name directly?  Will it be gleaned automatically from digital medical records?  How much of a person's case would be included?  Would there be nothing at all except the name?  And who has access?  Just the seller, or law enforcement too?  What about private sellers, just one guy trying to thin out his collection (/arsenal)?  Could this information be accessed as easily as someone can buy your credit score?  Could someone look me up even if I'm not trying to buy a gun?  Doesn't this violate my right to privacy?  I could eeeeeeasily see such a database being commoditized.  (Spell-check says that's not a word, but I think it passes grammatic muster).  How are we going to be protected from that?  Would we be?

And speaking of all the inaccuracies on credit reports, who do I complain to if there's been a mistake?  My mother can't get my brother's name removed as an alias from her credit report - and those are the geniuses who come up with the (much contested) No-Fly List.  Are we going to trust them to handle sensitive medical information as well?  How can I challenge or defend my mental health competency, and how long will it take?  Especially if, say, I've got a crazy ex who doesn't feel like abiding by a restraining order, but I had a bout of postpartum 5 years ago, or, you know, never...?

As I said, many, many questions.

There are undoubtedly clear cases where a dangerous mentally ill person waves a red flag (an online manifesto, a registered letter stating, "Hey, I'm going to stop by on Monday and shoot up the place...") that we could act upon.  Often we look back after a tragedy and say 'that should have been reported - right there!'  Or sometimes there is a trail of warnings that weren't followed up on, or weren't enough to prevent a tragedy, given current circumstances.  Those are the people we know we want to keep from getting a gun.  What concerns me is the unintended consequences of trying to keep them away from guns.  Not only the people, perhaps unfairly, who might be lumped in with them, but the ways in which a person's mental health status could be used against them in other areas of their life.

Oh, yeah.  What about the people who live with the mentally ill?  If I can't buy a gun, can my husband?  Or the shooter's mother?  Should she have had guns in her home when she knew the severity of her son's mental illness?  My therapist commented that that's kind of Safety 101 when you have someone you know might hurt themselves or others - you get anything harmful out of the house.  But should the government, in any way, mandate that?  I'm inclined to say that goes too far, but I didn't lose my child that day.  I don't know...  I think it might be a difficult if worthwhile compromise, but I think that's one of those areas that leaves us too vulnerable to abuse.

I have proposed all these many questions completely openly, to be pondered and discussed.  I haven't put them out there rhetorically to prove a point, other than, perhaps, that we have a lot to consider before taking any hasty actions.  But, make no mistake, we absolutely must act and soon.

One more thing before I go.  We must also follow through with better funding for mental health programs, as well as all safety net services.  It was dealing with the shortcomings of our public health services that first lead me back into a state of depression.

I was actually unusually happy during my first pregnancy.  But then I hurt my back.  Foolishly, I thought that that would be a pretty clear case for a referral to physical therapy, or what have you, but because of the restrictions - namely, the lack of adequate funding - in the Oregon Health Plan I got one denial after another.  Not only did this bring back my depression and panic attacks of old, but it resulted in a very difficult labor, causing additional injury to my back, preventing me from returning to work as I had planned.  It took several more requests and denials and repeated break-downs in my doctor's office before he was finally able to convince them to approve me for 6 whole visits to the physical therapist.

The PT was able to help me recover enough to return to work, though the problem was not really fixed until I got pregnant again (surprising, I know).  But by that point, with all the stress of the pain, the bureaucracy, and the reduced income, my mental state had seriously deteriorated.  Fortunately, being extra poor meant that I kept my state medical coverage for another 6 months, so I decided I'd make them pay up for some counseling, which I still feel they drove me into.  I probably could have used it, even on a good stretch, but I didn't really need it like I needed it then, after the Ordeal.

Unfortunately, though I was not healed, physically or mentally, my eligibility ended after I went back to work.  And I want to be clear, I wasn't back to work full time.  I had only picked up about 8 to 10 hours, at most, and making a little more than minimum wage.  So, for a family of 3, working less than a combined 50 hours a week at just above minimum wage isn't poor enough to get help.  It isn't enough to buy insurance on our own, but it isn't quite screwed enough to get all the help we need.  We do get help, and I am grateful for it, but it is not enough.  And I felt completely abandoned.

These are the kinds of financial realities that will really drive a person crazy.

So this was the headspace I was in when I got knocked up again.  There was no blissed-out period of this pregnancy.  There was a lot of anxiety - especially after the Ryan budget was released, just a couple weeks after I got the little pink line of doom.  There were longer dark periods.  And, oh, the debt ceiling debacle...  By the time sweet little Oliver was born, I could feel the altered chemistry in my brain.  I knew that this was different, and deeper, than what I had experienced before.  It's hard to describe if you haven't really dealt with depression...  This was a kind of chemical undercurrent that was causing the pull, as opposed to the mental pull producing the chemical waters that drown you...  A "chemical down" versus a "mental down" is how I refer to it in my head.

But, fortunately or unfortunately, I wasn't able to go back to work this time and we're now a family of 4 so the state is willing to say, "yeah, you're plenty screwed," enough to get medicaid again.  So, over the last year, I've been getting help and working my way out of it.  It's worth noting that when I first applied again (what a fun ordeal that was) I was told at my intake meeting that it would take 3 or 4 weeks before I met with my therapist.  That's how overwhelmed the mental health system is here in southern Oregon.  It's far worse in other places.  At the same time we are creating more stressed out people in need of help of all kinds, we are cutting back on the funding and availability of all kinds of help.

This is just a glimpse of where we are.  Other people have had other experiences, other stories to tell.  Things are complicated and under great strain.  I have been able to get help, but it has so often fallen so short.  So when the politicians and pundits say that we need to improve access to mental health services, they need to know how far we have to go to make this system, these networks, fully functional.  And then they need to make it happen.

Alright.  Discuss.

1 comment:

  1. It's like being put in a glass cage by yourself. You know you're there, you can see yourself slipping but there's nothing you can do about it. Something inside you has locked yourself up and walked away. There have been times when I have literally screamed in my head to not do something self-destructive while I was doing it. I can see myself in my head - thrashing about, crying, asking myself why I do this to me. I wouldn't wish that on anyone. ((HUGS))